Salama N
Masaa Madina Hospital, Madina, Saudi Arabia.
Int J Impot Res. 2004 Oct;16(5):441-7. doi: 10.1038/sj.ijir.3901203.
Nocturnal electrobioimpedance volumetric assessment (NEVA) is a procedure that can measure penile volume changes together with the number and duration of nocturnal erectile events. This study was conducted to evaluate the different NEVA patterns in diabetic patients with erectile dysfunction (ED), and demonstrate the extent to which tadalafil may affect the characteristics of nocturnal penile erections in these patients. Therefore, 38 patients with noninsulin-dependent diabetes and ED participated in this study. They were assessed with history intake including evaluation by the abridged five-item version of International Index of Erectile Function, clinical and psychiatric assessment and NEVA for three consecutive nights where placebo was given on the second night and tadalafil on the third night. In all, 14 potent males were taken as a control group. Data were analyzed using t-test. Results showed normal patterns in only six (16%) patients (central organic group), while abnormal patterns were observed in the remaining 32 (84%) patients (peripheral organic group). These abnormal patterns showed significant decrease in both the number (P=0.0001) and duration (P=0.03) of erectile events compared to those of controls. The percentage of penile blood volume change over baseline also decreased significantly (P=0.0002) relative to controls. Veno-occlusive dysfunction was the main pathology (23 patients, 72%) as suggested by NEVA. Tadalafil did not significantly change basal nocturnal penile tumescence results in either the central organic or control groups, but it did so significantly in the peripheral organic group (P=0.02 for duration change and P=0.01 for % blood volume change). In conclusion, NEVA may suggest some evidence about the pathophysiology of an underlying vasculogenic cause, thus directing towards the next specific step needed for a precise diagnosis. Tadalafil improves nocturnal erections in diabetic patients with peripheral but not central organic impotence.
夜间生物电阻抗容积评估（NEVA）是一种可测量阴茎容积变化以及夜间勃起事件的次数和持续时间的检查方法。本研究旨在评估糖尿病性勃起功能障碍（ED）患者的不同NEVA模式，并证明他达拉非对这些患者夜间阴茎勃起特征的影响程度。因此，38例非胰岛素依赖型糖尿病合并ED患者参与了本研究。对他们进行了病史采集评估，包括采用国际勃起功能指数简版五项问卷进行评估、临床和精神评估，并连续三晚进行NEVA检查，第二晚给予安慰剂，第三晚给予他达拉非。总共选取14例性功能正常的男性作为对照组。采用t检验对数据进行分析。结果显示，仅6例（16%）患者表现为正常模式（中枢器质性组），其余32例（84%）患者表现为异常模式（外周器质性组）。与对照组相比，这些异常模式的勃起事件次数（P = 0.0001）和持续时间（P = 0.03）均显著减少。阴茎血容量相对于基线的变化百分比也相对于对照组显著降低（P = 0.0002）。NEVA提示静脉闭塞功能障碍是主要病理改变（23例患者，72%）。他达拉非在中枢器质性组或对照组中均未显著改变基础夜间阴茎肿胀结果，但在外周器质性组中显著改变了结果（持续时间变化P = 0.02，血容量变化百分比P = 0.01）。总之，NEVA可能为潜在血管源性病因的病理生理学提供一些证据，从而为精确诊断指明下一步所需的具体步骤。他达拉非可改善外周而非中枢器质性阳痿的糖尿病患者的夜间勃起。
