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1.
VISER检查鉴别心理性与器质性勃起功能障碍(附320例报告)   总被引:2,自引:0,他引:2  
目的应用VISER鉴别心理性与器质性ED并利用该方法对心理性ED严重性进行客观分级。方法320例ED患者接受了VISER检查。首先海绵体内注射罂粟硷10mg;未诱发勃起,药物剂量增至30mg。将药物试验阳性者定义为心理性ED,并根据海绵体压力、波幅形态以及药物剂量将心理性ED分为轻、中、重二度。两次检查均失败者,行阴茎彩色多普勒超声和海绵体造影检查。结果本组中,心理性ED占81.9%,其中轻度、中度和重度者分别占19.8%,60.7%和19.5%。在部分病例中,检查结果与Zung氏抑郁量表评分具有一定相关性。33例接受阴茎多普勒超声或海绵体造影检查提示,正常13例,动脉性ED5例,静脉性ED9例,动脉静脉混合性ED6例。结论VISER有助于签别心理性与器质性ED,依据其结果对心理性ED严重程度进行客观分级,便于对患者选择有针对性的治疗。  相似文献   

2.
We questioned the need for more than one RigiScan recording for accurate assessment of sleep-associated penile erections and determine the necessity of consecutive nightly recordings for valid evaluation of sleep-associated erections. Men complaining of erectile dysfunction (ED) and referred to RigiScan evaluation for the first time participated. Recordings were performed at the patient's home during two consecutive nights, and data on test time, number of erections, erection duration, minimal and maximal base and tip tumescence and rigidity were retrieved for both nights. Normal erectile function was defined with the recording of at least one erection (70 out of 100% tip rigidity lasting for at least 10 min during either night). The main outcome measures were RigiScan recordings. Group 1 consisted of 29 men (mean age 42.4+/-13.8 years, range 22-71) who had normal erections, all during the first night. Group 2 consisted of 26 men (mean age 48.6+/-13.5 years, range 25-70) who failed to fulfill both criteria for normal erection. In Group 2, only the values for penile base rigidity and erection duration were normal during the first night: the parameters of maximal base tumescence, tip rigidity, number of effective erections and duration of effective erections that were impaired during the first night were significantly worse (P<0.01) during the second night. The required information for the diagnosis of psychogenic ED was obtained during the first night in >50% of the participants. Men with normal erections during the first night can be spared the inconvenience and cost of re-testing. Consecutive night recording should be reserved for patients whose recorded data during the first night did not fulfill the criteria for normal erection.  相似文献   

3.
The study aims to evaluate the effect of low-intensity extracorporeal shockwave therapy (Li-ESWT) on nocturnal erection and penile haemodynamics. Patients with erectile dysfunction (ED) were enrolled from January 2018 to March 2019. Self-reported erectile symptoms, the International Index of Erectile Function-5 (IIEF-5) and Erection Hardness Scores (EHS), nocturnal penile tumescence and rigidity (NPTR) and cavernous duplex Doppler ultrasound (CDDU) were evaluated. NPTR and CDDU were evaluated by Rigiscan and vascular ultrasound system respectively. Comparisons of NPTR and CDDU parameters were performed before and after Li-ESWT (Renova, once a week, 4 weeks in total). A total of 35 cases (mean age 36.51 ± 11.47 years) were enrolled for analysis. The IIEF-5 (10.60 ± 5.99 vs. 15.13 ± 6.22, p = .003), EHS (p = .016) and self-reported erectile hardness (p = .014) were significantly improved after 1-month treatment. Nocturnal erection frequency (p = .010), duration of total erection (p = .017), duration of erectile rigidity ≥60% at penile tip and base (p = .014 and p = .002) and the best erectile rigidity at penile tip and base (p = .012 and p = .005) improved significantly after treatment. However, no CDDU parameters improved after Li-ESWT (all p > .05). Li-ESWT can effectively improve subjective erectile function and nocturnal erection in ED patients. Large sample and well-designed studies need to be developed for supporting the current findings.  相似文献   

