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1.
PURPOSE: We compared erectile function status and satisfaction rates in patients who received treatment for erectile dysfunction (ED) with sildenafil, intracavernous prostaglandin E1 (ICI) and penile implant surgery (IPP). MATERIALS AND METHODS: A total of 138 consecutive patients who received treatment for ED between April 2000 and April 2001 were considered candidates for study. Mean followup was 19.54 months. Of the patients 27 were not available for followup and 26 were not on any form of treatment. Of the patients receiving treatment for ED 85 were administered the Erectile Dysfunction Inventory for Treatment Satisfaction (EDITS) questionnaire and the Erectile Function Domain (EFD) of the International Index of Erectile Function questionnaire. Three treatment groups were identified, including 31 patients on sildenafil citrate, 22 on ICI and 32 who underwent IPP. Mean total EDITS, EDITS Index and EFD scores in the 3 groups were considered for statistical evaluation. RESULTS: There was no statistical difference in the total EDITS (25.59 versus 27.06, p = 0.48), EDITS Index (58.16 versus 61.15, p = 0.49) or EFD (22.91 versus 20.26, p = 0.12) score between the groups on ICI and sildenafil citrate, respectively. Total EDITS, EDITS Index and EFD scores were significantly higher in patients who underwent IPP than those on sildenafil citrate (36.09 versus 27.06, p <0.001, 82.03 versus 61.51, p <0.001 and 27.88 versus 20.26, p <0.001, respectively). Total EDITS, EDITS Index and EFD scores were significantly higher in patients who underwent IPP than those on ICI (36.09 versus 25.59, 82.03 versus 58.16 and 27.88 versus 22.91, respectively, all p <0.001). CONCLUSIONS: At a mean followup of 19.54 months patients who underwent penile implant surgery had significantly better erectile function and treatment satisfaction than those receiving sildenafil citrate and intracavernous prostaglandin E1. 相似文献
2.
Amr Al‐Najar Carsten Maik Naumann Sascha Kaufmann Andrea Steinbach‐Jensch Moritz Franz Hamann Klaus‐Peter Jünemann Christof Van Der Horst 《BJU international》2009,104(6):834-837
OBJECTIVE
To assess the satisfaction profiles following penile prosthesis surgery in patients with erectile dysfunction (ED) in their seventh decade of life.PATIENTS AND METHODS
In all, 174 patients received, for the first time, a penile prosthesis between 1990 and 2007 in our department. Among these, 35 patients were aged ≥70 years at prosthesis implantation. Of these, 18 patients were still alive at the time of follow‐up. Using a telephone survey, patients were asked to answer the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) as well as the International Index of Erectile Dysfunction (IIEF). Another question in the survey was developed by the authors based on a comprehensive review of the literature, which assessed the usefulness of the device for the patient and the degree of their usage. This was formulated as follows: How many times per 2 weeks do you have a sexual intercourse?RESULTS
In all, 15 of 18 patients were either very or somewhat satisfied (83%). At follow‐up 11 out of 15 (73%) patients were using their prosthesis regularly. The mean IIEF and EDITS scores were 21.80 and 75.20, respectively.CONCLUSION
A penile prosthesis remains a highly promising treatment in older patients with a similar satisfaction rate to those published for younger patients. Thus, the motivation of the patient and not the age of the patient should be the main determinant factor in this surgical procedure. 相似文献3.
