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首页> 外文期刊>The journal of sexual medicine >Erectile function and sexual satisfaction before and after penile prosthesis implantation in radical prostatectomy patients: a comparison with patients with vasculogenic erectile dysfunction.
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Erectile function and sexual satisfaction before and after penile prosthesis implantation in radical prostatectomy patients: a comparison with patients with vasculogenic erectile dysfunction.

机译：前列腺癌根治术患者在阴茎假体植入前后的勃起功能和性满意度：与血管性勃起功能障碍患者的比较。

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INTRODUCTION: Patients with erectile dysfunction (ED) after radical prostatectomy (RP) may benefit from penile prosthesis (PP) implantation after failure of less invasive treatments. Aim. To assess surgical outcomes and satisfaction after PP implantation in RP patients and compare the results with those in patients with vasculogenic ED (controls). METHODS: A database of 415 consecutive PPs (January 1996-December 2008) was used to collate data on preimplantation ED treatments, surgical complications, satisfaction, and International Index of Erectile Function (IIEF) scores before and 3 months after implantation. The results for 90 post-RP implants (79 primary, 11 secondary) and 131 implants for vasculogenic ED were compared. MAIN OUTCOME MEASURES: The main outcome measures of this study are intra- and postoperative complications and IIEF domain scores. RESULTS: Mean follow-up of RP patients was 37.6 +/- 26.8 months. Mean interval between RP and PP implantation was 31.5 +/- 28.7 months. Nearly all primary implants (96.2%) were inflatable (3-piece, 70.1%; 2-piece, 24.1%). There was no significant difference between groups in terms of rates of infection (1.1%), mechanical failure (3.3%), and other surgical complications requiring revision surgery (migration, auto-inflation) (4.4%). For primary implants, the mean preimplantation IIEF score (all items) was significantly lower in RP patients than in controls (14.7 +/- 5.9 vs. 22.6 +/- 10.8, P = 0.003), chiefly because of significantly lower scores for erectile function, intercourse satisfaction, and orgasmic function. After PP implantation in RP patients, the scores for all domains improved, but the total score remained significantly lower than in controls (63.1 +/- 7.0 vs. 68.5 +/- 6.9, P = 0.005). The orgasmic function score was significantly lower (P < 0.001). Overall satisfaction rate was 86.1% in RP patients and 90.7% in controls (P = 0.3). CONCLUSIONS: PP implantation after RP is associated with low morbidity and high satisfaction. It improves the scores for all IIEF domains and, in particular, erectile function. Fibrosis of the retropubic space may require a second incision for reservoir placement or implantation of a 2-piece PP.
机译：简介：根治性前列腺切除术（RP）后出现勃起功能障碍（ED）的患者在微创治疗失败后可能会受益于阴茎假体（PP）植入。目标。评估RP患者在PP植入后的手术效果和满意度，并将其与血管生成性ED患者（对照组）的结果进行比较。方法：采用数据库的415个连续PP（1996年1月至2008年12月）来比较植入前和植入后3个月有关植入前ED治疗，手术并发症，满意度和国际勃起功能指数（IIEF）评分的数据。比较了90例RP后植入物（79例初生，11例次生）和131例血管生成性ED的结果。主要观察指标：这项研究的主要结果指标是术中和术后并发症以及IIEF域评分。结果：RP患者的平均随访时间为37.6 +/- 26.8个月。 RP和PP植入之间的平均间隔为31.5 +/- 28.7个月。几乎所有的主要植入物（96.2％）都是可充气的（3件，70.1％; 2件，24.1％）。两组之间的感染率（1.1％），机械衰竭（3.3％）和其他需要翻修手术的并发症（迁移，自动通气）（4.4％）没有显着差异。对于主要植入物，RP患者的平均植入前IIEF评分（所有项目）均显着低于对照组（14.7 +/- 5.9对22.6 +/- 10.8，P = 0.003），主要是因为勃起功能评分显着降低，性交满意度和性高潮功能。在RP患者中进行PP植入后，所有领域的得分均得到改善，但总得分仍显着低于对照组（63.1 +/- 7.0与68.5 +/- 6.9，P = 0.005）。性高潮功能评分显着降低（P <0.001）。 RP患者的总体满意度为86.1％，对照组为90.7％（P = 0.3）。结论：RP后PP植入与低发病率和高满意度有关。它提高了所有IIEF域的得分，尤其是勃起功能。耻骨后间隙的纤维化可能需要第二个切口，用于放置或植入两片式PP。

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