垂体腺瘤男性患者性功能障碍的临床研究
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摘要
目的：探讨不同病理类型垂体腺瘤男性患者性功能障碍的发病特征及其影响因素。
方法：回顾性分析我院2006年6月至2008年12月期间收治的86例男性垂体腺瘤患者术前资料,通过问卷调查获得患者手术前的性功能(IIEF5、性欲和射精功能)情况。分析性功能障碍与年龄、病理类型、侵袭性、大小、血清泌乳素及睾酮水平的相关性。
结果：
1.全部86例男性垂体腺瘤患者中69例(80.2%)有性功能障碍。功能性垂体腺瘤78例,其中66例(84.6%)有性功能障碍；无功能性垂体腺瘤患者8例,其中3例(37.5%)有性功能障碍。结果显示功能性垂体腺瘤组性功能障碍的发生率明显高于无功能性垂体腺瘤组,两组性功能障碍发生率存在显著性差异(P<0.05)。
2.功能性垂体腺瘤患者中,泌乳素腺瘤组(PRL组)ED有92.1%(35/38),性欲低下84.2%(32/38),射精障碍76.3%(29/38)。促性腺激素腺瘤组(FSH组)中ED有69.7%(16/23),性欲低下78.3%(18/23),射精障碍65.2%(15/23)。生长激素腺瘤组(GH组)中ED有70.6%(12/17),性欲低下52.9%(9/17),射精障碍41.2%(7/17)。将三组的性功能逐一比较,结果显示,PRL组ED的发生率明显高于FSH组和GH组(P<0.05)。而GH组性欲低下和射精功能障碍的发生率明显低于PRL组和FSH组(P<0.05)。
3.用Logistic回归分析,分析性功能障碍与年龄、病理类型、侵袭性、大小、血清泌乳素及睾酮水平的相关性。结果显示,勃起功能障碍、性欲低下、射精功能障碍均与垂体腺瘤类型存在显著的相关性(P<0.05),而与年龄、肿瘤大小、侵袭性、血清泌乳素及睾酮水平无明显相关性(P>0.05)。
结论：
1.男性功能性垂体腺瘤组性功能障碍发生率明显高于无功能性腺瘤组。
2.男性功能性垂体腺瘤组中,PRL组性功能障碍以ED为主要临床表现,GH组性欲低下和射精功能障碍的发生率都较FSH组和PRL组低。
3.垂体腺瘤的病理类型是男性患者性功能障碍的主要影响因素。
Objective:To discuss the clinical feature and related factors of sexual dysfunction in the male patients with pituitary adenomas.
Methods:We reviewed medical records of 86 male patients with pituitary adenomas and collected questionnaires about sexual function retrospectively, then analyzed the correlations between sexual behavior and age, tumor type, invasion, tumor size, serum prolactin, serum testosterone.
Results:69(80.2%) and 3(37.5%) sexual dysfunction were found in 78 patients with functioning pituitary adenomas and in 8 patients with Non-functioning pituitary adenomas, respectively. In the functioning pituitary adenomas groups, the incidence of erectile dysfunction and reduced sexual desire and ejaculation dysfunction was 92.1%(35/38) and 84.2%(32/38) and 76.3%(29/38) in PRL group, respectively. In the FSH group, the incidence of erectile dysfunction and reduced sexual desire and ejaculation dysfunction was 69.7%(16/23) and 78.3%(18/23) and 65.2%(15/23), respectively. In the GH group, the incidence of erectile dysfunction and reduced sexual desire and ejaculation dysfunction was 70.6%(12/17) and 52.9%(9/17) and 41.2%(7/17), respectively.
Conclusions The incidence of sexual dysfunction in the males with functioning pituitary adenomas was higher than in the males with Non-functioning pituitary adenomas. In the functioning pituitary adenoma groups, erectile dysfunction was the most important symptom in PRL group and the incidence, either reduced sexual desire or ejaculation dysfunction, in GH group was lower than in PRL group and FSH group. Pathology of the pituitary tumors was the main risk factor to result in sexual dysfunction.
