切换至 "中华医学电子期刊资源库"

中华腔镜泌尿外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (03) : 256 -261. doi: 10.3877/cma.j.issn.1674-3253.2022.03.015

临床研究

经尿道前列腺等离子剜除术和电切术对前列腺增生患者性功能影响比较的Meta分析
杨光林1, 莫林键1, 杨丹凌2, 黄耀锋1, 冯家乐1, 冯官正1, 程继文1,()   
  1. 1. 530021 南宁,广西医科大学第一附属医院泌尿外科
    2. 530021 南宁,广西医科大学公共卫生学院
  • 收稿日期:2021-01-29 出版日期:2022-06-01
  • 通信作者: 程继文
  • 基金资助:
    广西研究生教育创新计划项目(YCSW2021118); 广西科技基地和人才专项(桂科AD20297081)

Comparison of the effects of transurethral prostatic plasma enucleation and electrotomy on sexual function in patients with benign prostatic hyperplasia: A meta-analysis

Guanglin Yang1, Linjian Mo1, Danling Yang2, Yaofeng Huang1, Jiale Feng1, Guanzheng Feng1, Jiwen Cheng1,()   

  1. 1. Department of Urology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
    2. School of Public Health, Guangxi Medical University, Nanning 530021, China
  • Received:2021-01-29 Published:2022-06-01
  • Corresponding author: Jiwen Cheng
引用本文:

杨光林, 莫林键, 杨丹凌, 黄耀锋, 冯家乐, 冯官正, 程继文. 经尿道前列腺等离子剜除术和电切术对前列腺增生患者性功能影响比较的Meta分析[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2022, 16(03): 256-261.

Guanglin Yang, Linjian Mo, Danling Yang, Yaofeng Huang, Jiale Feng, Guanzheng Feng, Jiwen Cheng. Comparison of the effects of transurethral prostatic plasma enucleation and electrotomy on sexual function in patients with benign prostatic hyperplasia: A meta-analysis[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2022, 16(03): 256-261.

目的

探讨经尿道前列腺等离子剜除术(PKEP)与经尿道前列腺等离子电切术(PKRP)对前列腺增生(BPH)患者术后性功能的影响。

方法

通过检索PubMed、Cochrane liberary、Springer Link、Web of Science、CNKI、VIP、CBM和万方数据库,查找国内外已发表的关于比较PKEP和PKRP对BPH患者性功能的影响的中英文文献,检索时限为数据库建库至2020年5月1日,试验类型为随机对照试验(RCT),同时手动检索纳入文献的参考文献。严格按照所指定的纳入排除标准进行筛选,资料提取和质量评价,采用RevMan 5.3统计学软件进行Meta分析。

结果

经筛选最终纳入14篇文献,其中中文文献12篇、英文文献2篇,共纳入1 699例研究对象。Meta分析结果显示,术后6个月,PKEP与PKRP相比,IIEF-5评分高[SMD=0.53,95%CI(0.11~ 0.95),P<0.05],逆行射精发生率少[RR=0.75,95%CI(0.65~0.86),P<0.05],阴茎勃起功能障碍发生率低[RR=0.78,95%CI(0.68~0.90),P<0.05]。但在术后12个月,两种手术治疗方式患者IIEF-5评分、逆行射精发生率、阴茎勃起功能障碍发生率差异无统计学意义(P>0.05)。

结论

Meta分析表明,与PKRP相比,PKEP术后6个月IIEF-5评分得分高,能明显降低术后逆行射精率,阴茎勃起功能障碍发生率低。

Objective

To explore the effects of transurethral plasmakinetic enucleation of the prostate (PKEP) and transurethral plasmakinetic resection of the prostate(PKRP) on sexual function in patients with benign prostatic hyperplasia (BPH).

Methods

The manuscript of Chinese and English were searched in PubMed, Cochrane Library, Springer link, Web of Science, CNKI, VIP, CBM and Wanfang database,which content about the effect of PKEP and PKRP on the sexual function of patients with BPH. The retrieval time was from the establishment of the database to May 1, 2020. The trial type was randomized controlled trial (RCT), and the references of the included literatures were manually searched. The screening, data extraction and quality evaluation were performed in strict accordance with the specified inclusion and exclusion criteria. Meta-analysis was performed using RevMan 5.3 statistical software.

