摘要
目的探讨自体组织替代治疗超长段尿道狭窄对勃起功能的影响。方法回顾性分析2007年1月至2009年1月采用不同自体组织补片（阴囊纵隔、包皮内板、口腔黏膜）Onlay术式替代治疗超长段男性尿道狭窄患者的临床资料，并随访患者IIEF-5评分、QOL评分及最大尿流率，并与术前相应情况进行分析。结果根据研究标准收集23份有效数据。患者术前及术后3、6、12个月QOL评分分别为5．22±0．75、1．22±1．40、1．82±1．17、2．07±0．46，最大尿流率分别为（3．93±3．62）、（22．46±4．65）、（23．81±6．22）、（21．52±7．44）ml／s，术后不同时期均较术前明显改善（P〈0．01）。术前及术后3、6、12个月IIEF-5评分分别为14．47±9．55、14．70±5．32、14．26±3．29和14．58±3．62，组间比较差异尤统计学意义（P〉0．05）。9例狭窄部位累及至后尿道者术后3、6、12个月11EF5评分分别为11．67±2．59、12．35±1．83、13．19±1．67，1d例单纯前尿道狭窄者分别为17．79±6．42、16．57±d．78、16．01±3．85，2组间比较差异均有统计学意义（P〈0．05）。狭窄累及后尿道患者多元线性回归分析中，年龄、受伤时间及尿道狭窄段长度与替代术后IIEF-5评分呈多元线性相关。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可能对患者勃起功能产生一定影响。患者年龄和受伤时间对勃起功能有协同影响作用。
Objective To investigate the effect of substitutive reconstruction of long urethral stricture on male erectile function. Methods From January 2007 to January 2009, 23 patients with anterior or posterior long urethral stricture were accepted for a variety of onlay subslilutive procedures, including lingual mucosa, perputial skin, and mid scrotal skin. During the follow up, data from the International Index of Erectile Function 5 （IIEF- 5） questionnaire and the Quality of Life （QOL） questionnaire as well as maximal flow rate were recorded. All data were compared with those obtained before surgery. Results Significant improvement in QOL （1.22 ± 1.40, 1.82 ± 1. 17, 2.07±0.46） and maximal flow rate （22.46±4.65, 23.81±6.22, 21.52±7.44 ） could be observed 3, 6 and 12 months after surgery compared with those before surgery （5.22±0.75, 3.93±3. 62） （P〈0.01）. No significant differences in the responses to the IIEF 5 questionnaire were observed among all patients during the follow up （P〉0. 05）. At the 3, 6 and 12 months after procedure, scores of IIEF5 in patients with anterior urethral stricture （17. 79±6. 42, 16. 57±4. 78, 16. 01± 3.85） were significantly higher than those with posterior urethral stricture （11. 67±2. 59, 12. 35± 1.83,13.19±1.67, P〈0. 05）. In patients with posterior urethral stricture, the muhiple linear re gression showed that age, time interval of injury and length of stricture were related to the IlEF-5 score （P〈0. 05）. Conclusions Substitutive reconstruction for lreating the long urethral stricture has little effect on male erectile function. But the location of stricture, especially extended to posterior urethra, may have impact on the erectile function.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2011年第4期269-272,共4页
Chinese Journal of Urology
关键词
修复外科手术
尿道狭窄
组织替代
勃起功能
尿道重建
Reconstructive surgical procedures
Urethral stricture
Tissue replacement
Erectile function
Urethral reconstruction
