两种支架对中青年男性输尿管钬激光碎石术后勃起功能和生活质量影响的对比分析

目的:对比分析中青年男性患者输尿管镜钬激光碎石术后留置不同的输尿管支架对勃起功能和生活质量的影响。方法:118例中青年男性输尿管结石接受输尿管镜钬激光碎石的患者根据留置的支架管随机分为双J管组(n=60)和Polaris loop支架组(n=58),比较两组患者围手术期一般资料,记录不良事件及术后的随访结果等指标。结果:两组术前年龄、BMI、身高、结石直径及肾积水程度、手术时间、术中不良事件、术后保留支架时间等无统计学差异。术后4周留置支架期间,Polaris loop支架组在炎症指标、下尿路症状(LUTS)、排尿时腰疼、生活质量(QOL)评分、IPSS评分以及视觉疼痛模拟评分(VAS)等相关临床指标与双J管组比较差异均有统计学意义(P<0.05)。Polaris loop支架管组和双J管组患者术后第2、4、6周IIEF评分分别为[(8.44±2.10)分vs(12.50±1.78)分,P=0.003]、[(8.65±1.90)分vs(13.42±1.88)分,P=0.002]、[(13.57±1.01)分vs(17.38±2.47)分,P=0.003],术后第8周后复查两组患者IIEF评分无显著差异。结论:输尿管镜钬激光碎石术后留置输尿管支架影响中青年男性患者的生活质量和勃起功能。Polaris loop支架具有独特的鱼尾状设计,与传统双J管相比,对患者术后留置支架期间的生活质量和勃起功能干扰较小。

Influence of traditional double-J stent versus Polaris loop stent on the quality of life and erectile function of young and middle-aged men after ureteral laser lithotripsy

Objective:To investigate the impact of two different ureteral stents on the quality of life and erectile function of young and middle-aged men after ureteral laser lithotripsy.Methods:A total of 118 male patients aged 22-45 years underwent ureteral laser lithotripsy followed by indwelling of the traditional double-J stent(the DJS group,n=60)or Polaris loop stent(the PLS group,n=58).We obtained the general information,intra-and post-operative clinical data,and scores on QOL,IPSS,Visual Analogue Scale(VAS)and IIEF,and compared them between the two groups of patients.Results:There were no statistically significant differences in the body mass index,height,stone diameter,hydronephrosis degree,operation time,intra-operative adverse events,or post-operative stenting time between the two groups of patients.The PLS outperformed the DJS group in such clinical indexes as inflammation markers,lower urinary tract symptoms(LUTS),backache at urination,and QOL,IPSS and VAS scores during stenting at 4 weeks after operation(P<0.05).The IIEF scores of the PLS and DJS groups were 8.44±2.10 vs 12.50±1.78(P=0.003)at 2 weeks,8.65±1.90 vs 13.42±1.88(P=0.002)at 4 weeks,and 13.57±1.01 vs 17.38±2.47(P=0.003)at 6 weeks after operation,with no statistically significant difference between the two groups at 8 weeks.Conclusion:Ureteral stenting affects the quality of life and erectile function of young and middle-aged male patients after ureteral laser lithotripsy.The Polaris loop stent affects less the quality of life and erectile function of the patients than the traditional double-J stent during postoperative stenting.