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输精管切除术对未来下尿路症状诊断无影响:一项回顾性队列索赔数据库分析

Vasectomy has No Impact on Future Lower Urinary Tract Symptoms Diagnoses: A Retrospective Cohort Claims Database Analysis.

作者信息

Venigalla Greeshma, Kohn Taylor P, Pozzi Edoardo, Ramasamy Ranjith

机构信息

Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, Florida.

The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.

出版信息

JU Open Plus. 2023 Apr;1(4). doi: 10.1097/ju9.0000000000000018. Epub 2023 Apr 4.

Abstract

PURPOSE

The aim of this study was to assess whether there is an association between vasectomy and benign prostatic hyperplasia with associated lower urinary tract symptoms (BPH/LUTS) due to inflammatory etiology.

MATERIALS AND METHODS

We assessed the incidence of BPH/LUTS in men who had undergone vasectomy in a matched cohort analysis using the TriNetX Research Network. We identified men aged 30 to 60 years who underwent vasectomy and had a follow-up visit within 6 months to 5 years after vasectomy from January 2010 through December 2022 and compared them with matched controls. Outcomes recorded include diagnoses of BPH (N40, N40.1), BPH-related medication prescriptions, and BPH-related procedures. We accounted for confounding variables through propensity score-matching for age; race; and history of comorbid medical conditions: hyperlipidemia (International Classification of Disease-10: E78), metabolic syndrome (E88.81), overweight or obesity (E66), testicular hypofunction (E29.1), hypertension (I10-I16), nicotine dependence (F17), and obstructive sleep apnea (G47.33).

RESULTS

There was no significant difference in BPH diagnosis between postvasectomy men vs controls (0.84% vs 0.80%, RR: 0.95, 95% CI 0.86-1.05) or BPH/LUTS diagnosis (0.48% vs 0.44%, RR: 0.92, 95% CI 0.81-1.05) within 6 months to 5 years after vasectomy, respectively. No differences in BPH medication prescription (0.94% vs 0.84%) or rate of BPH procedures (0.022% vs 0.017%) were detected between the 2 groups.

CONCLUSIONS

This study suggests that vasectomy does not increase the risk of BPH development and/or LUTS worsening compared with the general population, providing assurance to both patients and health care providers who may consider vasectomy as a safe family planning option.

摘要

目的

本研究旨在评估输精管结扎术与因炎症病因导致的良性前列腺增生伴下尿路症状(BPH/LUTS)之间是否存在关联。

材料与方法

我们在一项匹配队列分析中,使用TriNetX研究网络评估了接受输精管结扎术男性的BPH/LUTS发病率。我们确定了年龄在30至60岁之间、在2010年1月至2022年12月期间接受输精管结扎术并在输精管结扎术后6个月至5年内进行随访的男性,并将他们与匹配的对照组进行比较。记录的结果包括BPH(N40,N40.1)的诊断、BPH相关药物处方以及BPH相关手术。我们通过对年龄、种族和合并症病史进行倾向评分匹配来控制混杂变量,合并症包括高脂血症(国际疾病分类-10:E78)、代谢综合征(E88.)、超重或肥胖(E66)、睾丸功能减退(E29.1)、高血压(I10-I16)、尼古丁依赖(F17)和阻塞性睡眠呼吸暂停(G47.33)。

结果

输精管结扎术后男性与对照组在输精管结扎术后6个月至5年内的BPH诊断(0.84%对0.80%,RR:0.95,95%CI 0.86-1.05)或BPH/LUTS诊断(0.48%对0.44%,RR:0.92,95%CI 0.81-1.05)方面均无显著差异。两组之间在BPH药物处方(0.94%对0.84%)或BPH手术率(0.022%对0.017%)方面未检测到差异。

结论

本研究表明,与普通人群相比,输精管结扎术不会增加BPH发生和/或LUTS恶化的风险,这为可能将输精管结扎术视为安全计划生育选择的患者和医疗服务提供者提供了保障。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59f5/10122437/6478d7f62f42/nihms-1890812-f0001.jpg

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