Kulmala R V, Lehtonen T A, Tammela T L
Department of Clinical Medicine, University of Tampere, Finland.
Scand J Urol Nephrol. 1996 Aug;30(4):313-6. doi: 10.3109/00365599609182313.
Impotence is the most serious complication of priapism. In order to study its incidence and risk factors, the final outcomes of 124 cases of priapism in previously potent patients were analyzed and correlated with the duration of symptoms, age of the patients, aetiology and modality of treatment. Thirty-nine per cent of the patients became impotent. The duration of symptoms before treatment correlated markedly with the risk of impotence, in that 92% of those whose priapism had lasted less than 24 h remained potent but only 22% of those for whom it had lasted longer than 7 days. The younger the patients the better the prognosis, so that 88% of those younger than 30 years preserved their potency but only 40% of those older than 50 years. The prognosis was poorest when heparin therapy or a combination of alcohol drinking and psychopharmaceuticals was the aetiological factor behind priapism. Only 31% of patients preserved their potency after conservative treatment for priapism, whereas 69% of those treated with small glandocorporeal shunts did so. Priapism is an emergency state, in which immediate procedures are necessary to ensure detumescence as soon as possible. If puncture with lavation and intracorporeal injection of alpha-sympathomimetics does not restore detumescence, small glandocorporeal shunts should be performed.
阴茎异常勃起是阴茎异常勃起最严重的并发症。为研究其发生率及危险因素，对124例既往性功能正常患者的阴茎异常勃起最终结局进行分析，并与症状持续时间、患者年龄、病因及治疗方式相关联。39%的患者出现阳痿。治疗前症状持续时间与阳痿风险显著相关，即阴茎异常勃起持续时间少于24小时的患者中，92%仍保持性功能，但持续时间超过7天的患者中只有22%仍保持性功能。患者年龄越小，预后越好，30岁以下患者中88%保持了性功能，而50岁以上患者中只有40%。当肝素治疗或饮酒与精神药物联合使用是阴茎异常勃起的病因时，预后最差。阴茎异常勃起经保守治疗后只有31%的患者保持了性功能，而接受小阴茎海绵体分流术治疗的患者中有69%保持了性功能。阴茎异常勃起是一种紧急情况，需要立即采取措施以尽快确保消肿。如果穿刺冲洗及阴茎海绵体内注射α-拟交感神经药不能恢复消肿，则应进行小阴茎海绵体分流术。
