Gan Melanie, Smit Marij, Dohle Gert R, Bosch J L H Ruud, Bohnen Arthur
Department of Urology, Erasmus MC, Rotterdam, The Netherlands.
BJU Int. 2007 Jun;99(6):1443-8. doi: 10.1111/j.1464-410X.2007.06803.x.
OBJECTIVE To analyse the incidence of ejaculatory dysfunction (EJD) and its associated bother, and to determine which factors predispose to incident EJD. SUBJECTS AND METHODS Men aged 50-78 years, registered in the general practices in Krimpen a/d Ijssel, the Netherlands, were recruited. Men were excluded if they had a history of prostatectomy, carcinoma of the bladder or prostate and neurogenic bladder disease. A baseline study and three follow-up assessments (I-III), all with questionnaires, i.e. the Benign Prostatic Hyperplasia impact index, International Prostate Symptom Score, International Continence Society (ICS)male sex questionnaire, and additional measurements, e.g. prostate volume, prostate specific antigen, were made at a mean of 2.2-year intervals. We assessed the objective variables of EJD as the ability to ejaculate, ejaculatory volume, painful ejaculation, and their associated bother (information extracted from the ICSmale sex questionnaire). RESULTS At baseline 671 of 1661 (40.4%) men already had EJD; the cumulative incidence of EJD was 16.5%, 24.7% and 33.1% after follow-up I, II and III, respectively. The mean percentage of men who were bothered with reduced ejaculatory volume or painful ejaculation was 18.3% and 40.6%, respectively. Multivariate analysis showed age, Sickness Impact Profile 'social' (questions on social impairment) and erectile dysfunction to be predisposing factors of EJD (P < 0.05 and R(2) = 0.048). When EJD was defined as a significantly reduced ejaculatory volume or anejaculation only, age and previous transurethral resection of the prostate (TURP) were determinants of EJD (P < 0.05 and R(2) = 0.083). Of the men who had TURP after the follow-up, 51.6% already had EJD at baseline. CONCLUSIONS The cumulative incidence of EJD after 6.5 years of follow-up was significant (33.1%) and EJD was bothersome, especially in men with painful ejaculation. Determinants of EJD were age, social impairment and erectile dysfunction. Predisposing factors of significant reduction of ejaculatory volume and anejaculation were age and TURP, although 51.6% of men already had EJD before TURP. Age appears to be the most significant predisposing factor of EJD.
目的 分析射精功能障碍（EJD）的发生率及其相关困扰，并确定哪些因素易引发新发EJD。 对象与方法 招募了荷兰伊瑟尔河畔克林彭地区普通诊所登记的50 - 78岁男性。有前列腺切除术、膀胱癌或前列腺癌病史以及神经源性膀胱疾病史的男性被排除。进行了一项基线研究和三次随访评估（I - III），每次均采用问卷调查，即良性前列腺增生影响指数、国际前列腺症状评分、国际尿失禁学会（ICS）男性性问卷，以及额外的测量，如前列腺体积、前列腺特异性抗原，平均间隔2.2年进行一次。我们将EJD的客观变量评估为射精能力、射精量、射精疼痛及其相关困扰（从ICS男性性问卷中提取的信息）。 结果 在基线时，1661名男性中有671名（40.4%）已有EJD；随访I、II和III后，EJD的累积发生率分别为16.5%、24.7%和33.1%。对射精量减少或射精疼痛感到困扰的男性平均百分比分别为18.3%和40.6%。多因素分析显示年龄、疾病影响概况“社会”（关于社会功能损害的问题）和勃起功能障碍是EJD的易感因素（P < 0.05且R(2) = 0.048）。当将EJD定义为仅射精量显著减少或无射精时，年龄和既往经尿道前列腺切除术（TURP）是EJD的决定因素（P < 0.05且R(2) = 0.083）。在随访后进行TURP的男性中，51.6%在基线时已有EJD。 结论 随访6.5年后EJD的累积发生率显著（33.1%），且EJD令人困扰，尤其是射精疼痛的男性。EJD的决定因素是年龄、社会功能损害和勃起功能障碍。射精量显著减少和无射精的易感因素是年龄和TURP，尽管51.6%的男性在TURP之前已有EJD。年龄似乎是EJD最显著的易感因素。
