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1.
目的 探讨脊髓损伤对男性性功能的影响.方法 对35例外伤性脊髓损伤患者分为完全性损伤组和不完全性损伤组,随访2年,采用国际勃起功能表(IIEF-5)评定勃起功能,观察脊髓损伤的治疗时间、损伤节段、损伤等级以及尿失禁、肌肉萎缩等因素对患者性功能的影响.方法 完全性损伤组中,患者伤前IIEF-5评分为21.13±0.81分,伤后2年IIEF-5评分为3.13±0.51分,不完全性损伤组中,患者伤前IIEF-5评分为21.40±1.39分,伤后2年IIEF-5评分为11.05±6.35.在两组中,不同的治疗时间、恢复时间、损伤节段、损伤等级、肌肉萎缩和尿失禁的有无对性功能的影响均存在显著差异(p<0.05).结论 外伤性脊髓损伤对男性性功能有明显的影响;治疗时间、恢复时间、损伤节段、损伤等级的不同和并发症等因素对性功能的损伤程度和恢复均有不同的影响.  相似文献   

2.
早泄(PE)是育龄期男性最常见的性功能障碍(SD)之一,选择性5-羟色胺再摄取抑制剂(SSRIs)具有良好的功效、耐受性和安全性,是临床治疗PE的一线药物。长期以来,对于有生育要求的年轻男性服用SSRIs的安全性存在一定争议。截至目前,多篇研究表明SSRIs会导致男性SD,并可能降低精液质量。本文综述了SSRIs对男性性功能与生育能力的影响及其作用机制的研究进展。大量证据显示,SSRIs可通过多种途径损害男性性功能与生育能力,包括打破激素稳态、下调5-HT1A受体、抑制精子发生和精子代谢、阻断精子转运以及损伤精子DNA,其对男性性功能与生育能力的影响呈时间和剂量依赖性。  相似文献   

3.
本文对25例截瘫伤员婚后性功能及生育能力的临床调查说明,不论损伤平面高低,对性的要求并不减退,25例中已有生育者18例,其中男16例,女2例;7例无生育者中男6例,女1例;颈、胸椎伤各1例,腰骶椎损伤5例。男性截瘫伤员不育可能是由于逆行射精或不能射精,尤其是马尾损伤者。结合文献重点讨论男性伤员对性功能的影响。对女性伤员的结婚和生育也进行了简单讨论。  相似文献   

4.
目的探讨脊髓损伤对男性性功能的影响。方法对2017年12月至2019年5月在郑州市第二人民医院诊治的39例外伤性脊髓损伤患者进行回顾性分析。伤后所有患者均手术处理。患者均为男性;年龄28~46岁,平均年龄(37.5±5.5)岁。采用勃起功能国际指数(international index of erectile function-5,IIEF-5)评定勃起功能,神经脊髓功能则用美国脊柱损伤协会(American spinal injury association,ASIA)制定的脊髓损伤神经学分类标准进行ASIA分级、ASIA运动及感觉评分进行评价,观察脊髓损伤前后脊髓神经功能受损及性功能的影响。术后行脊髓神经功能及性功能恢复的对比研究,并对性功能障碍患者进一步测定其反射性勃起和精神性勃起的情况。结果所有患者随访时间14~31个月,平均(21.9±5.2)个月。脊髓损伤后除运动感觉受损外,性功能也同时受损,与伤前比较差异具有统计学意义(P0.05)。IIEF-5评分由伤前的(22.9±1.4)分降为伤后的(11.3±2.7)分,术后提高到(17.9±5.2)分。ASIA感觉评分术前为(116.9±50.0)分,术后提高到(174.6±36.0)分;运动评分术前为(60.5±14.3)分,术后提高到(83.0±13.8)分,感觉评分与运动评分均较术前明显改善,差异有统计学意义(P0.05)。结论外伤性脊髓损伤除导致常见的运动感觉神经功能受损外,对男性性功能有明显的影响。治疗时间、受损节段、损伤程度、恢复时间等因素对性功能障碍的程度和恢复均有影响。  相似文献   

5.
目的 :了解男性心脏移植受者术后的性功能恢复状态。 方法 :对 11例男性心脏移植受者移植前后的性功能状态 (包括性欲、夜间及清晨勃起、自感勃起强度、性生活满意度和性生活频率等 )进行调查。 结果 :移植前受者性功能均普遍下降 ,而心脏移植后 10例受者性功能得到明显改善。 结论 :男性心脏移植受者术后的性功能状况得到明显改善 ,性功能的恢复受到心理社会因素影响。  相似文献   

