慢性前列腺炎患者生活质量临床调查

目的调查慢性前列腺炎(chronic prostatitis,CP)患者生活质量及性生活质量状况并分析影响生活质量及性生活质量的相关因素;方法随机选择CP患者,无记名填写CP症状评分量表(NIH-CPSI)、性功能评价表及年龄、病程等,并进行统计分析。结果CP总症状评分5~35分,平均(20.69±7.02)分;生活质量评分2~12分,平均(8.47±2.49)分;性生活质量总分18~53分,平均(38.79±7.55)分;生活质量评分与前列腺炎症状总分、疼痛及排尿症状评分之间有显著相关性;与性功能总评分、射精潜伏期、射精控制能力、性生活满意度、性生活自信度及性生活焦虑评分之间有显著相关性,与年龄、病程、前列腺液内白细胞及卵磷脂数量无显著相关性。结论CP导致生活质量、性生活质量下降,生活质量下降与患者CP症状、性功能下降、性生活满意度降低及配偶性生活满意度降低有关,生活质量及性生活质量下降与年龄、病程及前列腺液内白细胞及卵磷脂数量无明显相关性。     

慢性前列腺炎患者性功能状况调查

目的 调查慢性前列腺炎(CP)患者性功能状况,探讨CP患者性功能状况及性功能障碍的发病情况.方法 随机抽查CP患者600例.问卷调查患者一般情况①年龄、职业、文化程度、婚姻、病程、EPS检查结果;②国际前列腺炎症状评分表(NIH-CPSI);③勃起功能国际指数的问卷(IIEF-5);④勃起硬度分级;⑤90项症状清单.调查CP患者NIH-CPSI、射精痛情况以及早泄(PE)、勃起功能障碍(ED)、精神症状焦虑、抑郁情况,比较各症状间的相关性,统计不同的发生率.结果 NIH-CPSI与IIEF-5相关性分析中,P值为0.005,有统计学意义.600例患者中,射精痛与ED之间P值为0.000,有统计学意义.ED患病率随患者年龄增大而明显增加.NIH-CPSI与精神症状焦虑相关性P＜0.01,NIH-CPSI与精神症状抑郁相关性P＜0.05,前列腺炎伴随的ED与精神症状焦虑相关性P＜0.05,前列腺炎伴随的ED与精神症状抑郁情况相关性P＜0.01.结论 前列腺炎的各种症状可能是其伴随的性功能障碍原因之一,CP患者的ED患病率随患者年龄增长而明显增加,CP与精神症状(焦虑、抑郁)可能存在相互影响.     

包皮切除术对性功能影响的Meta分析

目的运用Meta分析的方法评估包皮切除手术对男性性功能的影响。方法检索研究包皮切除手术与性功能之间关系的文献,由两名评价员进行质量评价及数据资料提取,应用Rev Man5.3软件进行分析。结果8篇文献纳入研究,共计病例32 469例。Meta分析显示:接受包皮切除手术的患者与未行该手术的患者相比:勃起功能障碍的发生率、性欲减退的发生率、性交困难的发生率、高潮困难的发生率、性生活满意度无显著统计学差异。结论包皮切除手术对患者的性欲、勃起功能、射精功能、性高潮及性生活满意度没有明显的影响。期待更多高质量随机对照试验以进一步证实。     

铥激光剥橘式前列腺切除术对良性前列腺增生患者性功能影响的临床研究

目的:探讨铥激光剥橘式前列腺切除术对良性前列腺增生(BPH)患者性功能的影响。方法:选取我院120例采用铥激光剥橘式前列腺切除术进行治疗且尚有性生活的BPH患者为研究对象,随访并分析患者术前、术后6个月、12个月国际前列腺症状评分(IPSS)、生活质量评分(QOL)、残余尿量(PVR)、最大尿流率(Qmax)指标,使用国际勃起功能指数-5(IIEF-5)评价患者勃起情况,并记录患者射精疼痛、精量减少及逆行射精发生率。结果:术后6、12个月IPSS评分、QOL评分、PVR较术前均显著下降,Qmax较术前显著上升(P0.05);术前和术后6、12个月的IIEF-5评分比较差异无统计学意义(P0.05),勃起功能无明显下降。术后6、12个月精量减少、逆行射精发生率与术前比较差异有统计学意义(P0.05);术后6、12个月射精疼痛发生率与术前比较差异无统计学意义(P0.05)。结论:铥激光剥橘式前列腺切除术对患者性功能的影响较少。铥激光本身属性以及本术式独特的切除方法,对性功能具有一定的保护作用。     

