开放性根治性前列腺切除术术后的性功能障碍：临床相关性和预后因素。

Orgasmic dysfunction after open radical prostatectomy: clinical correlates and prognostic factors.

机构信息

St Elisabeth Hospital, Urology, Tilburg, The Netherlands.

出版信息

J Sex Med. 2010 Mar;7(3):1216-23. doi: 10.1111/j.1743-6109.2009.01567.x. Epub 2009 Nov 13.

DOI:10.1111/j.1743-6109.2009.01567.x

PMID:19912504

Abstract

INTRODUCTION

Erectile function after radical retropubic prostatectomy (RRP) is extensively discussed in literature. However, less is known about orgasm after RRP.

AIM

To analyze sexual function, in particularly orgasmic function, in men before and after RRP.

METHODS

Between 1977 and 2007 a RRP was performed in 1,021 men. All men were interviewed by their follow-up physician using a standardized interview about sexual function before and after RRP at regular intervals during a 2-year follow-up. The questions were related to sexual interest, sexual activity, spontaneous erections, and orgasmic function.

MAIN OUTCOME MEASURES

Sexual function, in particularly orgasmic function, before and after RRP. Factors potentially influencing orgasmic function, such as patients age, type of operation, pathological stage and continence status were analyzed for their predictive value. Results. Information about preoperative and postoperative sexual activity and spontaneous erection was available in 596 and 698 men, respectively. Additional questions were asked on sexual interest (N = 425) and orgasmic function (N = 458). Pre-operatively, sexual interest, sexual activity, spontaneous erections and orgasmic function were normal in 99%, 82.1%, 90.0% and 90% of men, respectively. After operation these values decreased to 97.2%, 67.3%, 29.4% and 66.8%, respectively. Orgasmic function was preserved in 141 of 192 men (73.4%) after a bilateral nerve sparing procedure, in 90 out of 127 men (70.9%) after a unilateral nerve-sparing procedure and in 75 of 139 men (54.0%) after non-nerve sparing technique. Postoperatively, orgasm was present in 123 (77.4%) men below the age of 60 years and in 183 (61.2%) men of 60 years and older (P < 0.0001). Orgasmic function was significantly affected by age >or=60 years, non-nerve sparing procedure and severe incontinence (more than two pads/day).

CONCLUSIONS

After RRP, orgasmic function is still present in the majority of men. A non-nerve sparing operation, age, and severe urinary incontinence are risk factors for orgasmic dysfunction after RRP.

摘要

介绍

根治性前列腺切除术（RRP）后勃起功能在文献中广泛讨论。然而，关于 RRP 后射精功能的了解较少。

目的

分析男性 RRP 前后的性功能，特别是射精功能。

方法

1977 年至 2007 年期间，1021 名男性接受了 RRP。所有男性在 2 年随访期间，由随访医生使用标准化访谈，在定期随访中，就 RRP 前后的性功能进行采访。问题涉及性兴趣、性活动、自发性勃起和射精功能。

主要观察指标

RRP 前后的性功能，特别是射精功能。分析影响射精功能的潜在因素，如患者年龄、手术类型、病理分期和控尿状态的预测价值。结果：596 名男性提供了术前和术后性活动信息，698 名男性提供了自发性勃起信息。另外还询问了 425 名男性的性兴趣和 458 名男性的射精功能。术前，99%、82.1%、90.0%和 90%的男性性兴趣、性活动、自发性勃起和射精功能正常。手术后，这些值分别下降到 97.2%、67.3%、29.4%和 66.8%。在双侧神经保留手术中，192 名男性中有 141 名（73.4%）保留了射精功能，127 名男性中有 90 名（70.9%）保留了单侧神经保留手术，139 名男性中有 75 名（54.0%）保留了非神经保留技术。手术后，123 名（77.4%）年龄<60 岁的男性和 183 名（61.2%）年龄≥60 岁的男性存在射精（每天使用 2 个以上尿垫）。年龄≥60 岁、非神经保留手术和严重尿失禁（每天使用 2 个以上尿垫）显著影响射精功能。