Iwahashi Yuya, Deguchi Ryusuke, Muraoka Satoshi, Wakamiya Takahito, Yamashita Shimpei, Kikkawa Kazuro, Kohjimoto Yasuo, Hara Isao
Department of Urology, Wakayama Medical University, Wakayama, Japan.
Curr Urol. 2024 Jun;18(2):148-154. doi: 10.1097/CU9.0000000000000227. Epub 2024 Jun 21.
We investigated potential disparities in health-related quality of life, particularly concerning urinary function, between patients with preserved and those with impaired sexual function after robot-assisted radical prostatectomy (RARP).
Between December 2012 and April 2020, 704 men underwent RARP in our hospital. This study included 155 patients with a preoperative 5-item International Index of Erectile Function (IIEF-5) of ≥12 points and an assessable IIEF-5 at 12 months postoperatively. Health-related quality of life was assessed using the 8-item Short-Form Health Survey and Expanded Prostate Cancer Index Composite (EPIC) preoperatively and at 3, 6, and 12 months postoperatively. A logistic regression analysis and Wilcoxon rank sum tests were performed.
Patients were grouped according to the median IIEF-5 score 12 months after surgery: those with preserved sexual function (n = 71) and those with impaired sexual function (n = 84). The mental component summary of the 8-item Short-Form Health Survey was better in the group with preserved sexual function at 6 months postoperatively than in the group with impaired sexual function ( < 0.01). In the EPIC, the group with preserved sexual function performed better not only in the sexual domain but also in the urinary domain at all time points compared with the group with impaired sexual function ( < 0.01). In the comparison of the urinary subdomains of the EPIC, there were no significant differences in urinary function or incontinence, but there were significant differences in urinary distress and irritative/obstructive scores ( < 0.01).
Patients with preserved postoperative sexual function after RARP showed better urinary function than those with impaired sexual function. Hence, preserved sexual function is closely associated with urinary function.
我们调查了机器人辅助根治性前列腺切除术（RARP）后性功能保留患者与性功能受损患者在健康相关生活质量方面的潜在差异，尤其关注泌尿功能。
2012年12月至2020年4月期间，我院704名男性接受了RARP手术。本研究纳入了155例术前国际勃起功能指数（IIEF-5）5项评分≥12分且术后12个月可评估IIEF-5的患者。术前以及术后3、6和12个月使用8项简短健康调查问卷和扩展前列腺癌指数综合问卷（EPIC）评估健康相关生活质量。进行了逻辑回归分析和Wilcoxon秩和检验。
根据术后12个月IIEF-5评分中位数对患者进行分组：性功能保留组（n = 71）和性功能受损组（n = 84）。术后6个月时，8项简短健康调查问卷的心理成分总结在性功能保留组中优于性功能受损组（<0.01）。在EPIC中，与性功能受损组相比，性功能保留组在所有时间点不仅在性领域表现更好，在泌尿领域也表现更好（<0.01）。在EPIC的泌尿子领域比较中，泌尿功能或尿失禁方面无显著差异，但在泌尿困扰和刺激/梗阻评分方面存在显著差异（<0.01）。
RARP术后性功能保留的患者比性功能受损的患者泌尿功能更好。因此，性功能保留与泌尿功能密切相关。