Results

After screening, 14 articles were included, 12 in Chinese and 2 in English. A total of 1 699 subjects were included. Meta-analysis showed that compared with PKRP, at 6 months after operation, PKEP had higher IIEF-5 score [SMD=0.53, 95%CI (0.11-0.95), P<0.05], less incidence of retrograde ejaculation [RR=0.75, 95% CI (0.65-0.86), P<0.05], and lower incidence of penile erectile dysfunction [RR=0.78, 95%CI (0.68-0.90), P<0.05]. However, there was no significant difference in IIEF-5 score, incidence of retrograde ejaculation and incidence of penile erectile dysfunction between the two surgical treatments at 12 months after operation (P>0.05).

Conclusion

Meta analysis shows that PKEP has higher IIEF-5 score, lower incidence of retrograde ejaculation and lower incidence of penile erectile dysfunction compared with PKRP at 6 months after operation.

表1 经尿道前列腺等离子剜除术和电切术对BPH患者性功能影响的Meta分析纳入的14篇文献
图1 PKEP组和PKRP组IIEF-5评分的Meta分析
图2 PKEP组和PKRP组逆行射精发生率的Meta分析
图3 PKEP组和PKRP组勃起功能障碍发生率的Meta分析
[1]
Li S, Kwong JSW, Zeng XT, et al. Plasmakinetic resection technology for the treatment of benign prostatic hyperplasia: evidence from a systematic review and meta-analysis[J]. Scientific Reports, 2015, 5: 12002.
[2]
Liu C, Zheng S, Li H, et al. Transurethral enucleation and resection of prostate in patients with benign prostatic hyperplasia by plasma kinetics[J]. J Urol, 2010, 184(6): 2440-2445.
[3]
Canalichio K, Jaber Y, Wang R. Surgery and hormonal treatment for prostate cancer and sexual function[J]. Translational Andrology & Urology, 2015, 4(2): 103-109.
[4]
孙志军,蒋军辉. 两种前列腺手术患者生存质量及性功能影响的比较[J]. 浙江临床医学, 2014, 15(6): 870-871.
[5]
孙启山,高岳林,闫士奇, 等. 前列腺切除术后的性功能调查[J]. 临床泌尿外科杂志, 2005, 20(9): 558-559.
[6]
刘鸣. 系统评价, meta分析设计与实施方法[M].北京:人民卫生出版社, 2011: 68-71.
[7]
卞军. 经尿道前列腺双极等离子腔内剜除术与切除术治疗良性前列腺增生的疗效比较[D]. 南方医科大学, 2008.
[8]
何国伟,刘春晓,尹杰, 等. 经尿道前列腺等离子腔内剜除术对良性前列腺增生患者性功能影响的前瞻性研究[J]. 中国基层医药, 2010, 17(12): 1640-1642.
[9]
程伟,刘修恒,陈明, 等. 经尿道双极等离子前列腺剜除术对良性前列腺增生尿道功能与性功能的影响[J]. 现代泌尿外科杂志, 2015, 20(12): 859-862.
[10]
江敦勤. 经尿道双极等离子前列腺剜除术治疗良性前列腺增生症效果观察[J]. 山东医药, 2016, 56(46): 97-99.
[11]
高华,李世江,王绍丽. 经尿道等离子前列腺电切术和剜除术治疗前列腺增生的随机对照研究[J]. 当代医学, 2018, 24(8): 51-53.
[12]
谢留定. 经尿道等离子前列腺剜除术对前列腺增生患者性功能的影响[J]. 临床研究, 2018, 26(12): 60-61.
[13]
董怀生,谷国杰,李良军, 等. 经尿道等离子微创不同术式对体积<100 ml BPH患者膀胱功能、性功能及并发症的影响[J]. 中华男科学杂志, 2018, 24(9): 807-810.
[14]
黄沛东,卢勇,陈晓生, 等. 经尿道双极等离子前列腺剜除术治疗老年前列腺增生的临床疗效分析[J]. 中国医学创新, 2019, 16(17): 52-55.
[15]
肖海涛,罗明俊. 经尿道双极等离子前列腺剜除术治疗良性前列腺增生伴膀胱结石的效果及其对患者性功能的影响[J]. 现代医学, 2019, 47(5): 502-507.
[16]
卢毅,俞凌,孟宏舟, 等. 双极等离子前列腺电切术与剜除术治疗良性前列腺增生的临床研究[J]. 浙江创伤外科, 2019, 24(5): 905-907.
[17]
邹生龙. 经尿道等离子前列腺剜除术对前列腺增生患者性功能的影响[J]. 临床合理用药杂志, 2020, 13(4): 131-132.
[18]
黄俊,孙明. PKERP与PKRP治疗良性前列腺增生症的疗效及术后对性功能影响的比较分析[J]. 中国临床新医学, 2020, 13(2): 172-175.
[19]