方法：回顾性分析我院2006年6月至2008年12月期间收治的86例男性垂体腺瘤患者术前资料,通过问卷调查获得患者手术前的性功能(IIEF5、性欲和射精功能)情况。分析性功能障碍与年龄、病理类型、侵袭性、大小、血清泌乳素及睾酮水平的相关性。
结果：
1.全部86例男性垂体腺瘤患者中69例(80.2%)有性功能障碍。功能性垂体腺瘤78例,其中66例(84.6%)有性功能障碍；无功能性垂体腺瘤患者8例,其中3例(37.5%)有性功能障碍。结果显示功能性垂体腺瘤组性功能障碍的发生率明显高于无功能性垂体腺瘤组,两组性功能障碍发生率存在显著性差异(P<0.05)。
2.功能性垂体腺瘤患者中,泌乳素腺瘤组(PRL组)ED有92.1%(35/38),性欲低下84.2%(32/38),射精障碍76.3%(29/38)。促性腺激素腺瘤组(FSH组)中ED有69.7%(16/23),性欲低下78.3%(18/23),射精障碍65.2%(15/23)。生长激素腺瘤组(GH组)中ED有70.6%(12/17),性欲低下52.9%(9/17),射精障碍41.2%(7/17)。将三组的性功能逐一比较,结果显示,PRL组ED的发生率明显高于FSH组和GH组(P<0.05)。而GH组性欲低下和射精功能障碍的发生率明显低于PRL组和FSH组(P<0.05)。
3.用Logistic回归分析,分析性功能障碍与年龄、病理类型、侵袭性、大小、血清泌乳素及睾酮水平的相关性。结果显示,勃起功能障碍、性欲低下、射精功能障碍均与垂体腺瘤类型存在显著的相关性(P<0.05),而与年龄、肿瘤大小、侵袭性、血清泌乳素及睾酮水平无明显相关性(P>0.05)。
结论：
1.男性功能性垂体腺瘤组性功能障碍发生率明显高于无功能性腺瘤组。
2.男性功能性垂体腺瘤组中,PRL组性功能障碍以ED为主要临床表现,GH组性欲低下和射精功能障碍的发生率都较FSH组和PRL组低。
3.垂体腺瘤的病理类型是男性患者性功能障碍的主要影响因素。
Objective:To discuss the clinical feature and related factors of sexual dysfunction in the male patients with pituitary adenomas.
Methods:We reviewed medical records of 86 male patients with pituitary adenomas and collected questionnaires about sexual function retrospectively, then analyzed the correlations between sexual behavior and age, tumor type, invasion, tumor size, serum prolactin, serum testosterone.
Results:69(80.2%) and 3(37.5%) sexual dysfunction were found in 78 patients with functioning pituitary adenomas and in 8 patients with Non-functioning pituitary adenomas, respectively. In the functioning pituitary adenomas groups, the incidence of erectile dysfunction and reduced sexual desire and ejaculation dysfunction was 92.1%(35/38) and 84.2%(32/38) and 76.3%(29/38) in PRL group, respectively. In the FSH group, the incidence of erectile dysfunction and reduced sexual desire and ejaculation dysfunction was 69.7%(16/23) and 78.3%(18/23) and 65.2%(15/23), respectively. In the GH group, the incidence of erectile dysfunction and reduced sexual desire and ejaculation dysfunction was 70.6%(12/17) and 52.9%(9/17) and 41.2%(7/17), respectively.
Conclusions The incidence of sexual dysfunction in the males with functioning pituitary adenomas was higher than in the males with Non-functioning pituitary adenomas. In the functioning pituitary adenoma groups, erectile dysfunction was the most important symptom in PRL group and the incidence, either reduced sexual desire or ejaculation dysfunction, in GH group was lower than in PRL group and FSH group. Pathology of the pituitary tumors was the main risk factor to result in sexual dysfunction.
引文
1. Korbonits M, Carlsen E. Recent clinical and pathophysiological ddvances in Non-Functioning pituitary adenomas [J]. Horm Res 2009; 71(suppl 2):123-130
2. Mancini T, Casanueva FF, Giustina A. Hyperprolactinemia and Prolactinomas [J]. Endocrinol Metab Clin N Am,2008,37:67-99.
3. Colao A. The prolactinoma [J]. Best Practice & Research Clinical Endocrinology & Metabolism,2009,23:575-596.
4.帅红霞,章激,吴丽利,等.垂体促性腺激素瘤的临床分析.临床内科杂志,2009,26：335-336.
5.顾昌伟.垂体生长激素腺瘤治疗现状与预后分析.中国微侵袭神经外科杂志,2008,13：90-93.
6. Lopes MB. Growth hormone-secreting adenomas:pathology and cell biology. Neurosurg Focus,2010,29(4):E2.
7. Nicolosi A, Laumann EO, Glasser DB, et al. Sexual behavior and sexual dysfunctions after age 40:the global study of sexual attitudes and behaviors. Urology,2004,64(5):991-997.
