CAJ | 학술논문

目的：调查性活跃男性患者行腹腔镜膀胱癌根治＋回肠膀胱术后勃起功能的现状，为进一步采取医疗干预措施提供参考和依据。方法2010年8月-2012年3月接受腹腔镜膀胱癌根治＋回肠膀胱术的25例已婚男性患者，术前性功能全部正常，定义其为性活跃男性，其中10例接受保留性神经膀胱癌根治＋回肠膀胱术，15例接受非保留性神经膀胱癌根治＋回肠膀胱术。对25例患者术前采用国际勃起功能问卷（IIEF-5）进行勃起功能评估，术后结合 IIEF-5并参考男子性功能问卷（O’ Leary 1995）自行设计调查问卷进行术后勃起功能及相关情况调查。结果与术前比较，25例患者术后12个月均无法达到可以插入阴道的勃起。 IIEF-5总分：保留性神经组10例患者从术前（20．60±2．22）分降至术后（1．90±1．73）分，非保留性神经组15例患者从术前（18．73±3．83）分降至术后（3．20±4．87）分，2组术前与术后比较差异均有统计学意义（ P ＜0．01）。2组术后自行设计量表总分比较差异无统计学意义（6．40±0．84 vs．6．20±0．78， P ＞0．05）。结论膀胱癌根治＋回肠膀胱术后男性勃起功能障碍的发生率较高。
목적：조사성활약남성환자행복강경방광암근치＋회장방광술후발기공능적현상，위진일보채취의료간예조시제공삼고화의거。방법2010년8월-2012년3월접수복강경방광암근치＋회장방광술적25례이혼남성환자，술전성공능전부정상，정의기위성활약남성，기중10례접수보류성신경방광암근치＋회장방광술，15례접수비보류성신경방광암근치＋회장방광술。대25례환자술전채용국제발기공능문권（IIEF-5）진행발기공능평고，술후결합 IIEF-5병삼고남자성공능문권（O’ Leary 1995）자행설계조사문권진행술후발기공능급상관정황조사。결과여술전비교，25례환자술후12개월균무법체도가이삽입음도적발기。 IIEF-5총분：보류성신경조10례환자종술전（20．60±2．22）분강지술후（1．90±1．73）분，비보류성신경조15례환자종술전（18．73±3．83）분강지술후（3．20±4．87）분，2조술전여술후비교차이균유통계학의의（ P ＜0．01）。2조술후자행설계량표총분비교차이무통계학의의（6．40±0．84 vs．6．20±0．78， P ＞0．05）。결론방광암근치＋회장방광술후남성발기공능장애적발생솔교고。
Objective To evaluate the erectile function in sexually active male patients receiving laparoscopic radical cystectomy (LRC) and ureteroileal urinary divertion to provide an additional reference for medical intervention .Methods From August 2010 to March 2012, 25 cases of bladder cancer patients who were married men underwent laparoscopic radical+ileal neobladder, all patients with the normal pre-operative sexual function , defined as sexually active males , 10 cases re-ceived neurological reservations bladder cancer radical +ileal neobladder and 15 patients received non-reserved neurological bladder cancer cure +ileal neobladder.Before surgery, assessed these 25 patients erectile function by using the International Index of Erectile Function Questionnaire (IIEF-5), after surgery combined with IIEF-5 with reference to male sexual function questionnaire (O’Leary 1995), self-designed questionnaire for post -operative erectile function and related survey were carried out.Results Compared with pre-operative, after 12 months, post-operative 25 cases were unable to achieve an erection can be inserted into the vagina.IIEF-5 total: Reserved neurological group of 10 patients from preoperative (20.60 ±2.22) points to postoperative (1.90 ±1.73) points, the non-reserved neurological group of 15 patients from preoperative (18.73 ±3.83) points to postoperative (3.20 ±4.87) points, there were significantly different between the two groups before and after surgery ( P <0.01).There was no statistically significant difference of 2 group self-designed total score (6.40 ±0.84 vs.6.20 ± 0.78, P >0.05).Conclusion There are higher incidence of erectile dysfunction after radical cystectomy and ureteroileal u -rinary divertion.