超长段尿道狭窄术后勃起功能状况评估

目的探讨自体组织替代治疗男性超长段尿道狭窄对勃起功能的影响。方法回顾性分析2003年1月—2007年1月间23例不同自体组织替代治疗患者的临床资料,并进行IIEF-5评分、QOL评分及最大尿流率的术前与术后随方观察。结果所有患者术后3月、6月随访时的QOL评分、最大尿流率较术前均有明显改善(P<0.01):而IIEF-5的平均评分无明显改变(P>0.05)。狭窄部位累及至后尿道时,患者勃起功能有减弱趋势(P<0.05),同期比较中术后3月、6月随访时狭窄部位累及至后尿道患者的IIEF-5平均值要显著低于单纯前尿道狭窄的患者(P<0.05)。狭窄累及后尿道患者多元线性回归分析中,年龄、受伤时间以及尿道狭窄段的长度与替代术后IIEF-5评分呈现多元线性相关。结论自体组织替代治疗男性超长段尿道狭窄对勃起功能影响不明显:狭窄段累及后尿道时则可能对患者勃起功能产生一定的影响。患者年龄、受伤时间对勃起功能起到协同影响作用。

Evaluation of erectile function after the reconstruction of long urethral stricture

Objective To investigate the effect of substitutive reconstruction of long urethral stricture on erectile function.Methods Total of 23 patients with long urethral stricture who received various kinds of substitutive procedure from January of 2003 to January of 2007 were retrospectively analyzed.During the follow_up,questionnaire for International Index of Erectile Function-5(IIEF-5),Quality of Life(QOL) questionnaire and maximal flow rate were finished.All data were comparatively analyzed with previous record before surgery.Results Significant improvement in QOL and maximal flow rate could be found 3 and 6 months after surgery compared with those before surgery(P<0.01),Patients with urethral stricture extended to posterior urethra were detected to be declining in erectile function At three or six months after operation,IIEF-5 scores in patients with anterior urethral stricture were significantly higher than that in those with posterior urethral stricture.For patients with posterior urethral stricture,age,length of stricture,time interval of injury and type of procedure,might be related to the IIEF-5 score by multiple linear regression analysis.Conclusion Substitutive reconstruction for treatment of long urethral stricture was almost no effect on male erectile function. But the location of stricture might be associated with erectile function,especially it extended to posterior urethra.Age and time interval of trauma also showed coordinated effect on erectile dysfunction