8. Heidelbaugh JJ. Management of erectile dysfunction[J]. Am Fam Physician.2010; 81(3):305-12.
9. Pinzone JJ, Katznelson L, Danila DC, et al. Primary medical therapy of micro-and macroprolactinomas in men. J Clin Endocrinol Metab.2000,85(9): 3053-3057
10. Buvat J. Hyperprolactinemia and sexual function in men:a short review. Int J Impot Res,2003,15(5):373-377.
11.徐剑,金自孟,邓洁英等.男性垂体催乳素大腺瘤103例临床分析.中华内科杂志,2005,44(5)：356-359.
12. Cury ML, Fernandes JC, Machado HR, et al. Non-functioning pituitary adenomas: clinical feature, laboratorial and imaging assessment, therapeutic management and outcome. Arq Bras Endocrinol Metabol,2009,53(1),31-39.
13. Corona G, Mannucci E, Fisher AD. Effect of hyperprolactinemia in male patients consulting for sexual dysfunction. J Sex Med,2007,4(5):1485-1493.
14.白文俊,王晓峰,李荣强,等.高泌乳素血症导致男性性功能障碍的诊断与治疗.中华泌尿外科杂志,2007,28：424-426.
15. Balercia G, Boscaro M, Lombardo F, et al. Sexual symptoms in endocrine diseases:psychosomatic perspectives. Psychother Psychosom.2007; 76(3):134-40.
16. Mir J, Munarriz R. Androgens and male sexual dysfunction. Curr Opin Endocrinol Diabetes,2006,13(3):267-271。
17. Stief C. Testosterone and erection:practical management for the patient with erectile dysfunction. Eur Urology supplements 2007, (6):868-873.
18. Wu FC, Tajar A, Beynon JM, et al. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med 2010;363:123-35.
19. Corona G, Mannucci E, Jannini EA,et al. Hypoprolactinemia:A new clinical syndrome in patients with sexual dysfunction. J Sex Med 2009; 6:1457-1466.
20. Colao A, The prolactinoma. Best practice & research endocrinology & metabolism.2009,23:575-596.
21. Carani C, Granata AR, Fustini MF, et al. Prolactin and testosterone:Their role in male sexual function. Int J Androl,1996,19(1):48-54.
22. Paick JS, Yang JH, Kim SW, et al. The role of prolactin levels in the sexual activity of married men with erectile dysfunction. BJU Int,2006,98(6):1269-73.
23. Selmanoff M. Tyrosine hydroxylase and POMC mRNA in the arcuate region are increased by castration and hyperprolactinemia [J]. Mol Brain Res,1991,10:277-281.
24. Gratzke C, Angulo J, Chitaley K, et al. Anatomy, physiology, and pathophysiology of erectile dysfunction. J Sex Med.2010 7(1 Pt 2):445-75.
25. Sorisky A. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med 2010; 363:19.
1. Buvat J. Hyperprolactinemia and sexual function in men:a short review [J]. International Journal of Impotence Research,2003,15:373-377.
2. Korbonits M, Carlsen E. Recent clinical and pathophysiological advances in Non-Functioning pituitary adenomas [J]. Horm Res,2009,71(suppl 2):123-130
3. Mancini T, Casanueva FF, Giustina A. Hyperprolactinemia and Prolactinomas [J]. Endocrinol Metab Clin N Am,2008,37:67-99.
4. Colao A. The prolactinoma [J]. Best Practice & Research Clinical Endocrinology & Metabolism,2009,23:575-596.
5.帅红霞,章激,吴丽利,等.垂体促性腺激素瘤的临床分析[J].临床内科杂志,2009,26：335-336.
6. Lopes MB. Growth hormone-secreting adenomas:pathology and cell biology [J]. Neurosurg Focus,2010,29(4):E2
7. Corona G, Mannucci E, Fisher AD, et al. Effect of hyperprolactinemia in male patients consulting for sexual dysfunction [J]. J Sex Med,2007,4(5):1485-1493.
8. Kadioglu P, Yalin AS, Tiryakioglu O, et al. Sexual dysfunction in women with hyperprolactinemia:a pilot study report [J]. J Urol,2005,174(5):1921-5.
9. Byerly M, Suppes T, Tran QV, et al. Clinical implications of antipsychotic-induced hyperprolactinemia in patients with schizophrenia spectrum or bipolar spectrum disorders:recent developments and current perspectives [J]. J Clin Psychopharmacol,2007,27(6):639-61.
10. Pinzone JJ, Katznelson L, Danila DC, et al. Primary medical therapy of micro and macroprolactinomas in men[J]. J Clin Endocrinol Metab,2000,85: 3053-3057.
11.徐剑,金自孟,邓洁英,等.男性垂体催乳素大腺瘤103例临床分析[J].中华内科杂志,2005,44(5)：356-359.
