Lehmann K, Schöpke W, Brütsch H P, Hauri D
Urologische Klinik, Departement Radiologie, Universitätsspital Zürich.
Schweiz Rundsch Med Prax. 1994 Sep 13;83(37):1030-3.
The assessment of an erectile dysfunction (ED) includes the history, a clinical examination and blood tests. There is some confusion about which basic hormonal tests are needed at the beginning of clinical evaluation. We feel that with the results from our patients we could help to answer this question. From 1 January 1990 until the December 31 1993 we evaluated 1134 patients for ED. Those who favoured a surgical correction of their ED were fully evaluated by nocturnal penile tumescence testing, penile arteriography, intracavernosal injection of vasoactive agents and dynamic pharmaco-cavernosometry. The results from these tests were correlated with luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone and prolactin. 183 (16.1%) of our patients with a mean age of 45 +/- 14 were fully evaluated. From these patients 76 were excluded because their ED was posttraumatic, undoubtedly psychogenic or could not be proven by the tests mentioned above. From the 107 patients finally included in this study, 90 had normal endocrine parameters. 17 patients had low testosterone. 14 of these patients had otherwise completely normal hormonal tests without evidence of secondary hypogonadism. Three patients had their low testosterone levels confirmed by repeated measurements. In addition, prolactin was significantly increased, and FSH and LH were near or below the lower reference value. When evaluating patients for the first time because of an erectile dysfunction, the measurement of testosterone as a single endocrine test is adequate. If testosterone is low, repeated measurements, combined with LH, FSH and prolactin, will identify patients with an ED due to an endocrine disease.
勃起功能障碍（ED）的评估包括病史、临床检查和血液检查。在临床评估开始时，对于需要进行哪些基本激素检查存在一些困惑。我们认为，根据我们患者的结果，我们可以帮助回答这个问题。从1990年1月1日至1993年12月31日，我们对1134例ED患者进行了评估。那些倾向于通过手术矫正ED的患者通过夜间阴茎勃起测试、阴茎血管造影、海绵体内注射血管活性药物和动态海绵体测压进行了全面评估。这些测试的结果与黄体生成素（LH）、卵泡刺激素（FSH）、睾酮和催乳素相关。我们平均年龄为45±14岁的183例（16.1%）患者进行了全面评估。在这些患者中，76例被排除，因为他们的ED是创伤后性的、无疑是心因性的或无法通过上述测试证实。在最终纳入本研究的107例患者中，90例内分泌参数正常。17例患者睾酮水平低。其中14例患者的其他激素测试完全正常，无继发性性腺功能减退的证据。3例患者通过重复测量证实睾酮水平低。此外，催乳素显著升高，FSH和LH接近或低于参考下限值。首次因勃起功能障碍评估患者时，仅测量睾酮作为单一内分泌测试就足够了。如果睾酮水平低，重复测量并结合LH、FSH和催乳素，将识别出因内分泌疾病导致ED的患者。
