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首页> 外文期刊>The journal of sexual medicine >Impacting factors for recovery of erectile function within 1 year following robotic-assisted laparoscopic radical prostatectomy.
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Impacting factors for recovery of erectile function within 1 year following robotic-assisted laparoscopic radical prostatectomy.

机译：机器人辅助腹腔镜前列腺癌根治术后1年内勃起功能恢复的影响因素。

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INTRODUCTION: Neurovascular bundle preservation generally results in good postoperative sexual function after radical prostatectomy. However, erectile function (EF) after radical prostatectomy is still a significant concern. The same surgical technique often results in different EF outcomes. AIM: We evaluated factors that correlate with recovery of EF within 1 year after robotic-assisted laparoscopic radical prostatectomy (RALP). METHODS: From January 2008 to May 2009, 145 consecutive patients underwent RALP by one surgeon. Patients were followed postoperatively at 3-month intervals and assessed for EF recovery, defined as an erection sufficient for penetrative intercourse with satisfaction. Baseline demographics, medical comorbidities, degree of nerve sparing, and perioperative and postoperative variables were recorded. Univariate and multivariate analyses were used to determine factors associated with EF recovery. MAIN OUTCOME MEASURES: Postoperative sexual outcomes were attained prospectively via our erectile state questionnaire. RESULTS: Complete follow-up EF data were available on 89 men. Within 1-year follow-up, 56 men (62.9%) recovered EF and 33 men (37.1%) did not. In univariate logistic regression analysis, race (black), diabetes mellitus, hyperlipidemia, and clinical T2 carcinoma of the prostate were associated with diminished EF. Higher-preoperative Sexual Health Inventory for Men score and incremental nerve sparing (enhanced lateral prostatic fascia sparing) were associated with higher odds of recovering potency. In multivariate analysis, hyperlipidemia was primary comorbidity associated with diminished EF, and bilateral nerve sparing with a minimum unilateral-enhanced status was the impacting factor for EF recovery within 1 year after surgery. CONCLUSIONS: Bilateral nerve preservation with a minimum unilateral-enhanced status is associated with improved recovery of EF, and hyperlipidemia is a significant negative predictive factor of postoperative EF recovery within 1 year following RALP. Therefore, it is important to control hyperlipidemia as well as to use the proper surgical technique in maximizing EF recovery within 1 year after radical prostatectomy.
机译：简介：神经血管束的保存通常会在前列腺癌根治术后带来良好的术后性功能。但是，根治性前列腺切除术后的勃起功能（EF）仍然是一个重要问题。相同的手术技术通常会导致不同的EF结果。目的：我们评估了与机器人辅助腹腔镜前列腺癌根治术（RALP）术后1年内EF恢复相关的因素。方法：自2008年1月至2009年5月，由一名外科医生对145例患者进行了RALP。术后每三个月随访一次患者，并评估EF恢复，EF恢复定义为勃起足以使穿透性交满意。记录基线人口统计学，医学合并症，神经保留程度以及围手术期和术后变量。使用单变量和多变量分析来确定与EF恢复相关的因素。主要观察指标：通过我们的勃起状态调查表前瞻性地获得术后性结果。结果：有89名男性获得了完整的随访EF数据。在1年的随访期内，有56例男性（62.9％）可以恢复EF，而33例男性（37.1％）没有。在单因素logistic回归分析中，种族（黑色），糖尿病，高脂血症和前列腺癌T2癌与EF降低有关。更高的术前男性性健康量表得分和增加的神经保留（增强的外侧前列腺筋膜保留）与恢复效力的可能性更高。在多变量分析中，高脂血症是EF减少的主要合并症，而双侧神经保留且单侧增强程度最低是手术后1年内EF恢复的影响因素。结论：单侧增强状态最少的双侧神经保存与EF恢复改善有关，高脂血症是RALP术后1年内EF恢复的重要阴性预测因素。因此，重要的是要控制高脂血症，并使用适当的手术技术以最大程度地在前列腺癌根治术后1年内恢复EF。

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