Ohebshalom Michael, Parker Marilyn, Waters Bedford, Flanagan Robert, Mulhall John P
Department of Urology, Weill Cornell Medical Center, New York, NY, USA.
BJU Int. 2008 Aug 5;102(5):592-6. doi: 10.1111/j.1464-410X.2008.07695.x.
To define haemodynamic changes after radical retropubic prostatectomy (RP) and the predictive value of these for the outcome of erectile function (EF), as although there are predictors of the recovery of EF, penile vascular changes might also affect the recovery of EF.
Prospective data were analysed from men who had RP followed by duplex penile Doppler ultrasonography (DUS) within 6 months of RP. All men had functional erections before RP, based on self-report and partner corroboration, and all completed the International Index of Erectile Function (IIEF) questionnaire serially after RP. The EF, based on IIEF scores, was then correlated with the penile DUS results.
In all, the study included 111 patients; 32 (29%) had normal erectile haemodynamics after RP, while 79 (71%) had abnormal haemodynamics. Twelve patients (11%) had a venous leak. There were no differences in mean patient age or comorbidity profile between those with and without haemodynamic changes. Comparing those with normal and abnormal haemodynamics, the mean IIEF EF domain scores were 25 and 17 (P = 0.025), the percentages of erectile rigidity at 18 months was 66% vs 35% (P = 0.013), the percentage of patients with normal EF domain scores was 28% vs 6% (P < 0.01), the percentage of patients with functional erections permitting sexual intercourse unassisted by pharmacological agents was 47% vs 22% (P = 0.018), and the percentage of patients responding to sildenafil citrate, as defined by vaginal penetration, was 72% vs 43% (P = 0.03), respectively.
The results of this prospective study indicate that a patient's penile vascular status is correlated with their EF after RP.
明确耻骨后根治性前列腺切除术（RP）后的血流动力学变化及其对勃起功能（EF）恢复的预测价值。虽然已有EF恢复的预测指标，但阴茎血管变化也可能影响EF的恢复。
对接受RP且在RP后6个月内接受双功能阴茎多普勒超声检查（DUS）的男性患者的前瞻性数据进行分析。所有男性在RP前根据自我报告和伴侣证实均有功能性勃起，且所有患者在RP后均连续完成国际勃起功能指数（IIEF）问卷。然后将基于IIEF评分的EF与阴茎DUS结果进行关联分析。
该研究共纳入111例患者；32例（29%）在RP后勃起血流动力学正常，79例（71%）血流动力学异常。12例患者（11%）存在静脉漏。有血流动力学变化和无血流动力学变化的患者在平均年龄或合并症方面无差异。比较血流动力学正常和异常的患者，IIEF-EF领域平均得分分别为25分和17分（P = 0.025），18个月时勃起硬度百分比分别为66%和35%（P = 0.013），EF领域得分正常的患者百分比分别为28%和6%（P < 0.01），能够在无需药物辅助的情况下进行性交的功能性勃起患者百分比分别为47%和22%（P = 0.018），以及根据阴道插入定义对枸橼酸西地那非有反应的患者百分比分别为72%和43%（P = 0.03）。
这项前瞻性研究结果表明患者的阴茎血管状态与RP后的EF相关。
