静脉性阳萎阴茎背深静脉病理改变

１９９０￣１９９５年期间，２２例静脉性阳萎患者接受手术治疗，其中行单纯性阴茎背静脉结扎切除术３例，阴茎脚加阴茎背静脉结扎术１９例。经平均１４．３个月随访，Ｉ级１例，阴茎勃起正常；Ⅱ级６例，阴茎仍勃起不坚，但可性交，总有效率７７．３％。作者对其中１６例患者的阴茎背深静脉进行了组织病理学研究，并以３例正常人阴茎背深静脉作对照。结果显示，所有１６例患者的阴茎背深静脉均有病理改变，其中最多见的是管壁增厚或     

阴茎背深静脉高位断流术治疗静脉性阳萎

为了提高静脉性阳萎的手术效果,作者在尸体阴茎静脉解剖及阳萎患者背深静脉造影研究的基础上,设计了阴茎背深静脉高位断流术,以此治疗静脉性阳萎26例,随访4～25个月,有效率达92.69%。作者认为:这一术式既避免了低位结扎术分流阻断不全的缺点,又可克服超高位结扎术易形成侧支循环引起复发的弱点,是一种较为理想的手术方法。     

阴茎背深静脉结扎治疗血管性阳萎远期效果

本文报告23例因血管性阳萎行阴茎背深静脉结扎术。23例术前均经doppler鉴别检查和阴茎海绵体造影确诊为阴茎背深静脉漏性阳萎。术后对17例随访2～3年,其中16例2年内阻茎勃起功能正常。     

阴茎背神经局部解剖学研究及其临床意义

目的:研究正常人阴茎背神经数目、走行和分布及其在阴茎背神经选择性切断术治疗原发性早泄手术中的应用价值。方法:解剖38具成年男性尸体阴茎,显露阴茎背神经,记录阴茎背神经的数目及走行、分布。选择314例原发性早泄患者行阴茎背神经选择性切断术,患者年龄20～45岁,病程1～22年。结果:38具尸体阴茎背神经平行分布于阴茎背侧和两侧面,4具尸体阴茎背神经分支分布到阴茎腹侧面;38具尸体阴茎背神经数目为(3.6±1.2)支,其中7支1例,6支1例,5支6例,4支9例,3支14例,2支7例。314例原发性早泄患者阴茎背神经数目为(7.0±1.9)支:其中5支64例,6支56例,7支52例,8支40例,9支33例,10支28例,11支25例,12支11例,13支5例。手术后阴道内射精潜伏期为(4.31±1.87)min,性生活满意度为(61±17)%,与手术前[(1.24±0.32)min;(23±6)%]相比,差异有显著性(P均<0.01)。结论:阴茎背神经数目异常增多可能是原发性早泄的病理学基础,阴茎背神经选择性切断术治疗原发性早泄安全、有效。     

改良式阴茎背神经切断术治疗原发性早泄

目的 探讨改良式阴茎背神经切除术的效果.方法 回顾分析广州、乐清、哈尔滨三家三级医院在2008年7月到2010年5月期间开展的338例该项手术.对术后的疗效,并发症给予客观的评价.结果 对338例原发性早泄患者中的87例经2年以上随访,显效率59.8%.术后射精潜伏期没有明显变化5例,阴茎麻木感2例,勃起功能障碍1例,阴茎血肿1例,切口感染2例.结论 改良式阴茎背神经切断术治疗原发性早泄安全,有效.     

经阴茎背深静脉栓塞治疗静脉漏性阳萎（附40例报告）

经阴茎背深静脉栓塞治疗静脉漏性阳萎（附４０例报告）宋华志，贺继刚，刘琴珍，闫小纺，田家林，李志雄，王平１９９４年４月～１９９５年１１月经阴茎背深静脉栓塞治疗静脉漏性阳萎４０例，疗效满意。报告如下。临床资料本组４０例，年龄２５～７０岁，平均３７．８岁。...     

