摘要目的：探讨腹腔镜前列腺癌根治术中膀胱颈完整保留对术后尿控功能及性功能的影响。方法：选取西安交通大学第二附属医院2015年3月–2019年3月期间收治的148例腹腔镜前列腺癌根治术患者作为研究对象,按照随机数字表法将其分为对照组（74例）与观察组（74例）。对照组不保留膀胱颈,观察组完整保留膀胱颈。比较两组手术指标,手术相关并发症,术后1个月和术后3个月的控尿情况,术前、术1个月和术后3个月国际勃起功能指数评分简表（IIEF-5评分）变化。结果：两组患者的手术时间、术中出血量和切除前列腺体积差异无统计学意义（P>0.05）。观察组并发症发生率（10.81%）低于对照组（18.92%）（P<0.05）。观察组术后1个月和术后3个月控尿正常的患者比例均高于对照组（52.70% vs. 27.03%、77.03% vs. 56.76%）（P<0.05）。观察组术后1个月和术后3个月IIEF评分均高于对照组[（19.54±0.87）分 vs. （18.63±0.45）分、（21.69±0.76）分 vs. （19.97±0.93）分]（P<0.05）。结论：腹腔镜前列腺癌根治术中完整保留膀胱颈有利于早期尿控功能的恢复,且对性功能影响小。
Abstract：Objective： To investigate the effect of bladder neck intact preservation on urinary control and sexual function after laparoscopic radical prostatectomy. Methods： The 148 patients with laparoscopic radical prostatectomy admitted to our hospital from March 2015 to March 2019 were selected as the study subjects. According to the random table method, all patients were divided into control group （n = 74） and observation group （n = 74）. The bladder neck was not preserved in the control group, and that was completely preserved in the observation group. The operation indexes, complications related to operation, urine control rate at 1 month and 3 months after operation, changes of IIEF-5 score before and 1 month and 3 months after operationwere compared between the two groups. Results： There were no significant differences in operation time, intraoperative blood loss and prostate volume between the two groups （P > 0.05）. The incidence of complications in the observation group （10.81%） was lower than that in the control group （18.92%） （P < 0.05）. The normal continence rate at 1st month and 3rd month after surgery in the observation group was significantly higher than that in the control group （52.70% vs. 27.03%, 77.03% vs. 56.76%; P < 0.05）. The IIEF scores in the observation group at 1st month and 3rd month after operation were significantly higher than those in the control group [（19.54±0.87）scores vs. （18.63±0.45）scores, （21.69±0.76）scores vs. （19.97±0.93）scores]; P < 0.05. Conclusion： The complete preservation of bladder neck in laparoscopic radical prostatectomy is conducive to the recovery of early urinary control and has little effect on sexual function.
南宁, 陈琦, 雒启东. 腹腔镜前列腺癌根治术中膀胱颈完整保留对术后尿控及性功能的影响[J]. 微创泌尿外科杂志, 2021, 10(6): 407-410.
NAN Ning, CHEN Qi, LUO Qidong. Effect of bladder neck intact preservation on urinary control and sexual function after laparoscopic radical prostatectomy. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2021, 10(6): 407-410.
