Li Cheng-jun, Liu Xiao-zhou, Zhou Guang-xin, Lu Meng, Zhou Xing, Shi Xin, Wu Su-jia, Xu Song
Zhonghua Nan Ke Xue. 2015 Mar;21(3):251-5.
To evaluate the erectile and ejaculatory function of sacral tumor patients after sacral nerve root resection and investigate the relationship of erectile and ejaculatory dysfunction (EED) with the level of sacral nerve injury.
This retrospective study included 47 male patients aged 16 to 63 (32.6 +/- 6.8) years treated by sacral tumor resection between January 2008 and August 2013. According to the levels of the sacral nerve roots spared in surgery, the patients were divided into four groups: bilateral S1-S3 (n=16), unilateral S1-S3 (n=21), unilateral S1-S2 (n=6), and unilateral S1 (n=4). The patients were followed up for 12 to 41 (27.2 +/- 10.9) months by questionnaire investigation, clinic review, and telephone calls about their erectile and ejaculatory function at 3, 6 and 12 months after surgery and in August 2013.
In the bilateral S1-S3 group, the incidence rates of EED were 31.25% (5/16), 25% (4/16), and 12.5% (2/16) at 3, 6, and 12 months respectively after surgery, with recovery of erectile and ejaculatory function in August 2013. The incidence rates of EED in the unilateral S1-S3 group were 85.71% (18/21), 71.43% (15/21), 52.38% (11/21), and 42.86% (9/21) at 3, 6 and 12 months and in August 2013, respectively; those in the unilateral S1-S2 group were 100% (6/6), 83.33% (5/6), 83.33% (5/6), and 66.67% (4/6) at the four time points; and those in the unilateral S1 group were all 100% (4/4). No statistically significant differences were found in the incidence rate of EED among the patients of different ages or tumor types (P > 0.05).
The incidence of postoperative EED in male patients treated by sacral tumor resection is closely related to the mode of operation. Sparing the S3 nerve root at least unilaterally in sacral tumor resection is essential for protecting the erectile and ejaculatory function of the patient.
评估骶骨肿瘤患者骶神经根切除术后的勃起和射精功能，并探讨勃起和射精功能障碍（EED）与骶神经损伤水平的关系。
本回顾性研究纳入了2008年1月至2013年8月间接受骶骨肿瘤切除术治疗的47例年龄在16至63（32.6±6.8）岁的男性患者。根据手术中保留的骶神经根水平，将患者分为四组：双侧S1-S3（n = 16）、单侧S1-S3（n = 21）、单侧S1-S2（n = 6）和单侧S1（n = 4）。通过问卷调查、临床复查以及术后3、6和12个月及2013年8月的电话随访，了解患者的勃起和射精功能，随访时间为12至41（27.2±10.9）个月。
双侧S1-S3组术后3、6和12个月时EED的发生率分别为31.25%（5/16）、25%（4/16）和12.5%（2/16），2013年8月勃起和射精功能恢复。单侧S1-S3组在术后3、6和12个月及2013年8月时EED的发生率分别为85.71%（18/21）、71.43%（15/21）、52.38%（11/21）和42.86%（9/21）；单侧S1-S2组在四个时间点的发生率分别为100%（6/6）、83.33%（5/6）、83.33%（5/6）和66.67%（4/6）；单侧S1组均为100%（4/4）。不同年龄或肿瘤类型患者的EED发生率差异无统计学意义（P>0.05）。
骶骨肿瘤切除术后男性患者术后EED的发生率与手术方式密切相关。骶骨肿瘤切除术中至少单侧保留S3神经根对保护患者的勃起和射精功能至关重要。