Zhu L, Chen S, Yang S, et al. Electrosurgical enucleation versus bipolar transurethral resection for prostates larger than 70 ml: a prospective, randomized trial with 5-year followup[J]. J Urol, 2013, 189(4): 1427-1431
[20]
Jiang Y, Bai X, Zhang X, et al. Comparative study of the effectiveness and safety of transurethral bipolar plasmakinetic enucleation of the prostate and transurethral bipolar plasmakinetic resection of the prostate for massive benign prostate hyperplasia (>80 ml)[J]. Med Sci Monit, 2020, 26: e921272.
[21]
Walsh PC, Marschke P, Catalona WJ, et al. Efficacy of first-generation Cavermap to verify location and function of cavernous nerves during radical prostatectomy: a multi-institutional evaluation by experienced surgeons[J]. Urology, 2001, 57(3): 491-494.
[22]
夏海缀,卢剑. 钬激光与铥激光前列腺剜除术对勃起功能的影响[J]. 中华男科学杂志, 2016, 22(12): 1131-1134.
[23]
胡啸天,曾晓勇,叶章群. 外科治疗对良性前列腺增生患者性功能的影响[J]. 现代泌尿生殖肿瘤杂志, 2012, 4(2): 118-120+127.
[24]
张红生,陈捷. 前列腺电切和剜除对前列腺术后性功能恢复的研究进展[J]. 中西医结合心血管病电子杂志, 2018, 6(20): 9-11.
[1] 蚁淳, 袁冬生, 熊学军. 系统免疫炎症指数与骨密度降低和骨质疏松的关联[J/OL]. 中华关节外科杂志(电子版), 2024, 18(05): 609-617.
[2] 李志文, 李远志, 李华, 方志远. 糖皮质激素治疗膝骨关节炎疗效的网状Meta分析[J/OL]. 中华关节外科杂志(电子版), 2024, 18(04): 484-496.
[3] 吴姗姗, 潘裕民, 刘晋, 张劲松, 乔莉. 睡眠呼吸暂停综合征患者静脉血栓栓塞症发生率的Meta分析[J/OL]. 中华危重症医学杂志(电子版), 2024, 17(04): 312-317.
[4] 薛庆, 施赛叶, 徐雅文, 盛夏, 张芹芹. 追踪方法学联合失效模式与效应分析在膀胱灌注化疗患者中的应用[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(06): 553-559.
[5] 吴春风, 卢国汉, 姚汝贺, 李健辉, 陈文杰, 黄宇. 21 F膀胱镜鞘联合8.0/9.8 F输尿管镜与等离子电切镜在膀胱结石钬激光碎石术中的应用[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(06): 579-584.
[6] 李想, 郭征, 田洪哲, 李杜, 熊梦瑶, 潘铁军. 1 470 nm半导体激光减容性切除治疗高危前列腺增生的临床研究[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(05): 448-452.
[7] 程志刚, 魏辉, 李一波, 韩健, 钟永豪, 王铭, 张文辉, 周传东. 经尿道前列腺剜除术中保留前列腺分叶沟间组织对术后顺行射精功能的保护[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(05): 453-458.
[8] 莫林键, 杨舒博, 农卫赟, 程继文. 人工智能虚拟数字医师在钬激光前列腺剜除日间手术患教管理中的应用[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(04): 318-322.
[9] 臧宇, 姚胜, 朱新勇, 戎世捧, 田智超. 低温等离子射频消融治疗腹壁疝术后补片感染的临床效果[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 687-692.
[10] 李康虎, 王继伟, 王光远. 腹腔镜下腹股沟疝修补术后并发症及防治进展[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(04): 369-375.
[11] 马振威, 宋润夫, 王兵. ERCP胆道内支架与骑跨十二指肠乳头支架置入治疗不可切除肝门部胆管癌疗效的Meta分析[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 807-812.
[12] 龚财芳, 赵俊宇, 游川. 围手术期肠内营养在肝癌肝切除患者中有效性及安全性的Meta分析[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(04): 551-556.
[13] 王芳, 刘达, 左智炜, 盛金平, 陈庭进, 蒋锐. 定量CT与双能X线骨密度仪对骨质疏松诊断效能比较的Meta分析[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(06): 363-371.
[14] 黄福秀, 张宁宁, 李晨阳, 李淑玲, 陈超. 单纯电切、单纯电凝与电凝电切术对扁平肠息肉疗效及不良事件发生率的影响[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(04): 310-314.
[15] 周倩妹, 王宪娥, 徐筱, 老慧琳, 赵欣悦, 胡菁颖. 多元化系统护理对老年人群牙周健康指标影响的系统评价[J/OL]. 中华临床医师杂志(电子版), 2024, 18(05): 500-506.
阅读次数
全文


摘要