垂体腺瘤男性患者性功能障碍的临床观察

目的 了解垂体腺瘤男性患者性功能障碍(SD)的发病特征和影响因素.方法 回顾性调查和分析86例男性垂体腺瘤患者术前性功能情况,总结不同类型垂体腺瘤男性患者SD的发病特征,分析SD与年龄、肿瘤类型、侵袭性、大小、血泌乳素水平和睾酮水平的相关性.结果 垂体腺瘤男性患者SD的发生率为80.2％( 69/86).其中,功能性垂体腺瘤患者SD发生率为84.6％ (66/78);无功能性垂体腺瘤患者SD发生率为37.5％( 3/8).功能性垂体腺瘤患者中,泌乳素腺瘤组(PRL组)勃起功能障碍(ED)发生率最高,达92.1％ (35/38),明显高于促性腺激素腺瘤组(FSH组)和生长激素腺瘤组(GH组)(P＜0.05).FSH组以性欲低下为主,发生率78.3％ (18/23).GH组ED发生率达70.6％( 12/17),其性欲低下和射精功能障碍的发生率明显低于PRL组和FSH组(P＜0.05).Logistic回归分析结果显示,垂体腺瘤男性性功能障碍与腺瘤病理类型的相关性有统计学意义(P＜0.05),而与年龄、肿瘤大小、侵袭性、血清泌乳素及睾酮水平的相关性差异无统计学意义(P＞0.05).结论 垂体腺瘤男性ED发生率很高,尤其是功能性垂体腺瘤.不同类型功能性垂体腺瘤男性性功能障碍的临床特征有所差异,泌乳素腺瘤ED发生率最高.腺瘤的病理类型是性功能障碍的主要影响因素.

Clinical trial of sexual dysfunctions in male patients with pituitary adenomas

Objective To explore the clinical features and related factors of sexual dysfunctions in male patients with pituitary adenomas.Methods The questionnaires of sexual functions were collected from 86 male patients with pituitary adenomas. We examined the clinical features of sexual dysfunctions and analyzed the correlations between sexual behaviors and age,tumor type,invasiveness,tumor size,serum levels of prolactin (PRL) and testosterone.Results The incidence of sexual dysfunctions was 80.2％ (69/86).Sexual dysfunctions were found in 84.6％ (66/78) of the patients with functioning pituitary adenomas and 37.5％ (3/8) of those with non-functioning pituitary adenoma respectively.In the PRL group,the incidence of erectile dysfunctions was 92.1％ (35/38) and it was higher than those in the FSH (folliclestimulating hormone) and GH (growth hormone) groups (P ＜ 0.05).In the FSH group,the incidence of reduced sexual desire was 78.3％ (18/23).In the GH group,the incidence of erectile dysfunctions was 70.6％ ( 12/17 ) and the incidence of reduced sexual desire or ejaculation dysfunction was lower than that of the PRL/FSH group (P ＜ 0.05).Conclusion The incidence of sexual dysfunctions is quite high in males with pituitary adenomas,especially for those with functioning pituitary adenomas.The clinical features of sexual dysfunctions vary in different types of functioning pituitary adenoma. The incidence of erectile dysfunctions is the highest in the PRL group.Pathological type of pituitary tumors is a major risk factor of sexual dysfunctions.