Hirsch I H, Smith R L, Chancellor M B, Bagley D H, Carsello J, Staas W E
Department of Urology, Jefferson Medical College, Philadelphia, PA 19107.
Paraplegia. 1994 Oct;32(10):661-4. doi: 10.1038/sc.1994.106.
The administration and suitability of intracavernous PGE-1 in men with neuropathic erectile dysfunction is reported herein. Twenty-seven men with neuropathic erectile dysfunction (SCI, 14; multiple sclerosis, 7; discogenic disease, 6) were evaluated and treated with intracavernous PGE-1. An average of 3.2 office sessions were required to learn adequate self-injection technique and determine optimal dosage requirement. Initial dosage for SCI men was 2.5 micrograms and increased in 2.5 micrograms increments to a mean maintenance dose of 6.2 micrograms. Quarterly monitoring up to 28 months demonstrated satisfactory erectile rigidity and duration of erection in all patients electing to pursue home administration of PGE-1. During this interval, over 40% of patients dropped out of the treatment program. No priapism or changes in serum chemistries, CBC, or platelets were observed during this period. Corporal fibrosis although not palpable, was detected subclinically by penile ultrasound in two men. This study confirms the safety and efficacy of self-administered intracavernous PGE-1 for neuropathic impotence. However, because of a significant rate of voluntary cessation, patients should be counseled regarding the full range of therapeutic alternatives to intracavernous therapy.
本文报道了海绵体内注射前列腺素E-1（PGE-1）治疗神经性勃起功能障碍男性患者的应用情况及适用性。对27例神经性勃起功能障碍患者（脊髓损伤14例、多发性硬化症7例、椎间盘源性疾病6例）进行了评估，并采用海绵体内注射PGE-1进行治疗。平均需要3.2次门诊就诊来学习适当的自我注射技术并确定最佳剂量需求。脊髓损伤患者的初始剂量为2.5微克，以2.5微克的增量增加，平均维持剂量为6.2微克。长达28个月的季度监测显示，所有选择在家自行注射PGE-1的患者勃起硬度和勃起持续时间均令人满意。在此期间，超过40%的患者退出了治疗方案。在此期间未观察到阴茎异常勃起或血清化学、全血细胞计数或血小板的变化。两名男性患者经阴茎超声检查在临床上未触及但亚临床检测到海绵体纤维化。本研究证实了自行注射海绵体内PGE-1治疗神经性阳痿的安全性和有效性。然而，由于自愿停药率较高，应向患者咨询海绵体内治疗的所有治疗选择。
