Konnak J W, Ohl D A
Department of Surgery, University of Michigan Medical Center, Ann Arbor.
J Urol. 1989 Aug;142(2 Pt 1):305-8. doi: 10.1016/s0022-5347(17)38740-2.
We treated 9 patients with vasculogenic impotence by penile revascularization using a microsurgical anastomosis between the inferior epigastric artery and the central corporeal penile artery. Diagnostic evaluation included penile brachial indexes and pelvic arteriograms, which were abnormal in all 9 patients. Revascularization was technically possible in 7 of 9 patients; 2 had inadequate central arteries. The penile brachial index initially was improved in all 7 patients, although 1 had an early occlusion at 2 months and 1 had a late occlusion at 4 years. Potency was improved initially in 6 of the 9 patients, with longer term improvement in 5 of 9 followed 1 to 8 years. Two patients remain potent currently. The advantages of this technique are a reasonably high technical success rate in selected patients, with improved initial potency in more than half. The disadvantages include technical difficulty, lack of clear-cut selection criteria and unknown long-term results.
我们采用显微外科技术将腹壁下动脉与阴茎海绵体中央动脉进行吻合，对9例血管性阳痿患者实施阴茎血运重建术。诊断评估包括阴茎肱动脉指数和盆腔动脉造影，9例患者的检查结果均异常。9例患者中有7例在技术上可行血运重建术；2例中央动脉不足。7例患者的阴茎肱动脉指数最初均有所改善，不过1例在2个月时出现早期闭塞，1例在4年时出现晚期闭塞。9例患者中有6例最初性功能得到改善，9例中有5例在随访1至8年后获得长期改善。目前有2例患者仍保持性功能。该技术的优点是在选定患者中技术成功率较高，超过半数患者的初始性功能得到改善。缺点包括技术难度大、缺乏明确的选择标准以及长期效果不明。
