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目的:探讨经尿道2微米铥激光剥橘式前列腺切除术(2-micronTmLRP-TT)治疗良性前列腺增生症对患者术后性功能的影响。方法:采用2-micronTmLRP-TT治疗BPH患者36例,记录患者最大尿流率、剩余尿量、国际前列腺症状评分、生活质量评分等指标。应用国际勃起功能指数问卷-5记录患者勃起情况并调查包括性欲、逆行性射精情况等,对手术前、后的性功能状况进行分析比较。结果:随访获得完整资料33例,随访率91.6%(33/36)。术前性功能正常的患者29例,术后患者均保留性欲和满意的性生活。术前IIEF-5评分(21.0±5.8),术后评分(19.3±6.1),两者比较差异无统计学意义。术后阴茎勃起硬度下降者占6.9%(2/29),与术前比较差异无统计学意义(P>0.05)。术后精液量明显减少者占41.4%(12/29),发生逆行性射精者占55.2%(16/29),晨间勃起次数增加者占10.3%(3/29),与术前比较差异均有统计学意义(P<0.05)。结论:2-micronTmLRP-TT治疗BPH切割精准,出血少,恢复快,并发症少,安全性高。除了精液量减少、逆行性射精外对性功能的影响较小;少数患者晨间勃起有所改善。
Objective: To investigate the effect of transurethral 2 μm 铥 laser tangerinectomy (2-micronTmLRP-TT) on postoperative sexual function in patients with benign prostatic hyperplasia (BPH). Methods: Thirty-six patients with BPH were treated with 2-micronTmLRP-TT. The maximum urinary flow rate, residual urine volume, International Prostate Symptom Score and Quality of Life score were recorded. The International Erectile Function Index Questionnaire-5 records the patient’s erection and investigates the situation including sexual desire and retrograde ejaculation. The status of sexual function before and after surgery is analyzed and compared. Results: 33 cases were followed up for complete information, with a follow-up rate of 91.6% (33/36). Twenty-nine patients had normal preoperative sexual function, and all patients had sexual desire and satisfactory sex after operation. Preoperative IIEF-5 score (21.0 ± 5.8), postoperative score (19.3 ± 6.1), there was no significant difference between the two groups. Postoperative erectile stiffness decreased by 6.9% (2/29), with no significant difference compared with preoperative (P> 0.05). Postoperative ejaculation volume was significantly decreased in 41.4% (12/29), retrograde ejaculation accounted for 55.2% (16/29), morning erectile dysfunction accounted for 10.3% (3/29), compared with the preoperative difference All were statistically significant (P <0.05). Conclusion: 2-micronTmLRP-TT for BPH is accurate, less bleeding, faster recovery, fewer complications and high safety. In addition to reduced semen volume, retrograde ejaculation had less effect on sexual function; a minority of patients had improved morning erectile function.