Lee B, Sikka S C, Randrup E R, Villemarette P, Baum N, Hower J F, Hellstrom W J
Department of Urology, Tulane University Medical Center, New Orleans, Louisiana.
J Urol. 1993 Jan;149(1):49-52. doi: 10.1016/s0022-5347(17)35996-7.
The evaluation of vasculogenic impotence by color flow Doppler ultrasound after injection of intracavernous vasoactive agents allows for simultaneous visualization in real time of arterial and venous blood flow. Normal arterial blood flow parameters after prostaglandin E1 injection have yet to be standardized. Our study was initiated to evaluate blood flow parameters in a normal control population after prostaglandin E1 and visual stimulation. A total of 20 healthy male volunteers 45 to 60 years old with histories of normal sexual function was selected. All volunteers were given intracavernous injections of 10 micrograms prostaglandin E1 and received concurrent visual stimulation by means of an erotic video. All patients developed rigid erections with no complications. Using color flow Doppler ultrasound measurements were done before and after prostaglandin E1 injection of right and left superficial and deep cavernous artery diameters, peak blood flow velocities and blood flow volumes. Results (mean plus or minus standard error) showed a significant increase in diameters after prostaglandin E1 in the superficial (20% increase) and deep (70% increase) penile arteries. Blood flow volume increased 3-fold for the superficial penile arteries (from 7.3 +/- 1.4 to 20 +/- 3.5 cc per minute) and 4-fold for the deep cavernous arteries (from 3.8 +/- 1 to 12.5 +/- 1.8 cc per minute). Peak blood flow velocity increased 2-fold (from 22 +/- 3 to 46 +/- 7 cm. per second) for the superficial arteries and 3-fold (from 12.5 +/- 2 to 37 +/- 5 cm. per second) for the deep cavernous arteries. These data suggest control values for normal erectile function in middle-aged men as a 70% increase in deep cavernous artery diameter, a systolic peak blood flow velocity greater than 30 cm. per second and more than 10 cc per minute of blood flow volume. With these standards the clinician may assess, design and follow treatment strategies for vasculogenic impotence.
注射海绵体内血管活性药物后，通过彩色多普勒超声评估血管性阳痿可实时同时显示动脉和静脉血流情况。前列腺素E1注射后的正常动脉血流参数尚未标准化。我们开展这项研究是为了评估前列腺素E1注射及视觉刺激后正常对照人群的血流参数。总共选取了20名年龄在45至60岁、性功能史正常的健康男性志愿者。所有志愿者均接受海绵体内注射10微克前列腺素E1，并通过色情视频接受同步视觉刺激。所有患者均出现了坚硬勃起且无并发症。利用彩色多普勒超声在注射前列腺素E1前后测量左右浅表和深部海绵体动脉直径、血流峰值速度和血流量。结果（均值±标准误）显示，前列腺素E1注射后浅表阴茎动脉（增加20%）和深部阴茎动脉（增加70%）直径显著增加。浅表阴茎动脉血流量增加了3倍（从每分钟7.3±1.4立方厘米增至20±3.5立方厘米），深部海绵体动脉血流量增加了4倍（从每分钟3.8±1立方厘米增至12.5±1.8立方厘米）。浅表动脉血流峰值速度增加了2倍（从每秒22±3厘米增至46±7厘米），深部海绵体动脉血流峰值速度增加了3倍（从每秒12.5±2厘米增至37±5厘米）。这些数据表明中年男性正常勃起功能的对照值为深部海绵体动脉直径增加70%、收缩期血流峰值速度大于每秒30厘米以及每分钟血流量超过10立方厘米。依据这些标准，临床医生可评估、设计并跟踪血管性阳痿的治疗策略。
