Department of Urology, Marmara University School of Medicine, Istanbul, Turkey.
Urology. 2010 Mar;75(3):598-601. doi: 10.1016/j.urology.2009.07.1330. Epub 2009 Nov 14.
To document the effects of the outcome of testicular sperm extraction (TESE) procedures on erectile function in patients with male factor infertility.
A total of 66 nonobstructive azoospermic patients were divided into 2 groups: group I, with sperm-positive results and group II, with sperm-negative results. The patients were evaluated with the International Index of Erectile Function-5 (IIEF-5) and Hospital Anxiety-Depression Scale. Hormones were analyzed before and 6 months after the procedure. Each group was compared with the use of the paired t test, where P <.05 was accepted as statistically significant.
The mean patient age was 34.8 years (range 24-53). Of 66 cases, 26 (40%) experienced positive results for the TESE. The median IIEF-5 score before TESE for group I and group II was 22 (minimum: 11, maximum: 25) and 23 (minimum: 10, maximum: 25), respectively. The median IIEF-5 score after TESE for group I and group II was 23.5 (minimum: 10, maximum: 25) and 18 (minimum: 15, maximum: 25), respectively. In patients who reported new onset erectile dysfunction (ED) 6 months after surgery, the mean follicle-stimulating hormone and luteinizing hormone levels increased from 21 +/- 2 to 38 +/- 3 IU/L (P <.001), and from 11 +/- 2 to 14 +/- 2 IU/L (P >.05), respectively. The mean total testosterone level decreased from 7.83 +/- 2 to 2.8 +/- 2 ng/mL (P <.001). The Hospital Anxiety and Depression Scale revealed that patients who reported new onset ED also reported both depression and anxiety.
Unsuccessful TESE procedures might have a negative effect on erectile function because of hormonal and psychological reasons. The andrologist should treat the ED of the patients and refer them to the psychiatrist for anxiety and depression assessment.
记录睾丸精子提取（TESE）手术结果对男性因素不育患者勃起功能的影响。
将 66 名非梗阻性无精子症患者分为 2 组：组 I，精子阳性结果；组 II，精子阴性结果。使用国际勃起功能指数-5（IIEF-5）和医院焦虑抑郁量表对患者进行评估。在手术前和手术后 6 个月分析激素。使用配对 t 检验对每组进行比较，P<.05 为有统计学意义。
患者平均年龄为 34.8 岁（24-53 岁）。66 例中，26 例（40%）TESE 结果阳性。组 I 和组 II 患者 TESE 前 IIEF-5 评分中位数分别为 22（最小值：11，最大值：25）和 23（最小值：10，最大值：25）。组 I 和组 II 患者 TESE 后 IIEF-5 评分中位数分别为 23.5（最小值：10，最大值：25）和 18（最小值：15，最大值：25）。术后 6 个月报告新发勃起功能障碍（ED）的患者中，卵泡刺激素和黄体生成素水平从 21±2 增至 38±3 IU/L（P<.001），从 11±2 增至 14±2 IU/L（P>.05）。总睾酮水平从 7.83±2 降至 2.8±2ng/mL（P<.001）。医院焦虑抑郁量表显示，报告新发 ED 的患者也报告了抑郁和焦虑。
TESE 手术不成功可能会因激素和心理原因对勃起功能产生负面影响。男科医生应治疗患者的 ED，并将他们转介给精神科医生进行焦虑和抑郁评估。
