Kayigil Onder, Agras Koray, Metin Ahmet
Department of Urology, Ataturk Teaching and Research Hospital, Angora Evleri, Sahin Sokak, E-4 blok No: 11, Ankara, 06800, Turkey.
Int Urol Nephrol. 2007;39(4):1203-8. doi: 10.1007/s11255-007-9238-2. Epub 2007 Jul 6.
To investigate the role of a new preoperative parameter, relaxation degree (RD), in the prediction of postoperative success after deep dorsal vein arterialization operations.
Chart reviews and electromyographic recordings were evaluated in 52 patients on whom deep dorsal vein arterialization was carried out for pure caverno-occlusive dysfunction. The efficiacy of the operation was assessed as improvement or failure according to the five-item version of international index of erectile function (IIEF). RD was defined as the percentage decrease in cavernous electrical activity (CEA) after intracavernous papaverine injection. Preoperative RD measurements were statistically compared between the improvement and the failure groups.
The mean age of patients was 34.2 +/- 8.1 years (range 25-49) with a mean follow-up of 32 +/- 8 months. Improvement was observed in 39 (75%) and failure in 13 (25%) patients. The mean RD values were 60% and 32% for surgical improvement and failure groups respectively (P < 0.01). In patients with mild ED, the mean RD value was 70.3% whereas it was 28.7% in patients with severe ED. The RD value of greater than 40% predicts surgical success with a specifity of 75% and a sensitivity of 90%.
The RD value of cavernous muscle seems to decrease as the severity of ED increases. In addition, RD may predict the outcome of penile revascularization operations and it may be a useful preoperative indicator for surgical success.
探讨一种新的术前参数——松弛度（RD）在预测阴茎背深静脉动脉化手术后手术成功中的作用。
对52例因单纯海绵体闭塞性功能障碍接受阴茎背深静脉动脉化手术的患者进行病历回顾和肌电图记录评估。根据国际勃起功能指数（IIEF）五项版本将手术效果评估为改善或失败。RD定义为海绵体内注射罂粟碱后海绵体电活动（CEA）的下降百分比。对改善组和失败组术前的RD测量值进行统计学比较。
患者的平均年龄为34.2±8.1岁（范围25 - 49岁），平均随访时间为32±8个月。39例（75%）患者手术效果改善，13例（25%）患者手术失败。手术改善组和失败组的平均RD值分别为60%和32%（P < 0.01）。轻度勃起功能障碍（ED）患者的平均RD值为70.3%，而重度ED患者的平均RD值为28.7%。RD值大于40%预测手术成功的特异性为75%，敏感性为90%。
随着ED严重程度的增加，海绵体肌的RD值似乎降低。此外，RD可能预测阴茎血管重建手术的结果，并且可能是手术成功的一个有用的术前指标。
