前列腺电切对前列腺增生症患者下尿路症状和性功能的影响

目的 评估前列腺电切治疗前列腺增生症(BPH)患者下尿路症状(LUTS)和勃起功能障碍(ED)的疗效.方法 选择96例BPH合并ED患者,予以前列腺电切治疗.采用国际前列腺症状评分(IPSS)、国际勃起功能障碍症状评分(IIEF-5)来评估治疗前后的疗效.结果 患者治疗前后的IPPS评分比较,差异有统计学意义(P＜0.05),患者治疗前后的IIEF-5评分比较,差异无统计学意义(P＞0.05).结论 前列腺电切可有效治疗前列腺增生症的LUTS,但对ED无明显改善.     

良性前列腺增生症与阴茎勃起功能障碍的相关性研究

目的探讨良性前列腺增生症(BPH)与阴茎勃起功能障碍(ED)的相关性。方法应用勃起功能国际问卷表(IIEF-5)对符合入选条件的BPH患者进行评估,根据IIEF-5评分值表,将BPH患者分为正常、轻、中、重度ED4组,比较4组之间的国际前列腺增生症状评分(IPSS)、最大尿流率Qmax、前列腺体积之间的差异,应用方差分析探讨其内在的联系。结果共收集BPH患者80例,年龄52~91岁,平均71.4岁。其中勃起功能正常者6例,轻、中、重度ED的患者分别为20例、22例、32例,ED的发病率高达93%。4组之间的IPSS分别为:16.67±2.73,21.6±7.89,21±7.40,23.06±6.78,Qmax分别为:12.37±1.50,8.91±7.67,7.60±4.60,8.94±4.63,前列腺体积分别为:34.53±8.06,76.61±27.72,91.93±43.37,71.14±35.98,应用SPSSversion.13.0软件包行方差分析,前列腺体积正常组与轻、中、重3组比较,存在着统计学差异;IPSS评分仅正常组与重度ED组间有统计学差异(P<0.05);而各组间Qmax比较未见统计学差异(P>0.05)。结论BPH患者伴有较高的ED发生率,且ED的程度与下尿路症状的严重程度和前列腺体积有一定的关联。     

良性前列腺增生症与勃起功能障碍的相关性研究

目的 研究中老年男性的下尿路症状(LUTS)与良性前列腺增生(BPH)及勃起功能障碍(ED)的相关性.方法 收集2006年1月至2008年2月在我院治疗的良性前列腺增生患者86例.对所有病例进行病史采集并进行统计学分析.结果 86例患者的ED患病率为68.60%.三个年龄组中ED的患病牢随着年龄的增加而升高.ED患病率随着LUTS程度的加重而逐渐升高.IPSS评分和残余尿量相关性良好(r=0.818,P<0.001);年龄和IIEF-5评分之间相关性良好(r=-0.688,P<0.001);IPSS评分和IIEF-5评分之间相关性良好(r=-0.686,P<0.001).控制年龄后进行统计分析,发现IPSS评分和IIEF-5评分之间仍然有相关性(r=-0.428,P<0.001).结论 前列腺体积和IPSS评分之间有弱相关性.残余尿量和IPSS评分之间相关性良好,说明残余尿量可以作为评价LUTS严重程度的一个重要指标.年龄、IPSS评分和IIEF-5评分的相关性良好,说明年龄和LUTS是ED的影响因素,其中LUTS是BPH引起ED的独立危险因素.     

