Sharlip I D
Pan Pacific Urology, San Francisco, California, USA.
Int J Impot Res. 1997 Dec;9(4):193-6. doi: 10.1038/sj.ijir.3900284.
Improvement in natural erections has been reported in approximately 9% of impotent men using intracavernous injections of vasoactive drugs for erection induction. The mechanisms which may account for this improvement are psychogenic, improved cavernous hemodynamics, prostaglandin-induced angiogenesis, improved cavernous oxygenation, cavernous smooth muscle hypertrophy and/or normal episodic fluctuations in erectile function. A review of the basic science literature on this subject reveals several theoretical explanations for this phenomenon but a review of the clinical literature reveals little convincing evidence that physiologic and/or pharmacologic factors are responsible for improvement in natural erections with intracavernous injection therapy. Furthermore, the prevalence of a placebo effect from impotence therapy exceeds the reported rate of improvement in natural or spontaneous erections. The most plausible explanations for spontaneous improvement in erections during or after intracavernous injection therapy are psychogenic and episodic variations in erectile function, rather than physiologic or pharmacologic factors. However, intracavernous injection therapy started soon after radical prostatectomy may have a protective effect in preserving normal cavernous physiology and erectile function in men being treated for prostate cancer.
据报道，约9%使用海绵体内注射血管活性药物诱导勃起的阳痿男性，其自然勃起功能有所改善。导致这种改善的机制可能是心理因素、海绵体血流动力学改善、前列腺素诱导的血管生成、海绵体氧合改善、海绵体平滑肌肥大和/或勃起功能正常的间歇性波动。对该主题的基础科学文献进行回顾，揭示了对这一现象的几种理论解释，但对临床文献的回顾显示，几乎没有令人信服的证据表明生理和/或药理因素是海绵体内注射疗法使自然勃起功能改善的原因。此外，阳痿治疗中安慰剂效应的发生率超过了所报道的自然或自发勃起功能改善的比率。海绵体内注射治疗期间或之后勃起功能自发改善的最合理原因是心理因素和勃起功能的间歇性变化，而非生理或药理因素。然而，在根治性前列腺切除术后不久开始的海绵体内注射治疗，可能对接受前列腺癌治疗的男性保留正常海绵体生理和勃起功能具有保护作用。