症状性良性前列腺增生对患者配偶生活质量的影响

目的:症状性良性前列腺增生(BPH)引起的下尿路症状(LUTS)及其相关事件不仅影响患者的生活质量,而且影响患者配偶的生活质量。本研究目的是调查手术治疗的症状性BPH患者配偶的生活质量。方法:本组包含50对患者及其配偶,患者经检查符合症状性BPH且准备行手术治疗。患者及其配偶分别自我填写相关问卷,其中患者填写IPSS及BPH影响指数问卷(BPHII),配偶填写包括睡眠、社会活动力、性生活、心理影响、担心前列腺癌、担心前列腺手术、料理家务能力在内的7个问题的问卷,并对相关资料进行统计学分析。结果:患者LUTS可不同程度地造成其配偶睡眠障碍(12%)、社会活动力下降(12%)、性生活衰退(20%)、心理影响(38%)、前列腺癌恐惧(68%)、前列腺手术恐惧(40%)及料理家务能力下降(14%)。但是患者配偶生活质量下降程度与患者IPSS、BPHII评分无相关性(P>0.05)。结论:患者的LUTS及其相关事件在一定程度上降低了其配偶生活质量。但是,患者症状的严重程度与其配偶生活质量无明显相关性。提示症状性BPH患者及其配偶应该了解BPH的相关知识及BPH手术的危险性。     

慢性前列腺炎患者1426例精神障碍调查分析

目的了解慢性前列腺炎(CP)患者精神障碍的患病情况及其相关因素,探讨精神心理因素在CP发病中的作用。方法应用Zung焦虑量表(SAS)和抑郁量表(SDS)、国际前列腺炎症状指数表(NIH-CPSI)、勃起功能指数表(IIEF-5)及自制相关因素调查表对1500例CP患者精神心理状况进行调查。SAS、SDS评分结果与国内正常人测试结果相比较,并分析其与病程、CPSI积分、症状存在时间、性功能状况、年龄、职业、文化程度、前列腺液(EPS)中白细胞数等因素的相关性。结果回收有效问卷1426份(95．07％)。SAS评分42．90±9．67,SDS评分44．24±10．20,均显著高于国内1340名正常人即常模测试结果(SAS 37．23±12．59,SDS 41．88±10．57)(P=0．000)。按SAS≥50、SDS≥53划界,有焦虑症状者337例(23．60%),有抑郁症状者309例(21．7％)。SAS、SDS得分和检出率与病程、CPSI积分、症状存在时间、性功能状况等有相关性(P=0．000),而与年龄、职业、文化程度、EPS中白细胞数无相关性。结论CP患者存在精神心理障碍,并与多种因素有关,精神心理因素在CP发病中具有重要作用。     

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。     

早泄患者临床特点分析

目的:探讨早泄(PE)患者的临床特点。方法:通过问卷式调查表收集128 例PE患者的临床资料,以国际勃起功能评分表(ⅡEF 5)积分少于22分为PE并发勃起功能障碍(ED),进行综合分析。结果:PE患者年龄为(33.1±8.4)岁,病程(3.9±4.0)年,射精潜伏期(1.0±0.6) min。自诉性生活质量差与性生活满意度差的患者分别为83.4%和83.6%。其中,PE并发ED患者42 例(32.8%);原发性PE患者90 例,继发性PE患者38例。两组相比,年龄、婚龄、病程、是否原发、性欲程度、性交频率、射精潜伏期、性生活质量、配偶性生活满意度等差异无统计学意义,ⅡEF 5各项问题及总分差异有统计学意义(P<0.01)。ⅡEF 5 问题2(Q2)和问题3(Q3)分值之和与ⅡEF 5积分明显相关(P<0.01)。通过ROC曲线分析,以<8 分为分界分值区分PE并发ED患者,敏感度92.9%,特异度100%。结论:PE为主诉的患者以射精潜伏期缩短、性生活质量和性生活满意度差为特点;其中PE并发ED患者32.8%,ⅡEF 5积分或其中Q2和Q3分值积分可用来评价PE患者勃起功能。     