中老年男性下尿路症状与良性前列腺增生及勃起功能障碍的相关性研究

目的 了解中老年男性下尿路症状(LUTS)与良性前列腺增生(BPH)及勃起功能障碍(ED)之间的相关性.方法 268例50岁以上被调查者行国际前列腺症状评分(IPSS)、生活质量评分(QOL)、国际勃起功能指数评分(IIEF-5),B超测量前列腺体积及残余尿量.并进行统计学分析.结果 IPSS与残余尿量呈高度相关(r＝0.78,P<0.001),IPSS和前列腺体积无相关性(r=0.15,P>0.05).IPSS评分和QOL评分呈高度相关(r=0.88,P<0.001).IIEF-5评分和IPSS评分呈负中度相关(r=-0.62,P<0.001),和前列腺体积无相关性(r=-0.11,P>0.05),年龄呈负弱相关(r=-0.42,P<0.001),IIEF-5评分和残余尿量呈负弱相关(r＝-0.53,P<0.001).三个年龄组(50～59岁,60～69岁,70岁以上)ED发病率分别为40.0%、66.67%、90.08%,不同程度LUTS患者ED发病率分别为37.5%、62.02%、91.48%.三组之间差异有统计学意义(P<0.05).控制年龄因素后仍发现IPSS评分和IIEF-5评分负相关(r=-0.53,P＜0.0001).结论 LUTS与前列腺体积无相关性,与QOL呈高度相关.IIEF-5和年龄及LUTS呈负相关,说明年龄、LUTS是ED的危险因素.且LUTS的严重程度和ED的发展密切相关.     

他达拉非治疗继发于良性前列腺增生下尿路症状的研究进展

他达拉非作为新一代的选择性磷酸二酯酶-5抑制剂(PDE5Is)为男性勃起功能障碍(ED)的治疗带来了全新的理念。继发于男性良性前列腺增生症(BPH)的下尿路症状(LUTS)由于其病因的复杂性,治疗效果受到多因素的影响,使得传统的临床治疗方法不可避免地存在各种难以预测的并发症。目前日益受到关注的他达拉非每日一次口服方案(OAD)治疗ED的新方案在临床研究中表现出了对继发于BPH的LUTS的显著的疗效,在治疗的早期,国际前列腺症状评分(IPSS)就得以显著改善。还有研究表明在同时存在ED和LUTS症状的BPH患者中,他达拉非也显著有效。本文旨在回顾PDE5Is对BPH相关症状治疗的相关研究进展,综述他达拉非治疗继发于BPH的LUTS的有效性和安全性证据。     

西地那非改善ED合并BPH患者勃起功能及下尿路症状

为评价枸橼酸西地那非对同时存在勃起功能障碍（ED）和良性前列腺增生症（BPH）相关性下尿路症状（LUTS）患者的临床疗效，Mc Vary KT等人进行了一项随机双盲研究[J Urol，2007，177（3）：1071—1077]，研究入选45岁及以上369例，IIEF评分≤25分和IPSS≥12分的男性患者，给予患者随机服用西地那非（n=189）或安慰剂（n=180），连续服用12周。评价患者的国际勃起功能评分（IIEF），国际前列腺症状评分（IPSS），良性前列腺增生症相关影响因子，性生活自信度／性关系问卷调查表和勃起功能障碍治疗满意指数评分。     

良性前列腺增生症状参数与性功能关系的临床分析

目的 分析不同程度性功能情况下良性前列腺增生(BPH)症状参数的分布情况,并探讨两者间的相关性.方法 根据国际勃起功能问卷评分表(IIEF-5)和不同的射精功能情况,将BPH患者分为勃起功能正常、轻度、中度和重度障碍4组和射精正常、射精量减少、射精痛或射精不适和早泄4组,分析各组间的下尿路症状(LUTS)、前列腺总体积(TPV)、最大尿流率(Qmax)间的情况,应用方差分析研究各参数间的差异,并探讨两者间的关系.结果 BPH患者165例,年龄53～75岁.144例有勃起功能障碍(ED)(87.27%),140例有射精功能障碍(EjD)(84.85%).研究显示:年龄与性功能关系密切.TPV在IIEF-5评分正常组与重度ED组间比较,差异有统计学意义;IPSS评分在IIEF-5正常组与轻、中、重度ED组间比较,差异有统计学意义.IPSS评分在射精正常组与精液量减少、射精痛或射精不适的组间比较,差异有统计学意义.结论 年龄是性功能障碍的主要因素.BPH患者中ED和EjD的发生率较高.ED的程度与LUTS的严重程度和TPV大小之间有相关性,而不同的射精障碍与LUTS的严重程度也有相关性.     

