Francisca E A, d'Ancona F C, Meuleman E J, Debruyne F M, de la Rosette J J
Department of Urology, University Hospital Nijmegen, The Netherlands.
J Urol. 1999 Feb;161(2):486-90. doi: 10.1016/s0022-5347(01)61930-x.
We evaluate changes in sexual function in patients treated with high energy transurethral microwave thermotherapy compared to transurethral resection of the prostate.
A total of 147 patients randomized to undergo transurethral microwave thermotherapy or transurethral resection of the prostate were asked to complete a self-administered questionnaire evaluating sexual function before, and 3 and 12 months after treatment. The questionnaire dealt with such items as social status, libido, quality of erection, ejaculation and overall satisfaction of sexual functioning.
There was a statistically significant improvement of micturition in both groups. The improvement in the transurethral prostatic resection group was significantly better than in the transurethral microwave thermotherapy group. Antegrade ejaculation occurred at 3 months following treatment in 27% of the transurethral prostatic resection group compared to 74% of the transurethral microwave thermotherapy group and at 1 year in 37 and 67%, respectively. Significantly more patients undergoing transurethral prostatic resection (36%) had changes in sexual function compared to the transurethral microwave thermotherapy group (17%). The transurethral microwave thermotherapy group was more satisfied with the sex life. Of these patients 55% graded sex as very satisfying compared to 21% in the transurethral prostatic resection group. The severity of symptoms was not correlated with sexual function in this study. In general, older patients had sexual dysfunction more often, while younger patients had pain during sexual activities more frequently.
Although clinically less effective, high energy transurethral microwave thermotherapy is a better therapeutic option than surgery for patients who want to preserve sexual function. In particular ejaculation is often preserved after transurethral microwave thermotherapy while there is significant deterioration following transurethral prostatic resection. In general, older patients have greater sexual dysfunction.
我们评估与经尿道前列腺切除术相比，接受高能经尿道微波热疗的患者性功能的变化。
总共147名随机接受经尿道微波热疗或经尿道前列腺切除术的患者被要求在治疗前、治疗后3个月和12个月完成一份自我管理的评估性功能的问卷。问卷涉及社会地位、性欲、勃起质量、射精及性功能总体满意度等项目。
两组患者排尿情况均有统计学意义上的显著改善。经尿道前列腺切除术组的改善明显优于经尿道微波热疗组。经尿道前列腺切除术组在治疗后3个月有27%出现顺行射精，而经尿道微波热疗组为74%；1年后分别为37%和67%。与经尿道微波热疗组（17%）相比，接受经尿道前列腺切除术的患者性功能出现变化的比例显著更高（36%）。经尿道微波热疗组对性生活更满意。在这些患者中，55%将性生活评为非常满意，而经尿道前列腺切除术组为21%。在本研究中，症状严重程度与性功能无关。一般来说，老年患者性功能障碍更常见，而年轻患者性活动时疼痛更频繁。
尽管在临床上效果较差，但对于希望保留性功能的患者来说，高能经尿道微波热疗是比手术更好的治疗选择。特别是经尿道微波热疗后射精功能常得以保留，而经尿道前列腺切除术后则会显著恶化。一般来说，老年患者性功能障碍更严重。
