Vacuum therapy in penile rehabilitation after radical prostatectomy: review of hemodynamic and antihypoxic evidence.
Vacuum therapy in penile rehabilitation after radical prostatectomy: review of hemodynamic and antihypoxic evidence.
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根治性前列腺切除术后阴茎康复中的真空治疗：血流动力学和抗缺氧证据的回顾
DOI：
10.4103/1008-682x.159716
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发表时间：
2016-05
影响因子：
2.9
通讯作者：
Yuan J
中科院分区：
文献类型：
--
作者：
Qian SQ;Gao L;Wei Q;Yuan J
一般来说，缺氧是松弛阴茎的正常生理状态，在勃起功能正常的男性中，这种情况会被定期的夜间勃起所打断。[1]根治性阴茎切除术后，由于神经失用症导致阴茎海绵体组织持续缺氧，导致阴茎海绵体平滑肌纤维凋亡和变性，从而缺乏自发性和夜间勃起。因此，克服缺氧被认为在神经失用中起着至关重要的作用。据报道，在阴茎康复中使用真空勃起装置（VED）是有效的，可以防止阴茎长度的损失。彩色多普勒超声和血气分析显示，VED使用后，体内血液增加，由动脉和静脉血液组成。在负压伤口治疗（NPWT）中观察到类似现象。然而，NPWT采用的负压低于VED，并且观察到低灌注区，其响应于伤口边缘附近的负压而增加。尽管如此，关于理想的负压水平，作用方式和VED治疗持续时间的问题仍然没有答案。此外，目前尚不清楚VED治疗期间阴茎是否出现低灌注区或PO 2梯度。为优化临床VED治疗方案，需要进一步研究VED的作用机制，尤其是阴茎不同部位的实时PO2测定。
Generally, hypoxia is a normal physiological condition in the flaccid penis, which is interrupted by regular nocturnal erections in men with normal erectile function. [1] Lack of spontaneous and nocturnal erections after radical prostatectomy due to neuropraxia results in persistent hypoxia of cavernosal tissue, which leads to apoptosis and degeneration of cavernosal smooth muscle fibers. Therefore, overcoming hypoxia is believed to play a crucial role during neuropraxia. The use of a vacuum erectile device (VED) in penile rehabilitation is reportedly effective and may prevent loss of penile length. The corporal blood after VED use is increased and consists of both arterial and venous blood, as revealed by color Doppler sonography and blood gas analysis. A similar phenomenon was observed in negative pressure wound therapy (NPWT). However, NPWT employs a lower negative pressure than VED, and a hypoperfused zone, which increases in response to negative pressure adjacent to the wound edge, was observed. Nonetheless, questions regarding ideal subatmospheric pressure levels, modes of action, and therapeutic duration of VED remain unanswered. Moreover, it remains unclear whether a hypoperfused zone or PO 2 gradient appears in the penis during VED therapy. To optimize a clinical VED protocol in penile rehabilitation, further research on the mechanism of VED, especially real-time PO 2 measurements in different parts of the penis, should be performed.
在猪模型中施用心肌局部负压期间，心外膜中没有产生灌注不足。
影响因子：
1.6
作者：
Lindstedt, Sandra;Malmsjo, Malin;Ingemansson, Richard
通讯作者：
Ingemansson, Richard