经尿道输尿管镜碎石术后无管化技术对男性性功能的影响

Impact of tubeless technique on male sexual function after transurethral ureteroscopic lithotripsy

摘要:

目的 探讨经尿道输尿管镜碎石术后无管化技术对男性性功能的影响。方法 选取2023年1月－2023年6月于该院行经尿道输尿管镜碎石的82例男患者作为研究对象，术前采用抽签法随机分为两组，39例碎石术后未留置双J管的男性患者作为无管化组，43例术后留置双J管的男性患者作为留置组。比较两组患者术后并发症（腰痛、血尿、膀胱刺激征和发热）情况；统计两组患者术前、术后1个月（留置组拔管前）、术后3个月和术后6个月的国际勃起功能指数问卷表-5（IIEF-5）评分、性生活质量调查表（SLQQ）评分和早泄诊断工具（PEDT）评分。结果 与留置组比较，无管化组术后1个月腰痛、血尿和膀胱刺激征明显减少，差异均有统计学意义（P < 0.05），但两组患者术后发热比较，差异无统计学意义（P > 0.05）。两组患者术前、术后3个月和术后6个月IIEF-5评分、SLQQ评分和PEDT评分比较，差异均无统计学意义（P > 0.05）。无管化组术后1个月IIEF-5评分和SLQQ评分明显高于留置组，PEDT评分明显低于留置组，差异均有统计学意义（P < 0.01）；无管化组组内不同时点IIEF-5评分、SLQQ评分和PEDT评分比较，差异均无统计学意义（P > 0.05）。留置组术后1个月IIEF-5评分和SLQQ评分明显低于术前，PEDT评分明显高于术前，术后3和6个月IIEF-5评分和SLQQ评分明显高于术后1个月，PEDT评分明显低于术后1个月，差异均有统计学意义（P < 0.01）；留置组组内不同时点IIEF-5评分、SLQQ评分和PEDT评分比较，差异均有统计学意义（P < 0.05）。结论 输尿管镜碎石术后无管化技术对男性的性功能影响较小，还能改善患者生活质量，减少腰痛、血尿和膀胱刺激征的发生。值得临床推广应用。

Abstract:

Objective To investigate the impact of tubeless technique on male sexual function after transurethral ureteroscopic lithotripsy.Methods 82 male patients from January 2023 to June 2023 with transethral ureteroscopic lithotripsy were selected as the study objects. Prior to surgery, 39 male patients without double J tube indwelling after lithotripsy were randomly selected as the tubeless group and 43 male patients with double J tube indwelling were selected as the indwelling group by drawing lots. General clinical data and postoperative complications (lumbago, hematuria, irritation sign of bladder and fever) of the two groups were compared. The International Index of Erectile Function-5 (IIEF-5) score, sexual life quality questionnaire (SLQQ) score and premature ejaculation diagnostic tool (PEDT) score of the two groups were statistically analyzed before surgery, 1 month after surgery (before excutation in indwelling group), 3 months and 6 months after surgery.Results Compared with the indwelling group, patients in the tubeless group had significantly fewer cases of lumbago, hematuria, and irritation sign of bladder 1 month after surgery, and the difference was statistically significant (P < 0.05), but there was no significant difference in postoperative fever between the two groups (P > 0.05). There were no statistically significant differences in the IIEF-5 score, SLQQ score and PEDT score between the two groups before the operation, 3 months after the operation and 6 months after the operation (P > 0.05). One month after the operation, the IIEF-5 score and SLQQ score of the tubeless group were significantly higher than those of the indwelling group, while the PEDT score was lower than that of the indwelling group, the differences were statistically significant (P < 0.01). There were no statistically significant difference in the IIEF-5 score, SLQQ score and PEDT score at different time points in the tubeless group (P > 0.05). The IIEF-5 score and SLQQ score of the indwelling group one month after the operation were significantly lower than those before the operation, while the PEDT score was significantly higher than that before the operation, the IIEF-5 score and SLQQ score of the indwelling group 3 and 6 months after the operation were significantly higher than those at 1 month after the operation, and the PEDT score was significantly lower than that at 1 month after the operation, the differences were statistically significant (P < 0.01). There were statistically significant differences in the IIEF-5 score, SLQQ score and PEDT score at different time points in the indwelling group (P < 0.05).Conclusion The tubeless technique after ureteroscopy has a relatively small impact on male sexual function and can significantly improve the quality of life of patients, alleviate lumbago, hematuria and irritation sign of bladder. It is worthy of clinical promotion and application.