彩色多普勒超声和夜间生物电阻抗容积测定对阴茎勃起功能障碍诊断的比较

目的:探讨彩色多普勒超声(CDUS)和夜间生物电阻抗容积测定(NEVA)对勃起功能障碍(ED)诊断的相互关系及后者对ED病因的诊断价值。方法:应用CDUS及NEVA分别检测45例ED患者的阴茎勃起情况,基于CDUS检测结果将ED患者分为动、静脉性及非血管性3组,对NEVA各参数进行组间两两比较,并探讨两种检查方法之间的相互关系。结果:非血管性ED组NEVA结果正常达94.4%,而动、静脉性ED组NEVA结果异常分别为75.0%和72.7%。NEVA各参数3组间相互比较仅静脉性ED组的阴茎血容量改变明显低于非血管性ED组(P=0.033)。结论:NEVA结果正常与否和CDUS提示的动、静脉功能良好与否存在较好的一致性;NEVA在一定程度上可以反映阴茎血管功能状况,提示ED的病因。     

NEVA夜间阴茎勃起测定系统的临床应用 (附83例报告)

目的探讨应用NEVA夜间阴茎勃起测定系统检测勃起功能障碍的可行性及其中存在的问题。方法83例门诊初诊勃起功能障碍的男性,睡前正确粘贴NEVA测定仪电极,完整检测睡眠时段,次晨把数据上传入主机回放分析。结果全部病人均对测试耐受良好,62例病人资料提示阴茎无器质性疾病,14例提示阴茎动脉轻度供血不足,7例提示阴茎动脉重度供血不足,3种勃起事件分别为(4.240.6)7次(,3.600.8)1次(,1.430.)69次;平均阴茎血容量峰/基准比值为(327.2251.6)3%,(171.3423.9)2%,(127.3414.5)8%。结论NEVA夜间阴茎勃起测定系统简便、无创,可作为勃起功能障碍病人的常规检测手段。     

夜间阴茎勃起测定系统筛选勃起功能障碍病人的临床应用

目的 :探讨应用尼娃牌 (NEVA)夜间阴茎勃起测定系统筛选勃起功能障碍 (ED)的可行性及意义。　方法 :2 0例门诊ED病人 ,睡前正确粘贴NEVA测定仪电极 ,带机过夜 ,次日数据回放输入主机分析。　结果 :全部病人均可耐受测定 ,依从性好 ,15例病人资料提示阴茎无器质性疾病 ,4例提示阴茎动脉供血不足 ,1例可疑阴茎静脉漏 ,3种病例勃起事件分别为 ( 4 .0± 0 .4 )、( 3 .2± 0 .3 )、( 2 .0± 0 )次 ,阴茎截面积最大改变量分别为( 0 .178± 0 .0 18)、( 0 .0 80± 0 .0 0 4 )、( 0 .13 5± 0 )cm2 ,平均勃起状态阴茎血容量分别为基准水平的 ( 2 2 5 .5± 12 .0 ) %、( 14 5 .2± 10 .6) %、( 12 8.0± 0 ) %。　结论 :尼娃牌夜间阴茎勃起测定系统操作简便、易行、无创伤 ,可区分心理性、血管性ED。     

勃起功能障碍患者夜间阴茎勃起监测的临床分析

近年来国内外越来越多的采用夜间阴茎勃起现象(NPT)监测,作为勃起功能障碍(ED)临床诊断的一个重要手段.我院采用YJZ-204A型阳痿检测仪对108例ED患者进行监测,其结果如下.     

彩色多普勒超声在诊断血管性阴茎勃起障碍中的价值

彩色多普勒超声检测阴茎血流状态不仅可以鉴别血管性阴茎勃起障碍（ＥＤ）与非血管性ＥＤ,而且在区别动脉性ＥＤ与静脉性ＥＤ中有一定意义［１,２］。本文采用彩色多普勒超声检测４５名血管性和非血管性ＥＤ患者阴茎海绵体内注射血管活性药物前后阴茎深动脉血流状态,探讨彩色多普勒超声在诊断血管性ＥＤ中的价值。材料与方法一、临床资料本组共４５名,于１９９６年３月至１９９６年１０月间随机选自浙江医科大学男性科门诊ＥＤ患者,均经详细询问病史。年龄２１～５５岁,平均３３岁,病程２月～１８０月,平均２６月。其中２５例非血管…     

