Kunelius P, Lukkarinen O
Urological Unit, Surgical Clinic, University of Oulu, Finland.
Int J Impot Res. 1999 Feb;11(1):21-4. doi: 10.1038/sj.ijir.3900377.
In a three-year follow-up study of 69 patients found that erectile dysfunction (ED) impairs many elderly men's life: up to 25% of the men aged 65 y and 80% of those aged 75 y suffer from erectile dysfunction. The most effective non-surgical treatment of ED is intracavernosal pharmacotherapy, and the most common vasoactive agent currently used is prostaglandin E1 (PGE1). The purpose of this study was to assess the long-term outcome of PGE1 treatment and the patients' overall satisfaction with their sexual life. Sixty-nine patients who had started ICI therapy three years earlier were invited to a control examination. The mean age of the patients was 60.5 y. The patients filled in a questionnaire, which included questions about the use of PGE1 treatment at home. All the patients evaluated their own satisfaction with their erection, ejaculation, orgasm and libido on a visual analytical scale (VAS, 0-100%). A clinical examination was made, and the penile shaft was examined by ultrasonography. Erection with the home dose of PGE1 was estimated by Rigiscan, and the degree of erection was also estimated clinically (grades 0-5) by a doctor. The most common doses of PGE1 used at home were between 10 and 20 m (58%), 46.4% of the patients had discontinued PGE1 therapy, the mean time of using PGE1 was 23.3 months. The mean coital frequency with PGE1 was 2.8 times per month. 34.8% of the patients (24 out of 69) reported that their own spontaneous erections had improved after the beginning of PGE1 therapy. The most common problem was hematomas in 10.1% of the patients (7 out of 69), which, however, were small and did not cause discontinuation of the therapy. There were three instances of priapism (4.3%), and four patients (5.8%) had fibrosis in ultrasonography. The patients' satisfaction with their erection at home was 67.3% with PGE1. The mean coital frequency with PGE1 therapy was quite low, 2.8 times per month, even though the patients' mean age was only 60.5 y, one reason may be the high price of PGE1 injections. The rate of improvement of spontaneous erections while using PGE1 was quite high, accounting for 34.8% of the patients. Most of the patients who discontinued the PGE1 therapy had a psychogenic etiology. There were no systemic side-effects with PGE1. Only 7.2% of the patients had prolonged pain after the injection, leading to drug discontinuation. It can be concluded that treatment with intracavernous injections of PGE1 is well tolerated and involves only minor problems. The patients' satisfaction with their erections at home with PGE1 therapy was good. Precise determination of the home dose of PGE1 and the teaching of the technique of injection are important at the beginning of this treatment modality.
在一项针对69名患者的为期三年的随访研究中发现，勃起功能障碍（ED）损害了许多老年男性的生活：65岁男性中高达25%以及75岁男性中80%患有勃起功能障碍。ED最有效的非手术治疗方法是海绵体内药物治疗，目前最常用的血管活性药物是前列腺素E1（PGE1）。本研究的目的是评估PGE1治疗的长期效果以及患者对性生活的总体满意度。邀请了69名三年前开始接受海绵体内注射疗法（ICI）的患者进行对照检查。患者的平均年龄为60.5岁。患者填写了一份问卷，其中包括有关在家中使用PGE1治疗的问题。所有患者通过视觉分析量表（VAS，0 - 100%）评估自己对勃起、射精、性高潮和性欲的满意度。进行了临床检查，并通过超声检查阴茎海绵体。通过Rigiscan评估在家中使用PGE1剂量时的勃起情况，医生也通过临床评估（0 - 5级）勃起程度。在家中使用的PGE1最常见剂量在10至20毫克之间（58%），46.4%的患者已停止PGE1治疗，使用PGE1的平均时间为23.3个月。使用PGE1时的平均性交频率为每月2.8次。34.8%的患者（69名中的24名）报告称，在开始PGE1治疗后，他们自身的自然勃起有所改善。最常见的问题是10.1%的患者（69名中的7名）出现血肿，不过血肿较小，未导致治疗中断。有3例阴茎异常勃起（4.3%），4名患者（5.8%）在超声检查中出现纤维化。患者在家中对使用PGE1后的勃起满意度为67.3%。尽管患者的平均年龄仅为60.5岁，但使用PGE1治疗时的平均性交频率相当低，每月2.8次，一个原因可能是PGE1注射价格高昂。使用PGE1时自然勃起的改善率相当高，占患者的34.8%。大多数停止PGE1治疗的患者有心理性病因。PGE1没有全身性副作用。只有7.2%的患者在注射后出现疼痛延长，导致停药。可以得出结论，海绵体内注射PGE1治疗耐受性良好，仅涉及一些小问题。患者对在家中使用PGE1治疗后的勃起满意度良好。在这种治疗方式开始时，精确确定家中PGE1的剂量以及注射技术的指导很重要。
