经尿道前列腺切除术 12 个月后，经直肠彩色多谱勒超声测量的参数与 BPH 患者性功能障碍之间存在显著关系。
Significant relationship between parameters measured by transrectal color Doppler ultrasound and sexual dysfunction in patients with BPH 12 months after TURP.
机构信息
Department of Anesthesiology, China Medical University, Taichung City, Taiwan.
Department of Anesthesiology, China Medical University Hospital, Taichung City, Taiwan.
出版信息
BMC Urol. 2021 Jan 13;21(1):9. doi: 10.1186/s12894-020-00776-2.
BACKGROUND
A link between sexual dysfunction and lower urinary tract symptoms due to benign prostatic hyperplasia (BPH) has been noticed. Transurethral resection of the prostate (TURP) remains the standard treatment for symptomatic BPH, whether TURP causes sexual dysfunction is still uncertain. In this retrospective study, we investigated the relationship between parameters measured by color Doppler ultrasound (CDU) and sexual dysfunction in patients with BPH 12 months after TURP.
METHODS
The parameters include presumed circle area ratio (PCAR), maximal horizontal area of seminal vesicles (MHA), resistive index of the prostate (RIP), and peak systolic velocity in the flaccid penis (PSV). The international prostate symptom score was used to evaluate the lower urinary tract symptoms and the five-item version of the International Index of Erectile Function was used to evaluate sexual function before and after TURP.
RESULTS
Of the 103 patients without sexual dysfunction before TURP, 11 (10.7%) had erectile dysfunction (ED) after TURP. These 11 patients had significantly lower PCAR, RIP, PSV and MHA than those without ED. The patients with retrograde ejaculation after TURP had significantly lower PCAR than those without retrograde ejaculation, and the patients with premature ejaculation after TURP had significantly lower MHA than those without premature ejaculation. Comparing the parameters between baseline and after TURP, PCAR, RIP, and MHA decreased significantly in the patients with sexual dysfunction, but no significant differences were noted in the patients without sexual dysfunction after TURP.
CONCLUSIONS
More extended TURP can lead to a higher incidence of ED and retrograde ejaculation in BPH patients without sexual dysfunction before TURP. Patients with a lower volume of seminal vesicles after TURP may have a higher incidence of premature ejaculation.
背景
良性前列腺增生（BPH）引起的下尿路症状与性功能障碍之间存在关联。经尿道前列腺电切术（TURP）仍然是治疗有症状 BPH 的标准方法，但 TURP 是否会引起性功能障碍仍不确定。在这项回顾性研究中，我们调查了 12 个月后接受 TURP 的 BPH 患者的彩色多普勒超声（CDU）测量参数与性功能障碍之间的关系。
方法
参数包括假定圆面积比（PCAR）、最大精囊水平面积（MHA）、前列腺阻力指数（RIP）和疲软阴茎的收缩期峰值速度（PSV）。国际前列腺症状评分用于评估下尿路症状，国际勃起功能指数的五分量表用于评估 TURP 前后的性功能。
结果
在 103 例 TURP 前无性功能障碍的患者中，11 例（10.7%）在 TURP 后出现勃起功能障碍（ED）。这 11 例患者的 PCAR、RIP、PSV 和 MHA 明显低于无 ED 的患者。 TURP 后发生逆行射精的患者的 PCAR 明显低于无逆行射精的患者，而 TURP 后发生早泄的患者的 MHA 明显低于无早泄的患者。与 TURP 前后的参数比较，有性功能障碍的患者的 PCAR、RIP 和 MHA 明显降低，但无性功能障碍的患者在 TURP 后则无明显差异。
结论
更广泛的 TURP 可能导致 TURP 前无性功能障碍的 BPH 患者发生更高的 ED 和逆行射精发生率。 TURP 后精囊容量较低的患者可能更容易发生早泄。
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