Erectile Response of Penis to Intracavernous Injection of Prostaglandin E1 Associated with Audio-Visual Sexual Stimulation (AVSS) and Dynamic Infusion Cavernosometry (DIC)

陰莖勃起是一種神經肌肉性的作用，其主要機轉是使海綿體平滑肌放鬆從而令陰莖動脈怒張、靜脈收縮，同時需配合神經系統有效的控制。據估計約有十分之一男性可能會發生陽萎。而導致陽萎的原因很多，其中以器質性佔了相當大部份。目前診斷陽萎的方法雖多，但卻沒有任何一種能達成滿意的效果。本篇是藉著視聽性刺激、陰莖海綿體動態壓力及前列腺素戊一型陰莖海綿體內注射之檢查來評估18位性功能失調病患。所有病患均以前列腺素戊一型20微克作陰莖海綿體內注射，陰莖勃起後10分鐘再予觀賞30分鐘色情錄影炎作為視聽性刺激。陰莖勃起反應可從海綿體內壓力及陰莖圓周之改變而得知。陰莖海綿體動態壓力之測定則以陰莖完全勃起時(內壓大於150毫米水銀柱)輸液灌注海綿體內開始時之速度及平穩狀態時之速度表示之。其中有9位患者接受前列腺素戊一型海綿體內注射後，其陰莖內壓力差之改變大於30毫米水銀柱，經杜卜勒複合超音波測定證實其動脈均屬正常而另外9位病患其壓力差之變改少於30毫米水銀柱，其中6位證實為動脈性陽萎。所有病患對視聽性刺激有反應者其生物振動感覺測定也屬正常。有6位病患其海綿體動態壓力結果顯示當輸液灌注開始時之流速每分鐘大於150毫升或其平穩狀態時之流速每分鐘大於50毫升時，經陰莖海綿體攝影均證實有靜脈漏血現象。初期結果認為此法對於鑑別診斷質性陽萎相當有效且簡便。唯其長期效果則有待進一步之評估與研究。

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並列摘要

Penile erection is a neuromuscular evetn involiving relaxation of cavernous smooth muscle, arterial dilatation, restriction of venous autflow and is undoubtedly under enural control. Impotence is estimated to affect 10% of male population. The majority of erectile dysfunction have organic origin. Several diagnostic modalities have been used to eval uate impotence, however, none of the methods is wholly satisfactory. In this prospective study of 18 impotent patients, we evaluated their erectile dysfunction by audio-visual sexual stimulation (AVSS) and dynamic infusion cavernosometry (DIC) associated with intracavernous prostaglandin E1 (PEG1) test. Penile erection was induced by intracavernous injection of PEG1 20 ug. Ten minuts later, AVSS was accomplished by watching an erotic videotape for 30 minutes. Erectile response was simultaneously indicated by intracavernous pressure (ICP) monitoring and penile circumference measurement. DIC was expressed by an initiated flow rate (IFR) and a maintanence flow rate (MFR) to full erection (ICP ≧ 150 mmHg). There were 9 patients whose ICP-difference (△P) between ICP at 10 minutes after PEG1 injection and the resting ICP greater than 30mmHg, 6 patients (66.7%) were disclosed arteriogenic impotence. All of the patients responded to AVSS their biothesiometry were also normal. Besides, there were 6 patients their DIC showed IFR more than 150 ml/min and/or MFR more than 50 ml/min whose cavernosograms showed vernous leakage. From our preliminary data, we concluded that it might be a feasibly simple and reliable method to differentiate diagnosis of organic impotence. However, the long-term efficacy must be determined.

並列關鍵字

audio-visual ； sexual stimulation ； dynamic infusion cavernosometry prostaglandin E1 ； impotence

國際替代計量

Erectile Response of Penis to Intracavernous Injection of Prostaglandin E1 Associated with Audio-Visual Sexual Stimulation (AVSS) and Dynamic Infusion Cavernosometry (DIC)

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