前尿道狭窄手术前后性功能状况研究

目的研究前尿道成形术对男性性功能的影响,并分析其影响因素.方法采用简明男性性功能量表(BMSFI)对2010年3月至2011年11月在我院接受前尿道成形术的61例男性前尿道狭窄患者的手术前后性功能状况进行调查分析.结果61例患者术后平均勃起功能评分低于术前(P=0.0033),但术后>1年即恢复至术前水平(P=0.0986);术后射精功能评分较术前明显提高(P=0.0261);性欲和总体满意度评分在手术前后无统计学差异.年龄≥40岁者术后勃起功能评分较术前下降(P=0.0339),<40岁者术后射精功能评分较术前显著提高(P=0.0019).外伤性尿道狭窄患者术后勃起功能评分较术前下降(P=0.0313),射精功能评分则明显提高(P=0.03 1 3).患者接受端端吻合术后勃起功能评分较术前下降(P=0.0332),但射精功能评分较术前提高(P=0.0033);接受移植物替代成形术后同样出现射精功能评分提高(P=0.0192);而接受皮瓣转移成形术后各项评分均无明显变化.狭窄部位与长度对性功能影响的多因素分析表明仅部位对勃起功能有影响(P=0.0214).结论前尿道成形术不影响患者的性欲、勃起功能和总体满意度,但可以明显改善射精功能.年龄、狭窄病因、狭窄部位以及手术方式等都是重要的影响因素.     

症状性良性前列腺增生患者生活质量分析

目的了解伴下尿路症状（LUTS）的良性前列腺增生（BPH）患者的生活质量.方法88例具有典型LUTS的BPH患者,平均年龄68岁.患者治疗前均行国际前列腺症状评分（IPSS）、勃起功能国际问卷（IIEF-5）、简明性功能问卷（BSFI）、焦虑自评量表、老年抑郁量表和BPH影响指数问卷（BII）调查,同时检测尿流率、前列腺体积和血清睾酮.应用多元逐步回归分析方法和一元相关回归分析方法评价各检测变量间的相关性.结果统计学分析显示：年龄与BSFI中勃起功能和IIEF-5有显著相关性（r=-0.552和r=-0.567,P=0.000）,IPSS评分与年龄有显著相关性（r=0.213,P=0.047）,BII与年龄无明显相关性.IPSS评分与BSFI中勃起功能和满意度有显著相关性（r=-0.332,P=0.002;r=0.302,P=0.005）,IPSS与BII间有显著相关性（r=0.420,P=0.000）.BII与抑郁评分间有显著相关性（r=0.426,P=0.002）.最大尿流率、前列腺体积和睾酮与BII评分间无明显相关性.结论LUTS对BPH患者的日常生活、性功能和心理有明显影响,BPH治疗前需重视老年患者的心理和生活质量.     

尿道重建治疗男性尿道狭窄对勃起功能、性生活质量的影响

目的:探讨男性尿道狭窄手术对勃起功能以及性生活质量的影响因素。方法:回顾性分析326例行尿道重建手术男性患者的临床资料,并进行随访,分析年龄、尿道狭窄部位、长度、手术方式、手术次数、狭窄复发对术后勃起功能及性生活质量的影响。结果:共收集172例患者(52.8%)有效数据,平均随访时间28.5个月。手术后勃起功能(P=0.002)、性生活质量评分(P=0.026)较术前明显下降。术前56例(32.6%)患ED,术后88例患ED(51.2%),增加18.6%;术前勃起功能正常116例中有38例(32.8%)术后出现ED。结论:尿道狭窄部位、手术方式、术后尿道狭窄复发会降低尿道重建术后患者勃起功能、性生活质量。后尿道狭窄、采用经会阴途径尿道吻合患者术后ED发生率更大。勃起功能、性生活质量随着时间增长而逐渐改善。     

The female partner''s satisfaction with sildenafil citrate treatment of erectile dysfunction

BACKGROUND: Data on female partners' satisfaction are scarce, although there have been many articles on patient satisfaction after sildenafil citrate treatment. The aim of this study was to evaluate the satisfaction of female partners of patients receiving sildenafil citrate for their erectile dysfunction (ED) and to assess the female partners' sexual function. METHODS: Ninety-eight patients with ED were treated. Their female partners were asked to answer a questionnaire we have prepared to evaluate the efficacy of treatment, sexual satisfaction and changes in quality of life. It also included a question about female sexual function. From the results, the relationship between their female partner's satisfaction and efficacy of treatment, as well as female sexual function, were assessed. RESULTS: Thirty (31%) questionnaires were returned to us for analysis. Effectiveness of the treatment was acknowledged by 90% of the partners. An improvement in their partner's quality of life was noticed by 60% of the women. The majority (66.7%) of the female partners were satisfied with sildenafil citrate treatment and 20% were disappointed. Moreover, 20% of the female partners were concerned about adverse events. Regarding female sexual function, some form of sexual dysfunction affected 46.7% of the women. Furthermore, a significant number (P = 0.0230) of the female partners disappointed with the treatment had some kind of sexual dysfunction. CONCLUSIONS: The results indicated that female partners reported relatively high levels of treatment satisfaction. Female partners' sexual function and anxiety regarding adverse events should be evaluated when their satisfaction with sildenafil citrate treatment is poor despite an improvement of erectile function.     

