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131名良性前前列腺增生患者前列腺切除术前的性功能
OBJECTIVE: The aim of the present study was to ascertain
the frequency of sexual dysfunction in patients with benign prostatic
hyperplasia (BPH) before prostatectomy. METHODS: The study population
included 131 patients aged 55-74 years (mean 61.4+/-2.7) with BPH.
The patients had been complaining of daytime urgency and nocturia
for the last 1-14 years (average 4.5+/-1.5 years). The diagnosis of
BPH was based on the anamnestic data, the International Prostate Symptom
Score (IPSS(0-35)) and quality of life assessment (L(0-6)), and results
of digital rectal examination, transrectal ultrasound, and uroflowmetry.
Sexual dysfunction was determined by retrospective analysis of the
psychosexual history (with and separately from the spouse), penile
brachial index (PBI), nocturnal penile tumescence (NPT), and blood
hormone levels (testosterone). RESULTS: The patients were divided
into two groups by severity of the urinary disorder: group I, severe
(IPSS(0-35)-L(6); n = 70); and group II, mild relative to group I
(IPSS(32-34)-L(4-5); n = 61). In group I, 15 patients (21.4%) performed
normal coitus, 24 (34.2%) had weak coitus with incomplete penetration,
and 21 (44.2%) had unsuccessful coitus because of a weak erection.
In group II, 28 patients (45.9%) had normal coitus, 25 (40.9%) incomplete
penetration, and 8 (13.1%) unsuccessful coitus. There was no significant
correlation between sexual function and the patients' general health
condition. The quantitative assessment of sexual dysfunction yielded
the following results in groups 1 and 2, respectively: negative NPT
in 32.4+/-1.8 and 24.4+/-2.1% (p<0.05); PBI <0.6 in 33.4+/-1.7
and 22.3+/-1.2% (p<0.001); and testosterone decrease to <12
nmol/l in 36.4+/-1.2 and 28.5+/-1.2% (p<0.05), respectively. The
differences between the groups were significant (p<0.05) for all
three parameters. CONCLUSIONS: Considering the 44. 2% rate of unsuccessful
coitus in the patients with a severe urinary dysfunction compared
to only 13.1% in those with a milder dysfunction and the significant
correlation between severe urinary dysfunction and measures of sexual
dysfunction, we suggest that BPH may be a risk factor for sexual dysfunction.
【引自Eur Urol 2000 Jul;38(1):53-8】 |
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