Kim Jung Kwon, Cho Min Chul, Son Hwancheol, Ku Ja Hyeon, Oh Seung-June, Paick Jae-Seung
Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Urology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
Urology. 2017 Jan;99:142-147. doi: 10.1016/j.urology.2016.09.037. Epub 2016 Oct 8.
To investigate patient perception of ejaculatory volume reduction after Holmium laser enucleation of the prostate (HoLEP).
A total of 192 patients were included in the analysis. All patients completed 6 self-developed, nonvalidated questionnaires. The questionnaires were composed of questions involving overall satisfaction, voiding symptom change, current experience of sexual intercourse, ejaculatory volume change, change of orgasmic intensity, and the patient's perception of postoperative ejaculatory volume reduction. Questionnaire results and clinical parameters were analyzed, and subgroup analysis according to the patient's perception was also performed.
The median patient age was 66.0 years, and the mean total prostate volume and enucleated prostate volume was 61.9 ± 24.1 mL and 22.4 ± 14.0 mL, respectively. Among 192 patients, 91 patients had had sexual intercourse within the past 3 months. Ejaculatory volume changes after HoLEP were as follows: "total loss" (76.9%), "decreased" (18.7%), and "no change"(4.4%). Among the 87 patients who reported ejaculatory volume reduction, their perceptions of this issue were as follows: "feels better"(2.3%), "not a problem" (16.1%), "disappointed, but able to tolerate, owing to improvement of voiding symptoms" (73.6%), and "dissatisfied and want to reverse the situation"(8.0%). Decreased orgasmic intensity was present in 48 (52.8%) patients. There were significantly more patients who reported decreased orgasmic intensity among those who wanted to reverse the situation compared with the others (P = .027).
Our study showed that most of the patients reported ejaculatory volume reduction and more than half of the patients reported decreased orgasmic intensity after HoLEP. We also found that patients' perceptions of ejaculatory volume reduction and orgasmic intensity were closely related to each other.
探讨患者对钬激光前列腺剜除术（HoLEP）后射精量减少的感知情况。
共有192例患者纳入分析。所有患者均完成了6份自行设计的、未经验证的问卷。问卷由涉及总体满意度、排尿症状变化、当前性交体验、射精量变化、性高潮强度变化以及患者对术后射精量减少的感知等问题组成。对问卷结果和临床参数进行分析，并根据患者的感知进行亚组分析。
患者中位年龄为66.0岁，平均前列腺总体积和剜除前列腺体积分别为61.9±24.1 mL和22.4±14.0 mL。192例患者中，91例在过去3个月内有过性交。HoLEP术后射精量变化如下：“完全丧失”（76.9%）、“减少”（18.7%）和“无变化”（4.4%）。在报告射精量减少的87例患者中，他们对该问题的看法如下：“感觉更好”（2.3%）、“不是问题”（16.1%）、“因排尿症状改善而失望但能忍受”（73.6%）和“不满意并希望扭转这种情况”（8.0%）。48例（52.8%）患者出现性高潮强度降低。与其他患者相比，希望扭转这种情况的患者中性高潮强度降低的患者明显更多（P = 0.027）。
我们的研究表明，大多数患者报告HoLEP术后射精量减少，超过一半的患者报告性高潮强度降低。我们还发现患者对射精量减少和性高潮强度的感知彼此密切相关。
