Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA.
Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA.
Sex Med Rev. 2018 Jul;6(3):429-437. doi: 10.1016/j.sxmr.2017.12.003. Epub 2018 Feb 12.
Pelvic surgeries are recognized to cause dysfunction of the male sexual response, which consists of erection, emission, expulsion, and orgasm. However, the least attention has been paid to male orgasmic dysfunction after invasive pelvic surgery.
To describe the available literature on post-pelvic surgery orgasmic dysfunction disorders.
A literature search was performed on PubMed using the search strings related to dysfunction of the male sexual cycle and orgasm after pelvic surgery.
Orgasmic dysfunction after pelvic procedures in urologic, colorectal, and vascular surgeries was assessed.
Radical prostatectomy was the most common procedure where orgasmic dysfunction was quantified. Anorgasmia post-operatively occurred in patients in a range of 5-70%. Dysorgasmia occurred less frequently from 7-14%. The prevalence of climacturia was highly variable occurring in 20-93% of patients. Radical cystectomy resulted in anorgasmia 33-62% of the time and climacturia ranged from 6-45%. Studies involving colorectal surgeries were less likely to assess for dysorgasmia and climacturia, but anorgasmia rates ranged from 0-52%. Most current studies do not differentiate between ejaculatory and orgasmic dysfunction. However, more recent studies have started to distinguish between the 2 disorders and publish more specific data on what components of the male sexual response has been affected by the specific surgery.
The male sexual response, specifically the male orgasm, is difficult to quantify in a non-obtrusive setting and can exhibit variability between patients and between sexual encounters in the same patient. Data involving the outcome of male orgasmic dysfunction after pelvic surgery are sparse, limiting health professionals' ability to appropriately counsel patients. Future work needs to standardize outcome assessment for orgasmic disorders, which, in turn, can be used across all surgical specialties. Haney NM, Alzweri LM, Hellstrom WJG. Male Orgasmic Dysfunction Post-Radical Pelvic Surgery. Sex Med Rev 2018;6:429-437.
盆腔手术被认为会导致男性性反应功能障碍，包括勃起、射精、排精和高潮。然而，对于侵入性盆腔手术后的男性性高潮功能障碍，关注最少。
描述关于盆腔手术后性高潮功能障碍障碍的现有文献。
在 PubMed 上使用与男性性周期和盆腔手术后性高潮功能障碍相关的搜索字符串进行文献检索。
评估了泌尿科、结直肠和血管手术中盆腔手术后的性高潮功能障碍。
大多数常见的评估术后性高潮功能障碍的手术是根治性前列腺切除术。术后无高潮发生率为 5-70%。性高潮障碍发生率较低，为 7-14%。性高潮后尿失禁的发生率变化很大，发生率为 20-93%。根治性膀胱切除术导致无高潮发生率为 33-62%，性高潮后尿失禁发生率为 6-45%。涉及结直肠手术的研究不太可能评估性高潮和性高潮后尿失禁，但无高潮发生率为 0-52%。大多数当前的研究没有区分射精和性高潮功能障碍。然而，最近的研究已经开始区分这两种疾病，并发布了关于特定手术影响男性性反应的哪些方面的更具体数据。
男性性反应，特别是男性性高潮，在非侵入性环境中难以量化，并且在患者之间和同一患者的不同性接触中表现出变异性。涉及盆腔手术后男性性高潮功能障碍结局的数据很少，限制了卫生专业人员适当咨询患者的能力。未来的工作需要标准化性高潮障碍的结局评估，这反过来又可以在所有外科专业中使用。
