骨盆骨折致尿道损伤所致勃起功能障碍
[Erectile dysfunction induced by pelvic fracture urethral injury].
作者信息
Tang Yu-Xin, Jiang Xian-Zhen, Tan Jing, Huang Kai, Tang Jin
机构信息
(C-U Men's Medical Research Center, Third Xiangya Hospital, Central South University, Changsha 410013, China.
出版信息
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2004 Aug;29(4):478-9, 493.
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 E1) 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 E1 is believed to be safe and effective for ED.
目的
探讨骨盆骨折尿道损伤后勃起功能障碍（ED）的病因、诊断及治疗方法。
方法
采用阴茎硬度测试仪（Rigiscan）和双功超声检查，确定29例骨盆骨折尿道损伤所致ED的病因，并分析其治疗方法。
结果
29例患者中，1例为心理性，28例为器质性，其中血管性7例，神经性15例。Rigiscan和双功超声检查显示15例勃起功能障碍的病因是神经性。23例经治疗有效。血管活性药物（前列腺素E1）注射治疗15例成功，万艾可治疗2例成功，比法尔治疗5例成功，腹壁下动脉-阴茎背动脉吻合血管重建术治疗1例成功。
结论
前列腺膜部尿道外侧海绵体神经损伤是该损伤后ED最可能的病因。阴茎海绵体内注射前列腺素E1被认为是治疗ED安全有效的方法。
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