Aim: To investigate the clinical characteristics of patients with Peyronie's disease (PD) and diabetes mellitus (DM). Methods: During an 8-year period, a total of 307 men seen at our outpatient clinic were diagnosed with PD. Clinical characteristics, penile deformities and the erectile status of patients with PD and DM together (n = 102) were retrospectively analyzed and compared to patients with PD alone with no risk factors for systemic vascular diseases (n = 97). Results:The prevalence of PD among men with DM and sexual dysfunction was 10.7 %. The mean age of diabetic patients with PD was (55.9 ± 8.9) years; in the no risk factor group it was (48.5 ± 9.0) years (P 〈 0.05). The median duration of DM was 5 years. The majority of diabetic patients with PD (56.0 %) presented in the chronic phase (P 〈 0.05), and they were more likely to have a severe penile deformity (〉 60°) than the no risk factor group (P 〈 0.05). In the diabetic group, the most common presenting symptom was penile curvature (81.4%), followed by a palpable nodule on the shaft of the penis (22.5%) and penile pain with erection (14.7%). A total of 19.6% of patients were not aware of their penile deformities in the diabetic group. Erectile function, provided by history and in response to intracavernosal injection and a stimulation test, was significantly diminished in patients with PD and DM (P 〈 0.05). Conclusion: DM probably exaggerates the fibrotic process in PD. Diabetic patients with PD have a higher risk of severe deformity and erectile dysfunction (ED). PD seems to be a silent consequence of DM and should be actively sought in diabetic men. (Asian JAndrol 2006 Jan; 8: 75-79) 相似文献
4.
福建省正常男性及勃起功能障碍患者阴茎勃起角度值的研究 总被引:6,自引:1,他引:5
目的 明确正常男性阴茎勃起角度值范围及临床意义。方法 采用阴茎勃起测量器 ,对 6 11例正常男性和 30例勃起障碍 (ED)患者的勃起情况进行研究。结果 正常男性阴茎勃起角度值应大于或等于 10 0度即可视为正常勃起 ,小于 10 0度应注意是否有ED的可能 ;阴茎勃起角度值随年龄增长逐渐减少 (P <0 .0 0 1) ,按年龄段评价勃起角度范围 :小于 19岁应大于等于 12 1度 ;2 0~ 2 9岁应大于或等于 110度 ;30~ 39岁应大于或等于 10 1度 ;4 0~4 9岁应大于或等于 98度 ;5 0~ 5 9岁应大于或等于 95度。性交频率是影响阴茎勃起角度的因素 (P <0 .0 0 1) ,但正常男性阴茎勃起角度值检测不受测试的时间、形体胖瘦、测试方法诸因素干扰 ;分析 30例经治疗显效的患者的勃起角度值 ,发现治疗前后勃起角度值有非常显著差异 (P <0 .0 1)。结论 阴茎勃起角度值可作为ED诊断和疗效判断的定量指标。 相似文献
5.
OBJECTIVE: To describe the relationship between the International Index of Erectile Function (IIEF) erectile domain score, and nocturnal penile tumescence and rigidity values measured by RigiScan (Timm Medical Technologies, Eden Prairie, MN). PATIENTS AND METHODS: In all, 73 men were evaluated with the IIEF and 2 nights of continuous penile monitoring with the RigiScan. Twenty-six men were evaluated before and after prostatectomy, for a total of 99 pairs of data points. We dichotomized the RigiScan results as 'adequate' (no erectile dysfunction, ED), or 'inadequate' (having ED), based on the 'best erectile event' over the 2 nights of monitoring. Two separate criteria for adequate erectile function were used, one of >70% rigidity for > or = 10 min, and the other >60% rigidity for > or = 10 min. The erectile domain score of the IIEF was calculated in the standard fashion. RESULTS: Using both the 70% and the 60% rigidity criteria, there was a statistically significant association between the IIEF erectile domain scores and the RigiScan data (r = 0.27, P = 0.008 and r = 0.29, P = 0.003, respectively). However, the sensitivity of the IIEF to predict ED based on RigiScan results using the 70% rigidity criteria was 68.9%, and the specificity was 57.1%. When the IIEF was used as a continuous predictor of RigiScan results, the area under the receiver-operating characteristic (ROC) curve was 0.66. Using the 60% criteria, the sensitivity was 55.8% and the specificity was 73.2%; the area under the ROC curve was 0.72. CONCLUSIONS: IIEF erectile domain scores and nocturnal penile tumescence and rigidity measurements are weakly associated, and the clinical utility of one test to predict the other is limited. However, because of the differences in the measured outcomes (perception of erectile function vs physiological capacity), a weak association does not disqualify either test's individual utility. 相似文献
6.
