Borchert Alex, Leavitt David A
Vattikuti Urology Institute, Henry Ford Hospital, Henry Ford Health System, 2799 West Grand Boulevard, K9, Detroit, MI, 48202, USA.
Curr Urol Rep. 2018 Jun 19;19(8):66. doi: 10.1007/s11934-018-0813-0.
Review how the various surgical treatments for benign prostatic hyperplasia and lower urinary tract symptoms impact on male sexual health and function.
The interplay between benign prostatic hyperplasia and erectile function is complex, and the conditions seem linked. Most cavitating procedures to improve male voiding will degrade ejaculatory and possibly erectile function. Many of the newer minimally invasive therapies appear to preserve sexual function in the short term while sacrificing some of the voiding improvements realized with more complete removal of the prostate adenoma. Benign prostatic hyperplasia will affect the majority of men at some point in life, and surgical treatment remains an integral option for managing the associated urinary symptoms. These treatments are associated with variable rates of sexual side effects, including ejaculatory, erectile, and orgasmic dysfunction. As the impact of these treatment modalities on sexual dysfunction has become more widely acknowledged, there has been a rise in interest in modalities that minimize adverse sexual side effects. Recent studies have sought to further elucidate the relationship between surgical treatment of benign prostate hyperplasia and sexual outcomes, and a number of studies have demonstrated that treatment of benign prostate hyperplasia can actually result in improved sexual function for some patients. This work intends to review the proposed pathophysiology behind the sexual side effects resulting from the surgical treatment of benign prostate hyperplasia and review the literature regarding both established and emerging surgical techniques.
综述良性前列腺增生和下尿路症状的各种外科治疗方法如何影响男性性健康和性功能。
良性前列腺增生与勃起功能之间的相互作用很复杂,且二者似乎有关联。多数改善男性排尿的空化手术会损害射精功能,甚至可能损害勃起功能。许多较新的微创治疗方法在短期内似乎能保留性功能,但会牺牲一些通过更彻底切除前列腺腺瘤所实现的排尿改善效果。良性前列腺增生在人生的某个阶段会影响大多数男性,手术治疗仍是管理相关泌尿系统症状的重要选择。这些治疗方法会导致不同发生率的性副作用,包括射精、勃起和性高潮功能障碍。随着这些治疗方式对性功能障碍的影响得到更广泛认可,人们对将不良性副作用降至最低的治疗方式的兴趣有所增加。近期研究试图进一步阐明良性前列腺增生手术治疗与性结局之间的关系,并且多项研究已表明,良性前列腺增生的治疗实际上可使部分患者的性功能得到改善。本文旨在综述良性前列腺增生手术治疗所致性副作用背后的病理生理学机制,并综述有关既定和新兴手术技术的文献。