Bjerre B D, Johansen C, Steven K
Department of Social Medicine and Psychosocial Health, Panum Institute, University of Copenhagen, Denmark.
Scand J Urol Nephrol. 1998 May;32(3):187-93. doi: 10.1080/003655998750015557.
A questionnaire study was carried out to compare the postoperative sexological problems after cystectomy and bladder substitution using the urethral Kock reservoir or the ileocecal reservoir with that following ileal conduit diversion. A total of 76 male patients with bladder cancer completed the questionnaire: 49 patients had a bladder substitution and 27 an ileal conduit diversion. Median follow-up was 1.3 years (range 0.5-6.4) and 4.8 years (range 2.4-14.7), respectively. Only 9% of all patients could achieve an erection at least every second time, in comparison to 82% preoperatively. Thirty-eight percent of all patients were able to achieve orgasm, and 26% were coitally active to some degree. Reasons for decrease or cessation of coitus were loss of potency among 77% and 96% respectively (p = 0.04), while those reporting decreased libido (29%), partner refusal (13%), and feeling less sexually attractive (20%) showed no between-group differences. Regression analysis showed no influence of type of operation, while age above 68 years influenced orgasmic ability and coital activity, and radiation treatment influenced whether the patient felt less sexually attractive than before surgery.
开展了一项问卷调查研究，以比较采用尿道Kock贮尿囊或回盲部贮尿囊进行膀胱切除及膀胱替代术后的性学问题，以及回肠代膀胱术后的性学问题。共有76例男性膀胱癌患者完成了问卷调查：49例行膀胱替代术，27例行回肠代膀胱术。中位随访时间分别为1.3年（范围0.5 - 6.4年）和4.8年（范围2.4 - 14.7年）。所有患者中只有9%至少能每两次达到一次勃起，而术前这一比例为82%。所有患者中有38%能够达到性高潮，26%在一定程度上仍有性交活动。性交减少或停止的原因分别是77%和96%的患者出现性功能丧失（p = 0.04），而报告性欲减退（29%）、伴侣拒绝（13%）和感觉性吸引力下降（20%）的患者在组间无差异。回归分析显示手术类型无影响，而68岁以上的年龄影响性高潮能力和性交活动，放疗影响患者是否感觉性吸引力比手术前下降。