NEVA-夜间阴茎勃起测定系统的临床应用(附600例报告)

阴茎勃起功能障碍(ED)是一种常见病，ED的发生可起源于多种不同的病理生理学过程，临床诊治工作需要对每一位ED患者进行病因诊断，目前夜间阴茎勃起测定(NPT)不仅是鉴别心理性和器质性ED的重要方法，而且是用来作为客观分析和评价ED治疗药物以及方法的一种必要研究手段，因此我们使用NEVA-夜间阴茎勃起测定系统对一组ED患者进行检查，现将检查情况报告如下。     

彩色多普勒超声在血管性阴茎勃起功能障碍诊断中的应用

目的评估阴茎海绵体注射后彩色多普勒超声对男性血管性阴茎勃起功能障碍（ED）患者诊断作用。方法47例ED患者经阴茎海绵体注射PGE1 30μg诱导勃起后行彩色超声多普勒检查左、右海绵体动脉血流指标,包括收缩期最大流速（PSV）,动脉舒张末期血流速度（EDV）,阻力指数（RI）。结果非血管性ED组41例（87.2%）,其中左、右海绵体动脉PSV分别〉25 cm/s者33例,左右海绵体动脉PSV相加〉50 cm/s者8例。动脉性ED组2例（4.25%）,左右海绵体动脉PSV均〈25 cm/s,背深静脉未见血流。静脉性ED组4例（8.51%）。结论阴茎海绵体注射血管活性药物后多普勒彩色超声对男性血管性ED检查是一种微创而准确的方法。     

夜间阴茎勃起试验在勃起功能障碍诊断中的应用

勃起功能障碍(erectile dysfunction,ED)常见于男性尤其是中、老年男性.根据病因将其分为器质性ED(动脉性、静脉性、神经性和内分泌性等)、心理性ED及混合性ED(器质性病因和心理因素同时存在)3种类型.ED的诊断除了详细的病史资料、体格检查和一般实验室检查之外,部分患者必须通过一种或者多种特殊检查才能最后确诊.随着对阴     

双功能彩色多普勒超声在勃起功能障碍诊断中的应用价值

目的 探讨血管活性药物诱导后双功能彩色多普勒超声(DCDU)对勃起功能障碍(ED)的诊断及其应用前景。方法 采用罂粟碱及立其丁混合液海绵体内注射诱导阴茎勃起后行DCDU检测,测定SPV、EDV、RI及判定勃起硬度分级。结果 动脉性ED16例,静脉性ED28例,非血管性ED23例,其中Peyronie’s病4例。阴茎硬度分级为Ⅴ度9例,Ⅳ度14例,Ⅲ度25例,Ⅱ度19例。Ⅳ、Ⅴ度提示为非血管性ED,Ⅲ度以下提示为血管性ED。结论 DCDU为筛选血管性ED的一线诊断方法。     

复方玄驹胶囊对勃起功能障碍患者夜间阴茎勃起的影响

目的探讨复方玄驹胶囊对勃起功能障碍(ED)患者夜间阴茎勃起的作用。方法通过RigiScan阴茎硬度检测仪对门诊就诊的32例ED患者进行夜间阴茎勃起硬度和膨胀度(NPTR)检测,根据结果分为器质性ED(13例)和心理性ED(19例)两组。两组患者完成国际勃起功能指数-5(IIEF-5)评估后给予复方玄驹胶囊口服,一日3次,一次3g,用药4周后使用RigiScan再次复测NPTR及再次完成IIEF-5评估。比较用药前后NPTR参数变化,包括勃起次数、阴茎头部有效勃起的持续时间、阴茎周径变化、阴茎头/根部硬度活动单位(RAU)及膨胀活动单位(TAU)以及IIEF-5评分变化情况。结果服用复方玄驹胶囊4周后,器质性ED组患者夜间勃起次数、阴茎头部有效勃起的持续时间、阴茎周径变化,以及阴茎头/根部RAU及TAU均有显著改善(P0.05);心理性ED组患者阴茎头部有效勃起的持续时间、平均勃起次数、阴茎周径变化有显著改善(P0.05),但头/根部的RAU及TAU与治疗前比较无统计学差异(P0.05)。器质性ED组治疗后IIEF-5评分显著改善[(7.5±2.1)vs.(5.9±1.6),P0.05],但心理性ED组治疗前后无统计学差异[(14.6±5.0)vs.(13.5±4.2),P0.05]。结论复方玄驹胶囊可改善器质性ED患者和心理性ED患者的夜间阴茎勃起状况。     

Prolonged nocturnal penile tumescence caused by epinastine

PURPOSE: We report a case of prolonged nocturnal penile tumescence (NPT) caused by the antiallergic agent epinastine. METHODS/RESULTS: We measured NPT using Rigiscan-Plus (DacoMed, Minneapolis, MN, USA) with or without the patient having taken epinastine. CONCLUSIONS: Considering its pharmacological effects on cyclic nucleotides, epinastine may have an effect on erectile function.     

