Guo Wei, Chen Qi-Wei, Yan Ji-Xiong
Department of Andrology, Xining First People's Hospital, Xining, Qinghai 810000, China.
Zhonghua Nan Ke Xue. 2020 Jun;26(6):522-527.
To explore the applicability of RigiScan monitoring data in the diagnosis of ED in the plateau area and evaluation of clinical therapeutic effects.
This study included 586 outpatients and inpatients with ED, aged 18－48 (mean 24.6) years, all confirmed according to the scores on the 5-item version of the International Index of Erectile Function (IIEF-5) and subjective description and treated in Xining First People's Hospital. We performed audiovisual sexual stimulation (AVSS) and nocturnal penile tumescence and rigidity (NPTR) tests by RigiScan monitoring and hierarchical diagnosis of those with abnormal AVSS and NPTR findings. After 1 to 6 months of individualized treatment with PDE5i drugs and a month of drug withdrawal and psychological intervention, we repeated the AVSS test and analyzed the data obtained in comparison with the IIEF-5 scores and subjective description of the patients before and after treatment.
Of the 586 patients, 3 were found normal and 583 abnormal (without effective erection, i.e., penile tip rigidity <60% and <10 min) in the AVSS test, while the repeated NPTR test showed 57 normal (with effective erection, i.e., penile tip rigidity ≥60% and ≥10 min). A total of 116 patients gave up the NPTR test. Altogether 410 of the cases were found without effective erection in the NPTR test before treatment, 207 (50.5%) with mild ED, 176 (42.9%) with moderate ED and 27 (6.6%) with severe ED. Of the 410 patients, based on the result of the repeated AVSS test after treatment, 255 (62.2%, including 172 cases ［42.0%］ of mild ED and 83 cases ［20.2%］ of moderate ED) were shown with effective erection, 124 (30.2%, including 35 cases ［8.5%］ of mild ED, 77 cases ［18.8%］ of moderate ED and 12 cases ［2.9%］ of severe ED) were significantly improved (P < 0.05), and the other 31 (7.6%, including 16 cases ［3.9%］ of moderate ED and 15 cases ［3.7%］ of severe ED) remained unchanged. The IIEF -5 score was remarkably increased after treatment compared with the baseline (18.62 ± 2.96 vs 11.62 ± 3.64, P < 0.05), and the erectile function and erection-control ability of the patients, according to their subjective description, were markedly improved after treatment.
RigiScan with AVSS and NPTR tests can objectively assess the severity of ED, screen its causes and evaluate the effects of medication and psychological intervention for patients in plateau areas.
探讨RigiScan监测数据在高原地区勃起功能障碍（ED）诊断及临床治疗效果评估中的适用性。
本研究纳入586例年龄在18至48岁（平均24.6岁）的ED门诊及住院患者，均依据国际勃起功能指数5项版（IIEF-5）评分及主观描述确诊，并在西宁第一人民医院接受治疗。我们通过RigiScan监测进行视听性刺激（AVSS）及夜间阴茎勃起硬度和勃起时间（NPTR）测试，并对AVSS和NPTR结果异常者进行分层诊断。在用磷酸二酯酶5抑制剂（PDE5i）药物进行1至6个月的个体化治疗及停药1个月并进行心理干预后，我们重复AVSS测试，并分析所获数据，与患者治疗前后的IIEF-5评分及主观描述进行比较。
586例患者中，AVSS测试发现3例正常，583例异常（无有效勃起，即阴茎头硬度<60%且<10分钟），而重复NPTR测试显示57例正常（有有效勃起，即阴茎头硬度≥60%且≥10分钟）。共有116例患者放弃NPTR测试。治疗前NPTR测试共发现410例无有效勃起，其中轻度ED患者207例（50.5%），中度ED患者176例（42.9%），重度ED患者27例（6.6%）。在这410例患者中，根据治疗后重复AVSS测试结果，255例（62.2%，包括轻度ED患者172例［42.0%］，中度ED患者83例［20.2%］）有有效勃起，124例（30.2%，包括轻度ED患者35例［8.5%］，中度ED患者77例［18.8%］，重度ED患者12例［2.9%］）有显著改善（P<0.05），另外31例（7.6%，包括中度ED患者16例［3.9%］，重度ED患者15例［3.7%］）无变化。治疗后IIEF-5评分较基线显著升高（18.62±2.96比11.62±3.64，P<0.05），且根据患者主观描述其勃起功能及勃起控制能力在治疗后明显改善。
RigiScan联合AVSS及NPTR测试可客观评估高原地区患者ED的严重程度，筛查其病因，并评估药物及心理干预的效果。