12. Stuart FM, Hammond DC, Pett MA, et al. Inhibited sexual desire in women [J]. Arch Sex Behav,1987,16:91-106.
13. Balercia G, Boscaro M, Lombardo F, et al. Sexual symptoms in endocrine diseases:psychosomatic perspectives [J]. Psychother Psychosom,2007, 76(3):134-140.
14. Stief C. Testosterone and erection:practical management for the patient with erectile dysfunction. Eur Urology, supplements 2007, (6):868-873.
15. Wu FC, Tajar A, Beynon JM, et al. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med,2010,363:123-135.
16. Corona G, Petrone L, Mannucci E, et al. Psycho-biological correlates of rapid ejaculation in patients attending an andrologic unit for sexual dysfunctions [J]. Eur Urol,2004,46:615-622.
17. Corona G, Mannucci E, Jannini EA,et al. Hypoprolactinemia:A new clinical syndrome in patients with sexual dysfunction. J Sex Med,2009,6:1457-1466.
18. Paick JS, Yang JH, Kim SW, et al. The role of prolactin levels in the sexual activity of married men with erectile dysfunction. BJU Int,2006,98(6):1269-73.
19. Kokay IC, Grattan DR. Expression of mRNA for Prolactin Receptor (Long Form) in Dopamine and Pro-Opiomelanocortin Neurones in the Arcuate Nucleus of Non-Pregnant and Lactating Rats [J]. JNeuroendocrinology,2005,17,827-835.
20. Gratzke C, Angulo J, Chitaley K, et al. Anatomy, physiology, and pathophysiology of erectile dysfunction. J Sex Med.2010,(7):445-475.
21. Heidelbaugh JJ. Management of erectile dysfunction [J]. Am Fam Physician, 2010,81(3):305-312.
22. Montague DK, Jarow JP, Broderick GA, et al. The management of erectile dysfunction:an AUA update [J]. J Urol,2005,174(1):230-239.
23. Buvat J, Lemaire A. Endocrine screening in 1022 men with erectile dysfunction: clinical significance and cost-effective strategy [J]. J Urol,1997,158:1764-1767.
24. Buvat J, Maggi M, Gooren L, et al. Endocrine aspects of male sexual dysfunctions [J]. J Sex Me,2010,7(4 Pt 2):1627-56.
25. Johri AM, Heaton JP, Morales A. Severe erectile dysfunction is a marker for hyperprolactinemia [J]. International Journal of Impotence Research,2001,13: 176-182.
26.赵曜,王镛斐,李士其,等.巨大不规则型垂体腺瘤的显微外科手术治疗[J].中华神经外科疾病研究杂志,2007,6(1)：27-30.
27.魏俊吉,王任直.垂体催乳素腺瘤诊治时的常见问题[J].中华神经外科杂志,2008,24(12)：948-949.
28.殷怡华,魏美娟,冯令达,等.女性垂体泌乳素微腺瘤的治疗方式[J].上海医学,2008,31(2)83-86.
29. Colao A, Ochoa AS, Auriemma RS, et al. Pituitary carcinomas [J]. Front Horm Res.,2010,38:94-108.
30. Lleva RR, Inzucchi SE. Diagnosis and management of pituitary adenomas [J]. Current Opinion in Oncology,2011,23:53-60.
31. Montorsi F, Adaikan G, Becher E,et al. Summary of the recommendations on sexual dysfunctions in men [J]. J Sex Med.2010,7(11),3572-88.
32. Dhir RR, Lin HC, Canfield SE, et al. Combination therapy for erectile dysfunction:an update review [J]. AJA. 2011 Mar 21 [Epub ahead of print].
1.那彦群主编中国泌尿外科疾病诊断治疗指南之前列腺炎诊断治疗指南人民卫生出版社,2009年205-245
2.顾方六主编现代前列腺病学人民军医出版社,2002年593-609
3.马乐潘柏年陈宝英主编男性不育与辅助生殖技术人民卫生出版社,2002年112-123
4. Weidner W, Ludwig M, Brahler E, Schiefer HG. Outcome of antibiotic therapy with ciprofloxacin in chronic bacterial prostatitis. Drugs 1999 58(Suppl 2):103-106.
5. Diemer T, Huwe P, Ludwig M, Schroeder-Printzen I, Michelmann HW, Schiefer HG, Weidner W. Influence of autogenous leucocytes and Escherichia coli on sperm motility parameters in vitro. Andrologia 2003 35:100-105.