预置可拆除膀胱颈荷包缝合法耻骨上经膀胱前列腺切除术对性功能的影响

目的 :评价预置可拆除膀胱颈荷包缝合法耻骨上经膀胱前列腺切除术对性功能的影响。　方法 :回顾性研究 2 0 0 0年 1月～ 2 0 0 3年 9月应用预置可拆除膀胱颈荷包缝合法耻骨上经膀胱前列腺切除术治疗的老年良性前列腺增生 (BPH)患者 1 1 0例 ,主要以国际勃起功能指数 5 (IIEF 5 )填写问答表格的方法 ,评价患者手术前后性功能的变化。　结果 :5 8例术前性功能正常者 ,术后 1 2例发生ED(轻度 7例 ,重度 5例 ) ;30例术前有轻度ED者 ,术后 4例发生重度ED ,5例勃起功能恢复 (IIEF 5评分 >2 1分 ) ,2 1例变化不明显 ;2 2例术前重度勃起功能障碍者 ,术后有7例IIEF 5评分增加 ( 4例成轻度 ,3例 >2 1分 )。手术前后IIEF 5评分差异无显著性 (P >0 .0 5 )。术前 6 8%的患者有晨间阴茎勃起 ,术后为 75 % (P >0 .0 5 )。 1 6例出现逆行射精 ,发生率约为 1 9%。 80 %的患者认为手术本身对性功能无影响。　结论 :预置可折除膀胱颈荷包缝合法耻骨上经膀胱前列腺切除术对性功能的影响少 ,是一种治疗老年男性BPH的安全的重要手段     

681例中老年男性下尿路症状与勃起功能障碍调查

目的 了解中老年男性人群中下尿路症状(LUTS)与勃起功能障碍(ED)的患病率，并且从流行病学角度评估年龄、下尿路症状严重度及ED严重度之间相关性。方法 在2002年9—10月对定点本院的高干高知年度体检中，对50岁以上中老年男性人群作国际前列腺症状评分(IPSS)，生活质量评分(QoL)，国际勃起功能指数评分(IIEF-5)调查。另外，对每个调查对象必须完成直肠指检，对资料完整的681例所有资料做统计学分析。结果 在681名调查对象中，50～59岁，60～69岁，70岁以上3个年龄组中，中重度LUTS(IPSS≥8)发病率分别为19．0％，32．2％，39.8％；而ED患病率分别为82．6％，87．9％，96.6％：ED在轻度LUTS(IPSS为0～7)，中度LUTS(IPSS为8～19)，重度LUTS(IPSS为20～35)3组中患病率分别为71．8％，92，4％，96，4％，3组之间有显著性差异。结论 本研究结果表明，LUTS与ED在上海市高于高知老年男性中有很高的患病率，并随年龄增长而上升，LUTS严重程度会影响ED的患病率。     

肾虚血瘀型良性前列腺增生患者勃起功能及生活质量的临床研究

目的:探讨良性前列腺增生(BPH)患者勃起功能及生活质量、健康状况的影响,为临床制定诊疗方案提供参考。方法:选择91例50～69岁有中度以上下尿路症状(LUTS)的中医辨证为肾虚血瘀证BPH患者,进行国际前列腺症状评分(IPSS)、国际勃起功能指数评分(IIEF-5)、生活质量评分(QOL)、生活质量调查问卷(ERTC QLQ-C30,3.0版本)等问卷调查,同时检测血清总睾酮(TT),并进行统计学分析。结果:随着年龄增长,前列腺增生程度、勃起功能障碍(ED)的发病率均呈现增高的趋势,IIEF-5评分60～69岁组明显低于50～59岁组(P0.05),但ED发病率比较差异无统计学意义(P0.05)。不同前列腺的体积,IIEF-5评分的有一定程度的差异,Ⅲ度增生与Ⅰ度比较差异有统计学意义(P0.05)。不同程度LUTS的BPH患者IIEF-5评分差异均有统计学意义(P0.01或P0.05),但ED的发病率相近(P0.05)。本组患者无论有无ED,其TT水平均在正常范围,但轻度ED及无ED患者的整体健康状况(Q29)、整体生活质量(Q30)及QOL均优于中、重度患者(均P0.01)。结论:BPH不仅是中老年男性引起LUTS的因素,并且可增加患者ED的发生风险,而且BPH及LUTS的加重,ED呈现加重趋势,ED与TT无明显相关,ED可能是影响BPH患者的生活质量及健康水平的重要因素,临床诊疗时应综合分析患者情况制定更好的治疗方案。     

