METHODS: We enrolled 100 patients with ureteral stones. According to the composition of the stones, they were divided into the calcium oxalate stone group and the uric acid stone group. All patients underwent ureteroscopic holmium laser lithotripsy. General data such as age, body mass index, course of disease, stone diameter, and degree of renal hydronephrosis were compared. Sperm parameters, including sperm density, sperm viability, and sperm deformity rate, as well as International Index of Erectile Function-5 questionnaire (IIEF-5) scores, and Quality of Life (QOL) scores, were measured and compared before and 6 weeks after the surgery.
RESULTS: There were no statistically significant differences in general data and sperm parameters between the two groups before the surgery (P > 0.05). However, there were significantly lower IIEF scores but significantly higher QOL scores in the uric acid stone group. In the calcium oxalate stone group, there were no statistically significant differences in sperm parameters, IIEF score, and QOL score before and after the surgery (P > 0.05). In the uric acid stone group, there were no statistically significant differences in sperm parameters before and after surgery (P > 0.05), whereas there were significantly higher IIEF scores but significantly lower QOL scores after the surgery (P < 0.05). The prevalence of erectile dysfunction (ED) in the uric acid stone group was 38.18% (21/55), which was significantly higher compared to 20.00% (9/45) in the calcium oxalate stone group (P < 0.05). The multivariate binary logistic regression analysis showed that the independent risk factor related to ED was uric acid stones (odds ratio: 2.637, 95% confidence interval 1.040-6.689, P = 0.041). No statistically significant differences were found in sperm parameters between patients with and without ED.
CONCLUSIONS: Compared with the calcium oxalate stone group, patients with uric acid stones had a higher prevalence of ED and poorer sexual performance.
方法:我们招募了100例输尿管结石患者。根据石头的组成,分为草酸钙结石组和尿酸结石组。所有患者均行输尿管镜下钬激光碎石术。一般数据,如年龄,身体质量指数,病程,石头直径,并对肾积水程度进行比较。精子参数,包括精子密度,精子活力,精子畸形率,以及国际勃起功能指数-5问卷(IIEF-5)评分,和生活质量(QOL)得分,术前和术后6周进行测量和比较。
结果:术前两组患者一般资料及精子参数比较差异无统计学意义(P>0.05)。然而,尿酸结石组的IIEF评分显著较低,但QOL评分显著较高.在草酸钙结石组中,精子参数没有统计学上的显著差异,IIEF得分,术前、术后QOL评分(P>0.05)。在尿酸结石组中,术前、术后精子参数差异无统计学意义(P>0.05),而IIEF评分明显较高,但术后QOL评分明显较低(P<0.05)。尿酸结石组勃起功能障碍(ED)患病率为38.18%(21/55),草酸钙结石组的20.00%(9/45)显著高于草酸钙结石组(P<0.05)。多元二元logistic回归分析显示,与ED相关的独立危险因素为尿酸结石(比值比:2.637,95%置信区间1.040~6.689,P=0.041)。在有和没有ED的患者之间,精子参数没有统计学上的显着差异。
结论:与草酸钙结石组相比,尿酸结石患者ED患病率较高,性功能较差.