Erectile impotence precipitated by organic factors and perpetuated by performance anxiety.

A survey of 72 men with erectile impotence showed that for 14 the onset had been concurrent with the start of a temporary physical disability (in 8), temporary exposure to a chemical agent in doses thought to be significant (in 4) or the return of sexual opportunity after a long period of celibacy or near-celibacy (in 2 older men). After elimination of that possible cause the impotence had persisted owing to anxiety about sexual performance. In another 6 of the 72 there were persistent nonpsychic causes for the impotence. Thus, in 28% of the men surveyed the precipitating cause of erectile impotence was organic. A large proportion of the cases of erectile impotence participated by a temporary nonpsychic factor could probably have been prevented with appropriate professional advice--for example, at the time an antihypertensive drug capable of causing the dysfunction was first prescribed.     

A parallel study on the effects in treatment of impotence by tonifying the kidney with and that without improving blood circulation.

141 cases of functional impotence of the kidney-deficiency type were treated by tonifying the kidney. On them, 103 cases at the same time were treated by improving blood circulation and the other 38 cases by the former only. As a result the total effective rate and the markedly effective rate in the former were 84.46% and 46.60% respectively; but in the latter, 60.55% and 13.15%. A significant difference was found in Ridit analysis (P < 0.05), indicating that method of tonifying the kidney with improving blood circulation is much better than by simply tonifying the kidney alone.     

Evaluation and treatment of sexual dysfunction in men with diabetes mellitus.

Sexual dysfunction is common among men with Type I and Type II diabetes. Tests of nocturnal penile tumescence (NPT) combined with waking tumescence and questionnaires can more accurately differentiate between primary organic and primary psychogenic impotence. This ability to differentiate the etiology of erectile dysfunction avoids the inappropriate use of penile injections and costly surgical procedures which are unnecessary in treatment of diabetic patients with primary psychogenic impotence. In patients with primary organic impotence, several new treatments are available which result in high patient satisfaction.     

慢性前列腺炎及所致的性功能障碍治疗浅析（附78例报告）

在１９８７年７月～１９９１年１１月接治的男性性功能障碍患者中，经检查确认由慢性前列腺炎引起的７８例，其中性欲低下或消失３６例，早泄３１例，阳萎１１例。在这些性功能障碍患者的治疗中，４６例是在治疗慢性前列腺炎的基础上进行（Ａ组），３２例只单纯治疗性功能障碍（Ｂ组），结果，性欲低下，早泄、阳萎的治愈率在Ａ组分别为９０．５％、８４．２％、８３．３％，在Ｂ组则为５３．５％、５０％、４０％，Ａ组疗效明显优于Ｂ组，因此，对慢性前列腺炎所致的性功能障碍应以病因治疗为主，同时配以前列腺内注药，加强性指导和心理治疗，可获得满意效果。     

维医异常黏液质型阳痿病证大鼠模型血脂水平与肝功能相关指标的改变及其生物学意义

目的：研究维医异常黏液质型阳痿病证大鼠模型血脂水平和肝功能相关指标的改变及其生物学意义。方法选用50只性功能正常的雄性 SD 大鼠,随机抽取10只为正常组,其余40只为造模组,采用芫荽实＋菠菜实＋湿寒性环境的干预条件建立异常黏液质证候模型,造模20 w 后通过 APO 勃起实验和性行为学实验筛选出阳痿病证模型,随后从中取8只为病证模型组,从未成阳痿的证候模型中取8只为证候模型组。将所有大鼠禁食8 h以后,用1％戊巴比妥钠腹腔注射（40 mg/kg）麻醉,腹主动脉采血,检测各组大鼠血清甘油三酯（TG）、胆固醇（CHOL）、低密度脂蛋白（LDL-C）、高密度脂蛋白（HDL-C）及白蛋白（ALB）、球蛋白（GLB）、白球蛋白比例（ALB/GLB）、谷丙氨酸（ALT）和谷草氨酸（AST）指标的变化情况。结果病证模型组与证候模型组 TG 水平较正常组显著降低（P ＜0．05）,病证模型组 LDL-C 水平较正常组显著升高（P ＜0．05）。病证模型组 ALB、ALB/GLB 水平较正常组显著降低（P ＜0．05）,病证模型组 AST 水平较正常组显著升高（P ＜0．05）。结论在异常黏液质阳痿病证大鼠模型中,可能存在肝细胞损伤及脂代谢紊乱。     

Successful non-invasive management of erectile impotence in diabetic men

The effectiveness of a device designed to overcome erectile impotence was assessed in 10 insulin dependent diabetics with no other cause for their erectile impotence. The 10 men and their partners were instructed how to use the device, which uses suction to induce penile engorgement and maintains erection with a constriction band. After three months they answered a questionnaire about its effectiveness and acceptability, assessing these by visual analogue scales. All the patients achieved lasting erections with the device and gave high mean scores for ease of use, effectiveness, and satisfaction, but three partners refused to complete the questionnaire having failed to come to terms with using the device. One couple stopped using it because of marital disharmony. This device provides a practical alternative for the treatment of erectile impotence in diabetic men. Unlike invasive treatments, it does not necessitate lengthy assessments of autonomic, endocrine, and erectile function and is safe to use and relatively cheap.     

