Division of Urologic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
J Sex Med. 2011 Oct;8(10):2935-43. doi: 10.1111/j.1743-6109.2011.02387.x. Epub 2011 Jul 19.
The association between early and late phase sexual health-related quality of life (HRQoL) following radical prostatectomy (RP) is unclear. Moreover, factors that predict either early or late sexual HRQoL decline have not been fully investigated.
The aim of this study was to evaluate the correlation between early and late phase sexual HRQoL decline, and identify clinical parameters that predict substantial sexual HRQoL decline after surgery in the early phase (3 months) and late phase (20 months) following RP.
We analyzed data on 2,345 consecutive patients who underwent radical retropubic prostatectomy, radical perineal prostatectomy, or robotic-assisted laparoscopic prostatectomy between 2001 and 2009 from the Duke Prostate Center database.
Sexual HRQoL was assessed using the Expanded Prostate Cancer Index Composite instrument at baseline, early and late phase after surgery. The Spearman rank test was used to calculate correlation coefficients between early and late phase sexual HRQoL decline. Logistic regression analysis was performed to identify factors associated with substantial sexual HRQoL decline during both phases.
Of 406 men who met our criteria, 217 (53.5%) men had normal erectile function, whereas 189 (46.5%) men had erectile dysfunction at baseline. Declines of sexual HRQoL during early phase had a significant association with that of a decline during late phase (r = 0.48, P < 0.001). In logistic regression, older age at surgery (odds ratio [OR], 1.06; P = 0.007 and OR, 1.08; P = 0.001), African-American race (OR, 4.32; P = 0.001 and OR, 3.13; P = 0.017), and overall comorbidity (OR, 1.43; P = 0.072 and OR, 1.72; P = 0.010) were consistently associated with substantial decline of sexual HRQoL in both early and late phases.
Sexual HRQoL at early and late phases after RP were strongly correlated. Additionally, several factors were identified to be a predictor for decline of sexual HRQoL. Our findings may be used to advise patients who possess aforementioned risk factors during both phases.
根治性前列腺切除术（RP）后早期和晚期与性生活相关的健康相关生活质量（HRQoL）之间的关系尚不清楚。此外，预测早期或晚期性生活 HRQoL 下降的因素尚未得到充分研究。
本研究旨在评估早期和晚期性生活 HRQoL 下降之间的相关性，并确定手术后早期（3 个月）和晚期（20 个月）手术中预测性生活 HRQoL 显著下降的临床参数。
我们分析了 2001 年至 2009 年间从杜克前列腺中心数据库中接受根治性耻骨后前列腺切除术、根治性会阴前列腺切除术或机器人辅助腹腔镜前列腺切除术的 2345 例连续患者的数据。
使用扩展前列腺癌指数综合工具在基线、手术后早期和晚期评估性生活 HRQoL。采用斯皮尔曼等级相关检验计算早期和晚期性生活 HRQoL 下降之间的相关系数。进行逻辑回归分析以确定与两个阶段的性生活 HRQoL 显著下降相关的因素。
在符合我们标准的 406 名男性中，217 名（53.5%）男性勃起功能正常，而 189 名（46.5%）男性在基线时患有勃起功能障碍。早期性生活 HRQoL 的下降与晚期下降有显著相关性（r = 0.48，P < 0.001）。在逻辑回归中，手术时年龄较大（优势比[OR]，1.06；P = 0.007 和 OR，1.08；P = 0.001）、非裔美国人种族（OR，4.32；P = 0.001 和 OR，3.13；P = 0.017）和总体合并症（OR，1.43；P = 0.072 和 OR，1.72；P = 0.010）与早期和晚期的性生活 HRQoL 显著下降均相关。
RP 后早期和晚期的性生活 HRQoL 密切相关。此外，还确定了一些因素是性生活 HRQoL 下降的预测因素。我们的发现可以用于在两个阶段为具有上述风险因素的患者提供建议。
