摘要
目的探讨高血流量阴茎异常勃起临床诊疗程序。方法5例阴茎异常勃起患者,经病史和体检,海绵体穿刺血气分析,彩色多普勒超声和超选择血管造影确诊为高血流量阴茎异常勃起,超选择阴部内动脉造影监视下动脉栓塞治疗,IIEF-5评分随访远期效果。结果4例有骑跨伤或会阴部钝性外伤史,血气分析结果接近动脉血。超声显示5例患者患侧海绵体动脉血流速度显著增加。超选择阴部内动脉造影4例患者在阴部内动脉海绵体支末端形成动静脉瘘(2例左侧和2例右侧);1例非外伤患者发现为海绵体血管瘤自发破裂。5例患者即时行明胶海绵动脉栓塞治疗,4例成功。1例失败患者改用微钢圈栓塞成功。随访结果无阴茎异常勃起复发,IIEF-5评分1例有中度勃起功能障碍。结论超选择性阴部内动脉栓塞是治疗高血流量阴茎异常勃起首选治疗方法。
Objective To evaluate the diagnostic, the therapeutic procedures and the long-term therapeutic result of high-flow priapism. Methods Five patients of high-flow priapism were diagnosed and studied by physical examination, cavernosal blood gas analysis, color Doppler ultrasonography and superselective angiography. Superselective embolizations were then processed when the fistulas had been found. Erectile function was determined using IIEF-5. Results Four patients of high-flow priapism resulted from straddle or blunt perineal trauma. The results of cavernosal blood gas analysis were near arterial level. Color Doppler ultrasonography of the cavernous body reavealed increased arterial flow in all the 5 cases. Superselective angiography showed unilateral fistulas of the branches of cavernsal artery in 4 cases (right 2 and left 2). In the case of nontraumatic patient a ruptured cavernsal angioma was found. Superselective embolization with gelatin sponge were carried out, erection were complete detumescence in 4 cases, One failure changed for microcoil was suecessed. Follow-up 6-50 months with no recurrence and a 59 years-old case has a moderate erectile dysfuction. Conclusion Superselective embolization is a better treatment for high-flow priapism, because it ensures a high preservation of premorbid rate erectile funtion.
出处
《中国男科学杂志》
CAS
CSCD
2005年第3期43-45,共3页
Chinese Journal of Andrology
