Department of Urology, Zhong-Xing Branch, Taipei City Hospital, Taipei, Taiwan.
J Formos Med Assoc. 2012 Jun;111(6):320-4. doi: 10.1016/j.jfma.2011.01.008. Epub 2012 Apr 10.
BACKGROUND/PURPOSE: In this study, we assessed the relationship between changes in intraoperative rectal temperature and erectile function in patients who have undergone transurethral resection of the prostate.
Eighty-six potential patients with benign prostatic hyperplasia-induced lower urinary tract symptoms were studied. Patients were divided into two groups: group 1-small prostates (<40 ml) and group 2-large prostates (≥ 40 ml), as determined by transrectal ultrasound measurement. The intraoperative rectal temperature was evaluated using a transrectal thermosensor and the differences between the highest intra- and preoperative temperatures were recorded. The erectile function at baseline, at three months and at one-year postoperatively was assessed using the International Index of Erectile Function-5 (IIEF-5) questionnaire.
Intraoperative rectal temperature differences were 0.54 ± 0.24°C for group 1 (n=45) and 0.44 ± 0.20°C for group 2 (n=41), (p=0.04). The IIEF-5 scores for group1 and group 2 were, respectively, 20.9 ± 1.6 and 20.6 ± 1.6 at baseline (p=0.32), 17.3 ± 2.9 and 18.7 ± 3.2 (p=0.037) at 3 months, 17.9 ± 2.7 and 18.7 ± 3.0 (p=0.17) at 1 year postoperatively. The deterioration of erectile function at 3 months post-operatively was observed for both groups. The percentage of retrograde ejaculation between two groups was not significantly different (p=0.33) at 1 year postoperatively.
Our study revealed that a higher intraoperative rectal temperature difference caused by transurethral resection of the prostate might affect the postoperative erectile function, particularly in patients with a small prostate.
背景/目的:本研究评估了经尿道前列腺切除术患者术中直肠温度变化与勃起功能之间的关系。
研究纳入了 86 例有下尿路症状的良性前列腺增生患者。根据经直肠超声测量,患者分为两组:组 1-小前列腺(<40ml)和组 2-大前列腺(≥40ml)。术中直肠温度使用直肠温度传感器进行评估,并记录术中最高温度与术前温度的差值。使用国际勃起功能指数-5(IIEF-5)问卷评估术前、术后 3 个月和 1 年的勃起功能。
组 1(n=45)和组 2(n=41)术中直肠温度差值分别为 0.54±0.24°C 和 0.44±0.20°C(p=0.04)。组 1 和组 2 的 IIEF-5 评分分别为:术前 20.9±1.6 和 20.6±1.6(p=0.32),术后 3 个月 17.3±2.9 和 18.7±3.2(p=0.037),术后 1 年 17.9±2.7 和 18.7±3.0(p=0.17)。两组术后 3 个月勃起功能均出现恶化。术后 1 年两组逆行射精的比例无显著差异(p=0.33)。
本研究表明,经尿道前列腺切除术中直肠温度差值升高可能会影响术后勃起功能,尤其是在小前列腺患者中。