Sun Guo-Hai, Wang Xun, Han You-Feng, Shi Liang
Department of Andrology, Drum Tower Hospital Affiliated to Nanjing University School of Medicine, Nanjing, Jiangsu 210008, China.
Zhonghua Nan Ke Xue. 2023 May;29(5):436-440.
To analyze the blood flow parameters of the cavernous arteries of ED patients after injection of vasoactive drugs, and to explore the differences in blood flow of the cavernous arteries in different erectile states.
Retrospectively analyzed the penile cavernous arterial blood flow parameters of 2568 adult male ED patients after injection of the vasoactive drug (alprostadil). The patients were divided into three groups: maintaining erection group with EHS (erection hardness score) ≥ 3 and sustained erection time ≥ 20 minutes (967 cases), nonpersistent erection group with EHS≥3 and sustained erection time<5 minutes (788 cases), and incomplete erection group with EHS<3 (813 cases). Compared the parameters of age, EHS, duration of erection, cavernous artery peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI) among the three groups respectively. The maintaining erection group was divided into the youth group (757 cases) which aged less than 40 years old and the middle-aged and elderly group (210 cases) with 40 years old or over. The parameters of PSV, EDV and RI between the two groups were compared. The incomplete erection group were divided into the good blood supply group (407 cases) with the bilateral PSV ≥35cm/s and the insufficient blood supply group (252 cases) with the bilateral PSV<35cm/s. The parameters of age, EHS, EDV and RI between the two groups were compared.
The age, PSV, EDV and RI of the three groups were significantly different (P<0.01). In the maintaining erection group, the PSV of the young group was significantly higher than that of the middle-aged and elderly group (P<0.05), but there was no statistically significant difference in EDV and RI (P>0.05). In the incomplete erection group, the EHS, PSV, EDV, and RI of the good blood supply group were significantly higher than those of the insufficient blood supply group (P<0.05), while the age was significantly lower than that of the latter (P<0.01).
The injection of vasoactive drugs combined with color Doppler ultrasound can directly reflect the blood supply of the cavernous arteries of the penis. The better the erection state, the better the blood supply of cavernous arteries. The middle-aged and elderly people are more likely to have cavernous arteries problem of insufficient blood supply than the young people.
分析血管活性药物注射后勃起功能障碍(ED)患者海绵体动脉的血流参数,探讨不同勃起状态下海绵体动脉血流的差异。
回顾性分析2568例成年男性ED患者注射血管活性药物(前列地尔)后的阴茎海绵体动脉血流参数。患者分为三组:勃起硬度评分(EHS)≥3且勃起持续时间≥20分钟的维持勃起组(967例)、EHS≥3且勃起持续时间<5分钟的非持续性勃起组(788例)、EHS<3的勃起不充分组(813例)。分别比较三组患者的年龄、EHS、勃起持续时间、海绵体动脉收缩期峰值流速(PSV)、舒张末期流速(EDV)及阻力指数(RI)参数。维持勃起组分为年龄<40岁的青年组(757例)和年龄≥40岁的中老年组(210例),比较两组的PSV、EDV及RI参数。勃起不充分组分为双侧PSV≥35cm/s的血供良好组(407例)和双侧PSV<35cm/s的血供不足组(252例),比较两组的年龄、EHS、EDV及RI参数。
三组患者的年龄、PSV、EDV及RI差异有统计学意义(P<0.01)。维持勃起组中,青年组的PSV显著高于中老年组(P<0.05),但EDV及RI差异无统计学意义(P>0.05)。勃起不充分组中,血供良好组的EHS、PSV、EDV及RI均显著高于血供不足组(P<0.05),而年龄显著低于后者(P<0.01)。
血管活性药物注射联合彩色多普勒超声可直接反映阴茎海绵体动脉的血供情况。勃起状态越好,海绵体动脉血供越好。中老年人群比青年人群更易出现海绵体动脉血供不足的问题。