多导睡眠仪监测下夜间阴茎勃起(NPT) 测定的应用价值

目的探讨多导睡眠仪监测下夜间阴茎勃起(NPT)测定在男性勃起功能障碍(ED)诊断中的作用及意义.方法我们将ED患者随机分成两组各60例、75例分别行多导睡眠仪监测下NPT和普通NPT检查,采用尼娃(NEVA)夜间阴茎勃起测定系统,以阴茎勃起幅度、勃起次数、勃起持续时间等作为评定指标.结果阴茎勃起幅度睡眠监测组为304.90±99.79,普通组为188.43±86.62,两组间存在显著差异(P＜0.01),两组的勃起次数、勃起持续时间也有差异(P＜0.05).结论多导睡眠仪监测下NPT测定具有准确掌握患者睡眠质量,检查数据误差小的优点,尤其对一些病情与诊断不符,怀疑普通NPT检查有假性结果的特殊病例,有较大的应用价值.     

夜间勃起功能监测结果与他达拉非治疗勃起功能障碍疗效的相关性研究

目的:评价夜间勃起功能监测(NPT)结果与他达拉非疗效的相关性。方法:188例ED患者,根据NPT结果分为NPT正常组(n=136)和NPT异常组(n=52),2组患者均给予他达拉非治疗,3次/周,每次20mg。治疗前及治疗1个月后,分别评价IIEF-5评分、阴茎插入成功率(SEP2)、完成性交成功率(SEP3)以及总体评价问卷(GAQ),比较2组间治疗前后各项指标的变化。结果:2组患者用药后其IIEF-5评分、SEP2、SEP3均显著高于用药前(P<0.01)。NPT正常组患者治疗后的IIEF-5评分、SEP2、SEP3及GAQ均显著高于NPT异常组患者治疗后结果(P<0.05,P<0.01)。结论:经过他达拉非治疗1个月后,NPT正常组患者勃起功能(包括IIEF-5评分、SEP2及SEP3)较NPT异常组改善更为显著,即NPT正常组患者行他达拉非治疗疗效更佳。     

The correlation between penile tumescence measured by the erectometer and penile rigidity by the RigiScan

BACKGROUND: The goal of this study was to evaluate the correlation between increments of penile tumescence and penile rigidity measured by the erectometer and the RigiScan, respectively. METHODS: Nocturnal penile tumescence (NPT) was measured in 25 volunteers (mean age, 49.5 years). The erectometer and the RigiScan were used simultaneously for a total of 47 nights. We studied the correlation between maximum penile circumferential changes determined by the erectometer and penile rigidity patterns measured by the RigiScan. RESULTS: Maximum circumferential changes during NPT measured by the erectometer were well correlated to those determined by the RigiScan (correlation coefficient, 0.719). In addition, penile circumferential changes measured by the erectometer corresponded well to the penile rigidity pattern determined by the RigiScan (P=0.0001). Specifically, maximum penile circumferential changes of more than 30 mm and less than 10 mm had 70% positive predictive value and 100% negative predictive value for predicting the normal rigidity pattern, respectively. CONCLUSIONS: Penile circumferential changes measured by the erectometer were well correlated to penile rigidity measured by the RigiScan, particularly when the increments were larger than 30 mm or less than 10 mm. These results suggested that the erectometer was a useful tool to estimate the penile rigidity patterns of the RigiScan.     

