使用磷酸二酯酶 5 抑制剂优化根治性前列腺切除术后的性功能结果。

Optimization of sexual function outcome after radical prostatectomy using phosphodiesterase type 5 inhibitors.

机构信息

Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Japan.

出版信息

Int J Urol. 2013 Mar;20(3):285-9. doi: 10.1111/iju.12071. Epub 2013 Jan 14.

Abstract

Erectile dysfunction after radical prostatectomy is a major complication affecting postoperative quality of life. For early recovery from postoperative erectile dysfunction, attention has focused on penile rehabilitation using vacuum devices, prostaglandin E1 injection into the corpus cavernosum of the penis or transurethral administration, and oral drugs such as phosphodiesterase type 5 inhibitors. Phosphodiesterase type 5 inhibitors have been used clinically based on the results of animal experiments that showed a preventive effect on fibrosis and loss of intracorporeal smooth muscle. Small randomized studies had reported a benefit from penile rehabilitation using phosphodiesterase type 5 inhibitors after radical prostatectomy. However, the largest trial to date, carried out in 2008, failed to show that daily phosphodiesterase type 5 inhibitor treatment was superior to on-demand phosphodiesterase type 5 inhibitor treatment for erectile function recovery after radical prostatectomy. Thus, debate continues as to its efficacy in humans. Reports on penile rehabilitation using phosphodiesterase type 5 inhibitors have appeared after these negative results, and phosphodiesterase type 5 inhibitors are still widely used as first-line treatment in penile rehabilitation.

摘要

根治性前列腺切除术后勃起功能障碍是影响术后生活质量的主要并发症。为了使术后勃起功能障碍早日恢复,人们关注使用真空装置、阴茎海绵体注射前列腺素 E1 或经尿道给药以及磷酸二酯酶 5 抑制剂等药物进行阴茎康复治疗。磷酸二酯酶 5 抑制剂在临床上的应用基于动物实验结果,这些结果表明其对纤维化和海绵体平滑肌丧失具有预防作用。小型随机研究报告称,根治性前列腺切除术后使用磷酸二酯酶 5 抑制剂进行阴茎康复治疗有益。然而,迄今为止规模最大的 2008 年试验并未显示,与按需使用磷酸二酯酶 5 抑制剂相比,每日使用磷酸二酯酶 5 抑制剂治疗对根治性前列腺切除术后勃起功能的恢复更有效。因此,关于其在人类中的疗效仍存在争议。在这些阴性结果公布后,出现了关于使用磷酸二酯酶 5 抑制剂进行阴茎康复治疗的报告,并且磷酸二酯酶 5 抑制剂仍广泛用作阴茎康复治疗的一线治疗药物。

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