6. Depuydt C, Zalata A, Christophe A, Mahmoud A, Comhaire F. Mechanisms of sperm deficiency in male accessory gland infection. Andrology 1998,30:29-33.
7. Everaert K, Mahmoud A, Depuydt C, et al. Chronic prostatitis and male accessory gland infection-is there an impact on male infertility (diagnosis and therapy)?2003 andrologia 35,325-330
8.魏学斌,黄世明,徐留玉等。慢性前列腺炎与男性不育相关因素分析。中国基层医药2009 16卷1537-1538
9.鄢桃飞,江立,许传亮,惠宁.伴前列腺炎的不育症患者治疗后的精液分析.中国男科学杂志2008年第22卷21-23
10. Pasqualotto FF, Sharma RK, Potts JM, et al. Seminal oxidative stress in patients with chronic prostatitis. Urology.2000-55(6):881-885.
11. Nickel JC, Alexander RB, Schaeffer AJ, et al. Leukocytes and bacteria in men with chronic prostatitis/chronic pelvic pain syndrome compared to asymptomatic controls. J Urol 2003; 170:818-822.
12. Estrada LS, Champion HC, Wang R, et al. Effect of tumor necrosis factor-alpha(TNF-alpha)and interferon-gamma(IFN-gamma)on human sperm motility, viability and motion parameters. Int J Androl,1997,20(4):237—242.
13. Shiva M, Gautam AK, Verma Y, et al. Association between sperm quality, oxidative stress, and seminal antioxidant activity. Clin Biochem.2011, 44(4):319-24.
14. Motrich RD, Maccioni M, Molina R, et al. Reduced semen quality in chronic prostatitis patients that have cellular autoimmune response to prostate antigens.Hum Reprod.2005,20(9):2567-72.
15. Potts JM:Prospective identification of National Institutes of Health category IV prostatitis in men with elevated prostate specific antigen. J Urol,2000.164: 1550-1553,
16. Korrovits P, Ausmees K, Mandar R, Punab M. Prevalence of asymptomatic inflammatory (National Institutes of Health Category IV) prostatitis in young men according to semen analysis. Urology.2008 Jun; 71 (6):1010-5. Epub 2008 May 2.
17. Murphy AB, Macejko A, Taylor A, et al. Chronic prostatitis:management strategies.Drugs.2009;69(1):71-84.
18. Low N, McCarthy A, Macleod J, etal. Epidemiological social, diagnostic, and economic evaluation of population screening for genital chlamydial infection. Health Technol Assess 2007; 11:1-165.
19. LaMontagne DS, Fenton KA, Randall S, Establishing the National Chlamydia Screening Program in England:results from the first full year of screening. Sex Transm Infect 2004; 80:335-341.
20. Kelly A. Cunningham and Kenneth W. Beagley. Male Genital Tract Chlamydial Infection:Implications for Pathology and Infertility. Biology of Reproduction 200879,180-189
21. Gallegos G, Ramos B, Santiso R, et al. Sperm DNA fragmentation in infertile men with genitourinary infection by Chlamydia trachomatis and Mycoplasma. Fertil Steril 2008;
22. Nickel J, Zadeikis N, Spivey M. Clinical significance of antimicrobial therapy in chronic prostatitis associated with non-traditional uropathogens [abstract]. J Urol 2005; 173:S30
23. Nickel JC, Downey J, Clark J, et al. Levofloxacin for chronic prostatitis/chronic pelvic pain syndrome in men:a randomized placebo-controlled multicenter trial. Urology 2003 Oct; 62 (4):614-7.
24. Moslemi MK, Tavanbakhsh S. Selenium-vitamin E supplementation in infertile men:effects on semen parameters and pregnancy rate. Int J Gen Med.2011,23;4: 99-104.
25. Kefer JC, Agarwal A, Sabanegh E Role of antioxidants in the treatment of male infertility. Int J Urol.2009 May; 16(5):449-57.
26. Ketefian A, Hu J, Bartolucci AA, et al. Fifteen-year trend in the use of male reproductive surgery:analysis of the healthcare cost and utilization project data. BJU Int.2011,107(7):1118-1123.
2. Mancini T, Casanueva FF, Giustina A. Hyperprolactinemia and Prolactinomas [J]. Endocrinol Metab Clin N Am,2008,37:67-99.
3. Colao A. The prolactinoma [J]. Best Practice & Research Clinical Endocrinology & Metabolism,2009,23:575-596.
4.帅红霞,章激,吴丽利,等.垂体促性腺激素瘤的临床分析.临床内科杂志,2009,26：335-336.
5.顾昌伟.垂体生长激素腺瘤治疗现状与预后分析.中国微侵袭神经外科杂志,2008,13：90-93.