Kadioglu A Oktar T Kandirali E Kendirci M Sanli O Ozsoy C 《International journal of impotence research》2004,16(6):540-543
The aim of this study was to analyze characteristics of patients with Peyronie's disease (PD) diagnosed during a standard evaluation for erectile dysfunction (ED) and compare them with patients presenting with the classical complaints of PD. During a 10-y period, a total of 448 patients were evaluated at our two outpatient clinics, directed by the same author (AK). They were divided into two groups: group I consisted of patients, who presented with only ED and were unaware of their penile deformity, and group II consisted of patients with the classical features of the disease. The clinical characteristics, penile deformities, erectile status and the presence of comorbidities were determined in the two groups. Of 448 Peyronie's patients, 16% (n=71) were detected during diagnostic work-up for ED. In this group of patients, ED was the presenting symptom for a mean period of 31.3+/-9.7 months. The mean age of men was 57.54+/-8.75 and 52.21+/-10.27 y in groups I and II, respectively (P=0.0001). The mean degree of deformity was 31.5+/-12.66 degrees in group I and 41.16+/-19.14 degrees in group II (P=0.0001). In group I (n=71), 69% (n=49) of the patients had a poor erectile response to the combined injection and stimulation (CIS) test. Also, in this group, the mean degrees of deformity in CIS-positive and -negative patients were 27.05+/-12.50 and 33.80+/-12.03 degrees , respectively (P=0.033). Diabetes mellitus (40%) was the leading comorbidity in group I, while at least one comorbidity was observed in 73% of the cases (P=0.001). A remarkable percent of Peyronie's patients (16%) were detected during a standard evaluation for ED. This study analyzed, for the first time, the frequency and the characteristics of incidentally diagnosed Peyronie's patients who presented with only ED. Our data indicate that one should always consider the possibility of PD in older patients with diabetes, presenting with only ED. 相似文献
7.
El-Sakka AI 《International journal of impotence research》2003,15(6):426-429
We investigated the association between the International Index of Erectile Function (IIEF) and axial penile rigidity parameters in patients with erectile dysfunction (ED). A total of 516 male patients (491 patients with ED and 25 patients without ED) were assessed using IIEF. Patients were assessed for axial penile rigidity (APR) using a digital inflection rigidometer. Mean age+/-s.d. was 52.4+/-9.9 y. ED was mild in 11.4% of the patients, moderate in 40.1%, and severe in 48.5%. Regarding APR, the following was found: (1) no significant difference between patients who had a mild degree of ED and patients who had no ED (P>0.05); (2) a significant difference between patients with different degrees of ED (P<0.05 for each); (3) a significant association between overall presence of ED and low APR (P<0.05). IIEF score is associated with APR and can differentiate between patients with and without ED. 相似文献
8.
A surgical algorithm for penile prosthesis placement in men with erectile failure and Peyronie's disease 总被引:1,自引:0,他引:1
We developed an algorithm for surgical management and placement of penile prostheses in patients with erectile failure (ED) and Peyronie's disease (PD). We identified 46 men ages 40 to 77 y with PD who could not attain an adequate erection with sexual stimulation and pharmacotherapy. All men were candidates for penile straightening and inflatable prosthesis placement using the following algorithm. Manual molding was attempted initially, followed by tunica incision for insufficient straightening. For tunical defects greater than 2 cm, polytetrafluoroethylene (PTFE) patch grafting was performed to prevent prosthesis cylinder herniation and recurrent deformity from cicatrix contraction. Mean preoperative penile curvature was 53 degrees (0-90). Prosthesis implantation with manual molding, implant with plaque incision, and implant with plaque incision and PTFE grafting were successfully accomplished in 25 (54%), 12 (26%), and nine (20)% respectively. Mean follow-up was 39 months (range 1-74). Full erectile capacity with a straight phallus was achieved in all patients. Complications included temporary (< 8 months) decreased penile sensation in four (9%), mild (< 2 cm) penile shortening in three (7%), delayed ejaculation in one (2%), and infection requiring explanation in one diabetic male (2%). All of the implanted prostheses provided satisfactory rigidity with no mechanical failures or recurrent curvature. We conclude that inflatable penile prosthesis implantation is a safe and effective therapy with a high satisfaction rate in men with ED and PD. The developed algorithm helps define prosthesis placement and straightening techniques to obtain optimal results with minimal complications. 相似文献
9.
