选择性动脉栓塞治疗动脉性阴茎异常勃起(5例报告)  

Selective embolization for arterial priapism: A report of 5 cases

作　　者：谢敏凯 郑大超[1] 刘冲[1] 姚海军[1] 王忠[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院泌尿外科,上海200011

出　　处：《中华男科学杂志》2018年第1期59-61,共3页National Journal of Andrology

基　　金：国家自然科学基金(81600519)~~

摘　　要：目的:介绍选择性栓塞术治疗动脉性阴茎异常勃起的经验。方法:2011年2月至2015年5月收治了5例因会阴部创伤致阴茎异常勃起的患者,平均年龄35(25~37)岁,创伤后2~5 d发病。所有的患者都经过体格检查、血气分析、阴茎多普勒超声检查,患者术前进行IIEF-5问卷调查。患者都经过3周保守治疗失败,接受选择性动脉栓塞治疗,栓塞治疗后继续局部压迫及冰敷等保守治疗。术后6、12个月所有患者再次接受IIEF-5问卷调查。结果:所有患者创伤前勃起功能正常[(IIEF-5(24.60±0.55)分],1例患者术后立即疲软,4例患者需要3~17 d的保守治疗后治愈。没有患者再次接受动脉栓塞治疗。平均随访27.2(13~48)个月,没有患者复发。患者术后6、12个月IIEF评分正常[(24.00±1.00)、(24.20±0.82)分],与创伤前相比无统计学差异。结论:选择性动脉栓塞是治疗动脉性阴茎异常勃起的有效手段,而且不影响患者勃起功能。患者治疗后并不会立即无痛疲软,可延长术后保守治疗时间,不急于再次手术。Objective ： To introduce our experience in the treatment of arterial priapism by superselective embolization. Meth- ods： This study included 5 cases of perineal trauma-induced arterial erectile dysfunction treated in our departmentbetween February 2011 and May 2015, all failingpreviously to respond to 3 weeks of conservative treatment. The patients were aged 25 -47 （ mean 35 ） years, with the onset of arterial priapism at 2 - 5 days after trauma, and all subjected to physical examination, blood gas analysis, color Doppler ultrasonography of the corpora cavernosum, and IIEF-5 scoring. All the patients underwent superseleetive embolization, fol- lowed by local pressing and cold compression, and IIEF-5 scores were obtained again at 6 and 12 months postoperatively. Results： All the patients had normal erectile functionbefore trauma, with a mean IIEF-5 scoreof 24.60 -＋ 0.55. Complete detumescenceor pain- less flaccidity of the penis was achieved in 1 case immediately after surgery and in the other 4 after 3 - 17 days of postoperative conser- vative treatment. None of the patients needed a second embolization and no relapse was found during a mean follow-upof 27.2 （ 13 - 48 ）months. The IIEF-5 scores obtained at 6 （24.00 ± 1.02） and 12 months （24.20 ±0.82） were normal, with no statistically sig- nificant differencesfrom that before trauma. Conclusion ： Selective embolization is a safe and effective option for the treatment of arte- rial priapism. In case of no immediate painless flaccidity of the penis after surgery, conservative treatment can be extended rather than a second operation.

关 键 词：阴茎异常勃起 选择性动脉栓塞 勃起功能障碍 

分 类 号：R698.1[医药卫生—泌尿科学]