Department of Urology, Kinki Central Hospital of Mutual Aid Association of Public School Teachers, Itami, Hyogo, Japan.
PLoS One. 2022 Aug 11;17(8):e0272652. doi: 10.1371/journal.pone.0272652. eCollection 2022.
Transurethral enucleation with bipolar (TUEB) is a safe and effective surgery for benign prostatic obstruction (BPO). However, few data exist concerning the influence of TUEB on erectile function (EF) in patients with BPO.
To evaluate the influence of TUEB on EF in patients with BPO at 3- and 12-month follow-up.
We prospectively enrolled 51 patients who underwent TUEB from June 2016 to April 2020. We evaluated maximum urinary flow rate (Qmax), postvoid residual urine (PVR), International Prostate Symptom Score (IPSS), quality of life (QoL), and International Index of Erectile Function-5 (IIEF-5) preoperatively and at 3- and 12-month follow-up. We classified the patients according to their preoperative IIEF-5 score into group 1 (IIEF-5 ≥10; n = 24) and group 2 (IIEF-5 <10; n = 27), and for further evaluation of EF, into subgroups a: severe (IIEF-5 5-7), b: moderate (8-11), c: mild to moderate (12-16), d: mild (17-21), and e: no erectile dysfunction (22-25). Data are displayed as median or median (interquartile range).
The study comprised 51 patients with a median age of 75 (70.5-79.5) years. Median prostate and transition zone volumes were 69.5 (46.5-78.8) mL and 30.5 (19-43) mL, respectively. Urinary function improved significantly when comparing respective preoperative, 3-month, and 12-month follow-up values: Qmax (7.6, 12.9, 15.2 mL/s), PVR (50, 0, 0 mL), IPSS (20.5, 9, 6), and QoL (5, 2, 2), respectively. There was no significant change in IIEF-5 score across the three time points: 9, 7, 8. The IIEF-5 score slightly but significantly increased between the preoperative and 12-month follow-up values in group 2 (5, 5, 6) and subgroup a (5, 5, 5).
TUEB was effective and safe surgery for patients with BPO and showed no significant influence on EF at 12-month follow-up after TUEB in patients with BPO.
经尿道前列腺切除术联合双极电切术（TUEB）是治疗良性前列腺梗阻（BPO）的安全有效的手术。然而，关于 TUEB 对 BPO 患者勃起功能（EF）的影响的数据很少。
评估 TUEB 对 BPO 患者 EF 的影响，随访时间为 3 个月和 12 个月。
我们前瞻性纳入了 51 例 2016 年 6 月至 2020 年 4 月期间行 TUEB 的患者。我们评估了最大尿流率（Qmax）、残余尿量（PVR）、国际前列腺症状评分（IPSS）、生活质量（QoL）和国际勃起功能指数-5（IIEF-5），术前及 3 个月和 12 个月随访时。我们根据术前 IIEF-5 评分将患者分为组 1（IIEF-5≥10；n=24）和组 2（IIEF-5<10；n=27），并进一步评估 EF，分为亚组 a：重度（IIEF-5 5-7）、b：中度（8-11）、c：轻度至中度（12-16）、d：轻度（17-21）和 e：无勃起功能障碍（22-25）。数据显示为中位数或中位数（四分位距）。
研究纳入了 51 例年龄中位数为 75（70.5-79.5）岁的患者。前列腺和移行区体积中位数分别为 69.5（46.5-78.8）mL 和 30.5（19-43）mL。与术前、3 个月和 12 个月随访时相比，尿功能明显改善：Qmax（7.6、12.9、15.2mL/s）、PVR（50、0、0mL）、IPSS（20.5、9、6）和 QoL（5、2、2）。三组时间点 IIEF-5 评分无显著变化：9、7、8。组 2（5、5、5）和亚组 a（5、5、5）患者的 IIEF-5 评分在术前和 12 个月随访时略有但有统计学意义的增加。
TUEB 是治疗 BPO 患者的有效安全手术，在 TUEB 后 12 个月随访时，对 BPO 患者的 EF 无显著影响。