4.
目的:探讨Doppler超声在静脉性勃起功能障碍(ED)诊断中的应用价值。方法:10例静脉性ED者在阴茎海绵体内血管活性药物注射(ICI)后,行Doppler超声检查,并同时海绵体内灌注生理盐水,动态观察不同勃起状态海绵体动脉舒张期血流变化,30例心理性ED者仅ICI后行Doppler超声检查作对照。结果:静脉性ED者在勃起硬度差时,海绵体动脉舒张期表现为前向血流(正值表示),随着海绵体内生理盐水灌注后,勃起硬度逐渐增加,舒张末期血流消失;达正常勃起时,舒张期表现逆向血清(负值表示)。心理性ED者在阴茎膨胀期、海绵体动脉舒张期表现前向血流,正常勃起时,舒张期表现逆向血流。结论:在海绵体动脉供血正常情况下,静脉关闭障碍导致海绵体内压受损,舒张期出现血流动力学异常,前向血流为一特征性表现,因此Doppler超声在静脉性勃起功能障百的诊断中具有一定价值。  相似文献   

5.
Aim: To determine the effect of sildenafil citrate on the nocturnal penile erections (i.e. time to onset, the duration of erection, and the interval between first and second erections) of healthy young men. Methods: Twenty-two potent men, 23-29 years old, were recruited for the study. All subjects completed three sessions over consecutive nights using the RigiScan monitoring device (Dacomed, Minneapolis, USA). After a first night of adaptation, night 2 records were their baseline values, and on night 3 they received 100 mg of sildenafil citrate. Statistical comparisons were done between the second and third night data. Results: The mean time to onset of the first erection with sildenafil citrate was (34 ± 18) min, whereas it was (74 ± 24) min (P 〈 0.001) without sildenafil citrate. The number of erections observed during the first 5 h after sildenafil citrate medication was 3.6 ± 0.5 in contrast to 2.4 ± 0.5 with no medica- tion (P = 0.001). The interval between first and second erections was shorter with sildenafil citrate: (52 ± 26) min vs. (85 ± 34) min (P = 0.01). The duration of the last erection was statistically significantly longer with the sildenafil citrate: (64 ± 33) min vs. (42 ± 28) min (P 〈 0.01). Conclusion: Healthy young men achieved erection within 34 min after sildenafil citrate administration, which is shorter than the 1 h interval proposed by the manufacturer. The interval between the first and second erections was shorter and the duration of the last nocturnal erection was longer.  相似文献   

6.
无创性动态阴茎海绵体测压初探   总被引:1,自引:1,他引:0  
目的 :初步评价VISER软件进行无创性动态阴茎海绵体测压在ED诊断中的应用。 方法 :采用AquariusXLT型尿流动力学仪配置的VISER软件 ,辅助眼镜式影像仪听觉视觉性刺激 (AVSS)或阴茎海绵体内血管活性药物注射 (ICI)进行无创性动态海绵体测压 68例 ,其中ED病人 4 8例 ,正常对照 2 0例。 结果 :正常对照 2 0例均可通过AVSS诱发勃起 ;4 8例ED病人中 ,18例单纯通过AVSS可诱发勃起 ,占 3 7.5 % ;3 0例单纯AVSS无效者 ,给予罂粟碱 10mg海绵体内注射 ,其中 19例出现勃起 ,占 63 .3 %。VISER检查结果表明 ,除受ICI影响 ,ED罂粟碱组的勃起平均时间延长外 ,勃起数据和峰值数据中的其他多项指标ED各组均低于对照组 ,尤其表现为勃起和峰值总能量降低。 结论 :VISER具有精确的动态阴茎海绵体测压功能 ;辅助眼镜式影像仪有助于增强AVSS的效果和减少阴茎海绵体ICI剂量 ;由于VISER检查具有无创、准确、便捷等优点 ,有望成为今后ED诊断的首选方法。  相似文献   