Sexual behavior and sexual function of adults after hypospadias surgery: a comparative study

PURPOSE: We assessed sexual behavior and sexual function in adults operated on for hypospadias. MATERIALS AND METHODS: Long-term psychosexual adjustment was assessed with a standardized questionnaire which was mailed to 57 patients with hypospadias older than 18 years and 60 age matched normal control subjects. RESULTS: A total of 37 patients with hypospadias and 39 controls participated. Self-reported strength of libido on a scale of 1 to 5 was shown to be similar in the 2 groups. Patients with hypospadias did not have problems in achieving erection and average self-rated quality of erection ranging from 1 to 5 was the same as that of controls (mean value 4.5). Patients with hypospadias noted curvature in a downward direction in a significantly higher proportion compared to controls (40% vs 18%, respectively). There were 13 patients with hypospadias who had ejaculation difficulties, of whom 6 had spraying and 7 had only dribbling of ejaculate. Patients with hypospadias masturbated significantly less often, were significantly less sexually active and had a smaller total number of sexual partners compared to control subjects. Control subjects were significantly more completely satisfied with their sexual life compared to patients with hypospadias (76.92% vs 51.35%, respectively). CONCLUSIONS: Sexual function of patients who underwent surgery for hypospadias in general is not affected. However, there is clearly a difference in certain aspects of sexual behavior between patients with hypospadias and controls. Followup and adequate counselling of patients who underwent surgery for hypospadias in adult life is necessary.     

Sexual function before and after mesh repair of inguinal hernia

AIM: Several factors having an influence on the quality of life after an inguinal hernia repair have been studied, yet little has been reported on sexual function before and after this operation. METHODS: In a prospective follow-up study from January 1999 to July 2002, 210 men and 14 women were asked to answer an anonymous questionnaire of 40 questions before elective inguinal hernia repair to assess pre- and postoperative sexual function (preoperatively, 3 months postoperatively and every 6 months afterwards). Inguinal hernia repair was performed using a standardized Plug and Patch mesh technique. RESULTS: Fifty-two (23.2%) patients mentioned preoperative sexual dysfunction related to the groin hernia. Postoperatively, the surgical repair had a positive influence on the sexual function in these patients. Thirty-six (16%) patients complained of postoperative sexual dysfunctions, which improved or disappeared over the next few months. All patients suffered surgical complications, which were surgically treated in six cases. Symptoms specifically associated with inguinal hernias can cause certain limitations in the sexual life. CONCLUSIONS: In most cases, and in the absence of postoperative complications, the operative repair can lead to a recovery of the sexual life in patients with preoperative sexual dysfunction, while, in most cases, it does not affect patients with a preoperative normal sexual life.     

Dissociation of sexual function and sexual bother following autologous sural nerve grafting during radical prostatectomy

AIM: We prospectively investigated health-related quality of life (HR-QOL), including sexual function and sexual bother, in patients who underwent nerve grafting during a radical prostatectomy in comparison with those who underwent a non-nerve-sparing radical prostatectomy. METHODS: Between August 2001 and May 2004, radical prostatectomies were performed on 69 patients with clinical T1-T2N0/M0 prostate cancer. Of these, 66 patients (22: nerve-grafting patients, 44: non-nerve-sparing and non-nerve-grafting patients) were enroled into this study. The observation periods ranged from 12-46 months (median: 29 months). The general HR-QOL was measured with the SF-36 General Health Survey and disease-specific HR-QOL was measured with the University of California Los Angeles-Prostate Cancer Index. RESULTS: Penile tumescence was observed in 11 out of 15 (73.3%) prostate-specific antigen failure-free patients who underwent unilateral nerve grafting with contra-lateral nerve-sparing or bilateral nerve grafting. Vaginal penetration was observed in six out of 15 (40.0%) patients. The time for partial erection and for intercourse, respectively, ranged from 3-21 months (median = 6 months) and 6-36 months (median = 13.5 months). There were no significant differences in general HR-QOL changes over time between the nerve-grafting patients and the patients without any nerve-preserving procedures. The sexual function score was significantly better in the nerve-grafting (bilateral nerve graft or unilateral nerve graft with contra-lateral nerve-sparing) patients than in the non-nerve-sparing/non-nerve-grafting patients. The sexual bother score, however, was more serious for the patients who underwent nerve-grafting surgery than for the non-nerve-sparing/non-nerve-grafting patients. CONCLUSION: Sexual bother is serious for patients who attempt to maintain sexual function after special surgical procedures, such as nerve-grafting surgery. We should be aware that careful counseling is needed to avoid impatient and excessive hope for the recovery of sexual function.     

