Knispel H H
Department of Urology, Klinikum Steglitz, Free University of Berlin, FRG.
Urol Int. 1991;47(3):144-8. doi: 10.1159/000282208.
Currently, indications for penile venous surgery are dynamic pharmacocavernosographic findings in impotent patients who fail to respond to intracorporeal application of vasoactive substances and who demonstrate unimpaired arterial perfusion. We used pharmacocavernosometry to measure penile intracorporeal maintenance flow rate in 48 impotent men: 20 had maintenance flow rates higher than 30 ml/min, 12 of the 20 had leakage mainly via Santorini's plexus. In 7 of this 12, venous ligation procedures were initially successful, and in 6 of them erectile function returned. After a mean follow-up, seven of the 12 eventually had to be treated with penile implants. Another 4 used self-injection of prostaglandin E1; only 1 patient reported spontaneous erections sufficient for intercourse. Poor long-term results of surgery and recent data on active mechanisms in venous outflow restriction raise doubts as to whether penile venous surgery can ever cure so-called venous incompetence.
目前，阴茎静脉手术的适应证是对海绵体内应用血管活性物质无反应且动脉灌注未受损的阳痿患者的动态药物海绵体造影结果。我们采用药物海绵体测量法对48例阳痿男性的阴茎海绵体内维持流速进行了测量：20例维持流速高于30 ml/分钟，这20例中有12例主要通过圣托里尼丛发生渗漏。在这12例中的7例中，静脉结扎手术最初是成功的，其中6例恢复了勃起功能。经过平均随访，12例中的7例最终不得不接受阴茎植入治疗。另外4例采用前列腺素E1自我注射；只有1例患者报告有足以进行性交的自发勃起。手术的长期效果不佳以及近期关于静脉流出受限的活性机制的数据引发了对阴茎静脉手术能否治愈所谓静脉功能不全的质疑。