Long-term treatment of erectile dysfunction with a phosphodiesterase-5 inhibitor and dose optimization based on nocturnal penile tumescence

Associate Editor Michael G. Wyllie Editorial Board Ian Eardley, UK Jean Fourcroy, USA Sidney Glina, Brazil Julia Heiman, USA Chris McMahon, Australia Bob Millar, UK Alvaro Morales, Canada Michael Perelman, USA Marcel Waldinger, Netherlands

OBJECTIVE

To test the hypothesis that a variable dosage of the oral phosphodiesterase type 5 (PDE5) inhibitor sildenafil (25, 50, 100 mg) or vardenafil (5, 10, 25 mg) determined according to results obtained from nocturnal penile tumescence and rigidity (NPTR, RigiScan), given nightly for 1 year, can improve spontaneous erectile function (EF) in men with mild‐to‐moderate arteriogenic erectile dysfunction (ED); this regimen was compared with a fixed daily dosage of sildenafil 25 mg or vardenafil 5 mg.

PATIENTS AND METHODS

In a prospective open‐label, parallel‐group trial 154 men with ED were randomized either to fixed low‐dose sildenafil 25 mg or vardenafil 5 mg (group 1) or to the lowest erectile dosage of sildenafil (25, 50 or 100 mg) or vardenafil (5, 10 or 20 mg) (group 2) provoking an erectile event as measured by NPTR nightly for 1 year. The EF domain of the International Index of Erectile Function (IIEF) was assessed before and 1 year after the beginning of treatment, and at 4 weeks after ending treatment.

RESULTS

After 1 year, 27 of 63 (64%) evaluable men in group 1 had an EF domain score in the normal range, vs 46 of 61 (75%) men in group 2. After the subsequent 4‐week wash‐out phase, both groups continued to have improved EF domain scores; 22 of 63 (35%) men in group 1 still had a score in the normal range, whereas 38 of 61 (62%) in group 2 had a normal score. The EF domain score in group 1 and 2 improved significantly after 1 year of treatment, from 13.6 to 18.9, and 15.1 to 23.9, respectively (P < 0.01). After the subsequent 4‐week wash‐out phase, men from both groups maintained this significant level of EF, at 17.1 and 22.4, respectively (P < 0.05).

CONCLUSION

Nightly PDE5‐inhibitor treatment 1 year in a dosage determined by NPTR measurements results in better EF than giving a fixed dosage of sildenafil (25 mg) or vardenafil (5 mg). This improvement persisted for >4 weeks beyond the end of treatment. The results from this open‐label, randomized trial warrant verification under double‐blind, placebo‐controlled conditions.     

Erectile function and nocturnal penile tumescence in patients with prostate cancer undergoing luteinizing hormone-releasing hormone agonist therapy.

BACKGROUND: Luteinizing hormone-releasing hormone (LHRH) agonists have been widely used as effective agents in endocrine therapy for prostate cancer. Continuous administration of the drug results in profound suppression of testicular androgen production. However, the side effects on erectile function have not been fully investigated. METHODS: We studied the influences of testosterone suppression on male sexual function and nocturnal penile tumescence in nine sexually active patients with prostate cancer who were treated with an LHRH agonist. RESULTS: Following reduction of serum testosterone concentrations to a castration level by the administration of the LHRH agonist, sexual desire, sexual interest and sexual intercourse were totally annulled, with significant changes in frequency, magnitude, duration and rigidity of nocturnal erections observed in all patients. CONCLUSIONS: These results demonstrate that the LHRH agonist strongly suppresses erectile function and sexual activity. Taking into account the quality of sexual function for relatively young and sexually active patients and their partners, it is necessary to establish effective modalities that minimize the adverse effects on sexual function for the treatment of patients with prostate cancer.     

Effect of low-intensity extracorporeal shockwave therapy on nocturnal penile tumescence and rigidity and penile haemodynamics

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.     

Stratification of penile vascular pathologies in patients with Peyronie's disease and in men with erectile dysfunction according to age: a comparative study