6.
直肠癌传统手术往往在术中损伤盆腔自主神经.导致术后性功能和排尿功能严重障碍。我院近5年开展直肠全系膜切除术(TME)原则下解剖并保留自主神经治疗直肠癌.明显改善了男性病人术后的自主功能,使其性功能和排尿功能恢复良好,现报道如下。  相似文献   

7.
传统直肠癌根治术对男性患者排尿和性功能的影响   总被引:1,自引:0,他引:1  
目的研究传统直肠癌根治术对男性患者排尿和性功能的影响。方法通过电话、调查表等方式随访48例65岁以下男性直肠癌术后患者的排尿功能和性功能情况,并进行回顾性分析。结果术后性功能障碍总发生率为58.33%,术后排尿功能障碍总发生率为56.25%,比较手术时年龄50岁以下组和50岁以上组性功能和排尿功能障碍发生率;比较不同手术方式(Dixon术及Mile’s术后)性功能和排尿功能障碍发生率;比较DukesB,C期患者性功能和排尿功能障碍发生率,均无统计学意义。结论男性患者直肠癌术后排尿功能和性功能障碍发生率高。手术时患者年龄,手术方式及肿瘤侵犯程度对术后排尿功能和性功能障碍没有直接影响。  相似文献   

8.
目的 研究直肠癌根治术对男性患者排尿和性功能的影响,并探讨相应的护理对策.方法 通过发放调查表、门诊面谈及电话随访等方式调查48例65岁以下男性直肠癌术后患者的排尿功能和性功能情况,并进行回顾性分析.结果 术后10 d排尿功能障碍发生率为56.25%,术后1个月性功能障碍发生率为58.33%.不同年龄、手术方式及Dukes分期患者排尿和性功能障碍发生率比较,差异无显著性意义(均P>0.05).结论 男性患者直肠癌术后排尿和性功能障碍发生率高.需采取针对性护理,促进其排尿和性功能恢复.  相似文献   

9.
目的分析男性性行为损伤的常见类型、易患因素、预防措施及临床诊治。方法回顾分析1990-2006年17例男性性行为损伤患者的临床资料。结果外伤性淋巴管炎2例、阴茎海绵体破裂3例、包皮嵌顿5例、阴茎系带断裂3例、阴茎金属圈套1例、尿道口裂伤2例、阴茎挫伤1例。其中因粗暴性交及非正常体位性交引发损伤10例,强烈手淫5例,金属圈套入和口交引起各1例。经药物或者手术治疗后患者均好转或痊愈。结论男性性行为损伤主要发生在性功能旺盛年龄,性知识缺乏、文化程度偏低、生殖器有先天疾患、异常体位性交、粗暴性交、手淫、口交等是损伤的重要因素。早期诊治生殖器官疾患和正确的性知识教育是预防男性性行为损伤的有效措施。  相似文献   

10.
男性性功能障碍诊治框架   总被引:6,自引:1,他引:5  
性功能障碍是成年男性常见病,本文回顾国内外最新文献,对男性性功能障碍的诊治流程作一概述。  相似文献   

11.
Sexual dysfunction in men with paraparesis in lumbar burst fractures   总被引:5,自引:0,他引:5  
Kim HS  Kim NH  Lee HM  Park HW  Ha JW  Park JO 《Spine》2000,25(17):2187-2190
STUDY DESIGN: A retrospective follow-up study. OBJECTIVES: To review and analyze the sexual function of patients who have sustained lumbar fractures with incomplete paraparesis. SUMMARY OF BACKGROUND DATA: As a result of advances in surgical techniques, most patients with lumbar fractures have significant recovery of neurologic status. Because motor functions are important to patients, most of the studies have concentrated their analyses on motor recovery. Many patients who have almost completely recovered motor function, however, may have sexual dysfunction, especially men. METHODS: Forty-three patients with lumbar fractures that resulted in incomplete paraparesis were analyzed. American Spinal Injury Association motor index points were determined for each patient before and after surgery and used for comparison between American Spinal Injury Association motor index and international index of erectile function score. Eleven male patients who reported sexual dysfunction were evaluated by using Rigiscan. RESULTS: During the follow-up period, 42 patients showed neurologic recovery. Average improvement of American Spinal Injury Association motor score was 13. 1 and average international index of erectile function score was 45. Average improvement of American Spinal Injury Association motor score for patients who had not reported sexual dysfunction was 12.5, and average international index of erectile function score was 52. For 11 patients in the sexual dysfunction group, preoperative motor score was 28.0, and average improvement of score was 14.9. Nocturnal penile tumescence monitoring results were abnormal in four cases. Averaged international index of erectile function score was 15. There was a statistically significant difference between the sexually healthy and dysfunctional groups in international index of erectile function score (P < 0.05), whereas no difference was noted in American Spinal Injury Association motor score. CONCLUSIONS: Neurologic recovery after lumbar fractures was improved. Regardless of neurologic recovery, most patients reported some disability, usually caused by pain and occasionally sexual dysfunction. Impairment of sexual function was present in four patients (9.3%). Although these patients may preserve psychiatric erection potential, they usually experienced sexual problems.  相似文献   