Unstable tibio-fibular fractures treated with an external fixator--a clinical report of 1033 cases.

From 1977 to 1987, 1033 cases of unstable tibio-fibular fractures were treated with an external fixator designed by the authors. Among them, 232 involved open fractures. All of the patients were followed up for 4 to 90 months (average 20 months). The duration of bed confinement averaged 8.3 days, and the mean time necessary for clinical bone union was 54 days. Anatomical or nearly anatomical bone apposition was effected in 878 cases (85.0%), functional apposition in 141 cases (13.6%) and malunion in 14 cases (1.4%). The overall functional results were as follows: excellent in 769 cases (74.4%), good in 218 cases (21.1%), fair in 32 cases (3.1%), and poor in 14 cases (1.4%). The design of the device and its indications are also discussed.     

胸腰椎压缩性骨折椎体成形术疗效观察

目的通过观察椎体成形术对不同原因所致的胸腰椎压缩性骨折的治疗效果,探讨椎体成形术在椎体压缩性骨折治疗中的适用范围及应用中应注意的问题.方法采用椎体成形术治疗胸腰椎压缩性骨折患者53例62椎,其中外伤压缩性椎体骨折12例12椎,椎体转移性肿瘤4例7椎,骨质疏松压缩性骨折37例43椎.结果 53例胸腰椎压缩性骨折患者椎体成形术后早期(3d内)评定为优者40例,良11例,差2例.优良率96%.得到3个月以上随访的39例42椎患者中再次评定为优者28例,良8例,差3例,优良率92%.结论椎体成形术是一种较理想的治疗无神经症状的胸腰椎压缩性骨折的方法,它具有效果好、损伤小、费用低的特点,其最佳适应证为骨质疏松所致的压缩性骨折.     

Caverno-saphenous shunt in the treatment of priapism.

The painful pathological condition of the penis, priapism, is usually associated with serious destructive changes which lead to impotence if treatment is with-held or delayed. Conservative therapy is slow, uncertain and usually ineffective. Early surgical decompression of the corpora cavernosa, repeated if necessary, is essential if impotence is to be averted. Two unusual cases of this condition recently seen at the University College Hospital, Ibadan, in which treatment had been delayed for periods previously thought to be too long for recovery are herein presented and the management described. It is advised that failure of the initial surgical operation calls for early re-operation to establish a new shunt.     

后尿道损伤早期处理附30例报告

目的探讨后尿道损伤早期处理方式。方法总结我科30例后尿道损伤患者的临床资料,分析术后并发症及排尿情况。结果 30例患者中单纯膀胱穿刺造瘘术3例,留置导尿6例,输尿管镜下尿道会师术12例,尿道会师术6例,尿道修补吻合术3例,留置尿管2~6周,术后排尿良好10例（阳痿1例）,尿道狭窄14例（阳痿2例）,随访时间3月至84月,失访6例。结论输尿管镜下尿道会师术治疗后尿道损伤手术简单,创伤小,时间短,安全性高,具有较强的实用性,可是作为后尿道损伤首选治疗方法有待进一步证实。     

不同术式治疗良性前列腺增生症术后性功能比较

[目的]比较开放与腔内不同术式治疗良性前列腺增生症(BPH)术后对性功能的影响.[方法]对120例腔内经尿道前列腺电切术(TURP)与经尿道前列腺汽化电切术(TVP)和80例包括膀胱耻骨上前列腺摘除术(SPPC)与保留尿道前列腺切除术(MPC)开放手术的BPH病人进行9个月的追踪观察,总结其术后阳萎及逆行射精发生率.[结果]TURP与TVP术后阳萎发生率分别是10%(4/41)和5%(2/42),逆行射精发生率分别是55%和51%.SPPC与MPC术后阳萎发生率分别是10%(3/31)和3%(1/29),逆行射精发生率分别是48%和14%.[结论]治疗BPH的4种术式术后性功能损害TVP和MPC优于TURP和SPPC,逆行射精发生率MPC术式明显优于其他术式.     