Assessment of the efficacy of Viagra (sildenafil citrate) using the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) 总被引:2,自引:0,他引:2
Treatment satisfaction is a predictor of long-term compliance in patients with erectile dysfunction (ED). We assessed patient satisfaction with and efficacy of Viagra (sildenafil citrate) using the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) and 3 global efficacy questions. Twenty-nine men with ED who had completed a prior study of MUSE (alprostadil) versus Caverject (alprostadil) took a 50-mg dose of Viagra 1 h preceding intercourse. Efficacy and patient satisfaction with Viagra were high. Satisfaction as measured by EDITS was highly correlated to patients' final ED treatment choice. This correlation could make EDITS useful in identifying long-term patient satisfaction, and thus of considerable clinical benefit. 相似文献
10.
Efficacy and treatment satisfaction with on-demand tadalafil (Cialis) in men with erectile dysfunction 总被引:2,自引:0,他引:2
Skoumal R Chen J Kula K Breza J Calomfirescu N Basson BR Kopernicky V 《European urology》2004,46(3):362-9; discussion 369
OBJECTIVE: Tadalafil (Cialis) is an inhibitor of phosphodiesterase type 5, which mediates relaxation of vascular smooth muscle in the corpus cavernosum thus facilitating erection. The purpose of this multicentre, randomized, double-blind, parallel group, placebo-controlled study was to evaluate efficacy and treatment satisfaction of on-demand Cialis in men with mild-to-severe erectile dysfunction (ED). METHODS: Following a 4-week treatment-free run in period, patients stratified into three severity groups by the International Index of Erectile Function (IIEF) Erectile Function (EF) domain score were randomized to receive either placebo or Cialis 20 mg taken on demand over a 12-week period. Efficacy endpoints were change from baseline in IIEF EF domain scores, responses to Sexual Encounter Profile diary (SEP) questions, and responses to the Global Assessment Questions (GAQ). Treatment satisfaction was evaluated using the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire in two of seven participating countries where validated translations were available. RESULTS: Of the 443 men who entered the trial, 409 (mean age, 52 years) formed the intent-to-treat population. Mean baseline demographics and ED severity measures were balanced between treatment groups except for a higher percentage of patients na?ve to sildenafil in the tadalafil group compared to placebo (50% versus 36%). The percentage of patients in each IIEF EF severity class (mild, moderate and severe) was 47%, 30% and 23% for placebo patients and 48%, 29% and 23% for tadalafil patients, respectively. Tadalafil was significantly superior to placebo on all primary efficacy measures (IIEF EF domain scores, SEP15, GAQ1; p < 0.001); notably 64% of tadalafil patients achieved a normal IIEF EF domain score at endpoint compared to 16% of placebo patients (p < 0.001). Of the 185 patients completing the EDITS questionnaire (137 receiving Cialis and 48 receiving placebo), tadalafil-treated patients had a median EDITS score of 84 (95%CI 80, 86), which was significantly higher than the median score for placebo-treated patients of 41 (95%CI 32, 59; p < 0.001; Wilcoxon test). The proportion of patients satisfied with treatment (defined as final EDITS score greater than 50) was 87% for the tadalafil-treated group and 46% for the placebo-treated group (p < 0.001; exact test). Adverse events were significantly more common with tadalafil than placebo (p < 0.01) and included primarily headache (7.2% versus 1.9%) and flushing (4.6% versus 0%). One patient discontinued tadalafil treatment due to back pain. CONCLUSION: In men with mild-to-severe ED, tadalafil 20 mg significantly improves erectile function, demonstrates superior treatment satisfaction relative to placebo, and is well tolerated. This is the first study to yield efficacy data on tadalafil in an Eastern European population of men with erectile dysfunction, and the first to measure satisfaction with the EDITS questionnaire in any study population of men with this condition using tadalafil. 相似文献
11.