阴茎背神经选择性切断术对阴茎敏感度影响的临床研究

目的 通过阴茎生物震感阈值测定法评估阴茎背神经选择性切断术前后阴茎敏感度的变化.方法 原发性早泄患者92例行阴茎背神经选择性切断术,分别检测术前、术后1个月和术后3个月的阴茎生物震感阈值.结果 阴茎头震感阈值(GPVT):术前为(0.048±0.015)μm,术后1个月为(0.280±0.084)μm,术后3个月为(0.282±0.081)μm;阴茎体震感阈值(PSVT):术前为(0.061±0.014)μm,术后1个月为(0.064±0.022)μm,术后3个月为(0.065±0.020)μm.统计学方差分析:(1)术后1个月GPVT比术前明显升高(P＜0.05);(2)术后3个月GPVT比术前显著升高(P＜0.05);(3)术后1个月和3个月GPVT无明显变化(P＞0.05);(4)术前、术后PSVT无明显变化(P＞0.05).结论 (1)阴茎生物震感阈值测定法是简便、无创、可定量、重复性好的阴茎背神经感觉客观检测方法之一.(2)阴茎背神经选择性切断术后阴茎头敏感度降低、震感阈值提高.(3)阴茎背神经选择性切断术治疗原发性早泄安全、有效.     

超声引导改良阴茎背神经阻滞联合酮咯酸氨丁三醇预先镇痛用于患儿包皮环切术的效果

目的观察超声引导改良阴茎背神经阻滞联合酮咯酸氨丁三醇预先镇痛用于患儿包皮环切术的效果。方法选择包皮环切术的患儿45例,ASAⅠ级。采用随机数字表法分为三组,每组15例。三组均采用相同的静脉麻醉,A组与B组术前在超声引导下行改良阴茎背神经阻滞,给予0.2%罗哌卡因+0.8%利多卡因混合液0.1 ml/kg;A组与C组术前肌注酮咯酸氨丁三醇1mg/kg。记录丙泊酚和舒芬太尼总用量、术中呼吸抑制和体动反应、PACU苏醒时间、苏醒后至出PACU时间、术后躁动、恶心、呕吐、瘙痒等不良反应以及术后使用对乙酰氨基酚栓补救镇痛的例数。结果与C组比较,A组与B组丙泊酚和舒芬太尼总用量明显减少,术中体动和呼吸抑制发生率明显降低,苏醒时间和苏醒后至出PACU时间明显缩短,对乙酰氨基酚栓使用率明显降低(P0.05)。A组对乙酰氨基酚栓使用率明显低于B组(P0.05)。三组均未发生恶心、呕吐或瘙痒等不良反应,三组术后躁动发生率差异无统计学意义。结论超声引导改良阴茎背神经阻滞联合酮咯酸氨丁三醇预先镇痛用于患儿包皮环切术安全有效且具有良好的术后镇痛效果。     

阴茎背神经切断术治疗早泄

目的评价阴茎背神经切断术治疗早泄的效果。方法自1997~2006年门诊早泄患者19例行阴茎背神经切断术治疗早泄。局麻下于阴茎背侧距冠状沟0.5~1cm处做2~3cm横切口,切开深筋膜,暴露左右两侧之阴茎背神经,并切除部分神经分支。记录患者手术前后阴道内射精潜伏时间和夫妻双方性交满意度。结果19例患者术前平均阴道内射精潜伏时间和性交满意度分别为(1.01±0.58)min(0.10~1.90min)和(14.89±6.08)%(5%~25%),术后平均射精潜伏期和性交满意度分别为(4.14±2.99)min(0.40~9.10min)和(57.47±28.28)%(10%~87%),手术前后相比P<0.01。19例中15例有效,有效率为78.95%,4例无效,2例出现术后轻度局部疼痛,1周后缓解。结论阴茎背神经切断术是一种治疗早泄的有效方法,适用于治疗年轻且不合并ED的患者。     

Selective measurement of digital nerve conduction velocity

We developed a new method to measure the nerve conduction velocity of a single digital nerve. In 27 volunteers (27 hands), we separately stimulated each digital nerve on the radial and ulnar sides of the middle and ring fingers. A double-peaked potential was recorded above the median nerve at the wrist joint when either the radial-side nerve or the ulnar-side nerve of the middle finger was stimulated. The first peak of this potential had disappeared after the digital nerve was blocked under the stimulating electrodes, and the peak appeared again coinciding with the decrease of anesthesia. Shifting the stimulating electrodes on the digital nerve resulted in no significant difference in the peak conduction velocity. It is possible that each peak of the potential was attributable to conduction of an action potential along one of the two digital nerves. This new method allows the assessment of a single digital nerve, and may be clinically useful for assessing the rupture of a digital nerve and the sensory nerve action potentials in carpal tunnel syndrome. Received: June 30, 2000 / Accepted: November 20, 2000     

