阴茎异常勃起评估与管理的当代最佳实践。

Contemporary best practice in the evaluation and management of stuttering priapism.

作者信息

Kousournas Georgios, Muneer Asif, Ralph David, Zacharakis Evangelos

机构信息

St Peter's Andrology Centre London, University College Hospital of London, UK.

出版信息

Ther Adv Urol. 2017 Jul 4;9(9-10):227-238. doi: 10.1177/1756287217717913. eCollection 2017 Sep-Oct.

Abstract

Stuttering priapism is rare and under-investigated clinical entity. Although it shares similarities with ischaemic priapism, by definition, stuttering priapism has distinct characteristics that advocate for a different management in the clinical setting. Therefore, the management of stuttering priapism aims primarily to prevent recurrence rather than the resolution of spontaneous attacks. A multimodal approach and the individualization of each case are essential because of the diversity of the condition and the plethora of proposed therapeutic strategies. Understanding the underlying pathophysiology and familiarity with contemporary, past and emerging future agents and therapeutic options are required in order to provide an optimal solution for each patient. In addition, patient counselling and the option to combine therapeutic strategies and challenge second-line therapies are essential weapons in the armament of the urologist. Although further clinical trials and studies are mandatory in order to obtain solid data and provide recommendations, all therapeutic options are analysed, with specific interest in the potential advantages and disadvantages. A structured evaluation procedure is also described.

摘要

间歇性阴茎异常勃起是一种罕见且研究不足的临床病症。尽管它与缺血性阴茎异常勃起有相似之处,但从定义上讲,间歇性阴茎异常勃起具有独特的特征,这表明在临床环境中需要采用不同的管理方法。因此,间歇性阴茎异常勃起的管理主要旨在预防复发,而非解决自发性发作。由于病情的多样性和众多提出的治疗策略,多模式方法和每个病例的个体化至关重要。为了为每个患者提供最佳解决方案,需要了解潜在的病理生理学,并熟悉当代、过去和新兴的治疗药物及治疗选择。此外,患者咨询以及结合治疗策略和挑战二线治疗的选择是泌尿外科医生的重要武器。尽管为了获得可靠数据并提供建议,进一步的临床试验和研究是必不可少的,但我们对所有治疗选择进行了分析,特别关注其潜在的优缺点。还描述了一种结构化的评估程序。

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