Goldstein I, Udelson D
Department of Urology, Boston University School of Medicine, USA.
Int J Impot Res. 1998 May;10 Suppl 2:S28-33; discussion S49-51.
Erectile dysfunction may be defined in terms of axial penile rigidity, the physical property that enables the erection to be utilized as a penetration tool during sexual activity. Erectile dysfunction occurs when inadequate axial penile rigidity results in buckling of the penile column when subjected to axial compressive loading situations during vaginal intromission. New multi-disciplinary engineering studies of penile hemodynamic and structural dynamic relationships are reviewed concerning the determinants of axial penile rigidity. Axial penile rigidity develops as a continuum during the increases in intracavernosal pressure and volume changes from the flaccid state and is influenced by intracavernosal pressure, penile tissue mechanical properties and penile geometry. Two penile tissue mechanical properties are especially relevant; cavernosal maximum volume at relatively low intracavernosal pressure, and tunical distensibility, the relative volume of the fully erect to completely flaccid pendulous penis. Two penile geometric properties are critical; the penile aspect ratio, defined as the diameter to length ratio of the pendulous penis, and the magnitude of the flaccid penile diameter. Clinically measured values of axial buckling forces in patients undergoing dynamic pharmacocavernosometry strongly correlated to theoretic-based analytic derived magnitudes of axial penile rigidity based on these above pressure, tissue and geometric determinants. Since axial penile rigidity is not exclusively dependent upon intracavernosal pressure, patients with normal erectile hemodynamics may be erroneously labelled as having psychogenic dysfunction where their true pathophysiology may be related to abnormal penile tissue properties and/or penile geometric factors. Similarly, some patients may claim sufficient rigidity for penetration, but have abnormal hemodynamic erectile function studies. They may have uniquely advantageous tissue mechanical and/or geometric properties. More research is needed concerning axial penile rigidity, a most influential factor determining functional erectile quality, erectile potency and successful coitus.
勃起功能障碍可以根据阴茎轴向硬度来定义，这是一种物理特性，使勃起能够在性活动中用作插入工具。当阴茎轴向硬度不足导致在阴道插入过程中受到轴向压缩负荷时阴茎柱弯曲时，就会发生勃起功能障碍。本文综述了有关阴茎轴向硬度决定因素的阴茎血流动力学和结构动力学关系的新的多学科工程研究。阴茎轴向硬度在海绵体内压力增加以及阴茎从疲软状态发生体积变化的过程中连续发展，并受海绵体内压力、阴茎组织力学特性和阴茎几何形状的影响。有两种阴茎组织力学特性尤其相关；相对较低海绵体内压力下的海绵体最大体积，以及白膜扩张性，即完全勃起与完全疲软下垂阴茎的相对体积。有两种阴茎几何特性至关重要；阴茎纵横比，定义为下垂阴茎的直径与长度之比，以及疲软阴茎直径的大小。在接受动态药物海绵体测压的患者中，临床测量的轴向屈曲力值与基于上述压力、组织和几何决定因素的基于理论分析得出的阴茎轴向硬度大小密切相关。由于阴茎轴向硬度并非完全取决于海绵体内压力，勃起血流动力学正常的患者可能会被错误地标记为患有心因性功能障碍，而其真正的病理生理学可能与异常的阴茎组织特性和/或阴茎几何因素有关。同样，一些患者可能声称有足够的硬度进行插入，但勃起血流动力学功能研究异常。他们可能具有独特的有利组织力学和/或几何特性。关于阴茎轴向硬度这一决定功能性勃起质量、勃起能力和成功性交的最有影响力的因素，还需要更多的研究。
