精索静脉结扎术对阴道内射精潜伏期的影响

目的:调查精索静脉曲张患者的阴道内射精潜伏期(IELT),并研究精索静脉结扎术对IELT的影响及疼痛视觉模拟评分(VAS)与IELT的关系。方法:选择接受精索静脉结扎术的有规律性生活的112例患者,术后6个月进行随访,根据术前IELT分为IELT≤2 min组及IELT2 min组,调查入选患者手术前后IELT、VAS评分及中国早泄患者性功能评价(CIPE-5)评分。结果:81例患者获得有效随访。①81例精索静脉曲张患者中IELT≤2 min组18例,IELT2 min组63例。IELT≤2 min组及IELT2 min组患者术后均较术前出现IELT显著延长(1.26±0.37)min vs(4.53±1.69)min,P0.01;(5.14±2.03)min vs(7.69±4.51)min,P0.05]。②IELT≤2 min组患者CIPE-5手术后较手术前有显著升高(15.64±2.37)分vs(11.27±3.52)分,P0.05],IELT2 min组患者手术前后CIPE-5未见显著差异(21.83±5.49)分vs(20.42±4.65)分,P0.05]。两组患者CIPE-5评分分级术后分别较本组术前有显著性差异(χ2=6.353,P=0.042;χ2=3.910,P=0.048)。③两组患者VAS评分手术后较手术前有显著下降(1.56±0.83)分vs(3.18±0.92)分和(1.74±0.79)分vs(3.24±0.95)分,P均0.05]。两组患者治疗后VAS评分分级较同组术前均有显著改善(χ2=4.433,P=0.035;χ2=10.088,P=0.001)。④两组患者VAS评分变化与IELT变化呈显著负相关(r=-0.572,P0.01;r=-0.465,P0.05)。结论:精索静脉曲张可能是早泄的原因之一,精索静脉结扎术可使部分精索静脉曲张并IELT≤2 min的患者受益,且疼痛的VAS评分改善情况与IELT延长时间呈显著负相关,精索静脉曲张与早泄的关系值得进一步研究。

Spermatic vein ligation and intra-vaginal ejaculation latency

Objective： To investigate the intra-vaginal ejaculation latency time （IELT） of varicocele patients, the influence of spermatic vein ligation on IELT, and the relationship of Visual Analogue Score （VAS） with IELT. Methods： We selected 112 males who had regular sexual life after spermatic vein ligation and conducted follow-up visits for 6 months. According to preoperative IELT, we divided the patients into an IELT ≤2 min group and an IELT 〉 2 min group, and compared their IELT, VAS and Chinese Index of Sexual Function for Premature Ejaculation-5 （CIPE-5） scores before and 6 months after operation. Results： Follow-up was accomplished in 81 of the patients, 18 in the IELT ≤2 min group and 63 in the IELT 〉2 min group. Compared with the baseline, IELT was significantly prolonged postoperatively in both the IELT 42 min group （ 1.26 ±0.37] vs 4.53± 1.69] min, P 〈0.01 ） and the IELT 〉 2 min group （ 5.14 ± 2.03 ] vs 7.69 ± 4. 51 ] min, P 〈 0.05） ; the postoperative CIPE-5 scores were remarkably improved in the former （ 11.27 ± 3.52 vs 15.64 ± 2.37, P 〈 0.05 ） but insignificantly in the latter group （20.42 ± 4.65 vs 21.83 ± 5.49, P 〉 0.05） ; the postoperative grades of the CIPE-5 scores showed significant differences in both groups （ x^2 = 6. 353, P = 0.042 and x^2 = 3. 910, P = 0.048） ; the postoperative VAS was markedly increased （3.18 ± 0.92 vs 1.56 ± 0.83 and 3.24 ± 0.95 vs 1.74 ± 0.79, P 〈 0.05 ）, with significant differences in the grades of VAS in both groups （ x^2 = 4. 433, P = 0.035 and X2 = 10.088, P = 0. 001 ）. The variation of VAS was negatively correlated with that of IELT in both groups （ r = - 0.572, P 〈 0.01 and r = - 0. 465, P 〈 0. 05 ）. Conclusion ： Varicocele may be one of the causes of premature ejaculation, and some of the varicocele patients with IELT ≤2 min may benefit from spermatic vein ligation. Improved VAS is negatively correlated with prolonged IELT. The relationship between varicocele and premature ejaculation deserves further studies.