Messaoudi R, Menard J, Parquet H, Ripert T, Staerman F
Département d'urologie-andrologie, CHU Robert-Debré, avenue du Général-Koenig, 51100 Reims, France.
Prog Urol. 2011 Jan;21(1):48-52. doi: 10.1016/j.purol.2010.07.019. Epub 2010 Sep 28.
To assess the impact of RP on patients' sexual desire and orgasm.
Prospective, cross-sectional survey using a 16-item self-administered questionnaire. We assessed relevant domains of male sexual function (erectile function, sexual desire, and orgasm), psychological impact and treatment of ED.
A total of 63 consecutive patients after RP were included (mean age: 63.9). Median time between questionnaire and RP was 26.8 months (range 6-67). After RP, 74.6 % of patients used ED treatments. Lower sexual desire and intercourse frequency were reported in respectively 52.4 and 79.4 %. Orgasm was modified in most patients: 39.7 % described loss of orgasm and 38.1 % reported decreased intensity. Involuntary loss of urine at orgasm (climacturia) was reported in 25.4 %. Negative psychological impact was reported in 68.3 % (loss of self-esteem, loss of masculinity, anxiety).
RP adversely affected erectile and orgasmic functions but also sexual desire, self-esteem and masculinity despite treatments. Candidates for RP should be aware of ED but also of other postoperative sexual dysfunctions.
评估根治性前列腺切除术（RP）对患者性欲和性高潮的影响。
采用一份包含16个条目的自填式问卷进行前瞻性横断面调查。我们评估了男性性功能的相关领域（勃起功能、性欲和性高潮）、心理影响以及勃起功能障碍（ED）的治疗情况。
总共纳入了63例RP术后的连续患者（平均年龄：63.9岁）。问卷与RP之间的中位时间为26.8个月（范围6 - 67个月）。RP术后，74.6%的患者使用了ED治疗。分别有52.4%和79.4%的患者报告性欲降低和性交频率降低。大多数患者的性高潮发生了改变：39.7%的患者描述性高潮丧失，38.1%的患者报告性高潮强度降低。25.4%的患者报告在性高潮时有不自主漏尿（性高潮期遗尿）。68.3%的患者报告有负面心理影响（自尊丧失、男子气概丧失、焦虑）。
尽管进行了治疗，但RP对勃起和性高潮功能以及性欲、自尊和男子气概均产生了不利影响。RP的候选患者应了解ED以及其他术后性功能障碍。
