A systematic review of randomized controlled trials and cohort studies was conducted to evaluate data for the effects of minimally invasive procedures for treatment of symptomatic benign prostatic hyperplasia (BPH) ...A systematic review of randomized controlled trials and cohort studies was conducted to evaluate data for the effects of minimally invasive procedures for treatment of symptomatic benign prostatic hyperplasia (BPH) on male sexual function. The studies searched were trials that enrolled men with symptomatic BPH who were treated with laser surgeries, transurethral microwave therapy (TUMT), transurethral needle ablation of the prostate (TUNA), transurethral ethanol ablation of the prostate (TEAP) and high-intensity frequency ultrasound (HIFU), in comparison with traditional transurethral resection of the prostate (TURP) or sham operations. A total of 72 studies were identified, of which 33 met the inclusion criteria. Of the 33 studies, 21 were concerned with laser surgeries, six with TUMT, four with TUNA and two with TEAP containing information regarding male sexual function. No study is available regarding the effect of HIFU for BPH on male sexual function. Our analysis shows that minimally invasive surgeries for BPH have comparable effects to those of TURP on male erectile function. Collectively, less than 15.4% or 15.2% of patients will have either decrease or increase, respectively, of erectile function after laser procedures, TUMT and TUNA. As observed with TURP, a high incidence of ejaculatory dysfunction (EjD) is common after treatment of BPH with holmium, potassium-titanyl-phosphate and thulium laser therapies (〉 33.6%). TUMT, TUNA and neodymium:yttrium aluminum garnet visual laser ablation or interstitial laser coagulation for BPH has less incidence of EjD, but these procedures are considered less effective for BPH treatment when compared with TURP.展开更多
目的探讨单用他达拉非5mg/日以及联用硫辛酸治疗糖尿病性ED的临床疗效。方法选择2017年1月至2018年12月就诊我科的糖尿病性ED患者181例,经第一阶段他达拉非5mg/日治疗12周后,仍诉勃起功能障碍及部分合并射精功能障碍的43例患者纳入最终...目的探讨单用他达拉非5mg/日以及联用硫辛酸治疗糖尿病性ED的临床疗效。方法选择2017年1月至2018年12月就诊我科的糖尿病性ED患者181例,经第一阶段他达拉非5mg/日治疗12周后,仍诉勃起功能障碍及部分合并射精功能障碍的43例患者纳入最终研究统计并接受第二阶段治疗;第二阶段采用他达拉非5mg/日联合硫辛酸治疗12周。最终纳入研究统计患者在治疗前及第一、第二阶段治疗后均使用IIEF-5、Rigiscan及男性射精功能评分量表分别评估勃起满意度、勃起功能、射精功能等并记录。通过三次结果分析单用他达拉非5mg/日及联用硫辛酸治疗糖尿病性勃起功能障碍及合并射精功能障碍的疗效。结果他达拉非5mg/日联合硫辛酸治疗较单用他达拉非5mg/日及治疗前均显著提高患者IIEF-5分值,差异有统计学意义(P<0.05);单用他达拉非5mg/日及联合硫辛酸治疗较治疗前Rigiscan检测参数均有提高,差异有统计学意义(P<0.05),他达拉非5mg/日联合硫辛酸相比单用他达拉非5mg/日除阴茎头部胀大活力单位(Tumescence Activity Units TAU)差异无统计学意义(P>0.05),其余参数差异均有统计学意义(P<0.05)。糖尿病性ED伴Ej D患者单用他达拉非5mg/日治疗后男性射精功能评分较治疗前差异无统计学意义(P>0.05);联用硫辛酸治疗后部分射精功能评分项改善,较治疗前及单用他达拉非5mg/日治疗差异有统计学意义(P<0.05)。结论单用他达拉非5mg/日或联用硫辛酸均可改善糖尿病性ED患者的勃起功能,联用硫辛酸可改善部分射精功能。展开更多
Ejaculatory dysfunction is a highly prevalent clinical condition that may be classified along a continuum that ranges from premature ejaculation (PE), through retarded or delayed ejaculation (DE), to complete anej...Ejaculatory dysfunction is a highly prevalent clinical condition that may be classified along a continuum that ranges from premature ejaculation (PE), through retarded or delayed ejaculation (DE), to complete anejaculation (AE). Retrograde ejaculation (RE) represents a distinct entity in which ejaculate is expelled either partially or completely into the bladder. While DE and PE are significant sources of sexual dissatisfaction among men and their partners, patients with these disorders retain normal fertility in most cases. Conversely, men with AE and RE are unable to deliver sperm into the female genital tract and are therefore rendered subfertile. Therefore, in reviewing ejaculatory disorders as they relate to fertility, this paper will primarily focus on the diagnosis and management of AE and RE. Physiology, diagnostic strategies, pharmacological treatments, and procedural interventions relevant to AE and RE are discussed.展开更多
