Bookstein J J, Fellmeth B, Moreland S, Lurie A L
Department of Radiology, University of California, San Diego 92103.
Cardiovasc Intervent Radiol. 1988 Aug;11(4):218-24. doi: 10.1007/BF02577006.
The present section presents further observations regarding cavernosometry and cavernosography, emphasizing the value of intracavernosal injection of a papaverine-phentolamine combination. Subsequent pharmacocavernosometry during fluid infusion then enables (1) precise quantitation of cavernosal leak by the pharmacologic maintenance erection flow (PMEF) method, and (2) determination of cavernosal pressure pulsations, a useful reflection of arterial sufficiency. In patients with excessive cavernosal leak, pharmacocavernosography supplements the examination by indicating the routes of persistent major venous drainage, key information in planning venoablative therapy. Compared with nonpharmacologic methods for cavernosometry and cavernosography, we feel the pharmacologic technique offers the following advantages: (1) it enables the highly accurate and reproducible PMEF method for quantitating cavernosal leakage; (2) the sites of abnormal leakage can be evaluated by cavernosography only after the pharmacologic technique; (3) the infusion volumes required to produce erection are smaller, more physiologic, and more conveniently administered; (4) the amplitude of the cavernosal pressure pulsation becomes useful as an index of arterial sufficiency; and (5) pulsations of the dorsal penile artery are amplified to the point of easy palpability, or more reliable Doppler detection.
本节将进一步阐述关于海绵体测压法和海绵体造影术的观察结果，重点强调阴茎海绵体内注射罂粟碱-酚妥拉明合剂的价值。随后在液体输注过程中进行药物海绵体测压法，可实现：（1）通过药物维持勃起血流（PMEF）法精确量化海绵体漏血情况；（2）测定海绵体压力波动，这是反映动脉供血充足程度的一项有用指标。对于海绵体漏血过多的患者，药物海绵体造影术可通过显示持续存在的主要静脉引流途径来补充检查，这是规划静脉闭合治疗的关键信息。与海绵体测压法和海绵体造影术的非药物方法相比，我们认为药物技术具有以下优点：（1）它能够采用高度准确且可重复的PMEF法来量化海绵体漏血情况；（2）只有在采用药物技术之后，才能通过海绵体造影术评估异常漏血的部位；（3）产生勃起所需的输注量更小、更符合生理情况且给药更方便；（4）海绵体压力波动的幅度可作为动脉供血充足程度的指标；（5）阴茎背动脉的波动被放大到易于触诊的程度，或者更便于进行可靠的多普勒检测。