不同术式治疗前列腺增生症术后对性功能的影响

目的：比较开放与腔内不同术式治疗良性前列腺增生症（BPH）术后对性功能的影响。方法：对120例腔内经尿道前列腺电切术（TURP）与经尿道前列腺汽化电切术（TVP）和80例行包括膀胱耻骨上前列腺摘除术（SPPC）与保留尿道前列腺切除术（MPC）开放手术的BPH患者进行9个月的追踪观察，总结其术后阳萎及逆行射精发生率。结果：TURP与TVP术后阳萎发生率分别是10％（4／41）和5％（2／42），逆行射精发生率分别是55％和51％。SPPC与MPC术后阳萎发生率分别是10％（3／31）和3％（1／29），逆行射精发生率分别是48％和14％。结论：治疗BPH患者的4种术式术后性功能损害TVP和MPC比对TURP和SPPC少，逆行射精发生率MPC术式比其他术式少。     

阴茎海棉体内注射罂粟碱和酚妥拉明治疗阳痿

用罂粟碱和酚妥拉明作阴茎海棉体内注射治疗阳痿５４例。治疗后，５１例阴茎迅速勃起，能进行满意的性生活，３例无效。并发症４例为持续性勃起，经对症处理后治愈。     

TVP与开放手术治疗前列腺增生症术后性功能比较

目的　比较经尿道前列腺汽化术 (TVP)、耻骨上前列腺摘除术 (SPP)治疗良性前列腺增生症(BPH)术对性功能的影响。方法　对 10 0例TVP及 10 0例SPP术后病人进行 12个月追踪观察 ,总结其术后阳萎及逆行射精发生率。结果　TVP与SPP术后阳萎发生率分别是 4 .35 % (3/6 9)和 10 .81% (8/74 ) ,逆行射精发生率分别是 4 4 .9% (31/6 9)和 4 1.9% (31/74 )。结论　此两种术式治疗BPH产生术后性功能损害TVP优于SPP(P <0 .0 1) ,逆行射精发生率无显著性差异 (P >0 .0 5 )。     

糖尿病阳萎与性激素及慢性并发症的关系

研究性激素和糖尿病慢性并发症在糖尿病阳萎发病中的意义，探索糖尿病阳萎发生的机理。测定３９例糖尿病患者血清促黄体素，促卵泡素，催乳素和睾酮的浓度，同时调查其慢性并发症的发病情况。发现１８例糖尿病阳萎患者血清ＬＨ，ＦＳＨ，ＰＲＬ和Ｔ浓度与２１例非阳萎糖尿病患者相互鸨显著差异，但糖尿病植物神经病变在阳萎组中的发生率     

对糖尿病阳痿患者MMPI的分析研究

目的：探讨糖尿病阳痿患者明尼苏达多项人格调查表（MMPI）的模式特点,尝试对糖尿病阳痿患者的心理状态和心理特征进行评定和描述,为其心理治疗提供较为客观的依据。方法：对102例糖尿病阳痿患者的MMPI测查结果进行统计学分析。结果：102例患者中有75例（73．5％）剖析图异常,23例（22．5％）剖析图显著异常。Hs、D、Hy量表原始分显著高于常模,Pa量表原始分显著低于常模。大部分患者的两点编码模式为13／31、12／21和23／32型。结论：大部分糖尿病阳痿患者存在心理障碍,有些甚至存在比较严重的心理障碍。他们的个性特征带有癔病色彩,表现为被动依赖、敏感多疑、易紧张、好诉苦、否认症状背后的心理问题。心理治疗不仅可以改善患者的情绪,提高性生活质量,同时也会减少糖尿病的其它并发症。     

Impotence: treatment by autoinjection of vasoactive drugs

One hundred and twenty five men with psychogenic or organic impotence used autoinjection of the penile corpora cavernosa with either papaverine or papaverine and phentolamine for a mean period of 10.5 months (range 1-24 months) to achieve penile erection for sexual intercourse. Prolonged (over four hours) painless erection resulted from 34 of the 3513 self administered injections. This seems to be a highly effective approach to treating impotence irrespective of the aetiology.     

针刺治疗功能性阳痿54例临床疗效观察

采用针刺方法治疗功能性阳瘘54例，辨证分为肾阳虚衰与湿热下注两个证型，有效率达92．6％。观察提示：年龄越大，疗效越差；病程越短，疗效越好；湿热下注型痊愈率较肾阳虚衰型为高。     

静脉性阳萎的血流多普勒频谱特征

目的 研究静脉性阳萎阴茎血流动力学异常所致彩色多普勒频谱变化。方法 ３２例静脉阳萎和８５例心理性阳萎在海绵状体血管性药物注射后,应用双功能超声（Ｂｉｏｓｏｕｎｄ－ＡＵ４ＵＳＡ）进行检查,观察海绵体动脉和背深静脉血流频谱变化,结果彩色多普勒谱显示静脉阳萎海绵体支脉在整个舒张期或舒张早,中期有前向血流,约９４％背深静脉存在的持续血流,结论 静脉性阳萎在彩色多普勒频谱上有特征性表现,对本病诊断有一定价值     

Plasma sex hormone concentrations in men with hypertension treated with methyldopa and/or propranolol

Serum concentrations of LH, FSH, testosterone and prolactin were measured in patients with hypertension treated with propranolol (34 cases), methyldopa (13 cases), and methyldopa + propranolol (11 cases). The results were compared with those obtained in 18 controls (hospital out-patients). There were no differences in these hormone concentrations in the various groups, and no difference between those complaining of impotence (13 cases) and those with normal sexual function. Impotence in hypertensive men on treatment with methyldopa cannot be explained by abnormalities in secretion of the reproductive hormones.