夜间阴茎勃起和硬度监测在心理性勃起功能障碍诊断中的作用：综述。

The Role of Nocturnal Penile Tumescence and Rigidity (NPTR) Monitoring in the Diagnosis of Psychogenic Erectile Dysfunction: A Review.

机构信息

Department of Infertility and Sexual Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.

Department of Urology, Peking University Third Hospital, Beijing, China.

出版信息

Sex Med Rev. 2019 Jul;7(3):442-454. doi: 10.1016/j.sxmr.2018.10.005. Epub 2019 Jan 4.

DOI:10.1016/j.sxmr.2018.10.005

PMID:30612976

Abstract

INTRODUCTION

Nocturnal penile tumescence and rigidity (NPTR) monitoring with RigiScan was considered one of the most reliable methods to differentiate psychogenic erectile dysfunction (pED) from organic ED. However, its reliability has been questioned because of some limitations in the practice.

AIM

To present contemporary views on the role of NPTR monitoring in the diagnosis of pED.

METHOD

We performed a comprehensive review of English-language literature on NPTR and pED by a PubMed search.

MAIN OUTCOME MEASURES

Studies were included if the mechanisms of pED and nocturnal erection and the practice of NPTR monitoring in ED were the main research contents.

RESULTS

The pED results from not only psychosocial factors but also physiological changes containing central nervous abnormality. NPTR monitoring with RigiScan is still considered a useful method for the diagnosis of pED. A normal NPTR recording in a man with ED complaints probably suggests pED, whereas an abnormal recording may represent organic ED. Radial rigidity of no more than 60% is correlated well with axial rigidity, but, when it is more than 60%, the correlation between them is questioned. The consistency between NPTR and sex-stimulated erection is questionable, and the correlation of NPTR with different patient-reported outcome scoring systems is different. A normal NPTR recording in patients with ED does not necessarily mean pED, especially in patients with spinal cord injury. NPTR recordings can be influenced by depression, smoking, aging, negative dream content, and sleep disorders.

CONCLUSION

NPTR monitoring with the RigiScan is still considered a useful diagnostic tool for pED at the present stage. However, there are some disputes regarding the correlation between penile radial rigidity and axial rigidity and between NPTR and sex-related erection, as well as normative evaluation criteria for ED and the possibility of a false NPTR result, that need to be further studied. Zou Z, Lin H, Zhang Y, et al. The Role of Nocturnal Penile Tumescence and Rigidity (NPTR) Monitoring in the Diagnosis of Psychogenic Erectile Dysfunction: A Review. Sex Med Rev 2019;7:442-454.

摘要

简介

夜间阴茎勃起和硬度（NPTR）监测使用 RigiScan 被认为是区分心理性勃起功能障碍（pED）和器质性勃起功能障碍（ED）的最可靠方法之一。然而，由于实践中的一些限制，其可靠性受到了质疑。

目的

介绍 NPTR 监测在诊断 pED 中的作用的最新观点。

方法

我们通过 PubMed 搜索对 NPTR 和 pED 的英文文献进行了全面综述。

主要观察指标

如果研究内容主要为 pED 的发病机制、夜间勃起和 NPTR 监测在 ED 中的应用，该研究则被纳入。

结果

pED 的发生不仅与心理社会因素有关，还与中枢神经系统异常等生理变化有关。使用 RigiScan 进行 NPTR 监测仍然被认为是诊断 pED 的有用方法。对于有 ED 症状的男性，如果 NPTR 记录正常，则可能提示为 pED，而异常记录可能代表器质性 ED。径向硬度不超过 60%与轴向硬度相关性良好，但超过 60%时，两者之间的相关性受到质疑。NPTR 与性唤起勃起之间的一致性存在疑问，与不同的患者报告结局评分系统的相关性也不同。ED 患者的 NPTR 记录正常并不一定意味着 pED，尤其是在脊髓损伤患者中。NPTR 记录可能受到抑郁、吸烟、衰老、负面梦境内容和睡眠障碍的影响。

结论

在现阶段，使用 RigiScan 进行 NPTR 监测仍然被认为是诊断 pED 的有用工具。然而，阴茎径向硬度与轴向硬度之间的相关性、NPTR 与性相关勃起之间的相关性、ED 的规范评估标准以及可能出现错误的 NPTR 结果等方面仍存在一些争议，需要进一步研究。Zou Z, Lin H, Zhang Y, et al. The Role of Nocturnal Penile Tumescence and Rigidity (NPTR) Monitoring in the Diagnosis of Psychogenic Erectile Dysfunction: A Review. Sex Med Rev 2019;7:442-454.