Sun Xiao-Lei, Ashok Raj, Gao Qing-Qiang, Song Tao, Yu Wen, Xu Zhi-Peng, Sun Guo-Hai, Dai Yu-Tian
Department of Andrology, Drum Tower School of Clinical Medicine, Nanjing Medical University, Nanjing, Jiangsu 210008, China.
Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221006, China.
Zhonghua Nan Ke Xue. 2020 Jul;26(7):601-604.
To explore the clinical value of phosphodiesterase type-5 inhibitors (PDE-5i) combined with RigiScan-based audiovisual sexual stimulation (AVSS) test in comparison with that of nocturnal penile tumescence (NPT) test in evaluation of erectile function.
A total of 166 ED patients, aged 21-63 (mean 31) years, with a disease course of 3 months to 10 years (mean 14 months), underwent NPT test or PDE-5i + RigiScan-based AVSS test from 2017 to 2018. We compared the results of the diagnostic strategies. Normal NPT patterns were presumed to indicate psychogenic and abnormal ones to indicate organic ED.
Compared with the results of NPT test, no statistically significant difference was observed in the accuracy rate between Viagra + AVSS test and Cialis + AVSS test (P > 0.05). PDE-5i + RigiScan-based AVSS test achieved a sensitivity of 78.9% and a specificity of 90.7% in the diagnosis of psychogenic ED and an overall accuracy rate of 81.9%. According to the results of PDE-5i + RigiScan-based AVSS test, the patients fell into a normal and an abnormal erection group, with significant differences between the two groups in age, disease course, IIEF-5 score and maintenance time of penile tip rigidity ≥60% (P < 0.05). ROC curve analysis indicated that PDE-5i + RigiScan-based AVSS test accurately manifested the erectile function of the patients.
Compared with NPT test, PDE -5i combined with RigiScan-based AVSS test is simple, inexpensive, practical and with a high sensitivity and specificity, and therefore can be used as the first-choice strategy for etiological diagnosis of ED.
探讨5型磷酸二酯酶抑制剂(PDE-5i)联合基于RigiScan的视听性刺激(AVSS)试验与夜间阴茎勃起(NPT)试验在评估勃起功能方面的临床价值。
2017年至2018年,共166例年龄在21至63岁(平均31岁)、病程3个月至10年(平均14个月)的勃起功能障碍(ED)患者接受了NPT试验或PDE-5i +基于RigiScan的AVSS试验。我们比较了诊断策略的结果。正常的NPT模式被认为提示心理性ED,异常模式提示器质性ED。
与NPT试验结果相比,万艾可+AVSS试验和希爱力+AVSS试验的准确率差异无统计学意义(P>0.05)。PDE-5i +基于RigiScan的AVSS试验在诊断心理性ED时的敏感性为78.9%,特异性为90.7%,总体准确率为81.9%。根据PDE-5i +基于RigiScan的AVSS试验结果,患者分为勃起正常组和异常组,两组在年龄、病程、国际勃起功能指数-5(IIEF-5)评分以及阴茎头硬度≥60%的维持时间方面差异有统计学意义(P<0.05)。ROC曲线分析表明,PDE-5i +基于RigiScan的AVSS试验能准确反映患者的勃起功能。
与NPT试验相比,PDE -5i联合基于RigiScan的AVSS试验简单、价廉、实用,且敏感性和特异性高,因此可作为ED病因诊断的首选策略。