靜脈性陽萎的評估：陰莖海棉體攝影檢查

Pharmacocavernosography: A Worthwhile Examination in the Evaluation of Venogenic Impotence

劉力璋(Li-Chang Liu) ； 劉樂輝(Lo-Hui Liu) ； 江金培(Chin-Pei Chiang) ； 黃俊雄(Chun-Hsiung Huang) ； 吳重慶(Chung-Cheng Wu)

《The Kaohsiung Journal of Medical Sciences》 5卷10期 (1989/10) Pp. 578-583

https://doi.org/10.6452/KJMS.198910.0578

摘要

自民國77年11月到78年7月，共有78位主訴陽萎的病人，接受陰莖海棉體內注射血管擴張劑之後，安排做陰莖海線體攝影檢查，呈現異常靜脈顯影共有63位〈80.8%〉，其中一位合併有peyronie’s disease；63位呈現異常靜脈顯影的病人當中，X光所能見到靜脈以前列線周圍靜脈叢佔最多，共53位〈67.9%〉，其次為近端靜脈有50位〈64.1%〉，接著為內陰靜脈有46位〈58.9%〉、和深部背靜脈有31位〈39.7%〉，龜頭顯影者有8位〈10.3%〉，外陰靜脈有8位〈10.3%〉以及尿道海棉體有3位〈3.8%〉，所以靜脈性陽萎的結紮手術必須盡可能地結紮所有可見到的靜脈，尤其是近端靜脈；78位當中有52位病人曾接受彩色杜卜勒複合超音波檢查，呈現異常靜脈顯影有43位〈82.7%〉，有否安排杜卜勒複合超音波檢查似乎並不太影響靜脈性陽萎的發生率；另外12位有中等或嚴重動脈性病變的病人，皆呈現異常靜脈顯影，所以這類病人似乎沒有必要再接受陰莖海棉體內攝影檢查。整個檢查過程並無重大併發症發生，如陰莖異常持續勃起，可見這種方法是一種相當簡單、實用、有價值的評估工具。細心操作，安全性高、併發症少、操作容易，能夠決定異常靜脈顯影的位置，以供手術時參考，但是仍無法決定或診斷靜脈性陽萎的程度。

並列摘要

Form November 1988 till July 1989, a total of 78 patients consulted our OPD with a chief complaint of impotence. These patients underwent evaluation with pharmacocavernosography (A cuon 128). Sixty-three (80.8%) patients were found to have abnormal venous drainage which, in one case, was associated with peyronie’s disease. Among these patients, the sites for the contrast medium in the determined as follows: the preprostatic plexus for 53(67.9%) patients, the proximal (cavernosal or crural) vein for 50(64.1%) patients; the internal pudendal vein for 46(58.9%) patients; the deep dorsal vein for 31(39.7%) patients; the external pudendal vein for 8(10.3%) patients. So the venous ligation for venogenic impotence had to include all these visible veins, especially the proximal vein. Among the 52 patients who once had received duplex scanning, 43 (82.7%) patients had abnormal veinous drainage. So the duplex sonography did not seem to influence the population of venous leakage and 12 patients exhibited moderate to severe degree of arteriogenic insufficiency. Pharmacocavernosography in these patients was less valuable. No severe complications, such as priapism, were found. We found pharmacocavernosography to be a simple, practical and useful tool for evaluating patients suspected to have venogenic impotence. It can determine the sites of venous leakage (the key information for planning venous ligation) and provides good morphological information in the study of cavernous bodies. But it was not reliable in the evaluation of the severity of venous leakage.

並列關鍵字

impotence ； pharmacocavernosography ； pharmacocavernoso metry