阴茎海绵体白膜破裂术后患者心理、勃起功能及排尿功能变化情况

目的:探究手术治疗阴茎海绵体白膜破裂对患者心理、勃起功能及排尿功能的影响。方法:选择2010年6月至2015年12月急诊收治的50例阴茎海绵体白膜破裂术后患者作为研究对象,采用Zung焦虑(SAS)和抑郁自评量表(SDS)、IIEF-5和IPSS在术后1 d、6个月和18个月评价患者的心理、勃起功能及排尿功能,并对术后心理与勃起功能两者之间的关系以及影响术后勃起功能的可能因素进行分析。结果:与手术前比较,术后6个月时患者的SDS(50.7±6.5)分vs(30.3±4.1)分]和SAS(55.4±7.7)vs(29.9±5.9)分]评分明显升高(P<0.01),而IIEF-5(18.4±2.1)分vs(22.4±1.3)分]评分显著降低(P<0.01);术后18个月时患者的SDS(50.7±10.0)分]和SAS(54.1±8.7)分]评分较6个月时无明显变化(P>0.05),仍明显高于未发生阴茎海绵体白膜破裂时(P<0.01);而IIEF-5(21.1±2.2)分]评分虽仍低于未发生阴茎海绵体白膜破裂时(P<0.01),但高于术后6个月时(P<0.01)。与未发生阴茎海绵体白膜破裂时相比,IPSS评分在术后6个月和18个月时无明显变化(P>0.05)。严重ED患者的SDS和SAS评分显著高于轻微ED患者。BMI和术前等待时间与术后短、长期勃起功能呈显著负相关。结论:阴茎海绵体白膜破裂术后患者会出现勃起减低,并伴有抑郁、焦虑等负面情绪,BMI和术前等待时间为患者术后发生ED的危险因素。

Changes of psychological,erectile and urinary functions of the patients with penile fracture after surgical treatment

Objective: To investigate the impacts of surgical treatment of penile fracture on the short-and long-term psychological, erectile and urinary functions of the patient. Methods: Fifty patients with penile fracture underwent surgical treatment in the Emergency Department of our hospital from June 2010 to December 2015. Using the Self-Rating Depression Scale(SDS), Self-Rating Anxiety Scale(SAS), IIEF-5 and IPSS, we evaluated the psychological, erectile and urinary functions of the patients at 1 day, 6 months and 18 months after surgery, and analyzed the relationship between psychological and erectile functions as well as the possible factors affecting erectile function postoperatively. Results: Compared with the baseline, significant increases were observed at 6 months after surgery in the SDS score(30.3 ± 4.1 vs 50.7 ± 6.5, P < 0.01) and SAS score(29.9 ± 5.9 vs 55.4 ± 7.7, P < 0.01) but a remarkable decrease in the IIEF-5 score(22.4 ± 1.3 vs 18.4 ± 2.1, P < 0.01). At 18 months, neither SDS(50.7 ± 10.0) or SAS score(54.1 ± 8.7) showed any statistically significant difference from that at 6 months(P > 0.05), but the IIEF-5 score(21.1 ± 2.2) was markedly lower than the baseline(P < 0.01), though higher than that at 6 months(P < 0.01). The IPSS scores at 6 and 18 months exhibited were not significantly different from that preoperatively(P > 0.05). Both the SDS and SAS scores were evidently higher in the patients with severe than in those with mild ED. The body mass index(BMI) and waiting time for surgery were significantly negatively correlated with short-and long-term erectile function of the patients after surgery. Conclusion: Patients with penile fracture may have decreased erectile function after surgery, accompanied with anxiety and depression. The risk factors for ED include BMI and waiting-for-surgery time.