An open, comparative, multicentre clinical study of combined oral therapy with sildenafil and doxazosin GITS for treating Chinese patients with erectile dysfunction and lower urinary tract symptoms secondary to benign prostatic hyperplasia

This study sought to investigate the clinical efficacy and safety of combined oral therapy with sildenafil and doxazosin GITS compared to sildenafil monotherapy in treating Chinese patients with erectile dysfunction (ED) and lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH/LUTS). The trial was conducted in hospitals in Beijing, Shanghai, Changsha, Wuhan and Guangzhou, five major cities in China. A total of 250 patients diagnosed with ED and BPH/LUTS aged 50-75 years, and who had International Index of Erection Function-5 (IIEF-5) scores ≤21 and International Prostate Symptom Score (IPSS) ≥10 points, were enrolled and randomly divided into Group A (168 cases; doxazosin GITS 4 mg once daily plus sildenafil 25-100 mg on demand) and Group B (82 cases; sildenafil 25-100 mg on demand). Efficacies were evaluated by IIEF-5 and IPSS scores and a quality of life (QoL) questionnaire, and adverse effects were evaluated during the treatment period. There were no statistically significant differences in mean age, and IIEF-5, IPSS and QoL scores pre-treatment between the two groups. After treatment, IIEF-5, IPSS and QoL scores were significantly improved in Group A, while only IIEF-5 scores were significantly improved in Group B compared with pre-treatment. There were no significant differences in side effects between the two groups. The results indicated that combined therapy with sildenafil and doxazosin GITS for the treatment of ED and BPH/LUTS is safe and effective compared to sildenafil monotherapy.     

Association between ED and LUTS in Japanese motorcyclists

Recently, the association between motorcycling and erectile dysfunction (ED) has been reported. Also, lower urinary tract symptoms (LUTS) were reported to be associated with ED. The aim of this study is to evaluate the association of ED with LUTS in motorcyclists. We investigated the prevalence and the status of ED using a 5-item version of the International Index of Erectile Function (IIEF-5) in 150 motorcyclists. ED was diagnosed when the IIEF-5 score was less than 17. The International Prostate Symptom Score (IPSS) was also applied, and the relationship between IIEF-5 and IPSS was evaluated. Of the 150 motorcyclists, 37 (25%) had ED, and 31 (21%) had moderate or severe symptoms of LUTS (IPSS >or=8). The IIEF-5 was significantly associated with the severity of IPSS (P=0.002) and age (P<0.0001). The IIEF-5 was also significantly associated with the scores of both voiding (P<0.0001) and storage symptoms (P=0.001). On stepwise logistic regression analysis, age and storage symptoms are independent risk factors for ED in motorcyclists. LUTS seemed to be associated with ED in motorcyclists.     

伴有下尿路症状的良性前列腺增生患者勃起功能状况及坦索罗辛的干预研究

目的:研究伴有下尿路症状(LUTS)的良性前列腺增生(BPH)对患者性功能的影响及坦索罗辛干预的效果。方法:192例典型的伴有LUTS的BPH患者治疗前进行国际前列腺症状评分(IPSS)、生活质量评分(QOL)、勃起功能障碍国际问卷5(IIEF-5)调查,同时检测最大尿流率(Qm ax)。然后随机分两组,治疗组(103例)给予坦索罗辛0.2 mg,对照组(89例)应用安慰剂,1次/d,疗程8周。分析治疗前不同因素对性功能的影响和治疗后LUTS及性功能改善情况。结果:192例患者治疗前IPSS评分3~32(20.20±6.81)分,QOL评分0~6(4.51±0.76)分,Qm ax 8~30(9.6±8.79)m l/s,IIEF-5评分1~24(9.80±8.62)分。勃起功能障碍(ED)发生率75%(144/192)。统计学显示:IPSS和IIEF-5有明显的相关性(r=-0.312,P<0.001)。年龄与IPSS和IIEF-5均有明显的相关性(r=0.203,P<0.005和r=-0.571,P<0.001)。对照组治疗后各项指标变化差异无显著性,治疗组治疗后各项指标较治疗前有明显改善(P<0.001),好于对照组(P<0.001)。结论:年龄和LUTS是性功能障碍的危险因素,LUTS的严重程度与性功能障碍的发展密切相关。坦索罗辛在改善LUTS的同时可明显改善患者的性功能状况。     