夜间阴茎勃起测定在性功能障碍诊断中的应用

对自诉有性功能障碍的患者１２０例，进行夜间阴茎勃起（ＮＰＴ）测定。结果：１２０例中精神性阳萎４７例，占３９．２％；器质性阳萎７３例，占６０．８％。认为，通过ＮＰＴ测定作为阳萎患者的初步筛选是有一定的临床价值。     

应用环指感觉神经传导速度测定诊断腕管综合征

目的探讨应用环指感觉神经传导速度(sensory nerve conduction velocity, SCV)诊断腕管综合征的方法。方法对18例(26手)腕部感觉动作电位潜伏期正常的患者，行顺向感觉神经传导速度测定，测定环指正中神经和尺神经SCV，中指正中神经SCV，对其结果进行比较，并与15例正常人(30手)作对照。结果中指正中神经SCV的异常率为50％，环指正中神经与尺神经SCV差值的异常率为84．6％。刺激6例(9手)患者环指后在正中神经腕部可记录到双峰波，对照组则未见。结论在腕管综合征肌电图的诊断中，比较正中神经和尺神经SCV的差值是早期诊断腕管综合征的敏感指标之一。     

Penile electrodiagnosis. Value of bulbocavernosus reflex latency versus nerve conduction velocity of the dorsal nerve of the penis in diagnosis of diabetic impotence

The nerve conduction velocity of the dorsal nerve of the penis was evaluated with a direct measuring technique in impotent men with and without diabetes mellitus. The average nerve conduction velocity was 37 M. per second in impotent diabetics and 45 M. per second in nondiabetics. The latency of the bulbocavernosus reflex showed no significant difference between the groups and was within normal limits. The measurement of the nerve conduction velocity of the dorsal nerve of the penis is a valuable test for assessment of impotence in patients with diabetes mellitus.     

Evidence of changes in sural nerve conduction mediated by light emitting diode irradiation

The introduction of light emitting diode (LED) devices as a novel treatment for pain relief in place of low-level laser warrants fundamental research on the effect of LED devices on one of the potential explanatory mechanisms: peripheral neurophysiology in vivo. A randomised controlled study was conducted by measuring antidromic nerve conduction on the peripheral sural nerve of healthy subjects (n=64). One baseline measurement and five post-irradiation recordings (2-min interval each) were performed of the nerve conduction velocity (NCV) and negative peak latency (NPL). Interventional set-up was identical for all subjects, but the experimental group (=32) received an irradiation (2 min at a continuous power output of 160 mW, resulting in a radiant exposure of 1.07 J/cm²) with an infrared LED device (BIO-DIO preprototype; MDB-Laser, Belgium), while the placebo group was treated by sham irradiation. Statistical analysis (general regression nodel for repeated measures) of NCV and NPL difference scores, revealed a significant interactive effect for both NCV (P=0.003) and NPL (P=0.006). Further post hoc LSD analysis showed a time-related statistical significant decreased NCV and an increased NPL in the experimental group and a statistical significant difference between placebo and experimental group at various points of time. Based on these results, it can be concluded that LED irradiation, applied to intact skin at the described irradiation parameters, produces an immediate and localized effect upon conduction characteristics in underlying nerves. Therefore, the outcome of this in vivo experiment yields a potential explanation for pain relief induced by LED.     

Nerve conduction velocity measurement of dorsal nerve of penis in normal and impotent males

Erection is dependent on peripheral and central neural influences. Both systems are open to electrophysiologic assessment in impotent males. Peripheral function can be assessed by measuring the conduction velocity in the dorsal nerve of the penis, and central pathways by measuring the cortical pudendal evoked response. These tests can be further supplemented by recording of nocturnal penile rigidity and by Doppler recording of penile blood flow to provide accurate causal delineation.     

Re: Penile electrodiagnosis. Value of bulbocavernosus reflex latency versus nerve conduction velocity of the dorsal nerve of the penis in diagnosis of diabetic impotence

Seminal vesicle abscesses are extremely rare and worthy of report. Computerized tomography easily verifies the diagnosis and simplifies the treatment of transurethral incision and drainage.