Tamura M, Iriguchi H, Miyamoto T, Kimura K, Kawanishi Y, Numata A, Yuasa M, Hashimoto H, Terao N, Kagawa S
Department of Urology, Takamatsu Red Cross Hospital, Kagawa, Japan.
Nihon Hinyokika Gakkai Zasshi. 1993 Mar;84(3):473-8. doi: 10.5980/jpnjurol1989.84.473.
We performed ligation of the crura penis for 34 impotents with corporal veno-occlusive insufficiency without arterial insufficiency and neural dysfunction from October 1987 to April 1991. Ages ranged from 24 to 72 (52.6 +/- 12.7) years old and follow up period was from 1 to 41 (17.7 +/- 12.6) months. For six patients ligation of the crura only was performed, for 22 ligation of the crura and deep dorsal vein (DDV) as well was performed at the same time, and for 6 crural ligation was performed after ligation of DDV. These operations required less than one hour and there were no severe complications. The postoperative results at 1 month were as follows: Excellent (sufficient spontaneous erection was recovered); 18, Improved (complete erection with intracavernous papaverine injection was achieved); 13, and Failure; 3. Erectile function was maintained only in 50% of the 18 pts. graded excellent. Ninety percent of the 31 patients graded either excellent or improved could maintain erectile function after 40 months with papaverine injection. Venous surgeries could not be a primary treatment for correcting the outflow abnormalities (of the veins). So it is conceivable that failure or recurrence could occur during a long follow up period. We concluded that crural ligation was acceptable as the first line treatment for erectile dysfunction due to corporal veno-occlusive insufficiency because of its relative non-invasiveness compared to other venous surgeries.
1987年10月至1991年4月,我们对34例患有海绵体静脉闭塞功能不全但无动脉供血不足和神经功能障碍的阳痿患者进行了阴茎脚结扎术。患者年龄在24至72岁之间(平均52.6±12.7岁),随访时间为1至41个月(平均17.7±12.6个月)。6例患者仅进行了阴茎脚结扎,22例同时进行了阴茎脚和阴茎背深静脉(DDV)结扎,6例在DDV结扎后进行了阴茎脚结扎。这些手术耗时不到1小时,且无严重并发症。术后1个月的结果如下:优(恢复了足够的自然勃起)18例;良(海绵体内注射罂粟碱后能完全勃起)13例;差3例。在18例评为优的患者中,仅50%维持了勃起功能。在评为优或良的31例患者中,90%在40个月后经罂粟碱注射仍能维持勃起功能。静脉手术不能作为纠正静脉流出异常的主要治疗方法。因此,在长期随访中可能会出现失败或复发。我们得出结论,阴茎脚结扎术可作为因海绵体静脉闭塞功能不全导致勃起功能障碍的一线治疗方法,因为与其他静脉手术相比,它相对无创。