12.
Infertility in individuals with neurologic disorders is complex in etiology and manifestation. Its management therefore often requires a multimodal approach. This review addresses the implications of spinal cord injury (SCI) and other neurologic disease on fertility, including the high prevalence of sexual dysfunction, ejaculation disorders and compromised semen parameters. Available treatment approaches discussed include assisted ejaculation techniques and assisted reproductive technology including surgical sperm retrieval and intracytoplasmic sperm injection (ICSI).  相似文献   

13.
ABSTRACT

In this paper the sexual response cycle and neurologic pathways involved in sexual functioning are reviewed. This is used as a foundation to review the spinal cord injury literature and examine what is primarily self-reported regarding sexual function with varying types of spinal cord injury. A recommendation is made for more thorough, objective studies through which hypotheses can be tested and a foundation built for prognostication of how sexual functioning will be altered after varying types of SCI. (J Am Paraplegia Soc 1991; 14: 40–43)  相似文献   

14.
The authors report a rare case of transverse fracture of the second sacral vertebra that was isolated, with neurologic deficit, and treated conservatively by reduction opposing the trauma mechanism, and immobilization in plaster. After 22 months there was good neurologic recovery, although some perineal sensory disorders persisted, as did sexual deficit. This method is believed to be a valid one as an alternative to surgery, which is difficult, and not without complications.  相似文献   

15.
A single-center experience with liver transplantation for Wilson's disease   总被引:1,自引:0,他引:1  
Abstract:  Wilson's disease is an inherited disorder of copper metabolism, presenting with prominent hepatic and neurologic manifestations. There is an established place for liver transplantation in the presence of liver disease, while the indication for neurologic manifestations is debated. Between 1993 and 2005, 11 patients were liver transplanted for Wilson's disease at our institution. We retrospectively reviewed the medical records of the patients. The pathology of the explanted livers was analyzed. The patients were divided into three groups based on the evolution of the disease. Postoperative data gathered included patient and graft outcome, complications, neurologic status, and copper metabolism. Six males and five females were transplanted at a mean age of 29.7 yr (range 15–48 yr). Three patients had a fulminant presentation, two patients had decompensation of established disease, and six patients had chronic disease. Neurologic features were prominent in five patients. The pathologic analysis of the explanted graft showed cirrhosis in all patients. The five patients with fulminant and acute on chronic presentations also showed necrosis in the explant. The mean postoperative follow-up was 56.8 months (range 10–129 months). Two patients were re-transplanted. One patient died because of severe sepsis. Two patients with severe neurologic dysfunction showed significant remission of symptoms. Liver transplantation is a safe and effective treatment for both acute and chronic presentations of Wilson's disease. Acute presentation correlates with the presence of necrosis in the explanted liver. In our series, there was a relevant improvement of the neurologic features after transplantation.  相似文献   

16.
Etiology of diabetic impotence   总被引:3,自引:0,他引:3  
We evaluated 31 male diabetics for sexual dysfunction. Patients were examined by an endocrinologist, psychologist or psychiatrist, urologist and neurophysiologist. Evaluation was done by penile blood pressure, pudendal nerve latency, psychologic testing and laboratory tests, including serum testosterone levels. Mean patient age was 53 years and the average onset of sexual dysfunction was 6 years after the diagnosis of diabetes. Results showed that 68 per cent of the patients had evidence of vascular occlusion, 26 per cent had neurologic abnormalities, 19 per cent had low plasma testosterone levels and 38 per cent had relevant psychological problems, although the condition was considered primarily psychogenic in only 19 per cent. Of those patients with abnormal nerve latencies 86 per cent had abnormal Doppler penile systolic pressures, while only 28 per cent of the patients with abnormal penile pressures had abnormal neurologic findings. These data suggest that vascular occlusion is the most prevalent abnormality in impotent diabetics and may predate neurologic abnormalities. The diabetics were divided into 2 groups, insulin-dependent and insulin-nondependent patients. A higher incidence of vascular lesions was found in insulin-dependent diabetics (83 versus 57 per cent), suggesting that vascular pathological conditions are related to severity of the diabetes. Although most diabetics have a vascular etiology for impotence one must remember that other causes may be present and that a thorough investigation is necessary.  相似文献   

