Ma Ming, Yu Botao, Qin Feng, Yuan Jiuhong
Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China.
Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China.
Transl Androl Urol. 2020 Apr;9(2):709-721. doi: 10.21037/tau.2020.03.10.
Vascular erectile dysfunction (ED) is closely related to cardiovascular events, and early diagnosis of vascular ED may be helpful to predict the occurrence of cardiovascular events and improve prognosis. At present, there are many approaches to diagnose ED, but each method has its advantages and limitations. This study retrospectively reviewed all available literature focusing on the diagnosis of vascular ED through a systematic PubMed and EMBASE search. According to the different application scenarios, the main methods for the diagnosis of vascular ED are divided into four categories. Intra-cavernous injection of vasoactive drugs is the earliest method used in the diagnosis of vascular ED and is a basic test. For the diagnosis of arterial ED, color duplex Doppler ultrasound, selective penile angiography, magnetic resonance imaging, and computed tomography are more commonly used. While for the diagnosis of venous ED, shear wave elastography, dynamic infusion cavernosometry and cavernosography are more accurate. Endo-peripheral arterial tonometry (PAT) has also been used to detect vascular endothelial function. Although various existing examinations are widely used for the evaluation of vascular ED, they still have some shortcomings, such as invasiveness, contingency, high false positive (negative) rate. New methods of long-term dynamic detection are needed.
血管性勃起功能障碍（ED）与心血管事件密切相关，早期诊断血管性ED可能有助于预测心血管事件的发生并改善预后。目前，诊断ED有多种方法，但每种方法都有其优缺点。本研究通过系统检索PubMed和EMBASE，回顾了所有关于血管性ED诊断的可用文献。根据不同的应用场景，血管性ED的主要诊断方法分为四类。海绵体内注射血管活性药物是诊断血管性ED最早使用的方法，也是一项基本检查。对于动脉性ED的诊断，彩色双功多普勒超声、选择性阴茎血管造影、磁共振成像和计算机断层扫描更为常用。而对于静脉性ED的诊断，剪切波弹性成像、动态灌注海绵体测压和海绵体造影更为准确。阴茎外周动脉张力测定（PAT）也已用于检测血管内皮功能。尽管现有的各种检查广泛用于血管性ED的评估，但它们仍存在一些缺点，如侵入性、偶然性、高假阳性（阴性）率。需要新的长期动态检测方法。
