Parra López María Loreto, Lozano Blasco Jose María, Osman García Ignacio, Congregado Ruiz Belén, Conde Sánchez Jose Manuel, Medina López Rafael Antonio
Seville Biomedicine Institute, IBiS/Virgen del Rocío University Hospital/CSIC/Seville University, Department of Urology and Nephrology, Seville, Spain.
Seville Biomedicine Institute, IBiS/Virgen del Rocío University Hospital/CSIC/Seville University, Department of Urology and Nephrology, Seville, Spain.
Rev Int Androl. 2021 Jan-Mar;19(1):49-52. doi: 10.1016/j.androl.2019.08.004. Epub 2020 Mar 5.
Adverse effects in the sexual sphere are common in patients who have undergone radical prostatectomy (RP). Climacturia, involuntary loss of urine during orgasm, occurs in 20-40% of cases after PR. We analyse its prevalence and associated risk factors after Robotic-assisted laparoscopic radical prostatectomy (RALRP).
We analyse the climacturia prevalence after robotic-assisted laparoscopic radical prostatectomy (RALRP) and the association with other related factors.
Retrospective study of 100 patients underwent PRLAR from May 2011 to July 2014. After excluding patients who received radiotherapy after surgery (17), those who did not have sexual activity (7) and those with whom it could not be possible contacted (14), a structured telephone interview was conducted in 62 patients, investigating: presence and intensity of climacturia, orgasmic quality, incontinence and erectile dysfunction (ED). Other factors analysed included neurovascular preservation and rehabilitative treatment for ED. The statistical analysis consisted of Chitest and logistic regression to evaluate associated factors.
The mean age was 56 vs 59 years and the mean follow-up time was 26.6 vs 20.3 months, in the group with climacturia and without climacturia, respectively. The prevalence of climacturia was 17.9% (slight leaks-82% and severe leaks-18%). In 37% of these patients occurred in all orgasms. The quality of orgasm after surgery was worse in 47%, better in 13% and equal in 40%. The quality of the orgasm worsened more frequently in the climacturia group (63% vs 37%). The urinary incontinence rate was 41%, always effort incontinence. It was more frequent in patients with climacturia (62% vs 38%). In all patients with climacturia, bilateral neurovascular bundles preservation was performed. 32% of the patients had undergone post-surgical erectile rehabilitation with oral drugs. No statistically significant differences were found between patients with or without climacturia respect to the parameters analysed.
Climacturia rate after PRLAR in our series was 17.9%. Patients with climacturia presented worse quality orgasms and a higher incontinence rate (p> 0.05). None of the analysed parameters could be defined as predictors of climacturia.
根治性前列腺切除术（RP）患者中，性方面的不良反应很常见。性高潮期尿失禁（性高潮时不自主漏尿）在前列腺切除术后的发生率为20%-40%。我们分析了机器人辅助腹腔镜根治性前列腺切除术（RALRP）后性高潮期尿失禁的发生率及其相关危险因素。
我们分析机器人辅助腹腔镜根治性前列腺切除术（RALRP）后性高潮期尿失禁的发生率及其与其他相关因素的关联。
对2011年5月至2014年7月期间接受机器人辅助腹腔镜根治性前列腺切除术（PRLAR）的100例患者进行回顾性研究。排除术后接受放疗的患者（17例）、无性活动的患者（7例）以及无法联系到的患者（14例）后，对62例患者进行了结构化电话访谈，调查内容包括：性高潮期尿失禁的存在情况及严重程度、性高潮质量、尿失禁及勃起功能障碍（ED）。分析的其他因素包括神经血管束保留情况及ED的康复治疗。统计分析采用卡方检验和逻辑回归来评估相关因素。
性高潮期尿失禁组和无性高潮期尿失禁组的平均年龄分别为56岁和59岁，平均随访时间分别为26. /6个月和20.3个月。性高潮期尿失禁的发生率为17.9%（轻度漏尿-82%，重度漏尿-18%）。其中37%的患者在所有性高潮时都会出现。术后性高潮质量较差的患者占47%，较好的占13%，相同的占40%。性高潮期尿失禁组中性高潮质量恶化更为常见（63%对37%）。尿失禁发生率为41%，均为压力性尿失禁。在性高潮期尿失禁患者中更为常见（62%对38%）。所有性高潮期尿失禁患者均进行了双侧神经血管束保留。32%的患者术后接受了口服药物勃起功能康复治疗。在分析的参数方面，性高潮期尿失禁患者与无性高潮期尿失禁患者之间未发现统计学上的显著差异。
我们系列研究中机器人辅助腹腔镜根治性前列腺切除术后性高潮期尿失禁的发生率为17.9%。性高潮期尿失禁患者的性高潮质量较差，尿失禁发生率较高（p>0.05）。所分析的参数均不能被定义为性高潮期尿失禁的预测因素。
