Urinary Tract and Pelvic Floor Reconstruction, Department of Urology, Unit 1373, University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030-4009, USA.
Curr Urol Rep. 2011 Dec;12(6):461-9. doi: 10.1007/s11934-011-0220-2.
With favorable prognosis, radical therapy for pelvic malignancy no longer is just about oncological control, but is important in achieving the trifecta of oncological clearance with acceptable sexual function and urinary outcomes. As we face the prospect of escalating urogenital dysfunction following our radical interventions, we need to carefully assess these functional outcomes and their impact on the quality of life of our patients. In men, this includes urinary impairments with stress urinary incontinence, various types of voiding dysfunction, and sexual impairments (primarily erectile dysfunction and orgasmic dysfunction). Based on appropriate clinical and diagnostic assessments of severity of adverse outcomes depending on patient preference, combination surgery for treatment of erectile dysfunction and stress urinary incontinence is effective and durable and has an established, definitive role to address this not uncommon problem. This article reviews the prevalence of the problem, the available therapeutic options, and evidence of efficacy of these therapies in combination.
预后良好,根治性治疗盆腔恶性肿瘤不再仅仅是为了控制肿瘤,还需要在实现肿瘤清除的同时,保持可接受的性功能和尿控效果,以达到三重目标。随着我们根治性干预后出现的尿生殖功能障碍逐渐增多,我们需要仔细评估这些功能结局及其对患者生活质量的影响。在男性中,这包括压力性尿失禁导致的尿失禁、各种类型的排尿功能障碍以及性功能障碍(主要是勃起功能障碍和性高潮功能障碍)。根据患者的偏好和适当的临床及诊断评估,针对不同严重程度的不良结局进行联合手术治疗勃起功能障碍和压力性尿失禁是有效和持久的,在解决这一并不少见的问题方面具有明确的作用。本文综述了这一问题的流行程度、现有治疗选择以及这些治疗方法联合应用的疗效证据。