Mulloy Evan, Li Shufeng, Belladelli Federico, Del Giudice Francesco, Glover Frank, Eisenberg Michael L
Department of Urology, Stanford University School of Medicine, Palo Alto, California.
Department of Dermatology, Stanford University School of Medicine, Palo Alto, California.
J Urol. 2023 Jan;209(1):253-260. doi: 10.1097/JU.0000000000002962. Epub 2022 Sep 9.
Priapism is a debilitating condition that affects sexual function. As a majority of cases are idiopathic, investigators have hypothesized underlying vascular dysfunction which may predispose men to priapism. We sought to determine if men are at risk for other sequelae of vascular dysfunction such as cardiovascular and thromboembolic disease after a priapism event.
Using a large commercial insurance claims data warehouse, we evaluated all men (age ≥20) with a diagnosis of priapism from 2003-2020 and matched them to a cohort of men with other urological disorders of sexual dysfunction (erectile dysfunction, Peyronie's disease, and premature ejaculation). We identified incident disease (cardiovascular disease, heart disease, embolism, thrombosis, cerebrovascular disease) for all cohorts.
A total of 10,459 men with priapism were identified and were matched to men with erectile dysfunction, Peyronie's disease, or premature ejaculation. The mean age was 51.1 years old. Men with priapism showed increased incidence of heart disease, both ischemic (HR 1.24, 95% CI 1.09-1.42) and other heart disease (HR 1.24, 95% CI 1.12-1.38) in the years following the priapism diagnosis. Incident cerebrovascular disease was also more likely in men with a history of priapism (HR 1.33, 95% CI 1.15-1.55). Men requiring treatment for ischemic priapism had a higher hazard of cardiovascular and cerebrovascular disease. In addition, men with more priapism episodes had a higher rate of cardiovascular disease and thromboembolic events.
Men with priapism are at increased risk for cardiovascular and cerebrovascular events in the years following a priapism.
阴茎异常勃起是一种影响性功能的使人衰弱的病症。由于大多数病例为特发性，研究人员推测存在潜在的血管功能障碍，这可能使男性易患阴茎异常勃起。我们试图确定男性在阴茎异常勃起事件后是否有患血管功能障碍的其他后遗症的风险，如心血管疾病和血栓栓塞性疾病。
利用一个大型商业保险理赔数据仓库，我们评估了2003年至2020年期间所有诊断为阴茎异常勃起的男性（年龄≥20岁），并将他们与一组患有其他性功能障碍性泌尿系统疾病（勃起功能障碍、佩罗尼氏病和早泄）的男性进行匹配。我们确定了所有队列中的新发疾病（心血管疾病、心脏病、栓塞、血栓形成、脑血管疾病）。
共识别出10459例阴茎异常勃起男性，并与勃起功能障碍、佩罗尼氏病或早泄男性进行匹配。平均年龄为51.1岁。阴茎异常勃起男性在阴茎异常勃起诊断后的几年中，患心脏病的发生率增加，包括缺血性心脏病（风险比1.24，95%置信区间1.09 - 1.42）和其他心脏病（风险比1.24，95%置信区间1.12 - 1.38）。有阴茎异常勃起病史的男性发生脑血管疾病的可能性也更高（风险比1.33，95%置信区间1.15 - 1.55）。需要治疗缺血性阴茎异常勃起的男性患心血管和脑血管疾病的风险更高。此外，阴茎异常勃起发作次数较多的男性患心血管疾病和血栓栓塞事件的发生率更高。
阴茎异常勃起男性在阴茎异常勃起后的几年中患心血管和脑血管事件的风险增加。
