Unsatisfactory outcomes of prolonged ischemic priapism without early surgical shunts: our clinical experience and a review of the literature.
Unsatisfactory outcomes of prolonged ischemic priapism without early surgical shunts: our clinical experience and a review of the literature.
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长期缺血性异常勃起而不进行早期手术分流的结果不令人满意：我们的临床经验和文献综述。
DOI：
10.1038/aja.2012.63
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发表时间：
2013
影响因子：
2.9
通讯作者：
Zhong Wang
中科院分区：
文献类型：
--
作者：
Da-Chao Zheng;Hai-Jun Yao;Ke Zhang;Ming-Xi Xu;Qi Chen;Yan-Bo Chen;Zhi-Kang Cai;Mu-Jun Lu;Zhong Wang
缺血性异常勃起是一种罕见的疾病，如果不及时治疗可导致严重的勃起功能障碍(ED)。这项回顾研究报告了我们治疗长期缺血性异常勃起的经验，并提出了我们进一步考虑的问题。本文对9例缺血性异常勃起患者进行了1~3种手术分流术，包括9例冬季分流术、2例Al-Ghorab分流术和1例Grayhack分流术。术后随访(平均21.11个月)，除1例死亡外，其余患者均记录术后特征。6名术后患者接受了25毫克的柠檬酸西地那非口服。术后采用国际勃起功能指数问卷(IIEF-5)中的5个条目评价患者的勃起功能，并与发病前的评分进行比较。所有患者均完全缓解，无一例复发。分离率为100%。7例患者行冬季分流术，1例采用Al-Ghorab分流术，1例采用Grayhack分流术。平均住院天数为8.22天。术后尿瘘1例，术后勃起功能障碍发生率为66.67%。4名异常勃起持续时间超过72小时的患者对长期的磷酸二酯酶5(PDE-5)抑制剂治疗没有反应。这些结果表明，手术分流术是使阴茎长期阴茎异常勃起后松弛的有效方法。然而，持续时间过长导致的严重ED是不可逆的，长期使用PDE-5抑制剂治疗无效。因此，我们建议这些患者及早进行阴茎假体手术。
Ischemic priapism is a rare occurrence which can cause severe erectile dysfunction (ED) without timely treatment. This retrospective study reports our experience in treating prolonged ischemic priapism and proposes our further considerations. In this paper, a total of nine patients with prolonged ischemic priapism underwent one to three types of surgical shunts, including nine Winter shunts, two Al-Ghorab shunts and one Grayhack shunt. During the follow-up visit (after a mean of 21.11 months), all patients' postoperative characters were recorded, except one patient lost for death. Six postoperative patients accepted a 25-mg oral administration of sildenafil citrate. The erectile function of the patients was evaluated by their postoperative 5-item version of International Index of Erectile Function Questionnaire (IIEF-5), which were later compared with their premorbid scores. All patients had complete resolutions, and none relapsed. The resolution rate was 100%. Seven patients were resolved with Winter shunts, one with an Al-Ghorab shunt and one with a Grayhack shunt. The mean hospital stay was 8.22 days. There was only one urethral fistula, and the incidence of postoperative ED was 66.67%. Four patients with more than a 72-h duration of priapism had no response to the long-term phosphodiesterase type 5 (PDE-5) inhibitor treatment. These results suggest that surgical shunts are an efficient approach to make the penis flaccid after prolonged priapism. However, the severe ED caused by prolonged duration is irreversible, and long-term PDE-5 inhibitor treatments are ineffective. Thus, we recommend early penile prosthesis surgeries for these patients.
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DOI：
10.1111/j.1743-6109.2011.02446.x
发表时间：
2012
期刊：
The journal of sexual medicine
影响因子：
--
作者：
A. Burnett
通讯作者：
A. Burnett
影响因子：
2.1
作者：
R. A. Bertram;C. Carson;G. Webster
通讯作者：
R. A. Bertram;C. Carson;G. Webster
影响因子：
2.1
作者：
R. Stein;A. Patel;R. Benoit
通讯作者：
R. Stein;A. Patel;R. Benoit
影响因子：
23.4
作者：
Ralph, David J.;Garaffa, Giulio;Minhas, Sukbinder
通讯作者：
Minhas, Sukbinder
影响因子：
2.1
作者：
WINTER C C
通讯作者：
WINTER C C