7.
目的:探讨不同月龄组大鼠勃起功能的变化规律,为建立增龄性大鼠ED模型提供动物实验依据。方法:80只雄性Wistar大鼠,分为3、6、12和18月龄组,分别灌胃枸橼酸西地那非进行阴茎勃起功能实验;20只3月龄雌性Wistar大鼠,随机分为4组,建立发情雌鼠模型,观察不同月龄雄鼠的勃起状况与勃起次数。结果:3、6、12和18月龄组Wistar大鼠勃起率及勃起次数分别为85%、75%、40%、30%及(2.27±0.80)、(2.00±0.61)、(1.40±0.51)、(1.29±0.49)次,不同月龄勃起率与勃起次数比较,差异有统计学意义(P<0.05),且随着月龄的增加,各组大鼠勃起功能有降低的趋势。分别将6、12、18月龄组的勃起率及勃起次数与3月龄组大鼠做两两比较,发现6月龄组与12月龄组较3月龄组的差异无统计学意义(P>0.05);18月龄组较3月龄组有明显降低,且差异有显著性(P<0.05)。结论:衰老是大鼠发生ED的主要危险因素,18月龄大鼠已具备建立增龄性大鼠ED模型的条件。  相似文献   

8.
Both RigiScan and the Snap Gauge band devices are used to objectively measure penile rigidity. The Snap Gauge band is the more simple and inexpensive of the two techniques. We investigated the correlation between the results obtained by both devices in order to evaluate whether the Snap Gauge band could be employed as the sole method of rigidity evaluation while not affecting the quality of diagnosis. Forty eight patients who were presented to our erectile dysfunction clinic used the two devices simultaneously, each according to the accepted protocols. Breakage of two and three strings of the Snap Gauge (good rigidity) correlated well with good tip and average rigidity as evaluated by the RigiScan. Snap gauge results also correlated with duration of erection, number of erections, the number of adequate erections, and the longest duration of erection measured by the RigiScan. Therefore, good rigidity according to the Snap Gauge test correlated well with the results of functional erections (number, rigidity, duration) as obtained by the RigiScan. The Snap Gauge band can be used to adequately evaluate penile rigidity. RigiScan measurements, which are more complicated and more expensive, should be reserved for selected patients in whom the results of the Snap Gauge band are inconclusive or when more detailed information is required.  相似文献   

9.
Previous studies have found that the ratio of estradiol to testosterone (E2/T ratio) has a negative effect on sexual function, but the relationship between the E2/T ratio and erection of the penis is not clarified. We conducted a retrospective study of 183 patients with erectile dysfunction and 52 healthy men to investigate the relationship between penis base erection and tip erection. All participants underwent nocturnal penile tumescence tests and medical history checks and had relevant biochemical and endocrine indicators measured. The ratio of estradiol to testosterone was calculated. The relationship between E2/T ratio and erectile time of penile tip and penile base was determined by univariate analysis, multivariate analysis and stratification analysis. After adjusting for mixed factors, the results showed that the E2/T ratio had a more significant negative effect on the base of the penis compared with the tip of the penis (Hazard ratio: −4.34 95% CI: −6.52, −2.16 p = .0001). Moreover, when the effective erection time was ≥10 min, the negative effect of E2/T on penile root erection was more obvious (HR ratio: −4.46 95% CI: −6.50, −2.43 p < .0001). In summary, our study demonstrated a negative relationship between E2/T ratio and penile erection, particularly at the root of the penis.  相似文献   

10.
We review our experience with Melanotan II, a non-selective melanocortin receptor agonist, in human subjects with erectile dysfunction (ED). Melanotan II was administered to 20 men with psychogenic and organic ED using a double-blind placebo-controlled crossover design. Penile rigidity was monitored for 6 h using RigiScan. Level of sexual desire and side effects were reported with a questionnaire. In the absence of sexual stimulation, Melanotan II led to penile erection in 17 of 20 men. Subjects experienced a mean of 41 min Rigiscan tip rigidity>80%. Increased sexual desire was reported after 13/19 (68%) doses of Melanotan II vs 4/21 (19%) of placebo (P<0.01). Nausea and yawning were frequently reported side effects due to Melanotan II; at a dose of 0.025 mg/kg, 12.9% of subjects had severe nausea. We conclude that Melanotan II is a potent initiator of penile erection in men with erectile dysfunction. Our findings warrant further investigation of melanocortin agonists and antagonists on penile erection. International Journal of Impotence Research (2000) 12, Suppl 4, S74-S79.  相似文献   

