Department of Urology, First Hospital of Shanxi Medical University, Shanxi, China.
Department of Urology, Tianjin Union Medical Center, Tianjin, China.
Urology. 2019 Oct;132:164-169. doi: 10.1016/j.urology.2019.06.030. Epub 2019 Jul 4.
To evaluate the impact of photoselective vaporization of the prostate (PVP) on erectile function (EF) utilizing a 160W GreenLight laser system with up to 36 months of follow-up in men with lower urinary tract symptoms caused by benign prostatic hyperplasia.
A prospectively maintained database of patients who underwent GreenLight PVP was retrospectively reviewed. International Index of Erectile Function-5 (IIEF-5) questionnaire was used to assess EF. In total, 265 sexually active patients who underwent 160W GreenLight laser PVP were identified and divided into Group A with baseline IIEF-5 <19 and group B with baseline IIEF-5 ≥19. IIEF-5, International Prostate Symptom Score, quality of life, postvoid residual, and Qmax were recorded preoperatively, perioperatively, and at follow-up after 1, 3, 6, 12, 24, and 36 months. Recorded data were analyzed statistically using t- and χ tests.
The preoperative and perioperative data of the 2 groups were comparable. Significant improvements in International Prostate Symptom Score, Qmax, quality of life, and postvoid residual were observed in both groups at every follow-up visit throughout the 36 months with no significant difference between the groups. EF was sustained postoperatively compared with the baseline in the whole study population. In Group A (preoperative IIEF-5 <19), EF was significantly improved at 1 month and 12 month (P= .02 and P= .002).
In patients undergoing PVP by 160W GreenLight laser for lower urinary tract symptoms secondary to benign prostatic hyperplasia, no significant detrimental effect was observed in the EF at up to 3 years of follow-up. However, in patients with preoperative erectile dysfunction (ED), we showed a significant improvement.
利用 160W 绿激光系统对因良性前列腺增生导致下尿路症状的患者进行前列腺选择性光汽化术（PVP），评估其对勃起功能（EF）的影响，随访时间长达 36 个月。
回顾性分析接受绿激光 PVP 的患者前瞻性维护数据库。采用国际勃起功能指数-5（IIEF-5）问卷评估 EF。共确定了 265 例有性生活的接受 160W 绿激光前列腺汽化术的患者，分为基线 IIEF-5＜19 的 A 组和基线 IIEF-5≥19 的 B 组。术前、术中及术后 1、3、6、12、24 和 36 个月记录 IIEF-5、国际前列腺症状评分、生活质量、残余尿量和最大尿流率。使用 t 检验和卡方检验对记录的数据进行统计学分析。
两组患者的术前和围手术期数据具有可比性。两组患者在整个 36 个月的随访中，在每次随访时，国际前列腺症状评分、最大尿流率、生活质量和残余尿量均有显著改善，两组间无显著差异。与基线相比，EF 在整个研究人群中术后维持。在 A 组（术前 IIEF-5＜19），EF 在术后 1 个月和 12 个月时显著改善（P=.02 和 P=.002）。
在因良性前列腺增生导致下尿路症状接受 160W 绿激光 PVP 的患者中，在长达 3 年的随访中，EF 未观察到明显的不良影响。然而，对于术前有勃起功能障碍（ED）的患者，我们发现其 EF 有显著改善。
