Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany.
Int J Impot Res. 2012 Jul-Aug;24(4):155-60. doi: 10.1038/ijir.2012.8. Epub 2012 May 3.
The core question of the study was whether the nerve-sparing status and surgical approach affected the patients' sexual life in the first year after surgery. In addition, determinants of erectile function (EF) and the extent of sexual activity were investigated. We conducted a multicentric, longitudinal study in seven German hospitals before, 3, 6 and 12 months after radical prostatectomy (RP). A total of 329 patients were asked to self-assess the symptoms associated with erectile dysfunction (ED). These symptoms were assessed using the International Index of Erectile Function and EORTC QLQ-PR25 questionnaires. A multiple regression model was used to test the influence of clinical, socio-demographic and quality-of-life-associated variables on the patients' EF 1 year after RP. Before surgery, 39% of patients had a severe ED (complete impotence). At 3, 6 and 12 months after surgery, it was 80, 79 and 71%, respectively. Although the surgical approach had no significant effect on EF, patients who had undergone nerve-sparing surgery had significantly lower ED rates. Nevertheless, 1 year after RP, 66% of these patients had severe ED. Age, nerve-sparing status and the burden of urinary symptoms had the greatest impact on the patients' EF. Regardless of nerve-sparing status and surgical approach, postsurgical improvement of EF does not mean a full convalescence of presurgical EF. Instead, it may rather reduce the degree of postsurgical ED in time. Consequently, urologists should disclose to the patient that ED is a likely side effect of RP.
研究的核心问题是神经保留状况和手术途径是否会影响患者术后第一年的性生活。此外，还调查了勃起功能（EF）的决定因素和性行为的程度。我们在德国的七家医院进行了一项多中心、纵向研究，在根治性前列腺切除术（RP）前、术后 3、6 和 12 个月进行。共有 329 名患者被要求自我评估与勃起功能障碍（ED）相关的症状。这些症状使用国际勃起功能指数和 EORTC QLQ-PR25 问卷进行评估。使用多元回归模型来测试临床、社会人口统计学和生活质量相关变量对患者 RP 后 1 年 EF 的影响。手术前，39%的患者有严重的 ED（完全阳痿）。术后 3、6 和 12 个月时，分别为 80%、79%和 71%。尽管手术途径对 EF 没有显著影响，但接受神经保留手术的患者 ED 发生率明显较低。尽管如此，在 RP 后 1 年，这些患者中有 66%仍有严重的 ED。年龄、神经保留状况和尿症状负担对患者的 EF 影响最大。无论是否进行神经保留和手术途径，手术后 EF 的改善并不意味着术前 EF 的完全康复。相反，它可能会随着时间的推移降低术后 ED 的程度。因此，泌尿科医生应该向患者透露 ED 是 RP 的一个可能的副作用。
