Department of Urology, Princess Alexandra Hospital, Brisbane, QLD, Australia.
J Sex Med. 2011 Dec;8(12):3446-51. doi: 10.1111/j.1743-6109.2011.02501.x. Epub 2011 Oct 7.
At least 20% of men with Peyronie's disease (PD) suffer from erectile dysfunction (ED). The fundamental mechanism is thought to arise from the progression of penile fibrosis, which was initially limited to the PD plaque within the tunica albuginea. However, recent studies have highlighted the possibility of fibrosis of the cavernosal vessel media wall leading to impairment of arterial inflow.
To evaluate the penile duplex ultrasonographic findings in PD of impotent men and to determine whether early features of PD might predict clinical progression.
Patient demographic, comorbidities, International Index of Erectile Function-5 scores, surgical intervention, and physical findings were documented. Penile curvature, plaque size, and peak systolic velocity (PSV) and end-diastolic velocity (EDV) on color duplex ultrasonography (CDU) were recorded.
We performed a retrospective review of all men presenting with penile curvature and length loss who underwent penile CDU between January 2001 and January 2010.
A total of 1,120 men underwent penile CDU during the 10-year period. Complete information was obtained in 810 men; 250 men complained of decreased penile rigidity, while 150 men were unable to sustain erection. Comorbidities were similar between men with PD with and without ED. Tunical thickening (65%) was the most common CDU feature, and mean cumulative calcifications was 24.2 mm(2) (1-360 mm(2) , standard deviation 76). The PSV and EDV on the right cavernosal artery were 14.2 cm/second and 3.5 cm/second, while the left cavernosal artery measurements were 15.1 cm/second and 3.2 cm/second. Multivariate logistic regression model showed strong correlation between plaque size and development of ED. Both veno-occlusive dysfunction and impaired cavernosal arterial inflow were associated with ED.
Veno-occlusive dysfunction and impaired cavernosal arterial inflow contributed to the development of ED, and larger plaque size is a strong predictor of surgical intervention.
至少 20%的 Peyronie 氏病（PD）患者患有勃起功能障碍（ED）。其基本机制被认为源于阴茎纤维化的进展，最初仅限于白膜内的 PD 斑块。然而，最近的研究强调了海绵体血管中膜壁纤维化导致动脉流入受损的可能性。
评估勃起功能障碍的 PD 男性的阴茎双功能超声检查结果，并确定 PD 的早期特征是否可能预测临床进展。
记录患者的人口统计学、合并症、国际勃起功能指数-5 评分、手术干预和体格检查结果。记录阴茎弯曲度、斑块大小以及彩色双功能超声检查（CDU）的收缩期峰值速度（PSV）和舒张末期速度（EDV）。
我们对 2001 年 1 月至 2010 年 1 月期间接受阴茎 CDU 的所有出现阴茎弯曲和长度缩短的男性进行了回顾性分析。
在 10 年期间，共有 1120 名男性接受了阴茎 CDU。810 名男性的完整信息得以获取；250 名男性抱怨阴茎硬度下降，而 150 名男性无法维持勃起。PD 伴或不伴 ED 的男性的合并症相似。白膜增厚（65%）是 CDU 最常见的特征，平均累积钙化面积为 24.2mm2（1-360mm2，标准差 76）。右侧海绵体动脉的 PSV 和 EDV 分别为 14.2cm/秒和 3.5cm/秒，而左侧海绵体动脉的测量值分别为 15.1cm/秒和 3.2cm/秒。多变量逻辑回归模型显示斑块大小与 ED 的发展密切相关。静脉阻塞性功能障碍和海绵体动脉流入受损均与 ED 相关。
静脉阻塞性功能障碍和海绵体动脉流入受损导致 ED 的发生，而较大的斑块面积是手术干预的有力预测指标。
