Department of Urology, Herlev Hospital, Copenhagen, Denmark.
J Sex Med. 2014 Sep;11(9):2318-26. doi: 10.1111/jsm.12624. Epub 2014 Jul 4.
Altered perception of orgasm, orgasm-associated pain, penile sensory changes, urinary incontinence (UI) during sexual activity, penile shortening (PS), and penile deformity following radical prostatectomy (RP) have received increasing attention from researchers.
The aim of this study is to describe the prevalence and predictors of the above-mentioned side effects.
This was a cross-sectional questionnaire-based study among men who had undergone RP between 3 and 36 months prior to study inclusion. Predicting factors were identified through logistic regression analyses.
The primary outcome measures were prevalence rates of the above-mentioned side effects.
Overall, 316 questionnaires were available for analyses. Of the sexually active patients (n = 256), 12 (5%) reported anorgasmia, whereas 153 (60%) reported decreased orgasm intensity. Delayed orgasms were reported by 146 (57%). Twenty-three patients (10%) had experienced pain during orgasm. UI during sexual activity were reported by 99 patients (38%). Out of the whole population, 77 patients (25%) reported sensory changes in the penis. A total of 143 patients (47%) reported a subjective loss of penile length of >1 cm. An altered curvature of the penis was reported by 30 patients (10%). Patients had increasing risk of UI during sexual activity (odds ratio [OR] 1.17; 95% confidence interval [CI] 1.10-1.25) and orgasmic dysfunction (OR 1.09; 95% CI 1.01-1.16) with increasing International Consultation on Incontinence Questionnaire scores. Erectile dysfunction (OR 1.81; 95% CI 1.07-3.10) and a high body mass index (OR 1.10; 95% CI 1.02-1.19) increased the risk of PS after RP. Nerve-sparing (OR 0.32; 95% CI 0.16-0.95) reduced the risk of PS.
Orgasm-associated problems, UI during sexual activity, penile sensory changes, PS, and penile deformity are common side effects to RP. Daytime UI, erectile dysfunction, and nerve-sparing status can help identify patients at risk.
射精感觉改变、射精相关疼痛、阴茎感觉变化、性行为时尿失禁（UI）、阴茎缩短（PS）和阴茎畸形是前列腺根治术后（RP）患者常见的问题，越来越受到研究者的关注。
本研究旨在描述上述副作用的发生率和预测因素。
这是一项横断面问卷调查研究，纳入了 RP 术后 3 至 36 个月的男性。通过逻辑回归分析识别预测因素。
主要结局指标为上述副作用的发生率。
共有 316 份问卷可用于分析。在有性行为的患者中（n=256），12 名（5%）患者报告存在射精功能障碍，153 名（60%）患者报告射精强度降低，146 名（57%）患者报告射精延迟。23 名（10%）患者在射精过程中感到疼痛。99 名（38%）患者报告性行为时 UI。在所有患者中，77 名（25%）患者报告阴茎感觉变化。143 名（47%）患者报告主观阴茎长度损失>1cm。30 名（10%）患者报告阴茎弯曲。国际尿失禁咨询问卷评分越高，患者发生性行为时 UI 的风险越高（比值比[OR] 1.17；95%置信区间[CI] 1.10-1.25）和射精功能障碍（OR 1.09；95% CI 1.01-1.16）。勃起功能障碍（OR 1.81；95% CI 1.07-3.10）和高体重指数（OR 1.10；95% CI 1.02-1.19）增加 RP 后 PS 的风险。神经保留（OR 0.32；95% CI 0.16-0.95）降低 PS 的风险。
射精相关问题、性行为时 UI、阴茎感觉变化、PS 和阴茎畸形是 RP 的常见副作用。日间 UI、勃起功能障碍和神经保留状态有助于识别有风险的患者。
