Elucidating the etiology of erectile dysfunction after definitive therapy for prostatic cancer
Elucidating the etiology of erectile dysfunction after definitive therapy for prostatic cancer
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DOI：
10.1016/s0360-3016(97)00554-3
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发表时间：
1998-01-01
影响因子：
7
通讯作者：
Eid, JF
中科院分区：
文献类型：
--
作者：
Zelefsky, MJ;Eid, JF
目的：为了确定治疗引起的勃起功能障碍的病因，谁接受手术或放疗的前列腺癌的患者。方法和材料：98例患者进行了评估勃起功能障碍后，明确治疗前列腺癌与多普勒超声检查前和前列腺素注射后。根据Duplex study.Results的结果，患者被分类为具有后源性、海绵体性、混合性（动脉源性/海绵体性）或神经源性阳痿，在接受根治性尿道切除术（RP）的患者中，31例（52%）有海绵体功能障碍，19例（32%）有动脉源性功能障碍，3例（5%）被分类为混合性，7例（12%）为神经源性功能障碍。在接受放疗（RT）的患者中，24例（63%）有动脉源性功能障碍，12例（32%）有海绵体功能障碍，1例（2.5%）被归类为混合性功能障碍，1例（2.5%）为神经源性功能障碍。多变量分析表明，在这些患者中，既往RT是动脉源性病因的唯一预测因子（p < 0.001），既往RP是海绵体病因的唯一预测因子（p < 0.04）。在RP和RT组中，中位勃起反应分别为70%和65%。动脉峰值流量
Purpose: To determine the etiology of treatment-induced erectile dysfunction among patients who underwent surgery or radiotherapy for prostatic cancer.Methods and Materials: Ninety-eight patients were evaluated for erectile dysfunction after definitive therapy for prostate cancer with Duplex ultrasonography before and after intracorporal prostaglandin injection. Patients were classified as having afteriogenic, cavernosal, mixed (arteriogenic/cavernosal), or neurogenic impotence based upon the results of the Duplex studies.Results: Among patients who underwent radical prostatectomy (RP), 31 (52%) had cavernosal dysfunction, 19 (32%) had arteriogenic dysfunction, 3 (5%) were classified as mixed, and 7 (12%) as neurogenic dysfunction. Among patients treated with radiotherapy (RT), 24 (63%) had arteriogenic dysfunction, 12 (32%) had cavernosal dysfunction, 1 (2.5%) were classified as mixed, and 1 (2.5%) as neurogenic dysfunction. A multivariate analysis identified prior RT as the only predictor of an arteriogenic etiology (p < 0.001) and prior RP as the only predictor of a cavernosal etiology (p < 0.04) for erectile dysfunction among these patients. In the RP and RT groups, the median erectile responses were 70 and 65%, respectively. Arterial peak flows