6. Lopes MB. Growth hormone-secreting adenomas:pathology and cell biology. Neurosurg Focus,2010,29(4):E2.
7. Nicolosi A, Laumann EO, Glasser DB, et al. Sexual behavior and sexual dysfunctions after age 40:the global study of sexual attitudes and behaviors. Urology,2004,64(5):991-997.
8. Heidelbaugh JJ. Management of erectile dysfunction[J]. Am Fam Physician.2010; 81(3):305-12.
9. Pinzone JJ, Katznelson L, Danila DC, et al. Primary medical therapy of micro-and macroprolactinomas in men. J Clin Endocrinol Metab.2000,85(9): 3053-3057
10. Buvat J. Hyperprolactinemia and sexual function in men:a short review. Int J Impot Res,2003,15(5):373-377.
11.徐剑,金自孟,邓洁英等.男性垂体催乳素大腺瘤103例临床分析.中华内科杂志,2005,44(5)：356-359.
12. Cury ML, Fernandes JC, Machado HR, et al. Non-functioning pituitary adenomas: clinical feature, laboratorial and imaging assessment, therapeutic management and outcome. Arq Bras Endocrinol Metabol,2009,53(1),31-39.
13. Corona G, Mannucci E, Fisher AD. Effect of hyperprolactinemia in male patients consulting for sexual dysfunction. J Sex Med,2007,4(5):1485-1493.
14.白文俊,王晓峰,李荣强,等.高泌乳素血症导致男性性功能障碍的诊断与治疗.中华泌尿外科杂志,2007,28：424-426.
15. Balercia G, Boscaro M, Lombardo F, et al. Sexual symptoms in endocrine diseases:psychosomatic perspectives. Psychother Psychosom.2007; 76(3):134-40.
16. Mir J, Munarriz R. Androgens and male sexual dysfunction. Curr Opin Endocrinol Diabetes,2006,13(3):267-271。
17. Stief C. Testosterone and erection:practical management for the patient with erectile dysfunction. Eur Urology supplements 2007, (6):868-873.
18. Wu FC, Tajar A, Beynon JM, et al. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med 2010;363:123-35.
19. Corona G, Mannucci E, Jannini EA,et al. Hypoprolactinemia:A new clinical syndrome in patients with sexual dysfunction. J Sex Med 2009; 6:1457-1466.
20. Colao A, The prolactinoma. Best practice & research endocrinology & metabolism.2009,23:575-596.
21. Carani C, Granata AR, Fustini MF, et al. Prolactin and testosterone:Their role in male sexual function. Int J Androl,1996,19(1):48-54.
22. Paick JS, Yang JH, Kim SW, et al. The role of prolactin levels in the sexual activity of married men with erectile dysfunction. BJU Int,2006,98(6):1269-73.
23. Selmanoff M. Tyrosine hydroxylase and POMC mRNA in the arcuate region are increased by castration and hyperprolactinemia [J]. Mol Brain Res,1991,10:277-281.
24. Gratzke C, Angulo J, Chitaley K, et al. Anatomy, physiology, and pathophysiology of erectile dysfunction. J Sex Med.2010 7(1 Pt 2):445-75.
25. Sorisky A. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med 2010; 363:19.
1. Buvat J. Hyperprolactinemia and sexual function in men:a short review [J]. International Journal of Impotence Research,2003,15:373-377.
2. Korbonits M, Carlsen E. Recent clinical and pathophysiological advances in Non-Functioning pituitary adenomas [J]. Horm Res,2009,71(suppl 2):123-130
3. Mancini T, Casanueva FF, Giustina A. Hyperprolactinemia and Prolactinomas [J]. Endocrinol Metab Clin N Am,2008,37:67-99.
4. Colao A. The prolactinoma [J]. Best Practice & Research Clinical Endocrinology & Metabolism,2009,23:575-596.
5.帅红霞,章激,吴丽利,等.垂体促性腺激素瘤的临床分析[J].临床内科杂志,2009,26：335-336.
6. Lopes MB. Growth hormone-secreting adenomas:pathology and cell biology [J]. Neurosurg Focus,2010,29(4):E2
7. Corona G, Mannucci E, Fisher AD, et al. Effect of hyperprolactinemia in male patients consulting for sexual dysfunction [J]. J Sex Med,2007,4(5):1485-1493.
8. Kadioglu P, Yalin AS, Tiryakioglu O, et al. Sexual dysfunction in women with hyperprolactinemia:a pilot study report [J]. J Urol,2005,174(5):1921-5.
