经尿道1.94 μm铥激光前列腺剜除术对良性前列腺增生患者性功能的影响

Effects of prostatic hyperplasia on sexual function in patients with benign prostatic hyperplasia by transurethral 1.94 μm enucleation of prostate

摘要:

目的 探讨应用1.94 μm铥激光行经尿道前列腺剜除术对良性前列腺增生（BPH）患者性功能的影响。方法 选取2015年5月－2019年6月该院收治的BPH患者120例，随机分为观察组和对照组。观察组60例，行经尿道1.94 μm铥激光前列腺剜除术；对照组60例，行经尿道前列腺等离子体双极电切术（TUPKP）。对比分析两组患者术前和术后6个月的国际勃起功能指数评分问卷表-5（IIEF-5）、国际前列腺评分（I-PSS）、残余尿量（PVR）、最大尿流率（MFR Qmax）、医院焦虑抑郁量表（HADS）、男性性健康调查问卷-射精功能障碍评分（MSHQ-EjD）和生活质量评分（QOL）等相关指标。结果 两组患者术后I-PSS评分分别为（7.24±2.65）和（7.10±3.46）分，两组比较，差异无统计学意义（P > 0.05）；但两组术后与术前比较，差异均有统计学意义（P < 0.05）。两组患者术后PVR、MFR Qmax和QOL评分比较，差异均无统计学意义（P > 0.05），但两组术后与术前比较，差异均有统计学意义（P < 0.05）。两组患者术后IIEF-5评分分别为（14.27±2.84）和（15.88±3.05）分，组间比较，差异有统计学意义（P < 0.05）；观察组术后与术前IIEF-5评分比较，差异有统计学意义（P < 0.05）。两组患者术后HADS焦虑评分（HADS-A）分别为（7.47±3.12）和（7.61±3.15）分，组间比较，差异无统计学意义（P > 0.05）；但两组术后与术前比较，差异有统计学意义（P < 0.05）。两组患者术后MSHQ-EjD评分和HADS抑郁评分（HADS-D）与术前比较，差异均无统计学意义（P > 0.05）。结论 经尿道1.94 μm铥激光前列腺剜除术与TUPKP均能明显改善BPH患者因前列腺增生引起的排尿不畅等下尿路症状，但1.94 μm铥激光具有更高效和对性功能影响更小的优势。

Abstract:

Objective To analyze the effects of f prostatic hyperplasia on sexual function in patients with benign prostatic hyperplasia (BPH) by transurethral enucleation of the prostate.Methods 120 patients with BPH treated during May 2015 and June 2019 were included in our study according to the inclusion criteria and randomly divided into observation group (60 cases treated with ThuLEP) and control group (60 cases treated with TUPKP). Compare and analysis the international index of erectile function-5 (IIEF-5), International prostate symptom score (I-PSS), postvoid residual urine (PVR), maximum flow rate (MFR Qmax), hospital anxiety and depression scale (HADS), male sexual health questionnair ejaculatory dysfunction (MSHQ-EjD) and quality of life score (QOL) before and 6 months after surgery.Results The I-PSS of the control group and the observation group were (7.24 ± 2.65) and (7.10 ± 3.46), and there were no significant difference between the two groups (P > 0.05), but there were statistically significant differences between the two groups after operation and before operation. There were no statistically differences in PVR, MFR Qmax, and QOL between the two groups, but there were statistically significant difference between the two groups before surgery and after surgery. The IIEF-5 of the control group and the observation group were (14.27 ± 2.84) and (15.88 ± 3.05), there were statistically significant differences (P < 0.05). The scores of the observation group after surgery were also improved than that of before surgery (P < 0.05). The anxiety scores of HADS-A were (7.47 ± 3.12) and (7.61 ± 3.15) in two groups after surgery, and there were no statistically difference between the two groups (P > 0.05), but there were significantly significant difference between the two groups after surgery and before surgery. There were no difference between the two groups in male sexual health questionnair ejaculatory dysfunction (MSHQ-EjD) and depression score (HADS-D) before and after surgery.Conclusion Although ThuLEP and TUPKP can significantly improve BPH patients with poor urination and lower urinary tract symptoms caused by BPH, but the ThuLEP with 1.94 μm laser can be higher efficiency and less impact on sexual function.