Israilov S, Niv E, Livne P M, Shmueli J, Engelstein D, Segenreich E, Baniel J
Institute of Urology, Rabin Medical Center, Beilinson Campus, Petah Tiqva 49110, Israel.
Int J Impot Res. 2002 Feb;14(1):38-43. doi: 10.1038/sj.ijir.3900812.
The aim of this study was to evaluate the effectiveness of a progressive program for the treatment of erectile dysfunction in patients with cardiovascular disease in whom sildenafil citrate (Viagra) was not an option. The study population included 106 patients selected from 267 with cardiovascular disease. The intracavernous injection program consisted of three protocols of increasingly complex combinations of vasoactive drugs, papaverine, phentolamine, prostaglandin E1 and atropine sulfate. Patients who failed the first protocol were switched to the second, and those who failed the second were switched to the third. A positive response was defined as an erection sufficient for vaginal penetration. A positive response was achieved on protocol I in 61 of the 106 patients (57.5%); protocol II in 32 of the remaining 45 patients (71.1%); and protocol III in seven of the remaining 13 patients (53.8%); the total success rate was 94.3%. These 100 patients were included in the 1-year follow-up, and 90 reported successful coitus at the end of that period: 79 patients (87.8%) with intracavernous injection and 11 (12.2%) without injection. The remaining 10 patients (10%) dropped out of the program, seven (7.0%) for health or marital reasons and three (3.0%) because of treatment failure. We conclude that a progressive program of intracavernous injections of vasoactive drugs may be a good alternative for the treatment of erectile dysfunction in patients with cardiovascular disease.
本研究的目的是评估一种渐进性方案对患有心血管疾病且无法使用枸橼酸西地那非（万艾可）的勃起功能障碍患者的治疗效果。研究人群包括从267例心血管疾病患者中选出的106例患者。海绵体内注射方案由三种血管活性药物（罂粟碱、酚妥拉明、前列腺素E1和硫酸阿托品）越来越复杂的组合方案组成。未通过第一个方案的患者转至第二个方案，未通过第二个方案的患者转至第三个方案。阳性反应定义为勃起足以进行阴道插入。106例患者中有61例（57.5%）在方案I中获得阳性反应；其余45例患者中有32例（71.1%）在方案II中获得阳性反应；其余13例患者中有7例（53.8%）在方案III中获得阳性反应；总成功率为94.3%。这100例患者纳入1年随访，90例在该期末报告性交成功：79例（87.8%）通过海绵体内注射，11例（12.2%）未注射。其余10例患者（10%）退出该方案，7例（7.0%）因健康或婚姻原因退出，3例（3.0%）因治疗失败退出。我们得出结论，海绵体内注射血管活性药物的渐进性方案可能是治疗心血管疾病患者勃起功能障碍的一种良好替代方法。