文摘A systematic review of randomized controlled trials and cohort studies was conducted to evaluate data for the effects of minimally invasive procedures for treatment of symptomatic benign prostatic hyperplasia (BPH) on male sexual function. The studies searched were trials that enrolled men with symptomatic BPH who were treated with laser surgeries, transurethral microwave therapy (TUMT), transurethral needle ablation of the prostate (TUNA), transurethral ethanol ablation of the prostate (TEAP) and high-intensity frequency ultrasound (HIFU), in comparison with traditional transurethral resection of the prostate (TURP) or sham operations. A total of 72 studies were identified, of which 33 met the inclusion criteria. Of the 33 studies, 21 were concerned with laser surgeries, six with TUMT, four with TUNA and two with TEAP containing information regarding male sexual function. No study is available regarding the effect of HIFU for BPH on male sexual function. Our analysis shows that minimally invasive surgeries for BPH have comparable effects to those of TURP on male erectile function. Collectively, less than 15.4% or 15.2% of patients will have either decrease or increase, respectively, of erectile function after laser procedures, TUMT and TUNA. As observed with TURP, a high incidence of ejaculatory dysfunction (EjD) is common after treatment of BPH with holmium, potassium-titanyl-phosphate and thulium laser therapies (〉 33.6%). TUMT, TUNA and neodymium:yttrium aluminum garnet visual laser ablation or interstitial laser coagulation for BPH has less incidence of EjD, but these procedures are considered less effective for BPH treatment when compared with TURP.
文摘目的探讨单用他达拉非5mg/日以及联用硫辛酸治疗糖尿病性ED的临床疗效。方法选择2017年1月至2018年12月就诊我科的糖尿病性ED患者181例,经第一阶段他达拉非5mg/日治疗12周后,仍诉勃起功能障碍及部分合并射精功能障碍的43例患者纳入最终研究统计并接受第二阶段治疗;第二阶段采用他达拉非5mg/日联合硫辛酸治疗12周。最终纳入研究统计患者在治疗前及第一、第二阶段治疗后均使用IIEF-5、Rigiscan及男性射精功能评分量表分别评估勃起满意度、勃起功能、射精功能等并记录。通过三次结果分析单用他达拉非5mg/日及联用硫辛酸治疗糖尿病性勃起功能障碍及合并射精功能障碍的疗效。结果他达拉非5mg/日联合硫辛酸治疗较单用他达拉非5mg/日及治疗前均显著提高患者IIEF-5分值,差异有统计学意义(P<0.05);单用他达拉非5mg/日及联合硫辛酸治疗较治疗前Rigiscan检测参数均有提高,差异有统计学意义(P<0.05),他达拉非5mg/日联合硫辛酸相比单用他达拉非5mg/日除阴茎头部胀大活力单位(Tumescence Activity Units TAU)差异无统计学意义(P>0.05),其余参数差异均有统计学意义(P<0.05)。糖尿病性ED伴Ej D患者单用他达拉非5mg/日治疗后男性射精功能评分较治疗前差异无统计学意义(P>0.05);联用硫辛酸治疗后部分射精功能评分项改善,较治疗前及单用他达拉非5mg/日治疗差异有统计学意义(P<0.05)。结论单用他达拉非5mg/日或联用硫辛酸均可改善糖尿病性ED患者的勃起功能,联用硫辛酸可改善部分射精功能。
文摘Ejaculatory dysfunction is a highly prevalent clinical condition that may be classified along a continuum that ranges from premature ejaculation (PE), through retarded or delayed ejaculation (DE), to complete anejaculation (AE). Retrograde ejaculation (RE) represents a distinct entity in which ejaculate is expelled either partially or completely into the bladder. While DE and PE are significant sources of sexual dissatisfaction among men and their partners, patients with these disorders retain normal fertility in most cases. Conversely, men with AE and RE are unable to deliver sperm into the female genital tract and are therefore rendered subfertile. Therefore, in reviewing ejaculatory disorders as they relate to fertility, this paper will primarily focus on the diagnosis and management of AE and RE. Physiology, diagnostic strategies, pharmacological treatments, and procedural interventions relevant to AE and RE are discussed.