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[髂内动脉远端阻断对男性肾移植受者阴茎血管及勃起功能的影响]

[Influence of the interruption of arteria iliaca interna distal end on penile vascularity and erectile function in male renal transplant recipients].

作者信息

Ji Zheng-Guo, Tian Yei, Tang Ya-Wang, Guo Hong-Bo, Zhang Lei, Lin Jun, Sun Wen, Xie Ze-Lin, Lü Wen-Cheng, Chen Li-Sheng

机构信息

Department of Urology, Beijing Friendship Hospital, Capital University of Medical Science, Beijing 100050, China.

出版信息

Zhonghua Nan Ke Xue. 2010 Apr;16(4):341-4.

Abstract

OBJECTIVE

It is controversial whether unilateral interruption of the arteria iliaca interna distal end affects penile hemodynamics and erectile function. The purpose of this study was to prospectively evaluate this influence by detecting the blood flow of the penile artery before and after renal transplantation.

METHODS

Thirty-three patients with chronic renal failure (CRF) on maintenance hemodialysis (MHD) received renal transplantation, the grafts revascularized by end-to-end anastomosis to the right internal iliac artery. Six months before and after the surgery, we obtained the IIEF scores of the patients, recorded their penile blood flow on color Doppler ultrasonography and the levels of serum creatinine, hemoglobin and serum cholesterol, and analyzed post-transplantation immunosuppressive medication.

RESULTS

The patients ranged in age from 21 to 55 years, of whom 36% had erectile dysfunction (ED) during MHD, and 33% after renal transplantation. A total of 67% of the renal transplant recipients (RTR) complained of unchanged and 15% deteriorated ED, while 18% admitted improved erectile function. The patients showed a significantly stronger sexual desire after the transplantation than before it (6.2 +/- 1.6 vs 8.9 +/- 0.9, P < 0.01). There was a significant decrease in peak systolic velocity (PSV) in the cavernous arteries after transplantation as compared with pre-transplantation (P < 0.01). Penile arterial blood flow insufficiency was found in none of the RTRs.

CONCLUSION

Unilateral interruption of the internal iliac artery decreases penile arterial blood flow, but not to such a degree as to result in ED. Unilateral interruption of the arteria iliaca interna distal end does not affect the erectile function of RTRs.

摘要

目的

单侧髂内动脉远端阻断是否会影响阴茎血流动力学及勃起功能存在争议。本研究旨在通过检测肾移植前后阴茎动脉血流,前瞻性评估这种影响。

方法

33例维持性血液透析(MHD)的慢性肾衰竭(CRF)患者接受肾移植,移植物通过与右髂内动脉端端吻合实现血管重建。手术前后6个月,我们获取患者的国际勃起功能指数(IIEF)评分,用彩色多普勒超声记录其阴茎血流情况以及血清肌酐、血红蛋白和血清胆固醇水平,并分析移植后的免疫抑制药物使用情况。

结果

患者年龄在21至55岁之间,其中36%在MHD期间存在勃起功能障碍(ED),肾移植后为33%。共有67%的肾移植受者(RTR)主诉ED无变化,15%恶化,而18%承认勃起功能改善。移植后患者的性欲显著强于移植前(6.2±1.6对8.9±0.9,P<0.01)。与移植前相比,移植后海绵体动脉的收缩期峰值流速(PSV)显著降低(P<0.01)。未发现RTR中有阴茎动脉血流不足的情况。

结论

单侧髂内动脉阻断会降低阴茎动脉血流,但程度不至于导致ED。单侧髂内动脉远端阻断不影响RTR的勃起功能。

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