17.
Male sexual dysfunction-a term that is commonly used to refer to erectile dysfunction, premature ejaculation, decreased libido and impaired orgasm-is the primary complaint encountered by many urologists. Despite the high prevalence and bothersome nature of these complaints, they are frequently neglected in clinical practice. This paper highlights clinical situations in which urologists should systematically evaluate male sexual functioning. These include men who present with several common urologic disorders, such as pelvic trauma, malignancies, and lower urinary tract symptoms associated with benign prostatic hyperplasia, neurologic disorders and infertility. Studies have shown that erectile dysfunction might be a clinical marker of endothelial dysfunction, and consequently of undetected diabetes, hypertension, dyslipidemia, coronary artery disease and depression. We also address the question of whether urologists should adopt wide-ranging screening regimens for sexual dysfunction.  相似文献   

18.
Biology of female sexual function   总被引:2,自引:0,他引:2  
Although the psychosocial and relationship aspects of female sexuality have been extensively investigated, studies concerning the anatomy, physiology and pathophysiology of female sexual function and dysfunction are limited. The paucity of biologic data may be attributed to a lack of reliable experimental models and tools for investigating female sexual function and to limited funding, which is critical for developing experimental approaches. Research efforts by several investigators in different laboratories have been establishing experimental models needed for investigating the physiologic mechanisms involved in the genital arousal response of sexual function. These experimental models have permitted assessment of genital hemodynamics, vaginal lubrication, regulation of genital smooth muscle contractility and signaling pathways, providing preliminary information about the role of neurotransmitters and sex steroid hormones in sexual function. Further research is needed to define the neurotransmitters responsible for vaginal smooth muscle relaxation and the role of sex steroid hormones and their receptors in modulating genital hemodynamics, smooth muscle contractility, and neurotransmitter receptor expression. Finally, a global and integral understanding of the biologic aspects of female sexual function requires investigation of the vascular, neurologic (central and peripheral), and structural components of this extremely complex physiologic process.  相似文献   

19.
Living-related liver transplantation for Wilson's disease   总被引:2,自引:0,他引:2  
Liver transplantation with liver grafts from deceased donors is the treatment of choice for patients suffering from Wilson's disease (WD) with end-stage liver disease. There are few reports, however, on the use of liver grafts from living-related donors for WD. Five (two pediatric and three adult recipients) underwent living-related liver transplantation (LRLT) for WD at the University of Tokyo. Two patients presented with fulminant hepatic failure with hemolysis, and the other three presented with decompensating cirrhosis, one with an overlapping neurologic WD. All recipients had a low serum ceruloplasmin level (median: 18 mg/dL), high urinary copper level (mean: 1119 microg/d), and presented with Kayser-Fleischer rings before transplantation. Although one patient died from early graft thrombosis unrelated to WD, the other four patients have shown an excellent long-term prognosis. Following successful transplantation, there was a significant reduction in urinary copper excretion (median: 64 microg/d) in all patients. The neurologic symptoms of WD in one patient, however, worsened after 2 months and gradually subsided, but not completely, over the 2-yr follow-up. For advanced liver failure in WD, we consider LRLT a valuable life-saving option. The improvement of neurologic symptoms, however, requires further evaluation.  相似文献   

20.
Living-related liver transplantation for Wilson''s disease   总被引:5,自引:0,他引:5  
Orthotopic liver transplantation has been applied to the treatment of Wilson's disease (WD), living-related liver transplantation (LRLT) has also been indicated for WD with increasing frequency. Between January 2001 and November 2003, 22 LRLTs were performed on patients (19 pediatric, three adults) with WD in liver transplantation center. Two patients were transplanted because of a presentation coexistent with fulminant hepatic failure. Twenty presented with chronic advanced liver disease with (n = 9) or without (n = 11) associated neurologic manifestations. All the recipients had low serum ceruloplasmin levels with a mean value of 12.8 +/- 3.2 mg/dl before transplantation and increased to an average of 26.0 +/- 3.6 mg/dl after LRLT at the latest evaluation. The survival patients with neurologic manifestations such as tremor, dysarthia, dysphagia, dystonia and sialorrhea had improved after LRLT. This suggests that LRLT not only resolves the hepatic but also ameliorates the neurologic consequences of WD.  相似文献   

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