Department of Urology, University of South Florida, Tampa, FL, USA.
J Sex Med. 2012 Nov;9(11):2938-42. doi: 10.1111/j.1743-6109.2012.02903.x. Epub 2012 Aug 20.
Fifty-two-year-old male with history of multiple insults to his erectile tissue, including insertion and removal of penile implant, presents with significant partial erectile function, substantial enough for anal penetration during sexual intercourse.
Erectile function rigid enough for anal penetration, let alone any erectile function after removal of an inflatable penile prosthesis (IPP), is rare. This article, to our knowledge, is the first case of a patient who has undergone multiple insults to his erectile tissue, including an episode of ischemic priapism followed by implantation and removal of an IPP, who presents with erectile function sufficient enough for coitus.
Outcome measured via standardized patient questionnaires and penile Doppler following injection of Trimix.
An objective measure of the patient's erectile function was performed via penile Doppler.
Penile Doppler after 10-mcg injection of Trimix revealed numerous perforating vessels from the corpora spongiosum providing blood flow to the corpora cavernosa. The patient obtained approximately 60-70% rigid erection.
To our knowledge, and after thorough review of the literature, we could not find any reports of erectile function significant enough to take part in sexual intercourse and penetration after removal of a three-piece IPP. The implant usually disrupts the normal anatomy which allows for cavernosal arterial vasodilation and increased blood flow into the corpora. Following dilation of the corpora the cylinders are inserted and inflated, and the smooth muscle that makes up the corpora cavernosum is compressed against the wall of the tunica albuginea. Theoretically, the remaining smooth muscle tissue may retain some of its physiologic function, adding some additional girth to the penis with an already activated IPP during sexual intercourse.
这位 52 岁男性，曾多次受到阴茎组织损伤，包括阴茎植入物的插入和移除，目前存在部分勃起功能障碍，但足以在性交时进行肛门插入。
勃起功能足以进行肛门插入，更不用说在移除可充气阴茎假体 (IPP) 后还有任何勃起功能，是罕见的。据我们所知，本文是第一例患者经历了多次阴茎组织损伤，包括缺血性阴茎异常勃起发作，随后植入和移除 IPP，患者的勃起功能足以进行性交。
通过注射 Trimix 后的标准化患者问卷和阴茎多普勒评估来测量结果。
通过阴茎多普勒评估患者的勃起功能。
在注射 10 微克 Trimix 后，阴茎多普勒显示出来自海绵体的许多穿孔血管，为海绵体提供血流。患者获得了大约 60-70%的刚性勃起。
据我们所知，在对文献进行彻底审查后，我们没有发现任何关于勃起功能足以进行性交和穿透的报告，在移除三件式 IPP 后。植入物通常会破坏允许海绵体动脉扩张和增加血流进入海绵体的正常解剖结构。在扩张海绵体后，将圆柱体插入并充气，构成海绵体的平滑肌被压缩到白膜壁上。从理论上讲，剩余的平滑肌组织可能保留其一些生理功能，在已经激活的 IPP 期间，在性交时为阴茎增加一些额外的周长。
