Zumbé J, Scheidhauer K, Kieslich F, Heidenreich A, Klotz T, Vorreuther R, Engelmann U
Klinik und Poliklinik für Urologie, Universität zu Köln, Deutschland.
Urol Int. 1997;58(1):39-42. doi: 10.1159/000282943.
Variations of Hauri's penile revascularization have been in clinical use since 1983. The hemodynamics of the so-called three-vessel anastomosis remain uncertain despite successful, clinically reproducible results. The goal of this study was to depict the increased perfusion of the erectile system of the penis following revascularization by means of the inferior epigastric artery. Ten milliliters of heparinized peripheral venous blood was drawn from 10 patients prior to surgery. The radioactively tagged erythrocytes (1 mCi 99mTc) were reinjected via an additional incision in the donor vessel proximal to the anastomosis following completion of the three-vessel anastomosis and intracavernous injection of 20 micrograms PGE1. Once again, blood was drawn during the tumescence phase from both a peripheral vein and the corpora cavernosa within the normal circulatory duration and compared to the original specimen. Eight of ten patients displayed evidence of primary reperfusion of the corpora cavernosa via the inferior epigastric artery as the donor vessel. Using strict indications, revascularization of the penis is an effective mode of therapy for arterial erectile dysfunction.
自1983年以来，豪里阴茎血运重建术的各种术式一直在临床应用。尽管取得了成功且临床结果可重复，但所谓三血管吻合术的血流动力学仍不明确。本研究的目的是描述通过腹壁下动脉进行血运重建后阴茎勃起系统灌注增加的情况。术前从10例患者中抽取10毫升肝素化外周静脉血。在完成三血管吻合术并向海绵体内注射20微克前列腺素E1后，通过在吻合口近端的供体血管上另做切口，将放射性标记的红细胞（1毫居里99m锝）重新注入。在正常循环持续时间内，于阴茎勃起期再次从外周静脉和海绵体抽血，并与原始标本进行比较。10例患者中有8例显示通过腹壁下动脉作为供体血管实现了海绵体的初次再灌注。采用严格的适应证，阴茎血运重建术是治疗动脉性勃起功能障碍的一种有效治疗方式。