PURPOSE: Erectile dysfunction (ED) occurs in 20% to 54% of men with Peyronie's disease (PD). We investigated the role of vascular status in the pathophysiology of ED in patients with PD. MATERIALS AND METHODS: A total of 509 consecutive men with PD (group 1--impotent 259, 1a, and potent 250, 1b, mean age +/- SD 54.6 +/- 4.4 years) and 507 consecutive men with ED only (group 2--mean age 49.4 +/- 12.4 years) underwent penile duplex ultrasonography (PDU). Detailed sexual and medical history, and focused physical examination were performed in all patients. Patients in the 2, groups were stratified according to age (18 to 80 years) and classified according to PDU results (normal vascular status, arterial insufficiency, veno-occlusive dysfunction [VOD] and mixed vascular pathology). RESULTS: VOD was observed in 23.1% and 42.8% of patients in groups 1 and 2, respectively (p <0.05). Although VOD was significantly more common in group 2 (ED alone) than in group 1a (PD plus ED) in the third decade (p <0.05), overall PDU results showed no statistical difference for VOD between these 2 groups (p >0.05). Of note, mixed vascular pathologies were significantly higher in group 1a than in group 2 in the third through fifth decades (p <0.05), while arterial insufficiency was more common in the seventh decade (p <0.05). CONCLUSIONS: While many groups have investigated the vascular causes of ED, the exact etiology of ED in men with PD remains controversial. A possible relationship between ED and VOD in patients with PD has been previously reported. The current PDU study demonstrates that for all ages except 30 to 39 years the prevalence of VOD in patients with PD plus ED is similar to that of patients with ED alone.     

The actual incidence of papaverine-induced priapism in patients with erectile dysfunction following penile colour Doppler ultrasonography

Penile color Doppler sonography is a valuable method for evaluating erectile dysfunction. However, there are some concerns about the safety of this method due to the intracorporeal pharmacological injection, which may cause priapism as a complication, resulting in penile fibrosis. To evaluate the actual incidence of papaverine-induced priapism in patients with erectile dysfunction (ED) who underwent penile colour Doppler sonography and to determine the safety of this diagnostic tool, a retrospective study was conducted using the database of our institution. A total of 672 men with ED underwent penile color Doppler ultrasonography with the intracorporeal injection of 60 mg papaverine hydrochloride. The patient characteristics of priapism cases were retrospectively evaluated. Priapism in 18 of the 672 patients (2.68%) was successfully treated with blood aspiration, irrigation and injection of an α-agonist medication, when needed. Patients with priapism were younger compared with those without priapism; mean age 45 ± 12.51 (20–68) versus 50.93 ± 12.04 (17–78) ( P  < 0.001). Penile Doppler ultrasound is a safe procedure in evaluating erectile dysfunction. The incidence of priapism, which is the most important complication of this procedure, is low and can be managed successfully with conservative approaches.     

Comparison of international index of erectile function with nocturnal penile tumescence and rigidity testing in evaluation of erectile dysfunction

We tried to compare the parameters of nocturnal penile tumescence and rigidity (NPTR) testing with erectile function (EF) domain score of International Index of Erectile Function (IIEF), which is used in diagnosis and determining the severity of erectile dysfunction (ED), and to assess the sufficiency of IIEF in the diagnosis of ED. A total of 90 men, mean age 46 years (24-75), presenting with ED to our clinic between January 2001 and March 2003 were included in the trial. All the men answered the standard IIEF (15 questions) forms and was divided into four groups as mild ED, moderate ED, severe ED and no ED according to the EF domain score that is obtained from 1st, 2nd, 3rd, 4th, 5th and 15th questions. Then NPTR testing with the RigiScan Plus monitoring device was performed for two consecutive nights on those men. The distribution of the six parameters of NPTR testing (number of erections, duration of erections, TAU base, RAU base, TAU tip, RAU tip) among the four groups and the correlation with IIEF-EF domain score were evaluated. Additionally, the distribution of the risk factors (diabetes mellitus, hypertension, atherosclerotic heart disease, dyslipidemia and smoking) was analyzed both among the four groups and in each group. According to IIEF-EF domain scores of 90 patients, 16 (18%) had severe ED, 21 (23%) moderate ED, 41 (46%) mild ED and 12 (13%) no ED. There was no statistically significant difference between the risk factors among the men in these groups (P > 0.05). When the IIEF-EF domain scores were compared with parameters of NPTR testing, no statistically significant difference was obtained among ED groups (mild, moderate, severe) (P > 0.05). However, we observed a statistically significant difference between three ED groups and no ED group (P < 0.05). If NPTR testing is considered as a gold standard test, sensitivity, specificity, positive predictive value and negative predictive value of IIEF-EF domain score in ED diagnosis are 100, 17.9, 29.4 and 100% respectively. In conclusion, we did not observe a clinical correlation between IIEF-EF domain scores and NPTR parameters in the whole population; however, we observed that if IIEF-EF domain scores were normal, NPTR parameters were also normal. In other words, we can say that if the initial IIEF-EF domain scores are normal, then we do not have to perform NPTR testing. This could be helpful to make a cost-effective diagnosis.