11.
Aim: Nitric oxide (NO)-mediated smooth muscle relaxation causes penile erections. The endothelial NO synthase (eNOS) coenzyme tetrahydrobiopterin (BH4) converts eNOS-mediated catalytic activity from oxygen radical to NO production, improving endothelial function and vascular smooth muscle relaxation. Methods: Using quantitative immunohistochemistry, 8-isoprostane and nitrotyrosine concentrations were compared in cavernosal tissue from 17 potent and 7 impotent men, and the effect of single oral doses of BH4 on penile rigidity and tumescence was investigated. The pharmacodynamic effect of single oral doses of BH4 on penile rigidity and tumescence was investigated in a randomized, placebo-controlled, double-blind cross-over fashion in 18 patients with erectile dysfunction (ED) while receiving visual sexual stimulation. Results: 8-isoprostane content in endothelium and smooth muscle was signifi- cantly higher in impotent patient samples; the level of nitrotyrosine was unchanged in ED patients. Relative to placebo, a single dose of 200 mg BH4 led to a mean increase in duration of 〉 60% penile rigidity (33.5 rain [95% confidence interval (CI): 13.1-49.3] at base and 29.4 rain [95% CI: 8.9-42,2] at tip). A 500-mg dose increased the relative duration of 〉 60% penile rigidity by 36. I rain (95% CI: 16.3-51.8) at the base and 33.7 rain (95% CI: 11.4-43.9) at the tip. Treatments were well tolerated. Conclusion: BH4 treatment is suggested to switch eNOS catalytic activity from super-oxide to NO formation, leading to a reduced formation of free radical reaction product 8-isoprostane without alteration of nitrotyrosine. The observed results make BH4 a suitable candidate as an ED treatment through reconstitution of altered catalytic activity of the eNOS. (Asian JAndro12006 Mar; 8: 159-167)  相似文献   

12.
糖尿病性阴茎勃起功能障碍动物模型血清雄激素测定   总被引:13,自引:2,他引:11  
SD大鼠注射链脲佐菌素制造溏尿病(DM)动物模型后,注射阿朴吗啡观察不同时期大鼠阴茎勃起情况,筛选DM性阴茎勃起功能障碍(ED)大鼠模型,测定其血清LH、FSH及睾酮的浓度,并观察睾丸组织的显微结构,研究DM性ED的发病机理。结果DM性ED大鼠血清睾酮浓度显著降低,睾丸组织显微结构发生明显病理性改变,且上述变化与DM病程密切相关;LH在DM早期无改变、晚期明显降低;FSH无明显改变。提示DM严重影阴茎勃起功能及雄激素的合成分泌,雄激素降低可能是其主要发病机理之一。  相似文献   

13.
The aim of this study was to assess the influence of anxiety and plasma catecholamines on the pharmaco-induced erection of psychogenic erectile dysfunction (ED) patients. A total of 23 patients with psychogenic ED aged from 19 to 43 y were submitted to: (1) anxiety evaluation by the Spielberger's State and Trait Anxiety Inventory-STAI; (2) intracavernous injection of PGE1 10 microg+phentolamine 1 mg with the response monitored by Rigiscan; (3) blood sampling from cavernous bodies and cubital vein for adrenaline and noradrenaline levels determination by high performance liquid chromatography. The whole procedure was done in a single clinical setting at the same day. We found no significant correlation between the erection rigidity and the cavernous or peripheral catecholamines or between erection rigidity and anxiety scores. Some patients showed rigid erections despite high anxiety scores or penile catecholamine levels while others, with incomplete erections, had much smaller levels. These results are suggestive of a more complex mechanism controlling the penile sympathetic responsiveness in psychogenic ED patients.  相似文献   