El-Sakka AI 《European urology》2006,49(3):564-569
PURPOSE: To assess the prevalence of Peyronie's disease (PD) among patients with erectile dysfunction (ED). MATERIALS AND METHODS: A total of 1,440 male patients with ED were enrolled in this study. Patients were interviewed for ED using the International Index of Erectile Function (IIEF). All patients were also screened for socio-demographic data and risk factors for ED that included age, smoking, diabetes, hypertension, dyslipidemia, Ischemic Heart Disease (IHD), and psychological disorders. The diagnosis of PD was based on a palpable penile plaque or acquired penile curvature. Patients underwent routine laboratory investigation in addition to testosterone and prolactin assessment. RESULTS: Mean ages +/-SD were 54.1 +/- 6.9 (range 42-71) and 52.5 +/- 11.9 (range 20-84) years for patients with and without PD respectively. Of the patients, 11.8% had mild, 38.3% had moderate and 49.9% had severe ED. 7.9% of the patients had PD. Significant associations between PD and both the longer duration and the increased severity of ED were detected. There were also significant associations between PD and the following socio-demographic risk factors of ED: age, obesity, smoking, duration and number of cigarettes smoked per day. Concomitant diseases and medical comorbidities such as diabetes, dyslipidemia, psychological disorders and the presence of at least one risk factor were significantly associated with PD in patients with ED. CONCLUSIONS: Peyronie's disease was not rare among the study population. There were significant associations between ED risk factors and PD. Further studies are needed to investigate how much ED and PD influence each other. 相似文献
12.
Zargooshi J 《BJU international》2002,89(9):890-894
OBJECTIVE: To determine the long-term outcome of the surgical management of penile fracture. PATIENT AND METHODS: In all, 170 patients (mean age 27 years, sd 13, median 24, range 13-80) with penile fracture undergoing surgery between April 1990 and December 2000 were reviewed. In addition to a history, physical examination and hospital records, long-term potency (> 6 months after surgery) was evaluated using the patients' self-rated assessment of erectile function and the International Index of Erectile Function (IIEF-5) questionnaire. The results were correlated with the surgical findings. A control group of 200 men also self-rated their erectile function and completed the IIEF-5. For those patients who presented with their partners, the partner's satisfaction with erections was also evaluated. The mean (median, range) follow-up after injury was 53 (61, 6-132) months. RESULTS: Satisfactory and painless erectile function with a soft straight penis was reported by 162 patients (95.2%). Complications occurred in eight patients (4.7%), of whom seven developed a mild (four) to moderate (three) penile curvature; five had penile nodules and four reported mild paresthesia over the scar line. Mild and moderate erectile dysfunction (ED) was reported by five and three patients, and four and five of controls, respectively (P > 0.05). There was no difference between the surgical findings of six patients with complications and those of the remaining 162. However, in the two remaining cases extensive injury was associated with moderate ED after surgery. Of eight patients with ED, seven responded to intracavernosal injection with papaverine/phentolamine. Erectile function returned within a mean (range) of 2 (1-5) days and coitus was possible approximately 2 weeks after the repair. Of the patients' partners, 94.1% reported satisfaction with erections and only one reported de novo dyspareunia. Penile fracture was not associated with an increased risk of ED (odds ratio 0.95; 95% confidence interval, 0.35-2.53). In sexually active participants, the mean (sd, range) IIEF-5 score for 162 patients was 23.2 (2.7, 13-25) and not significantly different from that for the 194 controls, at 22.8 (2.1, 11-25). However, patients had higher scores than controls for erectile firmness and maintenance ability (P < 0.05). CONCLUSIONS: Surgery for a fractured penis is safe and effective, restoring erectile function to that of controls. Surgical treatment is very satisfactory for patients and partners. Considering these encouraging results, surgical intervention is strongly recommended. 相似文献
13.