症状性良性前列腺增生患者的性功能调查

目的:调查伴有下尿路症状(LUTS)的良性前列腺增生(BPH)患者治疗前性功能障碍的程度,并分析性功能障碍与LUTS、年龄的相关性。方法:88例具有典型LUTS的BPH患者,年龄49~86(67.90±7.59)岁。所有患者均进行了国际前列腺症状评分(IPSS)、勃起功能障碍国际问卷-5(IIEF-5)、简明性功能问卷(BSFI)调查,并同时检测尿流率、前列腺总体积和血清睾酮。应用多元逐步回归分析方法和一元相关回归分析评价各检测变量间的相关性。结果:本组患者IPSS评分2~33(18.4±7.79)分。IIEF-5评分1~25(8.50±8.98)分,其中勃起功能障碍(ED)患者76例(86.36%)。BSFI中性欲部分评分0~8(1.92±2.21)分,其中性欲低下患者65例(72.86%);勃起功能部分评分0~16(4.18±4.96)分,其中ED患者70例(79.55%);射精部分评分0~8(2.55±3.57)分,其中射精障碍患者60例(68.18%);问题部分评分0~12(10.44±3.57)分;满意度部分评分0~4(1.90±1.37)分。统计学分析表明:年龄只与BSFI中勃起功能有显著的相关性(γ=-0.552,P=0.000),同样IIEF-5与年龄有显著的相关性(γ=-0.567,P=0.000),IPSS评分与年龄有显著的相关性(γ=0.213,P=0.047)。IPSS评分与BSFI中勃起功能和满意度有显著的相关性(γ=-0.332,P=0.002;γ=-0.302,P=0.005)。IIEF-5与BSFI中性欲、勃起功能和射精部分评分具有一致的相关性(P<0.05)。血清睾酮与年龄、IIEF-5和BSFI评分间无明显相关性(P>0.05),同样最大尿流率和前列腺总体积与IPSS、IIEF-5和BSFI评分间无明显相关性(P>0.05)。结论:年龄和LUTS是性功能障碍的危险因素,LUTS的严重程度与性功能障碍的发展密切相关。     

The effectiveness of sildenafil citrate in patients with erectile dysfunction and lower urinary system symptoms and the significance of asymptomatic inflammatory prostatitis

We evaluated the effectiveness of sildenafil citrate on lower urinary system symptoms (LUTS) by using symptom score scales. We also evaluated whether or not the presence of asymptomatic inflammatory prostatitis had an effect on the alteration in the symptom scores. A total of 36 male patients were included in the study. For all the cases, 'International Prostate Symptom Score' (IPSS), 'National Health Institute Chronic Prostatitis Symptom Index' (NIH-CPSI) and 'International Index of Erectile Function' (IIEF-5) were investigated and the scores were calculated in the first visit. Sildenafil citrate was given for 30 days and at the second visit IPSS, NIH-CPSI and IIEF-5 scores were once more analyzed. Afterwards, the alterations of the scores between visits were statistically compared. Mean age of the 36 cases included in the study was 59.03±1.35. When the alterations in parameters of first visit and second visit were evaluated, we found a statistically significant increase in IIEF-5 and a statistically significant decrease in IPSS, IPSS-QOL (Quality of Life). In addition, when the cases were divided into two groups with and without asymptomatic inflammatory prostatitis, in the cases with asymptomatic inflammatory prostatitis, sildenafil citrate caused improvement only in ED, but had no effect on LUTS. Sildenafil citrate use in cases with LUTS and ED has an improving effect on LUTS as well as ED. However, in cases with asymptomatic inflammatory prostatitis, sildenafil citrate did not lead to an improvement in LUTS.     