9. Byerly M, Suppes T, Tran QV, et al. Clinical implications of antipsychotic-induced hyperprolactinemia in patients with schizophrenia spectrum or bipolar spectrum disorders:recent developments and current perspectives [J]. J Clin Psychopharmacol,2007,27(6):639-61.
10. Pinzone JJ, Katznelson L, Danila DC, et al. Primary medical therapy of micro and macroprolactinomas in men[J]. J Clin Endocrinol Metab,2000,85: 3053-3057.
11.徐剑,金自孟,邓洁英,等.男性垂体催乳素大腺瘤103例临床分析[J].中华内科杂志,2005,44(5)：356-359.
12. Stuart FM, Hammond DC, Pett MA, et al. Inhibited sexual desire in women [J]. Arch Sex Behav,1987,16:91-106.
13. Balercia G, Boscaro M, Lombardo F, et al. Sexual symptoms in endocrine diseases:psychosomatic perspectives [J]. Psychother Psychosom,2007, 76(3):134-140.
14. Stief C. Testosterone and erection:practical management for the patient with erectile dysfunction. Eur Urology, supplements 2007, (6):868-873.
15. Wu FC, Tajar A, Beynon JM, et al. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med,2010,363:123-135.
16. Corona G, Petrone L, Mannucci E, et al. Psycho-biological correlates of rapid ejaculation in patients attending an andrologic unit for sexual dysfunctions [J]. Eur Urol,2004,46:615-622.
17. Corona G, Mannucci E, Jannini EA,et al. Hypoprolactinemia:A new clinical syndrome in patients with sexual dysfunction. J Sex Med,2009,6:1457-1466.
18. Paick JS, Yang JH, Kim SW, et al. The role of prolactin levels in the sexual activity of married men with erectile dysfunction. BJU Int,2006,98(6):1269-73.
19. Kokay IC, Grattan DR. Expression of mRNA for Prolactin Receptor (Long Form) in Dopamine and Pro-Opiomelanocortin Neurones in the Arcuate Nucleus of Non-Pregnant and Lactating Rats [J]. JNeuroendocrinology,2005,17,827-835.
20. Gratzke C, Angulo J, Chitaley K, et al. Anatomy, physiology, and pathophysiology of erectile dysfunction. J Sex Med.2010,(7):445-475.
21. Heidelbaugh JJ. Management of erectile dysfunction [J]. Am Fam Physician, 2010,81(3):305-312.
22. Montague DK, Jarow JP, Broderick GA, et al. The management of erectile dysfunction:an AUA update [J]. J Urol,2005,174(1):230-239.
23. Buvat J, Lemaire A. Endocrine screening in 1022 men with erectile dysfunction: clinical significance and cost-effective strategy [J]. J Urol,1997,158:1764-1767.
24. Buvat J, Maggi M, Gooren L, et al. Endocrine aspects of male sexual dysfunctions [J]. J Sex Me,2010,7(4 Pt 2):1627-56.
25. Johri AM, Heaton JP, Morales A. Severe erectile dysfunction is a marker for hyperprolactinemia [J]. International Journal of Impotence Research,2001,13: 176-182.
26.赵曜,王镛斐,李士其,等.巨大不规则型垂体腺瘤的显微外科手术治疗[J].中华神经外科疾病研究杂志,2007,6(1)：27-30.
27.魏俊吉,王任直.垂体催乳素腺瘤诊治时的常见问题[J].中华神经外科杂志,2008,24(12)：948-949.
28.殷怡华,魏美娟,冯令达,等.女性垂体泌乳素微腺瘤的治疗方式[J].上海医学,2008,31(2)83-86.
29. Colao A, Ochoa AS, Auriemma RS, et al. Pituitary carcinomas [J]. Front Horm Res.,2010,38:94-108.
30. Lleva RR, Inzucchi SE. Diagnosis and management of pituitary adenomas [J]. Current Opinion in Oncology,2011,23:53-60.
31. Montorsi F, Adaikan G, Becher E,et al. Summary of the recommendations on sexual dysfunctions in men [J]. J Sex Med.2010,7(11),3572-88.
32. Dhir RR, Lin HC, Canfield SE, et al. Combination therapy for erectile dysfunction:an update review [J]. AJA. 2011 Mar 21 [Epub ahead of print].
1.那彦群主编中国泌尿外科疾病诊断治疗指南之前列腺炎诊断治疗指南人民卫生出版社,2009年205-245
2.顾方六主编现代前列腺病学人民军医出版社,2002年593-609
3.马乐潘柏年陈宝英主编男性不育与辅助生殖技术人民卫生出版社,2002年112-123
4. Weidner W, Ludwig M, Brahler E, Schiefer HG. Outcome of antibiotic therapy with ciprofloxacin in chronic bacterial prostatitis. Drugs 1999 58(Suppl 2):103-106.