OBJECTIVE: To assess the outcome of using modified human fascia lata (Tutoplast, Mentor Corp, Santa Barbara, CA, USA) in the surgical management of Peyronie's disease (PD), as the penile deformity associated with PD can be corrected by plaque incision and saphenous vein grafting (Lue procedure). PATIENTS AND METHODS: In all, 14 patients (mean age 51 years, range 34-59) with PD had their penile deformity corrected by plaque incision and Tutoplast grafting. Three patients had a previous unsuccessful Nesbit operation. The mean (range) penile deformity before surgery was 67.2 (20-90) degrees and the mean follow-up was 31 (17-37) months. RESULTS: Using set criteria, 13 patients were satisfied (excellent or satisfactory) with the results of surgery. The penis was completely straight in 11 of 14 patients. One patient developed de novo erectile dysfunction after surgery. In 10 patients there was no penile shortening, whereas four reported penile shortening of >1 cm. CONCLUSION: Fascia lata Tutoplast grafts provide a reliable and well tolerated biomaterial for penile reconstruction in PD. The outcome of using Tutoplast is similar to that from saphenous vein but without the morbidity associated with the donor site. However, there remains a significant risk of penile shortening and development of erectile dysfunction. 相似文献
14.
PURPOSE: Penile implants are associated with a high level of patient satisfaction. Studies to date have failed to use instruments that accurately record patient satisfaction data. We used 2 validated instruments to assess the chronology of efficacy and satisfaction profiles in men undergoing penile prosthetic surgery. MATERIALS AND METHODS: Men who elected penile implant surgery were administered the International Index of Erectile Function (IIEF) questionnaire preoperatively, and 3, 6 and 12 months postoperatively as well as the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire 3, 6 and 12 months postoperatively. Comparison was done of preoperative and postoperative values for the overall IIEF, IIEF erectile function domain, IIEF satisfaction domain and EDITS. All surgeries were primary and in all patients an inflatable implant device was placed. RESULTS: A total of 96 men with a mean age of 56 years were enrolled in the study. All 12-month scores were statistically significantly higher than baseline scores. The 12-month values were statistically higher than 6-month values for the IIEF satisfaction domain and for EDITS. CONCLUSIONS: This study indicates that implant surgery causes a dramatic improvement in erectile function. It also indicates that satisfaction increases in year 1 after implant surgery with significant improvements in the second half of year 1. Current efforts are aimed at following this cohort of patients in an even more long-term fashion as well as evaluating partner satisfaction profiles. These findings should permit clinicians to provide penile prosthesis candidates with optimistic and realistic expectations for implant device function and postoperative satisfaction. 相似文献
15.
Diminished vascular endothelial function results in decreased vasodilator capacity and is associated with erectile dysfunction (ED) in patients afflicted with type 2 diabetes. The current study was designed to evaluate whether daily use of sildenafil could alter endothelial function and improve penile rigidity in a group of patients with diabetic ED. A double-blind, placebo-controlled, prospective trial was conducted with 24 men with type 2 diabetes who were randomized into 2 groups: one receiving daily sildenafil (50 mg, n = 12) and the other placebo (n = 12) for 10 weeks. Erectile function was captured subjectively using the International Index of Erectile Function (IIEF-5), and endothelial function was objectively monitored via brachial artery flow-mediated dilation. Among the placebo and sildenafil groups, there were no significant differences in average patient age, time from type 2 diabetes diagnosis, duration of ED, or baseline IIEF-5 scores. Past medical histories, including smoking, alcohol consumption, hypertension, and hyperlipidemia, were also similar. At the conclusion of the 10-week trial, patients who received daily sildenafil had significantly improved erectile rigidity as captured by IIEF-5 (P < .001) and increased endothelial function via brachial artery flow-mediated dilation (P < .01). Endothelial function in men with type 2 diabetes was enhanced with daily sildenafil. Improved erectile rigidity and enhanced vascular circulation was noted after 10 weeks of daily sildenafil use. 相似文献
16.
