老年人勃起功能障碍的临床特点

勃起功能障碍 (ED)是成年男性的常见病 ,其发病率随年龄增长而增加〔1〕。本研究结合国际勃起功能指数 - 5 (IIEF- 5 )分析老年勃起功能障碍的临床特点。1　对象与方法1.1　一般资料　 1998年 4月～ 1999年 10月门诊 6 0岁以上老年 ED患者 48例 (老年组 ) ,年龄 6 0～ 74岁 (中位年龄 6 4.5岁 )。病程 0 .6～ 2 4年 (平均 6 .2年 )。伴随高危因素者 31例 ,糖尿病 7例 ,心脏病 4例。同期 40岁以下 ED患者 40例作为对照组 ,年龄 2 5～ 40岁 (中位年龄 37岁 )。病程 0 .4～ 10年 (平均3.8年 )。 8例患者伴有高危因素 ,其中伴血脂异常者 6例…     

加强老年性勃起功能障碍的临床研究

勃起功能障碍(简称ED)是指阴茎不能达到或不能维持足以进行满意性交的勃起.ED是中老年男性的常见病.早在19世纪,就有许多科学家在探讨正常的阴茎勃起的机理.目前被大家所接受的理论是,阴茎勃起过程是一系列的神经血管活动.勃起的程度取决于动脉流入血量和静脉流出血量之间的平衡.当动脉流入血量低并与静脉流出量平衡时,阴茎处于松弛状态.当动脉流入增加,而静脉流出减少时,阴茎因含血量增加而肿大并坚硬,这就是勃起.     

老年性勃起功能障碍的治疗策略

正勃起功能障碍(erectile dysfunction,ED)的治疗可分为心理治疗、药物治疗和手术治疗等几类。老年性ED的治疗策略也有相类似之处,却具有鲜明的老年人特点。1是否需要治疗青年ED患者由于要完成生育功能,和谐性生活也是夫妻感情生     

勃起功能障碍与心血管疾病

近来发现 ,勃起功能障碍与心血管疾病关系密切。在发病机制上 ,二者呈鲜明的共因和互为因果关系 ;在治疗上 ,二者之间的相互影响十分显著     

老年勃起功能障碍病人血流动力学探讨

目的 探讨老年人血管因素在勃起功能障碍中的作用。方法 随机抽取40例勃起功能正常和59例勃起功能障碍老年人先以脉冲超声波多普勒探测阴茎背动脉横切面图形，再用微机图像扫描仪自动测量图形面积，最后计算出阴茎背动脉每分钟血流量。结果 勃起功能正常两年龄组间阴茎背动脉横切面积和血流量均无显著性差异（P＞0．05）；勃起功能正常与勃起功能障碍两组间阴茎背动脉横切面积有显著性差异（P＜0．05），血流量差别更显著（P＜0．01）。结论 根据血液流变学原理提示血管横切面积及血流量在老年勃起功能障碍中起重要作用。     

糖尿病勃起功能障碍的研究进展

勃起功能障碍（ED）的定义为：阴茎不能充分或维持勃起，以致不能完成满意的性生活。糖尿病（DM）是ED最重要的危险因子之一。Rendell等研究指出DM患者ED的发生率在美国高达50％。Dey等发现DM患者ED的发生率比非DM人群高3倍。2型糖尿病（T2DM）患者随着病程的延长，ED的发生率逐渐增高。吸烟史越长，吸烟的强度越大，DM患者发生ED的危险性也越高。     

糖尿病膀胱病变与糖尿病勃起功能障碍

糖尿病膀胱病变(DC)和糖尿病勃起功能障碍(ED)均为糖尿病常见并发症。DC主要由糖尿病多发性神经病变所致,DC膀胱功能异常以膀胱感觉丧失或受损为特征,部分患者有残余尿或尿潴留,其治疗以尽量排空残余尿为主,可辅以神经生长因子治疗。糖尿病ED的发病主要是由多发性神经病变和血管病变的联合作用所致,西地那非治疗对糖尿病ED有效,一些疗效更好的新药和新疗法正在研制中。     

