Billis Evdokia, Kontogiannis Stavros, Tsounakos Spyridon, Konstantinidou Eleni, Giannitsas Konstantinos
Laboratory of Clinical Physiotherapy and Research, Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Rio, Greece.
Department of Urology, University Hospital of Patras, 26504 Rio, Greece.
Healthcare (Basel). 2023 Oct 22;11(20):2793. doi: 10.3390/healthcare11202793.
Hard flaccid syndrome (HFS) is a rather rare, acquired clinical entity affecting young men's well-being, sexual and social life. HFS presents with a cluster of symptoms including penile-specific somatosensory disturbances, a semi-rigid penis at the flaccid state without any stimulation or desire, erectile dysfunction, perineal and/or penile pain, associated urinary symptoms, emotional distress as well as other psychosocial and stress-related manifestations. Although its pathophysiology is still not well understood, initial penile trauma causing minor nerve and vascular disturbances to the penis and associated pelvic floor musculature is suggested to trigger the syndrome. Despite the scarcity of research on HFS, the present report describes a case of a young male clinically diagnosed with HFS, who benefited from a biopsychosocial management strategy, focusing on pain management, therapeutic exercise approaches, such as pelvic floor exercise re-education, graded exposure to activity as well as education on lifestyle and stress-related modifications. This holistic management approach has been clinically reasoned in this case report, and the need for more evidence-based studies developing diagnosing criteria, elaborating pathophysiological mechanisms and testing the efficiency of different therapeutic options is highlighted.
硬瘫综合征（HFS）是一种相当罕见的后天性临床病症，影响着年轻男性的身心健康、性生活和社交生活。硬瘫综合征表现为一系列症状，包括阴茎特定的躯体感觉障碍、在无任何刺激或性欲情况下处于疲软状态时阴茎半硬、勃起功能障碍、会阴和/或阴茎疼痛、相关的泌尿系统症状、情绪困扰以及其他心理社会和与压力相关的表现。尽管其病理生理学仍未完全明确，但据推测，最初导致阴茎及相关盆底肌肉组织轻微神经和血管紊乱的阴茎创伤会引发该综合征。尽管关于硬瘫综合征的研究较少，但本报告描述了一例临床诊断为硬瘫综合征的年轻男性病例，该患者受益于一种生物心理社会管理策略，该策略侧重于疼痛管理、治疗性运动方法，如盆底肌运动再教育、逐步增加活动量以及生活方式和压力相关调整的教育。本病例报告从临床角度阐述了这种整体管理方法，并强调了开展更多基于证据的研究以制定诊断标准、阐明病理生理机制以及测试不同治疗方案有效性的必要性。