14.
目的:研究高同型半胱氨酸血症(HHcy)勃起功能障碍大鼠体内一氧化碳/血红素加氧酶2(CO/HO-2)体系的变化。方法:雄性4周龄Wistar大鼠40只,体重280~310 g,正常喂养1周后,随机分为正常对照组(A组,10只),余30只给予3%蛋氨酸饲料4周后,测定尾静脉血Hcy,将Hcy>16.0μmol/L的大鼠确定为HHcy,由此确定造模成功。将模型组随机均分为B组(HHcy大鼠模型组,继续给予3%蛋氨酸饲料喂养),C组(HHcy盐酸甜菜碱治疗组,每天继续给予3%蛋氨酸饲料喂养,下午定时给予60 mg/kg甜菜碱,0.3 ml生理盐水溶液灌胃)和D组[每日给与锌卟啉IX腹腔内注射45μmol/(kg.d)],4周后处死大鼠提取标本血检测Hcy含量、阴茎海绵体中Hcy的含量及阴茎组织CO测定。分别于4周和8周2个时间点进行阿朴吗啡实验。结果:比较4组大鼠血浆Hcy浓度、阴茎勃起次数、阴茎海绵体组织CO浓度及阴茎组织血管中HO-2阳性细胞数量的检测结果,与A组[(12.55±0.82)μmol/L、(1.88±0.05)次、(10.55±1.73)μmol/L、6 059±1 257]比较,B组[(25.01±0.94)μmol/L、(0.70±0.05)次、(9.51±1.52)μmol/L、2 595±514]血浆中Hcy水平显著上升(P<0.05),阴茎勃起次数、CO的含量与HO-2阳性细胞均下降(P<0.05或P<0.01),并且Hcy与阴茎勃起次数呈负相关性(P<0.01);C组[(14.37±0.47)μmol/L、(1.18±0.08)次、(10.36±1.56)μmol/L、6 295±1 156]与B组比较,阴茎海绵体内Hcy含量下降,而CO与HO-2含量明显升高,阴茎勃起次数明显升高,有统计学意义(P<0.05或P<0.01)。结论:阴茎海绵体中的CO含量及阴茎海绵体HO-2表达减低可能是导致HHcy大鼠勃起功能障碍的原因之一。甜菜碱降低血浆Hcy浓度,增加阴茎海绵体中CO含量,是治疗HHcy勃起功能障碍的机制之一。  相似文献   

15.
SD大鼠注射链脲佐菌素制造糖尿病(DM)动物模型后,注射阿朴吗啡观察6周、8周及12周大鼠队茎勃起情况,筛选MD性阴茎勃起功能障碍(ED)大鼠模型,研究其海绵体肌及坐骨耻骨肌重量及显微结构的改变,并测定其血清睾酮浓度,以探讨DM性ED的发病机理。结果:DM性ED大鼠模型球海绵体肌和坐骨耻骨肌重量及血清睾酮浓度显著降低;显策结构发生明显病理性改变,且上述变化与DM病程密切相关。揭示DM严重影响阴茎勃  相似文献   

16.
Sildenafil improves nocturnal penile erections in organic impotence.   总被引:4,自引:0,他引:4  
We studied the effects of sildenafil on nocturnal penile erections. We prospectively evaluated 36 patients with organic or psychogenic impotence and 5 normal, potent men. All patients completed 3 sessions of consecutive nights using the RigiScan Plus device. The first two nights the patients were asked to take placebo before the session and to take 50 mg of sildenafil before the third session. In the organic impotence group the use of sildenafil induced a significant improvement in time of rigidity 60-100%, rigidity and tumescence activity unit values and rigidity and tumescence activity unit values per hour in the tip and base. In the psychogenic impotence group it caused significant improvement only in rigidity activity unit per hour in the tip. In the potent men, changes were statistically insignificant. Sildenafil improves nocturnal penile erectile activity in organic impotence. Our study shows that phosphodiesterase inhibitors can improve penile erections not induced by sexual stimulation.  相似文献   

