Başar M M, Sargon M F, Başar H, Atan A, Ak F, Celik H H, Başar R, Akalin Z
Clinic of First Urology, Ankara Numune Hospital, Turkey.
Int J Urol. 1998 May;5(3):252-5. doi: 10.1111/j.1442-2042.1998.tb00599.x.
Biopsy and electrical activity recordings of the corpus cavernosum are 2 new diagnostic methods for the evaluation of impotent men. We evaluated the corpus cavernosum ultrastructure and electromyography (EMG) recordings from patients with erectile dysfunction.
Twenty erectile dysfunction patients with veno-occlusive dysfunction underwent a detailed history, physical examination, biochemical tests, hormonal analysis, injection of an intracavernous vasoactive agent (60 mg papaverine-HCl), color penile Doppler ultrasonography, cavernosometry/ cavernosography and corpus cavernosum electromyography (CC-EMG). Thirteen patients underwent total vein ligation and 7 had penile prosthesis implantations. Tissue samples were obtained during surgery from both corpora cavernosa and examined by transmission electron microscopy. Control corporal tissue samples were taken from 3 cadavers.
In 15 patients, CC-EMG recordings were 15.6 +/- 0.65 microV in the flaccid state, which decreased in 13 patients after papaverine (5.61 +/- 0.25 microV; P < 0.001). Five patients with diabetes mellitus had low amplitudes in the flaccid state (5.26 +/- 0.45 microV), which did not vary significantly after a papaverine injection (4.99 +/- 0.75 microV). The pathology of the corpus cavernosum biopsy specimens revealed a smooth muscle cell thickened basal membrane, dilated rough endoplasmic reticulum, and increased numbers of fibroblasts, but ultrastructurally normal endothelial cells lining the sinusoids. There was no difference between samples from diabetic or nondiabetic patients, or from either side of the corpora cavernosa. The only pathologic change observed in the controls was mitochondrial swelling.
CC-EMG is less invasive and a valuable method in patients with erectile dysfunction, whereas no specific findings were observed from penile biopsy specimens.
阴茎海绵体活检和电活动记录是评估阳痿男性的两种新诊断方法。我们评估了勃起功能障碍患者的阴茎海绵体超微结构和肌电图（EMG）记录。
20例静脉闭塞性功能障碍的勃起功能障碍患者接受了详细的病史、体格检查、生化检查、激素分析、海绵体内血管活性药物注射（60mg盐酸罂粟碱）、阴茎彩色多普勒超声检查、海绵体测压/海绵体造影及阴茎海绵体肌电图（CC-EMG）检查。13例患者接受了完全静脉结扎，7例植入了阴茎假体。手术期间从双侧阴茎海绵体获取组织样本，并通过透射电子显微镜检查。对照海绵体组织样本取自3具尸体。
15例患者在疲软状态下CC-EMG记录为15.6±0.65μV，13例患者注射罂粟碱后降低（5.61±0.25μV；P<0.001）。5例糖尿病患者在疲软状态下振幅较低（5.26±0.45μV），注射罂粟碱后无明显变化（4.99±0.75μV）。阴茎海绵体活检标本的病理显示平滑肌细胞基底膜增厚、粗面内质网扩张和成纤维细胞数量增加，但窦状隙内衬的内皮细胞超微结构正常。糖尿病患者与非糖尿病患者的样本之间或阴茎海绵体两侧之间无差异。对照组观察到的唯一病理变化是线粒体肿胀。
CC-EMG对勃起功能障碍患者侵入性较小且是一种有价值的方法，而阴茎活检标本未观察到特异性发现。
