Wang Yubin, Shao Jinkai, Lu Yongning, Lü Yongan, Li Xiaodong
Department of Urology, Shanxi Provincial People's Hospital, Shuangtasi Avenue No. 29, 030012, Taiyuan, China,
Lasers Med Sci. 2014 Mar;29(2):689-93. doi: 10.1007/s10103-013-1386-2. Epub 2013 Jul 5.
The objective of this work is to evaluate the impact of 120-W 2-μm continuous wave (cw) laser vapoenucleation of the prostate in patients with benign prostatic hyperplasia (BPH) on sexual function. One hundred twenty-two consecutive patients with BPH were retrospectively collected in this study and were classified into two groups for surgical treatment with 2-μm cw laser vapoenucleation or transurethral resection of the prostate (TURP). International Index of Erectile Function (IIEF) and general assessment questions were completed before and 12 months after treatment to determine the impact on sexual function. A total of 33 patients (52.4%) in group 1 and 31 (52.5%) in group 2 reported various degrees of erectile dysfunction before surgery. Interestingly, an increase in IIEF-EF score by 2 points was reported by 16 (25.4%) and 14 (23.7%) patients, respectively, and mean EF score did show a marginal but not significant increase postoperatively in both group. Differences about orgasmic intercourse satisfaction, sexual desire domain, and overall satisfaction scores in each group were not significant between preoperative and postoperative, but there was a significant decrease in the orgasmic function domain score at 12 months postoperation in both groups (p < 0.001). The prevalence of postoperative retrograde ejaculation was significantly higher than at baseline assessment in two groups. This study demonstrates that there is no difference between 2 μm laser vapoenucleation and TURP in terms of impact on sexual function. No significant erectile function improvement was observed after surgery, but these two techniques significantly lowered the IIEF orgasmic function domain and this was mainly caused by retrograde ejaculation.
本研究旨在评估120瓦2微米连续波（cw）激光前列腺汽化术对良性前列腺增生（BPH）患者性功能的影响。本研究回顾性收集了122例连续的BPH患者，并将其分为两组，分别接受2微米cw激光汽化术或经尿道前列腺切除术（TURP）进行手术治疗。在治疗前和治疗后12个月完成国际勃起功能指数（IIEF）和一般评估问题，以确定对性功能的影响。第一组共有33例患者（52.4%），第二组有31例患者（52.5%）在手术前报告有不同程度的勃起功能障碍。有趣的是，分别有16例（25.4%）和14例（23.7%）患者报告IIEF-EF评分增加了两分，且两组术后平均EF评分确实均有小幅但不显著的增加。每组中关于性高潮性交满意度、性欲领域和总体满意度评分在术前和术后之间没有显著差异，但两组在术后12个月时性高潮功能领域评分均有显著下降（p<0.001）。两组术后逆行射精的发生率均显著高于基线评估时。本研究表明，2微米激光汽化术和TURP在对性功能的影响方面没有差异。术后未观察到勃起功能有显著改善，但这两种技术均显著降低了IIEF性高潮功能领域评分，这主要是由逆行射精引起的。