Patient-Reported Bladder,Bowel, and Sexual Function After Cauda Equina Syndrome Secondary to a Herniated Lumbar Intervertebral Disc

Background:Cauda equina syndrome (CES) is rare neurosurgical emergency requiring emergent surgical decompression to prevent bladder, bowel, and sexual dysfunction that can have significant impact on quality of life. There is a paucity of data relating to the prevalence of these long-term complications.Objective:The aim of this observational study was to evaluate the long-term prevalence of CES-related bladder, bowel, and sexual dysfunction and impact on quality of life to inform service provision.Methods:Participants were selected through coding of operative records of patients who underwent lumbar decompression for CES secondary to a herniated intervertebral disc at two large UK neurosurgical departments between 2011 and 2015 inclusive. A telephone-based survey including both validated and modified tools was used to collect data pertaining to bladder, bowel, and sexual function and impact on quality of life both before development of CES and at the time of the survey, at least 1 year postoperatively.Results:Of 135 patients contacted, 71 (42 male, 29 female) responded. Post-CES compared to pre-CES, there was higher prevalence and significant intrarespondent deterioration of bowel dysfunction, bladder dysfunction, perception of bladder function, sexual function, effect of back pain on sex life, and activities of daily living/quality of life (p < .0001 for all). Significant differences in individual questions pre-CES versus post-CES were also found.Conclusion:We show high prevalence of long-term bowel, bladder, and sexual dysfunction post-CES, with functional and psychosocial consequences. Our results demonstrate the need for preoperative information and subsequent screening and long-term multidisciplinary support for these complications.     

Influence of self-perceived incontinence severity on quality of life and sexual function in women with urinary incontinence

AIMS: We examined the impact of patient-perceived incontinence severity (PPIS) on health-related quality of life (QoL) and sexual function in women with urinary incontinence (UI). METHODS: Patients were recruited from clinic practices at one hospital. Between May 2004 and June 2006, 353 women 27-79 years old (mean 55.7) underwent detailed evaluations. To obtain health-related QoL and sexual function assessments, the patients were asked to fill the questionnaires including the incontinence quality of life (I-QoL) and female sexual function index (FSFI). Patients were categorized into the three groups according to the PPIS; 'mild,' 'moderate,' and 'severe.' RESULTS: Among groups, the duration of symptoms, rate of mixed UI, mean number of treatment visits over the past year, rate of UI associated without any activity, and Valsalva leak point pressure (VLPP) was significantly different (P < 0.05). The I-QoL total score and subscale scores deteriorated significantly as the PPIS increased (P < 0.001). Of the six domains in the FSFI questionnaire, four domains, namely, 'arousal' (P = 0.026), 'lubrication' (P = 0.012), 'orgasm' (P = 0.017), and 'pain' (P = 0.037) as well as the FSFI total score (P = 0.004) were significantly different among the groups. CONCLUSIONS: Our findings suggest that PPIS significantly influences health-related QoL and sexual function, and that strategies for assessing PPIS should be incorporated for assessing patients with UI.     

Does THA Affect Sexual Dysfunction in Female Patients With DDH?