17.
BACKGROUND: The aim of this study is to investigate the value of new nocturnal penile tumescence recording parameters, such as tumescence activity unit and rigidity activity unit values, total erection number and erection times, in differentiating between psychogenic erectile dysfunction and organic erectile dysfunction. We also aimed to determine the role of these parameters in differentiating arterial erectile dysfunction from veno-occlusive dysfunction. METHODS: Eighty-seven consecutive patients were allocated into three groups as psychogenic, arterial and venous erectile dysfunction after investigations. Nocturnal penile tumescence recording parameters between psychogenic and vascular erectile dysfunction and arterial and veno-occlusive dysfunction were compared. Mann-Whitney U-test, Pearson's chi2 test and correlation coefficient tests were used for statistical analysis. RESULTS: Depending on intracavernous injection, penile Doppler ultrasonography and cavernosometry tests, 37 patients (43%) had psychogenic impotence while 50 (57%) had organic pathologies. Of the 50 patients diagnosed with vascular impotence, 29 (48%) had arterial failure and 21 (42%) had veno-occlusive dysfunction. Nocturnal penile tumescence recording revealed psychogenic erectile dysfunction in 34 patients (39%) and vascular erectile dysfunction in 53 patients (61%). Nocturnal penile tumescence recording has been regarded as the gold standard and, in our series, it showed 90.6% sensitivity and 88.2% specificity in differentiating the cause of erectile dysfunction. Values of rigidity activity unit and tumescence activity unit were significantly higher in patients with psychogenic impotence (P < 0.001), when compared with vascular impotence. In patients with a vascular cause, no difference was found between arterial failure and veno-occlusive dysfunction with regard to tip tumescence activity unit, base tumescence activity unit, tip rigidity activity unit, base rigidity activity unit and erection time (P > 0.001). However, patients with arterial failure had less erection than patients with veno-occlusive dysfunction (P < 0.001). CONCLUSION: New recording parameters of nocturnal penile tumescence can differentiate organic and psychogenic erectile dysfunction more precisely. However, these recording parameters cannot distinguish subgroups with a vascular cause of erectile dysfunction.  相似文献   

18.
目的:评价每日小剂量他达拉非治疗骨盆骨折尿道断裂(PFUD)后勃起功能障碍(ED)的疗效。方法:2008年1月至2011年12月共有46例骨盆骨折尿道断裂后ED患者纳入观察。患者年龄25~51(33.9±7.2)岁,受伤时间3~72(19.6±12.7)个月。所有患者自诉受伤前的性功能正常。患者在未服用5型磷酸二酯酶抑制剂的情况下进行夜间勃起周径和硬度测量(NPTR)。根据NPTR检测结果将患者分为有夜间勃起异常组和无夜间勃起组。对所有患者给予每晚他达拉非10 mg治疗3个月,采用IIEF-5评分、性生活日记问题2和问题3评价治疗效果。结果:38例(82.6%)患者完成检查和治疗,8例失访。NPTR检测证实夜间勃起异常26例(68.4%),无夜间勃起12例(31.6%)。他达拉非治疗3个月后,夜间勃起异常组患者IIEF-5改善明显高于无夜间勃起组(P<0.05),夜间勃起异常组患者对SEP2和SEP3回答"是"的比例明显高于无夜间勃起组(76.9%vs41.7%,65.4%vs 25.0%,P<0.05)。结论:每日小剂量他达拉非可有效改善PFUD后ED患者的勃起功能,有夜间勃起的患者治疗效果更明显。  相似文献   

19.
西地那非对夜间勃起作用的研究   总被引:3,自引:3,他引:0  
目的:探讨西地那非对夜间勃起的作用。方法:对35例勃起功能障碍(ED)患者予以西地那非100 mg睡前口服,其中器质性28例,心理性7例。用尼娃(NEVA)监测夜间勃起情况。结果:28例器质性ED患者的勃起参数有明显改善(P<0.05),7例心理性ED患者无明显改善(P>0.05)。结论:在无性刺激条件下西地那非可改善器质性ED患者夜间勃起。  相似文献   

20.
彩色多普勒超声检查在血管性勃起功能障碍诊断中的应用   总被引:7,自引:2,他引:5  
目的:评估彩色多普勒超声在诊断血管性勃起功能障碍中的临床价值。方法:应用彩色多普勒超声技术,检测527例疑似血管性勃起功能障碍患者,海绵体注射血管活性药物前、后阴茎海绵体动脉血流动力学。结果:动脉性勃起功能障碍207例(49.88%),静脉性勃起功能障碍144例(34.70%),动静脉性勃起功能障碍64例(15.42%),非血管性勃起功障碍112例(26.99%)。结论:彩色多普勒超声技术是目前诊断血管性勃起功能障碍的一种微创而可靠的检查方法,其能够定量反映阴茎的血流动力学状态,为合理的治疗勃起功能障碍提供有价值的依据。  相似文献   

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