Katlowitz N, Albano G J, Patsias G, Golimbu M, Morales P
Male Reproductive Medicine and Impotency Program, Cabrini Medical Center, New York University, New York.
Urology. 1993 Dec;42(6):695-7. doi: 10.1016/0090-4295(93)90537-k.
Erections are inhibited by sympathetic stimulation. Anxiety or psychologic inhibition may produce abnormal response during impotence workup. The use of intracorporeal alpha blockers (phentolamine) and audiovisual sexual stimulation (AVSS) has been used to decrease sympathetic outflow and enhance erectile response. Thirty-three patients with suspected vasculogenic impotence were studied. They underwent pulsed Doppler ultrasound (PDUS) with multiple doses of tri-mix (mix of papaverine, phentolamine, and prostaglandin E1). AVSS was applied after maximal response to tri-mix. Seventeen patients (51.5%) responded to multidose with grade IV or V erection. When AVSS was started, 5 more patients responded, and 7 upgraded to grade V with overall response of 40 percent. AVSS can augment the in-office response to pharmacologic testing above that obtained by "maximal" pharmacologic dosing, thereby increasing the sensitivity and specificity of the test.
勃起受到交感神经刺激的抑制。焦虑或心理抑制可能在阳痿检查过程中产生异常反应。使用体内α受体阻滞剂（酚妥拉明）和视听性刺激（AVSS）已被用于减少交感神经流出并增强勃起反应。对33例疑似血管性阳痿的患者进行了研究。他们接受了多剂量三联混合液（罂粟碱、酚妥拉明和前列腺素E1的混合液）的脉冲多普勒超声（PDUS）检查。在对三联混合液产生最大反应后应用AVSS。17例患者（51.5%）对多剂量治疗有IV级或V级勃起反应。当开始使用AVSS时，又有5例患者有反应，7例升级为V级，总体反应率为40%。AVSS可以增强在办公室内对药物测试的反应，使其高于通过“最大”药物剂量所获得的反应，从而提高测试的敏感性和特异性。
