脊髓型颈椎病对男性勃起功能影响的临床分析

目的:探讨脊髓型颈椎病对男性性功能的影响及手术后性功能的恢复情况。方法:通过前瞻性随访22例男性患者,均因脊髓型颈椎病伴有性功能障碍接受手术治疗,术后随访平均16个月。手术前后的神经功能按照JOA评分标准,性功能评定采用勃起功能相关指数(IIEF-5),同时对手术前后患者反射性勃起和心理性勃起的情况进行对比研究。结果:大多数患者术后神经功能明显好转,术后JOA评分比术前提高(13.50±1.22vs9.64±1.87,P<0.01)。正常反射性勃起手术前后比较有显著性差异(95%vs82%,P<0.05),正常心理性勃起手术前后比较有显著性差异(91%vs18%,P<0.01),术后多数患者性功能明显好转,平均IIEF-5指数由术前的9.90±2.22提高到术后的20.89±3.89,两者差异显著(P<0.01)。结论:除了神经功能障碍外,脊髓型颈椎病也可导致性功能障碍,大多数表现心理性勃起异常而反射性勃起正常。术后随着神经功能的恢复,多数患者性功能也得以好转。

Clinical Analysis of Surgically Treated Cervical Spondyiotic Myelopathy with Erectile Dysfunction

Objective： To investigate the recovery of sexual function of surgically treated male patients with cervical spondylotic my- elopathy. Methods ： A prospective and a mean 16-month postoperative follow-up were conducted for 22 male patients surgically treated for cervical spondylotic myelopathy complicated by sexual dysfunction. Their neurologic scores were obtained by the Japanese Ortho- pedic Association （JOA） Scoring System, their sexual function assessed by the International Index of Erectile Function （IIEF）, and their pre- and post-operative reflexogenic and psychogenic erection analyzed by comparison. Results ： Most of the patients experienced an obvious improvement in neurological function after the surgery, with a significantly higher JOA score than pre-operation （ P 〈 0.01 ）. Compared with the preoperative rates of abnormal reflexogenic and psychogenic erection, 82% （ 18/22 ） and 18% （ 4/22）, the average IIEF scnre was elevated frompreoperatively （9.90 ± 2.22 ） to postoperatively （20.89 ±3.89）, with a statistically significant difference （P 〈 0. 01 ）. Conclusion ： Cervical spondylotic myelopathy induces sexual as well as neurological dysfunction, mostly with abnormal psychogenic but normal reflexogenic erection. With neurological recovery, most of the patients may experience an improvement in their sexual function after surgery. NatlJAndrol, 2008, 14 （10） ： 900-902