Chung Jae Seung, Park Sang Hyun, Oh Cheol Kyu, Kim Seong Cheol, Kim Taek Sang, Kang Pil Moon, Seo Won Ik, Kim Wan Seok, Yoon Jang Ho, Kang Dong Ii, Min Kweon Sik, Chung Jae Ii
Department of Urology, Haeundae Paik Hospital, Inje University, Busan, South Korea.
Department of Urology, Kosin Gospel Hospital, Kosin University, Busan, South Korea.
Lasers Med Sci. 2017 Sep;32(7):1517-1523. doi: 10.1007/s10103-017-2273-z. Epub 2017 Jul 6.
This study aimed to evaluate the impact of thulium:yttrium-aluminum-garnet (Tm:YAG) (RevoLix®) laser prostatectomy for the treatment of benign prostatic obstructions on erectile function (EF). A total of 208 patients who underwent Tm:YAG laser prostatectomies participated in this study. All cases were evaluated preoperatively and at 3, 6, and 12 months postoperatively using the International Prostate Symptom Score (IPSS), quality of life (QoL) score, and the International Index of Erectile Function (IIEF-5) questionnaires. Patients were divided into groups A (severe erectile dysfunction [ED]), B (moderate ED), and C (mild-to-normal ED), according to their IIEF-5 scores. The median patient ages were 69, 65, and 62 years in groups A, B, and C, respectively. Significant improvements occurred in the IPSS and QoL score within the groups during the 12-month follow-up period. The IIEF-5 scores at 3 months postoperatively were lower than the preoperative scores in groups B and C. The IIEF-5 scores subsequently improved during the 12-month follow-up period. The slope of the relationship between the IIEF-5 score and the time since Tm:YAG laser prostatectomy had a ß value of 0.2210 (95% confidence interval 0.103 to 0.338, p = 0.0003); hence, each postoperative month was associated with an increase of 0.2210 in the IIEF-5 score. The IIEF-5 scores gradually increased and reached the preoperative levels by the 12-month follow-up assessment. Although the IIEF-5 score dropped significantly during the first 3 months postoperatively, it improved over the following 12 months. Tm:YAG laser prostatectomy did not impact on EF ultimately.
钇铝石榴石（Tm:YAG）（RevoLix®）激光前列腺切除术治疗良性前列腺梗阻对勃起功能（EF）的影响。共有208例行Tm:YAG激光前列腺切除术的患者参与了本研究。所有病例在术前以及术后3个月、6个月和12个月时，使用国际前列腺症状评分（IPSS）、生活质量（QoL）评分和国际勃起功能指数（IIEF-5）问卷进行评估。根据IIEF-5评分，患者被分为A组（重度勃起功能障碍[ED]）、B组（中度ED）和C组（轻度至正常ED）。A组、B组和C组患者的中位年龄分别为69岁、65岁和62岁。在12个月的随访期内，各组的IPSS和QoL评分均有显著改善。B组和C组术后3个月时的IIEF-5评分低于术前评分。随后在12个月的随访期内IIEF-5评分有所改善。IIEF-5评分与Tm:YAG激光前列腺切除术后时间之间关系的斜率β值为0.2210（95%置信区间0.103至0.338，p = 0.0003）；因此，术后每个月IIEF-5评分增加0.2210。IIEF-5评分逐渐升高，到12个月随访评估时达到术前水平。虽然术后前3个月IIEF-5评分显著下降，但在随后的12个月中有所改善。最终，Tm:YAG激光前列腺切除术并未对勃起功能产生影响。
