一项关于慢性前列腺炎/慢性盆腔疼痛综合征（CP/CPPS）男性患者前列腺钙化与性功能障碍相关性的前瞻性研究。

A prospective study on association of prostatic calcifications with sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

作者信息

Zhao Zhigang, Xuan Xujun, Zhang Jingwei, He Jun, Zeng Guohua

机构信息

Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

出版信息

J Sex Med. 2014 Oct;11(10):2528-36. doi: 10.1111/jsm.12534. Epub 2014 Apr 16.

DOI:10.1111/jsm.12534

PMID:24735240

Abstract

INTRODUCTION

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common debilitating condition of unclear etiology. Sexual dysfunction is an important component of the clinical phenotype of CP/CPPS. Patients often have prostatic calcifications, but a link to sexual dysfunction is unknown.

AIM

The aim of this study was to evaluate the association of prostatic calcifications with sexual dysfunction in this condition.

METHODS

A total of 358 males with CP/CPPS were consecutively enrolled, and a prospectively maintained database of these patients was analyzed. Calcifications were diagnosed using ultrasound imaging of the prostate. Symptom severity was measured using the National Institutes of Health Chronic Prostatitis Symptom Index (CPSI). Sexual dysfunction was evaluated using the validated 15-item International Index of Erectile Function (IIEF-15) questionnaire and 5-item Premature Ejaculation Diagnostic Tool scales. The variables were compared between patients with prostatic calcifications and those without using the Student's t-test, Wilcoxon unpaired test, or chi-square test.

MAIN OUTCOME MEASURE

Logistic regression models were developed to explore a possible association between prostatic calcifications and sexual dysfunction.

RESULTS

Measurable calcifications in the prostate were found in 175 (48.9%) of the 358 patients. Patients with calcifications were more likely to have higher white blood cell counts or positive bacteria cultures in their prostatic fluid, longer symptoms duration, and lower scores for the total IIEF-15, IIEF-erectile function, and IIEF-intercourse satisfaction domains (P < 0.001 for each). However, the scores for CPSI, premature ejaculation, and IIEF-orgasmic function, IIEF-sexual desire, and IIEF-overall satisfaction domains were identical between men with and without calcifications (P > 0.05 for each). Furthermore, logistic regression analyses revealed that intraprostatic calcification is significantly associated with self-assessed erectile dysfunction (ED) (odds ratio:3.632, 95% confidence interval: 2.405-5.822, P < 0.001).

CONCLUSION

Our results showed that prostatic calcifications are significantly associated with the presence of ED in CP/CPPS males.

摘要

引言

慢性前列腺炎/慢性盆腔疼痛综合征（CP/CPPS）是一种病因不明的常见使人衰弱的病症。性功能障碍是CP/CPPS临床表型的一个重要组成部分。患者常伴有前列腺钙化，但与性功能障碍的关联尚不清楚。

目的

本研究旨在评估CP/CPPS患者中前列腺钙化与性功能障碍之间的关联。

方法

连续纳入358例CP/CPPS男性患者，并对前瞻性维护的这些患者的数据库进行分析。通过前列腺超声成像诊断钙化。使用美国国立卫生研究院慢性前列腺炎症状指数（CPSI）测量症状严重程度。使用经过验证的15项国际勃起功能指数（IIEF-15）问卷和5项早泄诊断工具量表评估性功能障碍。使用学生t检验、Wilcoxon非配对检验或卡方检验比较有前列腺钙化和无前列腺钙化患者的变量。

主要观察指标

建立逻辑回归模型以探讨前列腺钙化与性功能障碍之间的可能关联。

结果

358例患者中有175例（48.9%）前列腺存在可测量的钙化。有钙化的患者前列腺液中白细胞计数更高或细菌培养阳性的可能性更大，症状持续时间更长，IIEF-15总分、IIEF勃起功能和IIEF性交满意度领域得分更低（每项P < 0.001）。然而，有钙化和无钙化男性的CPSI、早泄以及IIEF性高潮功能、IIEF性欲和IIEF总体满意度领域得分相同（每项P > 0.05）。此外，逻辑回归分析显示前列腺内钙化与自我评估的勃起功能障碍（ED）显著相关（比值比：3.632，95%置信区间：2.405 - 5.822，P < 0.001）。