糖尿病勃起功能障碍的识别及临床处理

糖尿病勃起功能障碍（erectile dysfunction，ED）是男性糖尿病患者常见的并发症之一，是严重影响患者生活质量而叉易被医生忽视的问题。糖尿病所引发的神经、血管病变是糖尿病ED最常见的致病原因。国外资料显示糖尿病患者中ED患病率为35％～75％，比非糖尿病患者高3倍。而国内门诊2型糖尿病患者的ED患病率高达75．2％。近年的研究还显示，糖尿病ED可以是糖尿病的首发症状，同时又可以作为潜在的心血管疾病变的早期信号。本文就糖尿病ED的识别及临床处理做简要介绍。     

尿道下裂成形术后勃起功能障碍

尿道下裂患者多都有心理障碍 ,手术年龄越大越明显 ,且易发生心理性阴茎勃起功能障碍 (ED)。同时 ,手术过程中易损伤阴茎的组织结构 ,导致疤痕组织形成 ,手术还可导致异常的血管通道形成而出现静脉漏 ,或手术时在尿道膜部损伤神经从而导致器质性 ED。以上情况可在一患者同时存在。因此 ,进行 ED病因诊断时应按一定程序 ,并充分利用实验室检查。步骤为 :1详询病史及全面检查。依据一般病史及体检可初步判断患者 ED属于心理性还是器质性。如果患者为突然发病并有晨间硬性勃起 ,且维持时间长 ,则心理性 ED可能性较大。如果患者自尿道下裂手…     

老年男性272名勃起功能障碍患病情况调查

目的 了解老年男性勃起功能障碍患病情况，为临床诊治勃起功能障碍提供依据。方法 采用国际勃起功能指数评分的简化版中(IIEF-5)问卷调查性生活史，并回顾相关既往史、用药史和生活方式。结果 272名老年男性勃起功能障碍总患病率是89．7％，其中60～岁组是75．9％、70～岁组是78．6％、80～88岁组是100．0％；此次调查的老年男性中95．1％的高血压病患者伴发勃起功能障碍。结论 老年男性勃起功能障碍的患病率与年龄增长和高血压有关。     

Clinical and diagnostic approach to erectile dysfunction

Erectile dysfunction (ED), defined as the inability to achieve and/or maintain an erection sufficiently long for a satisfactory sexual performance or intercourse, is an important and common medical problem. ED is not a life-threatening disorder, but it influences the daily routine, social interactions, well-being and quality of life of the patient. Recent epidemiological data have shown a high prevalence and incidence of ED. The Massachusetts Male Aging Study found that 52% of men between the ages of 40 and 70 years reported ED with 9.6% having mild, 22.2% moderate and 17.2% complete or severe ED. In a large Italian cross-sectional study the overall prevalence of self-reported ED was 12.8% and the frequency of ED increases with age. ED may signal serious underlying and potentially life-threatening diseases, such as diabetes, hypertension, cardiovascular disease, peripheral vascular disease and other neurological and endocrine disorders. Also well documented is the role of some drug groups, certain types of surgery, injuries and the role of risk factors related to lifestyle such as smoking, alcohol consumption and inappropriate dietary habits accompanied by an abnormal serum level of cholesterol. The current availability of effective and safe oral drugs for ED in conjunction with the tremendous media interest in the condition, have resulted in an increasing number of men seeking help for ED. As a consequence, many physicians without background knowledge and clinical experience in the diagnosis of ED are involved in making decisions concerning the evaluation of such patients. The result of this is that some males with ED may undergo little or no evaluation before treatment is initiated and, in such circumstances, the disease causing the symptom (ED) may remain untreated. Baseline diagnostic evaluation for ED can identify the underlying pathological condition or the risk factors associated with ED in 80% of patients. This article reports a sequential approach for the diagnosis of ED that may diagnose reversible causes of ED and also unmask medical conditions that manifest with ED as the first symptom.     

Evaluation and treatment of erectile dysfunction in the aging male: a mini-review

Before the 20th century, individuals often did not live beyond the reproductive years, and sexuality of the elderly was not an issue. However, in the current era it is known that as life expectancy improves, both men and women are seeking to preserve their sexuality into old age. While the appreciation of sexuality persists with aging, a decline in sexual activity is typically seen with, and can be attributed to both general health problems as well as specific sexual dysfunctions. Erectile dysfunction is the most frequently diagnosed sexual dysfunction in the older male population. This mini-review provides an overview of contemporary literature concerning epidemiology, pathophysiology, assessment and treatment of erectile dysfunction in the aging male.     