Sansalone S Garaffa G Djinovic R Pecoraro S Silvani M Barbagli G Zucchi A Vespasiani G Loreto C 《Asian journal of andrology》2011,13(6):842-845
The long-term outcomes of 157 patients affected by Peyronie's disease (PD) who underwent penile straightening with Egydio's technique between January 2004 and December 2008 are reported. Only patients with PD who were stable for at least 6-12 months prior to surgery were enrolled in this study. Preoperative assessment included a dynamic echo colour Doppler ultrasound scan to evaluate the degree of penile deformity and the peak systolic velocity in the cavernosal arteries and an assessment of erectile function with the administration of the International Index of Erectile Function 5 (IIEF-5) questionnaire. Stretched penile length was recorded pre- and postoperatively. Surgical complications, cosmesis and sexual function, patient satisfaction and postoperative erectile function were assessed postoperatively at 3 months, 1 year and 2 years, respectively. After a median follow-up period of 20 months (range: 12-24 months), we found that mild residual curvature (12%) and glans hypoesthesia (3%) were the only causes of partial dissatisfaction. No rejection of the graft was observed. All patients recovered their ability to penetrate with no difficulty. In addition, an intraoperative average increase of 2.5 cm (range: 1.7-4.1 cm) in stretched penile length was recorded, with all patients engaging in penetrative sexual intercourse. In conclusion, this procedure represents a safe and reproducible technique for the correction of penile curvature resulting from PD and yields excellent cosmetic and functional results. 相似文献
17.
PURPOSE: We reviewed the experience with the 2-piece Ambicor penile prosthesis (American Medical Systems, Minnetonka, Minnesota) at 2 medical centers to investigate its mechanical reliability and complication rates as well as patient and partner satisfaction with the device. MATERIALS AND METHODS: From 1995 through 1999, 131 men underwent implantation of an Ambicor penile prosthesis at 2 medical centers. We performed a 3-part study consisting of a retrospective clinical record review, mailed patient and partner questionnaire, and mailed modified patient and partner Erectile Dysfunction Inventory of Treatment Satisfaction questionnaire. Mean followup was 43.4 months (range 12 to 73). RESULTS: All 131 men had a history consistent with an organic etiology of erectile dysfunction, including vascular disease in 62%, radical retropubic prostatectomy in 17%, Peyronie's disease in 15%, neophallus construction in 4% and radical pelvic surgery in 2%. Mean patient age was 56.8 years (range 22 to 76) at implantation. Overall there were complications in 10 cases (7.6%), including infection, hematoma and mechanical failure in 6 (4.6%), 1 (0.7%) and 3 (2.3%), respectively. A total of 112 men (85%) and 91 partners completed the questionnaire. All patient respondents still had an Ambicor prosthesis implanted and 96.4% had erection suitable for coitus. Overall patient and partner satisfaction was 96.4% and 91.2%, respectively. Of the respondents 92.9% of patients and 90.1% of partners would recommend the device to others. Of the 85 men (65%) and 46 partners who completed the modified Erectile Dysfunction Inventory of Treatment Satisfaction survey 90.6% and 82.6%, respectively, were satisfied or very satisfied overall with the penile prosthesis. CONCLUSIONS: The Ambicor penile prosthesis is associated with a low complication rate and reliable mechanical function. High satisfaction was reported by patients and partners. 相似文献
18.