5. Diemer T, Huwe P, Ludwig M, Schroeder-Printzen I, Michelmann HW, Schiefer HG, Weidner W. Influence of autogenous leucocytes and Escherichia coli on sperm motility parameters in vitro. Andrologia 2003 35:100-105.
6. Depuydt C, Zalata A, Christophe A, Mahmoud A, Comhaire F. Mechanisms of sperm deficiency in male accessory gland infection. Andrology 1998,30:29-33.
7. Everaert K, Mahmoud A, Depuydt C, et al. Chronic prostatitis and male accessory gland infection-is there an impact on male infertility (diagnosis and therapy)?2003 andrologia 35,325-330
8.魏学斌,黄世明,徐留玉等。慢性前列腺炎与男性不育相关因素分析。中国基层医药2009 16卷1537-1538
9.鄢桃飞,江立,许传亮,惠宁.伴前列腺炎的不育症患者治疗后的精液分析.中国男科学杂志2008年第22卷21-23
10. Pasqualotto FF, Sharma RK, Potts JM, et al. Seminal oxidative stress in patients with chronic prostatitis. Urology.2000-55(6):881-885.
11. Nickel JC, Alexander RB, Schaeffer AJ, et al. Leukocytes and bacteria in men with chronic prostatitis/chronic pelvic pain syndrome compared to asymptomatic controls. J Urol 2003; 170:818-822.
12. Estrada LS, Champion HC, Wang R, et al. Effect of tumor necrosis factor-alpha(TNF-alpha)and interferon-gamma(IFN-gamma)on human sperm motility, viability and motion parameters. Int J Androl,1997,20(4):237—242.
13. Shiva M, Gautam AK, Verma Y, et al. Association between sperm quality, oxidative stress, and seminal antioxidant activity. Clin Biochem.2011, 44(4):319-24.
14. Motrich RD, Maccioni M, Molina R, et al. Reduced semen quality in chronic prostatitis patients that have cellular autoimmune response to prostate antigens.Hum Reprod.2005,20(9):2567-72.
15. Potts JM:Prospective identification of National Institutes of Health category IV prostatitis in men with elevated prostate specific antigen. J Urol,2000.164: 1550-1553,
16. Korrovits P, Ausmees K, Mandar R, Punab M. Prevalence of asymptomatic inflammatory (National Institutes of Health Category IV) prostatitis in young men according to semen analysis. Urology.2008 Jun; 71 (6):1010-5. Epub 2008 May 2.
17. Murphy AB, Macejko A, Taylor A, et al. Chronic prostatitis:management strategies.Drugs.2009;69(1):71-84.
18. Low N, McCarthy A, Macleod J, etal. Epidemiological social, diagnostic, and economic evaluation of population screening for genital chlamydial infection. Health Technol Assess 2007; 11:1-165.
19. LaMontagne DS, Fenton KA, Randall S, Establishing the National Chlamydia Screening Program in England:results from the first full year of screening. Sex Transm Infect 2004; 80:335-341.
20. Kelly A. Cunningham and Kenneth W. Beagley. Male Genital Tract Chlamydial Infection:Implications for Pathology and Infertility. Biology of Reproduction 200879,180-189
21. Gallegos G, Ramos B, Santiso R, et al. Sperm DNA fragmentation in infertile men with genitourinary infection by Chlamydia trachomatis and Mycoplasma. Fertil Steril 2008;
22. Nickel J, Zadeikis N, Spivey M. Clinical significance of antimicrobial therapy in chronic prostatitis associated with non-traditional uropathogens [abstract]. J Urol 2005; 173:S30
23. Nickel JC, Downey J, Clark J, et al. Levofloxacin for chronic prostatitis/chronic pelvic pain syndrome in men:a randomized placebo-controlled multicenter trial. Urology 2003 Oct; 62 (4):614-7.
24. Moslemi MK, Tavanbakhsh S. Selenium-vitamin E supplementation in infertile men:effects on semen parameters and pregnancy rate. Int J Gen Med.2011,23;4: 99-104.
25. Kefer JC, Agarwal A, Sabanegh E Role of antioxidants in the treatment of male infertility. Int J Urol.2009 May; 16(5):449-57.
26. Ketefian A, Hu J, Bartolucci AA, et al. Fifteen-year trend in the use of male reproductive surgery:analysis of the healthcare cost and utilization project data. BJU Int.2011,107(7):1118-1123.