Effects Of Two Minimally Invasive Prostate Surgery On Postoperative Sexual Function In Patients With Benign Prostatic Hyperplasia

Objective:In this study,the effects of prostatic resection and prostatectomy on the sexual function of benign prostatic hyperplasia were evaluated through two kinds of prostatic surgery in different ages and different volumes of prostatic hyperplasia.The safety,effectiveness and feasibility of this method were evaluated and the clinical effects of the two kinds of surgical methods were evaluated.To provide scientific basis for selection and further clinical application.Method:From April 2016 to April 2017,180 cases of benign prostatic hyperplasia were treated in our department of urology.All the patients were divided into prostatic electroexcision group(electroexcision group)and prostatic enucleation group(enucleation group),with 90 cases in each group.The electrotomy group was divided into groups A and B according to age and divided into C,D and E groups according to the volume of prostate.The enucleation group was divided into groups A and B according to age and divided into C,D and e groups according to the volume of prostate.Group(A,a)between 30-49 years,(B,b)group 50-79 years old;(C,c)group of prostate volume(PV)<40 ml,(D,d)group PV 40-80.The changes of the International Prostatic Symptom Score(IPSS),the maximum urinary flow rate(Qmax),the residual urine volume(RUV),the retrograde ejaculation and the number of erectile times before and after the operation were observed in the two groups.Using the international index of erectile function(IIEF-5)and the self rating Anxiety Scale(SAS)before and after 3 months of follow-up,the effects of two kinds of prostate surgery on the sexual function and quality of life of the patients with different ages and different volumes of benign prostatic hyperplasia were observed.Result:1.Comparison of 1.patients in two groupsIn the prostatic enucleation group,the perforation of the capsule,the amount ofhaemorrhage(through the hemoglobin expressed by the rinse fluid)and the operation time were superior to those of the prostatic electroexcision group,and the difference was statistically significant(P<0.05).2.the patients in the prostatic enucleation group were better than the prostatic electroexcision group,but the transient incontinence was significantly more than that of the electroexcision group.The difference was statistically significant(P <0.05).3.In terms of residual urine volume(PVR),prostate symptom score(IPSS)and quality of life score(QOL)at 3 months after operation,the transurethral plasma enucleation group was significantly better than the electroprostatectomy group(P <0.05).4.IIEF-5 score and SAS score in different age groupsIn the group of electroprostatectomy,IIEF-5 score and SAS score in group A and B after treatment were significantly different from those before treatment(P < 0.05),and there were significant differences between the two groups after treatment(P <0.05).In the group of transurethral plasma enucleation of prostate,IIE-5 score and SAS score in group A and B after treatment were significantly different from those before treatment(P<0.05).F-5 score and SAS score after treatment were significantly different from those before treatment(P<0.05),and there were significant differences between the two groups after treatment(P < 0.05).In the same age group,IIEF-5score and SAS score in group A were significantly different from those in group A after treatment(P<0.05);IIEF-5 score and SAS score in group B and group B were significantly different from those in group A after treatment(P<0.05);IIEF-5 score and SAS score in group B were significantly different from those in group A after treatment(P<0.05).There was significant difference between group B and group B(P<0.05).5.IIEF-5 score and SAS score of patients with different volumeThe IIEF-5 score and SAS score in group C,D and E after treatment were significantly different from those before treatment(P<0.05),but there was no significant difference between the three groups after treatment(P>0.05);in group A and group B after transurethral endoplasmic prostatectomy,IIE-5 score and SAS score were significantly different after treatment(P < 0.05).F-5 score and SAS scoreafter treatment were significantly different from those before treatment(P < 0.05),and there were significant differences between the two groups after treatment(P <0.05).In the same age group,after treatment,IIEF-5 score and SAS score in group A were significantly different from those in group A(P < 0.05);after treatment,IIEF-5score and S score in group B and group A were significantly different from those in group A(P < 0.05);after treatment,IIEF-5 score and S score in group B were significantly different.There was significant difference in AS score between group B and group B(P < 0.05).6.The healing time of prostatic wound and its relationship with IL 6 and IL 8 in two groupsBy comparison,the healing time of prostatic wound in the enucleation group was significantly shorter than that in the electrosurgical group.In terms of interleukin-6 and interleukin-8,there was no significant difference in interleukin-6and interleukin-8 at 2 hours before operation between the two groups,and no significant difference in interleukin-6 and interleukin-8 at 24 hours after operation between the enucleation group and the point resection group.There was significant difference between the two groups(P < 0.05).Conclusion:1.Two kinds of minimally invasive endoprostatic surgery have good clinical efficacy in the treatment of benign prostatic hyperplasia,but transurethral plasma enucleation of the prostate is better.2.the incidence of erectile dysfunction is high in hospitalized patients,and there is a significant correlation between benign prostatic hyperplasia and erectile dysfunction.3.Transurethral plasma enucleation of the prostate is less invasive,more conducive to wound healing,less negative impact on erectile function of patients,and may play a role in the recovery of organic erectile dysfunction.4.younger BPH patients may be more likely to recover erectile function after surgery.5.BPH patients with small proliferative capacity may be more likely to recover erectile function after surgery.