Allen R P, Brendler C B
Department of Neurology, Johns Hopkins University, School of Medicine, Baltimore, Maryland.
J Urol. 1988 Sep;140(3):518-22. doi: 10.1016/s0022-5347(17)41707-1.
Although response to intracorporeal pharmacological erection testing has been proposed to determine the etiology of impotence, physiological criteria predicting this response have not been established and the literature includes conflicting results regarding which patients respond to pharmacological erection therapy. In this study 37 impotent patients underwent a diagnostic nocturnal penile tumescence evaluation (including measurements of rigidity, pulsations and bulboischiocavernosus muscle activity) and the results were correlated with subsequent response to intracorporeal pharmacological testing. Most but not all patients with psychogenic impotence and all with neurogenic impotence responded with good erections. For vasculogenic impotence response rate depended upon impairment severity determined from nocturnal penile tumescence measurements; none of the severe cases versus 90 per cent of the milder cases responded. The results indicate that response to intracorporeal pharmacological testing does not accurately distinguish psychogenic from organic impotence, is best for neurogenic impotence and worst for severe vasculogenic impotence, and can be predicted accurately by nocturnal penile tumescence measurements.
虽然有人提出通过体内药物勃起测试来确定阳痿的病因，但尚未确立预测该反应的生理标准，并且文献中关于哪些患者对药物勃起治疗有反应的结果相互矛盾。在本研究中，37例阳痿患者接受了夜间阴茎勃起诊断评估（包括硬度、搏动和球海绵体肌活动的测量），结果与随后对体内药物测试的反应相关。大多数（但并非全部）心因性阳痿患者以及所有神经性阳痿患者对勃起反应良好。血管性阳痿的反应率取决于夜间阴茎勃起测量所确定的损伤严重程度；重度病例无一有反应，而轻度病例中有90%有反应。结果表明，体内药物测试的反应不能准确区分心因性阳痿和器质性阳痿，对神经性阳痿效果最佳，对重度血管性阳痿效果最差，并且可以通过夜间阴茎勃起测量准确预测。