Epidemiology of erectile dysfunction

Following the landmark Massachusetts Male Aging Study (MMAS) that provided the first relatively unbiased study of the epidemiology of erectile dysfunction (ED), a number of additional studies were carried out in the U.S. and around the world. The studies vary in quality because they used different definitions of ED, different assessment instruments, different and sometimes biased sources of populations, inadequate response rates to questionnaires and interviews, cultural disparities in willingness to discuss sexual issues, and differing interpretations of the results. Nevertheless, the studies demonstrated similar levels of ED by age and an exponential rise with age. They also generally confirmed the conditions that correlated with ED in the MMAS, namely, diabetes, hypertension, coronary artery disease, prostate cancer therapy, and depression. These were exacerbated by cigaret smoking.     

Causes of erectile dysfunction

Erectile dysfunction (ED) arises as a result of a collision of circumstances among any of a number of factors (e.g., risk factors, causes, probable associations), each with its own primary power to affect the outcome. Furthermore, each of the components has its own timing as part of a complex effort of compensation and adjustment that often obscures the individual details. In the end, ED results from a failure of local tissues or systemic supply and control structures. The power of any individual “cause” to degrade erectile function is an important but as-yet unquantified property. The power of a small abnormality over a long or critical period (e.g., organogenesis), or many small contributions, or multiple risk factors will certainly be greater than the sum of the individual elements. Without a full quantitation of pathways and their potential influence, one can compare the importance of causative factors only in limited ways. Not surprisingly, it is the presence of a multiplicity of unidentified or poorly understood causative factors that accounts in large measure for the current inability to cure and prevent ED. There are two other important properties of a putatively causative factor for ED—reversibility and preventability—and these are strongly influenced by the time of onset and the duration of impact. Thus, a critical understanding that comes from recognizing the importance of the temporal associations of component factors is that the causes of ED in an individual may be guessed at but cannot be fully disclosed by an analysis of a “snap-shot” of the disease taken at the time of diagnosis.     

Treatment of erectile dysfunction

Erectile dysfunction (ED) is an inability to attain or maintain an erection sufficient for satisfactory sexual intercourse. It is an undertreated and underdiagnosed condition that can be due to vasculogenic, neurogenic, hormonal and psychogenic factors. Effective treatment of ED should restore quality of life and allow patients to return to the sex life they had before. Current therapeutic options include non-pharmacological treatments, locally administered drugs and oral therapies. The oral phosphodiesterase-5 (PDE5) inhibitors are considered first-line treatments of ED and have revolutionized ED management in the last five years. Three PDE5 inhibitors are currently available, sildenafil, vardenafil and tadalafil. They are all effective with similar efficacy and good safety profiles. However, tadalafil has the added benefit of a broad window opportunity offering patients more freedom to choose when to initiate sexual activity.     

From aspiration to achievement: assessment and noninvasive treatment of erectile dysfunction in aging men

More than 70% of elderly men (>or=65) remain sexually active, and more than 40%, according to one estimate, are dissatisfied with their sex lives. Declining sexual function and a reluctance to seek medical attention with advancing age are cross-cultural observations. Normal erection is largely dependent on intact function of the central and peripheral nervous systems and the penile vascular endothelium. Consequently, chronic conditions (e.g., cardiovascular disease, diabetes mellitus) and lifestyle factors (e.g., smoking) that have adverse effects on the vascular endothelium and central and peripheral nervous systems, as well as on endocrine function or connective tissues within the corpus cavernosum of the penis, can attenuate erectile function. Because of these associations, assessment of sexual function in elderly men often reveals not only erectile dysfunction (ED) but also other reversible conditions. An expanding array of noninvasive options is available to assist the clinician in individualizing ED therapy to the unique health and lifestyle needs of each elderly ED patient and his partner. These treatment alternatives include the phosphodiesterase type 5 inhibitors sildenafil, vardenafil, and tadalafil, as well as other oral medications, such as alpha-adrenoceptor antagonists and topical vasoactive or testosterone therapy.     

Treatment of erectile dysfunction

The evaluation and treatment of Erectile Dysfunction has evolved dramatically over the last 10 years thanks to the improvement of our understanding of the physiology of erection and the development of effective drugs to be taken "on demand" before intercourse. In addition, Erectile Dysfunction is now clearly recognized as a medical disorder. It is beyond the scope of this article to go into details about the physiology and pathophysiology of the sexual cycle and the different diagnostic procedures for evaluating erectile disorders. Rather, we will concentrate on the therapeutic options for managing erectile disorders after a brief review of the most recent concepts of erection physiology and diagnosis.