男性下尿路症状和勃起功能障碍的相关性分析

目的:了解社区年龄≥50岁男性人群中有下尿路症状(LUTS)者ED的患病情况,评估LUTS(梗阻症状、刺激症状)和ED之间的相关性。方法:2006年10～11月对社区年龄≥50岁、有固定性伴侣的男性进行IPSS、IIEF-5调查,调查对象均签署知情同意书,完成规定问诊及相关检查,应用统计学方法对IPSS评分、梗阻症状评分以及刺激症状评分与勃起功能之间的相关性进行分析。结果:共调查245例,171例有LUTS患者中ED患病率为81.9%(140/171),无LUTS患者74例作为对照组,ED患病率为29.7%(22/74)。LUTS组中各年龄组ED的患病率分别为:50～59岁73.1%(38/52)、60～69岁82.1%(46/56)、≥70岁88.9%(56/63),各年龄组之间IPSS、IIEF-5比较差异有显著性(P<0.01),各年龄组之间轻、中、重度ED所占比例比较差异有显著性(P<0.01)。LUTS组中IPSS评分程度分布:轻度80例(46.8%)、中度67例(39.2%)、重度24例(14.0%),不同程度LUTS中ED者所占比例分别为:轻度LUTS71.3%(57/80)、中度LUTS89.6%(60/67)、重度LUTS95.8%(23/24),LUTS程度和ED患病率之间有显著相差性(r=0.52,P<0.01)。171例平均梗阻症状评分(3.1±3.6)分,梗阻症状与IIEF-5评分相关系数r=-0.41(P<0.01),平均刺激症状评分(6.8±4.9)分,刺激症状与IIEF-5评分相关系数r=-0.59(P<0.01)。结论:社区LUTS人群中ED有较高的患病率,LUTS程度和ED患病率显著性正相关,与梗阻症状相比刺激症状对中老年男性性生活的影响更大。在治疗LUTS的同时应该考虑ED问题,以求更有效改善患者生活质量。     

Are lower urinary tract symptoms associated with erectile dysfunction in aging males of Taiwan?

INTRODUCTION: This study was conducted to evaluate the relationship between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) in aging males of Taiwan. PATIENTS AND METHODS: A free health screening for aging males (>or=45 years old) was conducted in Kaohsiung Medical University Chung-Ho Memorial Hospital in August 2004. LUTS and ED were assessed by validated symptom scales: the International Prostate Symptom Score (IPSS) and the International Index of Erectile Function-5 (IIEF-5). The subjects also completed a health and demographics questionnaire and underwent detailed physical examination, serum prostate-specific antigen level determination, and transrectal ultrasonography. RESULTS: The final study population consisted of 141 patients with a mean age of 59.8 years. The severity of LUTS and ED increased with age. After controlling for comorbidities, age (p<0.001) and IPSS score (p<0.001) were significantly associated with the IIEF-5 score. Furthermore, men with moderate to high IPSS scores were more likely to have ED as compared with those with mild symptoms after age adjustment (age-adjusted odds ratio 3.27, p=0.002). CONCLUSIONS: ED and LUTS are highly prevalent in our study population, and this prevalence increases with age. ED is significantly associated with the severity of LUTS after controlling for age and comorbidities. These results highlight the clinical importance of evaluating LUTS in patients with ED and the need to consider sexual issues in the management of patients with benign prostatic hyperplasia.     

