Sangiorgi Giuseppe, Colantonio Riccardo, Antonini Gabriele, Savino Antonio, Sperandio Massimiliano
Università degli Studi "Tor Vergata", Roma.
Laboratorio di Emodinamica, Ospedale San Pietro, Roma.
G Ital Cardiol (Rome). 2016 Oct;17(10 Suppl 1):12S-21. doi: 10.1714/2372.25474.
Erectile dysfunction (ED) is defined as the inability to get and maintain a sufficient erection to ensure an acceptable sexual activity for the subject and the partner. Although ED does not represent per se a serious disease, it carries a notable and severe influence on quality of life, with significant implications on familiar and social relationship; DE may cause depression, shame, impairment of personal esteem and relational problems. Among many possible etiologies of ED, atherosclerotic disease of penile arteries represents one of the most frequent causes, so it should always be looked for in patients with multiple risk factors for cardiovascular disease or an established coronary or peripheral artery disease. Up to 75% of patients with ED have a stenosis of the iliac-pudendus-penile artery system, deputy to perfusion of male genital organ. Recently the potential treatment of this pathologic condition by percutaneous approach has emerged with valid angiographic results and with a significant improvement in symptoms and quality of life. This review focuses on the normal anatomy and physiology of erection, the pathophysiology of ED, the common points between ED and ischemic cardiomyopathy and, lastly, the new chance of endovascular intervention for ED, to give our cardiologist colleagues the opportunity to screen and adequately treat patients with vascular ED.
勃起功能障碍(ED)的定义是无法获得并维持足够的勃起,以确保受试者及其伴侣能进行可接受的性活动。虽然ED本身并非严重疾病,但它对生活质量有显著且严重的影响,对家庭和社会关系有重大影响;ED可能导致抑郁、羞耻、个人自尊受损及人际关系问题。在ED众多可能的病因中,阴茎动脉粥样硬化疾病是最常见的原因之一,因此在患有心血管疾病多种危险因素或已确诊冠心病或外周动脉疾病的患者中应始终加以排查。高达75%的ED患者存在髂-阴部-阴茎动脉系统狭窄,这是男性生殖器官灌注不足的原因。最近,经皮途径对这种病理状况的潜在治疗方法已出现,血管造影结果良好,症状和生活质量有显著改善。本综述重点关注勃起的正常解剖学和生理学、ED的病理生理学、ED与缺血性心肌病的共同点,最后是ED血管内介入治疗的新机遇,以便让我们的心脏病学同事有机会筛查并充分治疗血管性ED患者。