腹膜外保留骶前神经对低龄前列腺癌根治术患者勃起功能、精子质量、性生活质量及排尿功能的影响

摘要

Objectives:To investigate the influence of reserving extraperitoneal anterior sacral nerve for younger patients undergoing radical prostatectomy on erectile function,sperm quality,quality of sexual life and urination function.Methods:80 prostate cancer patients treated in our hospital from January 2012 to December 2015 were randomly divided into two groups,with 40 patients in each control group.Control group received routine surgery,and observation group received operation focusing intraoperative extraperitoneal sacral neuroprotection.IIEF 5 score before and after surgery,postoperative semen and DFI index,sexual function related indicators 3 months after operation and postoperative urodynamic results of the two groups were compared.Results:After operation,IIEF -5 score of observation group was better than that of control group (P ＜ 0.05);sperm concentration,sperm motility and viability of observation group were better than these of control group (P ＜ 0.05);DFI index of observation group was less than that of control group (P ＜ 0.05).At 3 months after operation,libido and erectile function enhancement ratio of observation group was greater than that of control group (P ＜ 0.05);erectile dysfunction ratio of observation group was lower than that of control group (P ＜ 0.05);the maximum urine flow of observation group was significantly greater than that of control group (P ＜ 0.05);bladder compliance of observation group was significantly better than that of control group (P ＜ 0.05);the maximum detrusor pressure and maximum urethral pressure of observation group were significantly higher (P ＜0.05).Conclusion:Radical prostatectomy surgery focusing on reserving extraperitoneal anterior sacral nerve treatment can effectively improve postoperative sperm quality,voiding function,sexual function and postoperative quality of sex life.%目的:探讨腹膜外保留骶前神经对低龄前列腺癌根治术患者勃起功能、精子质量、性生活质量及排尿功能的影响.方法:选择2012年1月至2015年12月本院收治的前列腺癌患者80例,按照随机数字法分为两组,各40例,对照组实施常规手术治疗,观察组注重术中行腹膜外保留骶前神经保护,比较手术前后IIEF-5评分、两组术后精液常规及DFI指数、两组术后3月性功能相关指标及两组术后尿动力学检查结果.结果:术后观察组IIEF-5评分优于对照组(P＜0.05),观察组精子密度、精子活动率及活力均优于对照组(P＜0.05),且DFI指数小于对照组(P＜0.05);术后随访3月时,观察组出现性欲增强及勃起功能增强比例大于对照组(P<0.05),出现勃起功能障碍比例低于对照组(P＜0.05);观察组最大尿流量显著大于对照组(P＜0.05),膀胱顺应性显著优于对照组(P＜0.05),最大逼尿肌压力及最大尿道压力均显著高于对照组(P＜0.05).结论:低龄前列腺癌根治术术中注重行腹膜外保留骶前神经处理,能有效减少手术对患者术后性功能及排尿功能影响,提高术后精子质量及性生活质量.