Relationships between lower urinary tract symptoms, the bother they induce and erectile dysfunction

OBJECTIVE: To study the relationships between lower urinary tract symptoms (LUTS), LUTS-induced bother, age and erectile dysfunction. MATERIAL AND METHODS: A survey consisting of two questionnaires, the International Prostate Symptom Score (IPSS) (reflecting LUTS) and the International Index of Erectile Function (IIEF)-5 (reflecting erectile function), together with instructions on how to perform timed micturition, was sent to 2000 randomly selected men (age range 60-70 years) living in the five counties surrounding our hospital. The IPSS questionnaire included a question concerning the degree of bother induced by LUTS. RESULTS: The survey was answered by 1096 men; after the exclusion of incomplete answers, 924 surveys were evaluated. Of these 924 men, 725 (78%) were sexually active and included in the analyses. The prevalence of moderate-to-severe LUTS (IPSS>or=8) was 45%. The prevalence of erectile dysfunction (ED), defined as an IIEF-5 score of 相似文献   

Erectile dysfunction after transurethral prostatectomy for lower urinary tract symptoms： results from a center with over 500 patients

Aim:To identify possible risk factors for erectile dysfunction(ED)after transurethral resection of prostate(TURP)for benign prostatic hyperplasia(BPH).Methods:Between March 1999 and March 2004,629 patients underwentTURP in our department for the treatment of symptomatic BPH.All patients underwent transrectal ultrasoundexamination.In addition,the flow rate,urine residue,International Prostate Symptom Score(IPSS)and quality of life(QOL)were recorded for those who presented without a catheter.Finally,the erectile function of the patient wasevaluated according to the International Index of Erectile Function Instrument(IIEF-5)questionnaire.It was deter-mined that ED existed where there was a total score of less than 21.The flow rate,IPSS and QOL assessment wereperformed at 3 and 6 months post-treatment.The IIEF-5 assessment was repeated at a 6-month follow-up.A logisticregression analysis was used to identify potential risk factors for ED.Results:At baseline,522(83%)patientsanswered the IIEF-5 questionnaire.The mean patient age was(63.7±9.7)years.The ED rate was 65%.After 6months,459(88%)out of the 522 patients returned the IIEF questionnaire.The rest of the group was excluded fromthe statistical analysis.Six months after TURP,the rate of patients reporting ED increased to 77%.Statisticalanalysis revealed that the only important factors associated with newly reported ED after TURP were diabetes mellitus(P=0.003,r=3.67)and observed intraoperative capsular perforation(P=0.02,r=1.12).Conclusion:Theincidence of postoperative,newly reported ED after TURP was 12%.Risk factors for its occurrence were diabetesmellitus and intraoperative capsular perforation.(Asian J Androl 2006 Jan;8:69-74)     

Longitudinal changes in erectile function after thulium:YAG prostatectomy for the treatment of benign prostatic obstruction: a 1-year follow-up study

This study aimed to evaluate the impact of thulium:yttrium-aluminum-garnet (Tm:YAG) (RevoLix®) laser prostatectomy for the treatment of benign prostatic obstructions on erectile function (EF). A total of 208 patients who underwent Tm:YAG laser prostatectomies participated in this study. All cases were evaluated preoperatively and at 3, 6, and 12 months postoperatively using the International Prostate Symptom Score (IPSS), quality of life (QoL) score, and the International Index of Erectile Function (IIEF-5) questionnaires. Patients were divided into groups A (severe erectile dysfunction [ED]), B (moderate ED), and C (mild-to-normal ED), according to their IIEF-5 scores. The median patient ages were 69, 65, and 62 years in groups A, B, and C, respectively. Significant improvements occurred in the IPSS and QoL score within the groups during the 12-month follow-up period. The IIEF-5 scores at 3 months postoperatively were lower than the preoperative scores in groups B and C. The IIEF-5 scores subsequently improved during the 12-month follow-up period. The slope of the relationship between the IIEF-5 score and the time since Tm:YAG laser prostatectomy had a ß value of 0.2210 (95% confidence interval 0.103 to 0.338, p = 0.0003); hence, each postoperative month was associated with an increase of 0.2210 in the IIEF-5 score. The IIEF-5 scores gradually increased and reached the preoperative levels by the 12-month follow-up assessment. Although the IIEF-5 score dropped significantly during the first 3 months postoperatively, it improved over the following 12 months. Tm:YAG laser prostatectomy did not impact on EF ultimately.