Levine L A, Coogan C L
Department of Urology, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois, USA.
J Urol. 1996 Apr;155(4):1270-3.
We assessed penile vasculature in men with Peyronie's disease using color duplex ultrasound.
A total of 99 men with Peyronie's disease underwent duplex ultrasound with 60 mg. intracavernous papaverine to gain an understanding of penile vasculature and its correlation to erectile rigidity. Patients were stratified into groups according to duplex ultrasound vascular parameters and the presence or absence of impotence (that is rigidity adequate for intromission).
Of 97 men 31 (32%) complained of impotence, 8 of 99 (8%) had evidence of corporeal veno-occlusive dysfunction on duplex ultrasound (defined as end diastolic flow velocity greater than 4.5 cm. per second) and 43% had a history of vascular risk factors that may have contributed to erectile insufficiency. Impotent patients had decreased peak systolic flow velocity, increased end diastolic flow velocity and higher a percent of vascular risk factors (p= 0.0006, 0.027 and 0.0004, respectively) compared to potent patients.
Duplex ultrasound provides a dynamic noninvasive functional assessment of penile vasculature in Peyronie's disease. Although corporeal veno-occlusive dysfunction has been considered the primary vascular etiology of erectile dysfunction associated with Peyronie's disease, arterial insufficiency is a major contributor, which is best detected before definitive therapy.
我们使用彩色双功超声评估佩罗尼氏病男性患者的阴茎血管系统。
共有99例佩罗尼氏病男性患者接受了双功超声检查，并注射60毫克海绵体内罂粟碱，以了解阴茎血管系统及其与勃起硬度的相关性。根据双功超声血管参数以及是否存在阳痿（即硬度足以插入）将患者分层。
97例男性中，31例（32%）主诉阳痿，99例中有8例（8%）在双功超声检查中有海绵体静脉闭塞功能障碍的证据（定义为舒张末期流速大于每秒4.5厘米），43%有血管危险因素史，这些因素可能导致勃起功能不全。与有勃起功能的患者相比，阳痿患者的收缩期峰值流速降低、舒张末期流速增加且血管危险因素百分比更高（分别为p = 0.0006、0.027和0.0004）。
双功超声为佩罗尼氏病患者的阴茎血管系统提供了动态无创功能评估。虽然海绵体静脉闭塞功能障碍一直被认为是与佩罗尼氏病相关的勃起功能障碍的主要血管病因，但动脉供血不足是一个主要因素，在进行确定性治疗之前最好能检测到。
