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目的分析良性前列腺增生(BPH)患者在不同治疗方式下发生勃起功能障碍(ED)的危险因素。方法收集2006年1月至2007年10月在我院治疗的BPH患者128例,对所有病例进行病史采集。患者按不同的治疗方式分为经尿道前列腺电切(TURP)组62例和药物治疗组66例,开始治疗后6个月随访IIEF-5评分结果。对128例患者的完整资料进行统计学分析。结果128例患者治疗前的ED患病率为68.75%。TURP组治疗后ED的患病率升高了12.90%,术中前列腺包膜穿孔和前列腺体积>60ml的患者术后全部出现ED,术后逆向射精的发生率为90.91%。药物治疗组中,使用非那雄胺组的ED患病率增加了14.70%,无非那雄胺组的ED患病率下降了12.50%。结论TURP术后ED的患病率升高了12.90%,前列腺体积>60ml和术中前列腺包膜穿孔是TURP术后引起ED的重要危险因素,TURP术后逆行射精的发生率是90.91%。药物治疗中,非那雄胺对患者的勃起功能有负面影响,α_1-受体阻滞剂对勃起功能没有影响,对于有性生活需要的BPH患者,α_1-受体阻滞剂可以作为首选治疗药物。
Objective To analyze the risk factors for erectile dysfunction (ED) in patients with benign prostatic hyperplasia (BPH) under different treatment modalities. Methods A total of 128 patients with BPH who were treated in our hospital from January 2006 to October 2007 were enrolled in this study. All cases were collected for medical history. According to different treatment methods, patients were divided into transurethral resection of prostate (TURP) group of 62 cases and drug treatment group of 66 cases, 6 months after the start of treatment follow-up IIEF-5 score results. The complete data of 128 patients were statistically analyzed. Results The prevalence of ED before treatment in 128 patients was 68.75%. The prevalence of ED in TURP group increased by 12.90%. The patients with prostatic capsule perforation and prostate volume> 60ml all showed ED after operation. The incidence of postoperative ejaculation was 90.91%. In the drug-treated group, the prevalence of ED increased by 14.70% in the finasteride group and 12.50% in the non-finasteride group. Conclusions The prevalence of ED after TURP is increased by 12.90%, the volume of prostate> 60ml and the perioperative prostatic capsule perforation are the important risk factors of ED after TURP. The incidence of retrograde ejaculation after TURP is 90.91%. In drug therapy, finasteride has a negative effect on erectile function in patients, α_1-blockers have no effect on erectile function, and α_1-blockers may be the first choice for BPH patients with sexual needs drug.