骨盆骨折后勃起功能障碍

目的：探讨骨盆骨折后阴茎勃起功能障碍（ED）的原因及诊断和治疗方法。方法：对29例骨盆骨折后ED患者采用Rigiscan阴茎硬度监测、彩色多普勒超声等检查来分析出现ED的原因，同时对几种治疗方法进行比较。结果： 29例中心因性ED1例，血管性ED 7例（静脉性3例，动脉性4例），神经源性ED 15例，混合性ED 6例。23例治疗有效，其中服用万艾可有效的2例，使用前列腺素E1（PGE1）自行阴茎注射的15例，使用前列腺素E1软膏（Befar）的5例，行腹壁下动脉与阴茎背动脉吻合手术1例。结论：后尿道部位支配阴茎的神经受损是骨盆骨折后出现ED的主要原因。PGE1自行阴茎注射是治疗的有效方法之一。

Erectile dysfunction induced by pelvic fracture urethral injury

Objective To explore the aetiology, diagnosis,and treatment of erectile dysfunction(ED) after a pelvic fracture urethral injury.Methods Rigiscan and Duplex ultrasound were used to determine the causes of ED induced by pelvic fracture urethral injury in 29 patients and the therapeutic means were also analyzed. Results Of the 29 patients, 1 was psychological, 28 were physical, 7 vascular , and 15 neurological. Rigiscan and Duplex ultrasound revealed the cause of erectile failure as neurogenic in 15. Twenty three cases were effective by the therapy.The injection with vasoactive agents(prostagland in E 1) was successful in 15, Viagra in 2, Befar in 5, and revascularization of epigastric artery dorsal artery anastomosis in 1. Conclusion Disruption of the cavernous nerves lateral to the prostatomembranous urethra is the most likely cause of ED in this injury. Intracavernous injection of prostaglandin E 1 is believed to be safe and effective for ED.