Hatzichristou DG Hatzimouratidis K Tzortzis V Apostolidis A Bekos A Ioannidis E 《International journal of impotence research》2003,15(2):99-104
The purpose was to assess objectively and quantitatively the hemodynamic status and the degree of functional erectile impairment in a group of impotent patients. A clinical study was designed, incorporating pharmacocavernosometry (to evaluate arterial and veno-occlusive function) with axial buckling forces and penile geometry measurements in a group of impotent patients. The pressure gradient between the intracavernosal pressure associated with the presence of penile axial rigidity and the equilibrium intracavernosal pressure was calculated (axial rigidity gradient, ARG); such methodology allowed a quantitative characterization of functional impairment, as ARG expresses the intracavernosal pressure increase necessary to achieve axial rigidity and therefore potency. Penile geometry characteristics were also expressed by calculating the penile aspect ratio (diameter/length, D/L). In 83 consecutive patients tested (mean age 42.89+/-9.96), rigidity occurred at intracavernosal pressures between 50 and 100 mm Hg. A conversely proportional relation was noticed between penile aspect ratio values and the intracavernosal pressure associated with rigidity values, clearly demonstrating the important functional role of penile geometry. ARG demonstrated a wide range of values (3-69 mm Hg), reflective of the severity of the erectile dysfunction on each patient. Half (50.6%) of the patients had ARG values < or =20 mm Hg, indicative of minimal and minimal-to-moderate erectile impairment, while 20.48% had ARG between 21-30 and 28.92% >30 mm Hg, indicative of moderate and severe erectile dysfunction (ED) respectively. In all, 6% of the study group, all of them with primary ED, ARG <20 mm Hg had normal hemodynamics, but low penile aspect ratio values indicating that penile geometry may be the cause of insufficient rigidity. Hemodynamic integrity is the most critical, but not the only determinant of penile rigidity, as erectile impairment may be noticed in patients with normal arterial inflow and corporal veno-occlusive function. In such cases, unfavorable penile geometry should be considered as the possible etiological factor of impotence. 相似文献
19.
Serum testosterone (T) influences wound healing and levels are decreased in the age group at risk of Peyronie's disease (PD). The aim of the present study was to evaluate the severity of penile deformity in men with PD in relation to T levels. One-hundred and six patients with PD and T deficiency (serum T <3.5 ng/mL; Group 1) and those with normal T levels (Group 2) were compared according to the duration of PD, the size and location of the plaques, penile curvature, pain on erection, and the severity of erectile dysfunction. The mean degree of penile curvature in Group 1 was significantly greater than in Group 2 (32.0 ± 15.9° vs 21.8 ± 15.4°, respectively). The mean Group 1 score on the International Index of Erectile Function (IIEF)-5 was lower than the score for Group 2 (7.4 ± 3.7 vs 10.8 ± 4.8, respectively). The percentage of patients who complained of pain on erection did not differ between the two groups. Plaque size in Group 1 was larger than in Group 2 (3.0 ± 1.2 vs 2.0 ± 1.2 cm, respectively), whereas there was no significant difference in plaque location. Although there was a lower percentage of responders to medical treatment in Group 1, there were no differences in surgical outcomes between the two groups. These findings suggest that the presence of T deficiency in patients with PD exaggerates the severity of PD by affecting penile deformity, plaque size, and erectile dysfunction. Further studies are needed to confirm this relationship. 相似文献
20.
国产三件套可膨胀型阴茎假体植入术治疗截瘫病人勃起功能障碍 总被引:1,自引:1,他引:0
目的 :评价国产三件套可膨胀型阴茎假体 (IPP)对截瘫勃起功能障碍 (ED)病人康复治疗的临床应用效果。方法 :阴茎阴囊交界处切口植入国产三件套IPP ,治疗非手术疗法无效的截瘫ED病人 1 8例 ,以咨询或信访方式取得维持性交率及女方性交满意率。 结果 :1 8例截瘫ED病人手术均获成功 ,术后随访 3~ 36个月 ,平均 1 8个月。其中 1例出现假体内液体渗出并局部感染 ,2例出现机械性并发症 ,术后维持性交率 1 7/ 1 8。 3例出现射精反射。 结论 :国产三件套IPP治疗非手术疗法无效的截瘫ED病人 ,隐匿性好 ,康复效果确切 ,且价格低、机械故障率不高于国外产品 ,易被国内病人所接受 相似文献