Marshall G A, Breza J, Lue T F
Department of Urology, University of California School of Medicine, San Francisco.
Urology. 1994 Jun;43(6):844-8. doi: 10.1016/0090-4295(94)90147-3.
To investigate the phenomenon of spontaneous erections in patients on long-term intracavernous injection therapy.
We undertook an objective assessment of the penile circulation of 35 patients; 21 used prostaglandin E1 (PGE1) alone and 14 used a combination of papaverine, phentolamine, and PGE1. All underwent duplex ultrasonography before initiation of home self-injection and again after a mean of thirty-one months of treatment (most patients performed injections once or twice a week).
The diameter of the cavernosal arteries did not change significantly after treatment. However, the mean peak flow velocity increased highly significantly (P < 0.001): 17.9 cm/second in the right cavernous artery and 21.2 cm/second on the left before treatment; 24 cm/second on the right and 29 cm/second on the left after treatment. More than one third (13 of 35 patients [35%]) achieved functional erection without injection at least some of the time, giving clinical support to the sonographic findings.
We suggest that the combination of vasodilatory drugs and sexual stimulation may act to improve sinusoidal and penile arteriolar smooth muscle function.
研究长期接受海绵体内注射治疗的患者出现自发勃起的现象。
我们对35例患者的阴茎血液循环进行了客观评估；21例单独使用前列腺素E1（PGE1），14例使用罂粟碱、酚妥拉明和PGE1的联合用药。所有患者在开始家庭自我注射前均接受了双功超声检查，并在平均治疗31个月后（大多数患者每周注射一到两次）再次进行检查。
治疗后海绵体动脉直径无明显变化。然而，平均峰值流速显著升高（P < 0.001）：治疗前右侧海绵体动脉为17.9厘米/秒，左侧为21.2厘米/秒；治疗后右侧为24厘米/秒，左侧为29厘米/秒。超过三分之一（35例患者中的13例[35%]）至少在某些时候无需注射即可实现功能性勃起，为超声检查结果提供了临床支持。
我们认为血管扩张药物与性刺激相结合可能有助于改善海绵体和阴茎小动脉平滑肌功能。
