微创手术治疗对良性前列腺增生性功能的影响:系统性审查
Burak Akgul1, Abdüllatif Aydin2, Omer O Cakir2
1Department of Urology, Trakya University School of Medicine, Edirne, Türkiye.
Minerva urology and nephrology
|September 2, 2025
概括
对良性前列腺增生 (BPH) 的最小侵入性手术疗法 (MIST) 比传统方法更好地保护性功能. 虽然勃起功能障碍是罕见的,但射精功能障碍仍然是MIST的潜在风险.
科学领域:
- 尿道病学
- 外科创新
- 男人的健康
背景情况:
- 良性前列腺增生症 (BPH) 的治疗已经通过微创手术疗法 (MIST) 发展.
- 与传统手术相比,MIST可以降低患病率并改善性功能.
- 技术的进步不断改进BPH的治疗方案.
研究的目的:
- 系统地评估MIST对BPH患者勃起和射精功能的影响.
- 为了比较各种MIST程序的功能结果.
- 确定最能保护性健康的MIST.
主要方法:
- 在Medline,Embase和Cochrane图书馆进行系统的文献搜索,直到2024年12月.
- 包括遵守PRISMA指南的回顾性和前性研究.
- 分析国际勃起功能指数 (IIEF-5) 和男性性健康问卷-射精功能障碍 (MSHQ-EjD) 的得分,以及ED和EjD的发生率.
主要成果:
- 79项研究符合纳入标准,分析了各种MIST.
- 射精功能障碍 (EjD) 的发生率有所不同:WVTT (3.2% - 10.8%),Aquablation (7% - 15%),PAE (13.3% - 56%).
- 勃起功能障碍 (ED) 的发生率在TUNA (10年后为6. 8%) 和TUMT (5年后为1%) 中较低;除了基于放射技术的疗法外,勃起功能保持不变.
结论:
- 与传统BPH治疗相比,MIST在保护勃起和射精功能方面表现优越.
- 特定的MIST如PUL,iTIND和光度系统显示有希望的功能保存.
- 虽然ED通常保留,但EjD在几个MIST程序中仍然是一个显著的风险因素.
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