Section of Surgical Pathophysiology 4074, Rigshospitalet, Copenhagen University, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Surg Endosc. 2012 Apr;26(4):979-83. doi: 10.1007/s00464-011-1980-y. Epub 2011 Oct 20.
Dysejaculation and pain from the groin and genitals during sexual activity represent a clinically significant problem in up to 4% of younger males after open inguinal herniorrhaphy. The aim of this questionnaire study is to assess the prevalence of dysejaculation and pain during sexual activity after laparoscopic inguinal herniorrhaphy on a nationwide basis.
The study population comprised all men aged 18-50 years registered in the Danish Hernia Database (n = 1,671) who underwent primary laparoscopic herniorrhaphy between January 1, 1998 and November 30, 2009. Questionnaires regarding dysejaculation and pain during sexual activity were mailed 3 months to 12 years after surgery, and 1,172 patients were included for analysis.
The response rate was 68.7% (n = 805). Dysejaculation occurring after laparoscopic repair was present in 25 patients (3.1%). Pain from the groin or genitals during sexual activity was reported by 88 patients (10.9%), and 19 patients (2.4%) reported that the pain had impaired their sexual activity to a moderate or severe degree. Older patients and patients with longer follow-up had lower prevalence of pain during sexual activity.
Dysejaculation and pain-related impairment of sexual activity is a significant problem after laparoscopic inguinal herniorrhaphy. The role of improved laparoscopic technique with use of glue fixation of lightweight meshes to reduce the risk of developing these complications needs to be evaluated.
多达 4%的年轻男性在接受开放式腹股沟疝修补术后,会出现性活动时腹股沟和生殖器疼痛以及排精障碍等临床显著问题。本问卷调查研究旨在评估在全国范围内,经腹腔镜腹股沟疝修补术后排精障碍和性活动时疼痛的发生率。
研究人群包括在 1998 年 1 月 1 日至 2009 年 11 月 30 日期间接受初次腹腔镜疝修补术的所有 18-50 岁丹麦疝数据库(Danish Hernia Database)登记患者(n = 1671)。术后 3 个月至 12 年时,通过邮寄问卷的方式调查患者的排精障碍和性活动时疼痛情况,共纳入 1172 例患者进行分析。
应答率为 68.7%(n = 805)。腹腔镜修复后发生排精障碍的患者有 25 例(3.1%)。88 例(10.9%)患者报告性活动时腹股沟或生殖器疼痛,19 例(2.4%)患者报告疼痛对其性活动造成中度或重度损害。年龄较大的患者和随访时间较长的患者性活动时疼痛的发生率较低。
腹腔镜腹股沟疝修补术后,排精障碍和与疼痛相关的性活动受损是一个显著问题。需要评估改良腹腔镜技术(使用胶固定轻质网片以降低发生这些并发症的风险)的作用。