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[低功率传统脉冲模式经尿道铥激光前列腺汽化剜除术对良性前列腺增生患者性功能的影响]

[Effect of transurethral thuliumlaser vapoenucleation of the prostate with low-power conventional pulse mode on sexual function in patients with benign prostatic hyperplasia].

作者信息

Xue Yi-Feng, Dong Jia-Jun, Xu Yun-Hua, Wang Ping, Pan Lei, Chen Wei-Jun, Jing Yi-Feng, Fan Yun-Xia, Chen Hui-Xing

机构信息

Department of Urology, Jintan People's Hospital, Affiliated to Jiangsu University, Changzhou, Jiangsu 213200, China.

Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China.

出版信息

Zhonghua Nan Ke Xue. 2023 Dec;29(12):986-991.

Abstract

OBJECTIVE

To explore the effect of a novel transurethral thulium laser vapoenucleation of the prostate with low-power conventional pulse mode (LP-ThuVEP) on sexual function in patients with benign prostatic hyperplasia (BPH).

METHODS

89 BPH patients admitted to Department of Urology, Jintan People's Hospital, Affiliated to Jiangsu University, from January 2022 to June 2023 were selected and randomly divided into the LP-ThuLEP group (45 cases) and the transurethral plasma kinetic resection of the prostate (TUPKRP) group (44 cases). Perioperative indicators were recorded, and the IPSS, Qmax, Qavg, PVR, and QoL of the two groups of patients before surgery and 3 months and 6 months after surgery were comparatively analyzed. The effect of surgery on male sexual function was evaluated through the International Index of Erectile Function-5 (IIEF-5) score and the Male Sexual Health Questionnaire-Ejaculatory Dysfunction (MSHQ-EjD) score.

RESULTS

Compared with the TUPKRP group, the LP-ThuVEP group had no statistically significant difference in operation time (P>0.05), but there were statistical differences in bladder irrigation time and indwelling urinary catheter time (P<0.05) and significant statistical differences in the decrease in hemoglobin on the day of surgery and the disappearance time of gross hematuria induced by defecation after surgery (P<0.001). The perioperative complications of the two groups were comparable. Among the urinary tract symptom indicators, the LP-ThuVEP group had statistically significant differences in IPSS score, QoL score, and PVR compared with the TUPKRP group 3 months after surgery (P<0.05). In terms of male sexual function, there was a statistical difference in IIEF-5 scores between the two groups at 3 months and 6 months after surgery (P<0.05); Except that there was no statistical difference in the ejaculation-related satisfaction scores between the two groups at 3 months after surgery (P>0.05), there had all significant statistical differences in ejaculation function and satisfaction scores between and within the groups at 3 months and 6 months after surgery (P<0.001).

CONCLUSION

Compared with TUPKRP, the LP-ThuVEP can also effectively relieve urinary tract obstruction caused by BPH and has the advantages of less damage and faster recovery of erectile function and ejaculatory function of patients.

摘要

目的

探讨新型低功率传统脉冲模式经尿道铥激光前列腺汽化剜除术(LP-ThuVEP)对良性前列腺增生症(BPH)患者性功能的影响。

方法

选取2022年1月至2023年6月在江苏大学附属金坛人民医院泌尿外科住院的89例BPH患者,随机分为LP-ThuLEP组(45例)和经尿道前列腺等离子双极电切术(TUPKRP)组(44例)。记录围手术期指标,并对两组患者术前、术后3个月和6个月的国际前列腺症状评分(IPSS)、最大尿流率(Qmax)、平均尿流率(Qavg)、残余尿量(PVR)及生活质量(QoL)进行对比分析。通过国际勃起功能指数-5(IIEF-5)评分和男性性健康问卷-射精功能障碍(MSHQ-EjD)评分评估手术对男性性功能的影响。

结果

与TUPKRP组相比,LP-ThuVEP组手术时间差异无统计学意义(P>0.05),但膀胱冲洗时间和留置导尿管时间差异有统计学意义(P<0.05),术后当天血红蛋白下降幅度及术后排便诱发肉眼血尿消失时间差异有显著统计学意义(P<0.001)。两组围手术期并发症相当。在尿路症状指标方面,术后3个月LP-ThuVEP组与TUPKRP组相比,IPSS评分、QoL评分及PVR差异有统计学意义(P<0.05)。在男性性功能方面,术后3个月和6个月两组IIEF-5评分差异有统计学意义(P<0.05);除术后3个月两组射精相关满意度评分差异无统计学意义(P>0.05)外,术后3个月和6个月两组间及组内射精功能和满意度评分差异均有显著统计学意义(P<0.001)。

结论

与TUPKRP相比,LP-ThuVEP同样能有效缓解BPH所致尿路梗阻,且具有损伤小、患者勃起功能和射精功能恢复快的优点。

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