Kayigil Onder, Agras Koray, Okulu Emrah
Clinic of 2nd Urology, Ankara Ataturk Teaching and Research Hospital, Ankara, Turkey.
Int Urol Nephrol. 2008;40(1):125-31. doi: 10.1007/s11255-007-9304-9. Epub 2007 Nov 21.
Arterialization operations of the penis are recommended for young patients with erectile dysfunction (ED). In this study, we investigated the efficiency of deep dorsal vein arterialization (DDVA) in carefully selected healthy elderly patients
An initial extensive evaluation with corpus cavernosum electromyography, cavernosometry, and penile doppler ultrasonography was performed for 43 elderly patients with ED for whom the presence of risk factors (hypertension, diabetes, hyperlipidemia, smoking habit, psychiatric or neurologic disorders, liver or kidney failure, and history of major trauma) had been ruled out. All patients underwent to DDVA using the Furlow-Fisher technique. Surgical outcome was tested postoperatively by use of the fifteen-item International Index of Erectile Function questionnaire (IIEF-15). Surgical success was assumed if the score in the five-item version of the IIEF (IIEF-5) had increased by at least five points.
Of the patients, 21 were detected to have caverno-occlusive disease, 13 had arteriogenic disease, and 9 had both caverno-occlusive and arteriogenic disease. The mean age of the patients was 59.7+/-4.6 years and the mean follow-up time was 22.1+/-7.1 months. The operation was successful in 26 cases (60.5%) according to IIEF-5. Total IIEF-15 score was increased from 19.2+/-5.0 to 28.5+/-9.4 (P<0.05). Significant increases were observed in the erectile function, intercourse satisfaction, and overall satisfaction domains of IIEF-15. The preoperative degree of ED or the etiology of ED had no impact on the surgical results. Percent changes in the total IIEF-15 score and in its domains were no different between patients aged <60 and those aged >or=60.
DDVA could successfully be performed for carefully selected elderly patients as long as the presence of risk factors for ED are ruled out.
对于年轻勃起功能障碍（ED）患者，推荐阴茎动脉化手术。在本研究中，我们调查了在精心挑选的健康老年患者中进行阴茎深背静脉动脉化（DDVA）的有效性。
对43例排除了危险因素（高血压、糖尿病、高脂血症、吸烟习惯、精神或神经疾病、肝或肾衰竭以及重大创伤史）的老年ED患者进行了海绵体肌电图、海绵体测压和阴茎多普勒超声的初步广泛评估。所有患者均采用弗洛-费舍尔技术进行DDVA手术。术后使用15项国际勃起功能指数问卷（IIEF-15）测试手术效果。如果IIEF五项版本（IIEF-5）的得分至少提高5分，则认为手术成功。
患者中，21例被检测出患有海绵体闭塞性疾病，13例患有动脉源性疾病，9例同时患有海绵体闭塞性和动脉源性疾病。患者的平均年龄为59.7±4.6岁，平均随访时间为22.1±7.1个月。根据IIEF-5，26例（60.5%）手术成功。IIEF-15总分从19.2±5.0提高到28.5±9.4（P<0.05）。IIEF-15的勃起功能、性交满意度和总体满意度领域均有显著提高。术前ED程度或ED病因对手术结果无影响。年龄<60岁和年龄≥60岁的患者在IIEF-15总分及其领域的百分比变化无差异。
只要排除ED危险因素，对于精心挑选的老年患者，DDVA手术可以成功进行。