BackgroundSexual health, aside from reproduction, plays an important role in physical, intellectual, emotional and social facets of life. Developmental dysplasia of the hip (DDH) is a chronic orthopedic disease that has negative physical, social, and mental/spiritual effects, and lowers quality of life. However, no studies exist in the literature that focus on sexual function and health in patients with DDH.MethodsThe preoperative and postoperative 6th month and 1st year sexual functions of women who underwent surgical treatment (total hip arthroplasty) for DDH (Crowe 1–4) (n:50) and their spouses (n:30) were evaluated with Arizona Sexual Experience scale (ASEX) questionnaire which evaluates sexual function in 5 categories such as desire, arousal, erection/lubrication, orgasm, and satisfaction.ResultsThe ASEX scores were 22.3 ± 3.5 preoperatively, 17.8 ± 2 at the 6th postoperative month, and 14.8 ± 1.3 at the 1st postoperative year. The decrease in the average score showed that sexual dysfunction existed in the preoperative period and sexual function was positively affected in the postoperative period over time. The ASEX scores of the patients younger than 35 in the postoperative 6th month had higher scores (P = .29). The sexual life of the husbands was not affected by the wives’ surgery, even though their spouses had a chronic condition causing functional difficulties.ConclusionThis study showed that the sexual life of women with DDH, who had been treated with total hip arthroplasty, was positively affected, whereas their husbands were unaffected. Further studies focusing on the effect of physiological and emotional factors, in addition to the surgical treatment, on sexual function are needed.     

Patient-reported quality of life after radical prostatectomy for prostate cancer

BACKGROUND: Increasingly, quality of life (QOL) assessments are receiving greater attention in the management of malignancies, including prostate cancer. We evaluated the impact of radical prostatectomy on patient QOL 12 months or longer after surgery. PATIENTS AND METHODS: We evaluated the impact of radical prostatectomy on QOL in 60 patients with prostate cancer. The patients comprised two groups: the first group (n = 32) was evaluated 12 months or longer after radical prostatectomy; the second group (n = 28) was evaluated while awaiting radical prostatectomy. General health-related QOL was measured with the European Organization for Research and Treatment of Cancer Prostate Cancer QOL Questionnaire. Sexual function was assessed with the Sapporo Medical University Sexual Function Questionnaire. A newly developed instrument assessing urinary function was prepared only for the postoperative group. RESULTS: No differences between the two groups were seen in comparisons of general health-related QOL subscales. Men who underwent surgery reported significant deterioration in sexual function (decreased quality of erection, decreased sexual activity and decreased satisfaction with sex life) than those awaiting surgery. Of the 32 postoperative patients, 26 (81%) did not use pads at all, five (16%) used one or fewer pads per day due to occasional spotting and only one patient (3%) used two to four pads per day to deal with urine dripping. Twenty-six postoperative patients (81%) stated that, given the choice, they would undergo radical prostatectomy again. CONCLUSIONS: General health-related QOL does not appear to be compromised following radical prostatectomy. Patients are willing to accept some morbidity for a perceived survival benefit. Although minimal urinary dysfunction was reported, most patients were dissatisfied with postoperative sexual function. In preoperative counselling, greater emphasis should be placed on the risk of postoperative impotence.     

Male sexual function improves after ileal pouch anal anastomosis

PURPOSE: Restorative Proctocolectomy and Ileal Pouch Anal Anastomosis has become the gold standard surgical therapy for the majority of patients with mucosal ulcerative colitis. However sexual functional disturbances after this procedure can be a concern for patients. Therefore the aim of this study was to determine the outcome of sexual-function related quality of life in male patients undergoing restorative proctocolectomy. METHODS: One hundred and twenty-two male patients who underwent restorative proctocolectomy with ileal pouch anal anastomosis between 1995 and 2000 were evaluated by the validated International Index of Erectile Function (IIEF) scoring instrument. This index scale examines sexual function in five categories. These are erectile function, orgasmic function, sexual desire, intercourse satisfaction and overall satisfaction. The IIEF instrument was administered after surgery and then scores before and after RP/IPAA were evaluated and compared. The significance of age at the time of the surgery, type of surgery, type of anastomotic technique (mucosectomy vs stapled) and septic complications on sexual functional outcome were also investigated. RESULTS: Mean age at the time of the surgery was 39.9 +/- 11.5 years. The mean follow-up period (time between pouch surgery and IIEF completed) was 3.6 +/- 1.8 years. There was statistically significant improvement in 4 of 5 categories of sexual function (erectile function, sexual desire, intercourse satisfaction, and overall satisfaction) where patients had improved scores after surgery compared to prior to surgery. The mean erectile function score increased pre to post surgery by 2.12 points (P = 0.02), which indicates better sexual results. Anastomotic technique and septic complication did not influence the results, however, older age had a negative impact on results. CONCLUSIONS: Despite some adverse sexual functions, male patients who undergo RP/IPAA for the surgical management of their colitis may preserve or improve their overall sexual functional outcome.