阴茎背深静脉栓塞治疗静脉性勃起功能障碍

Embolization of the deep dorsal vein for the treatment of venogenic erectile dysfunction

目的评价应用无水乙醇栓塞阴茎背深静脉治疗静脉性勃起功能障碍(ED)的有效性。方法10例静脉性ED患者行阴茎背深静脉栓塞,其诊断依靠阴茎彩超及海绵体造影。分离阴茎背深静脉后插入静脉导管至前列腺静脉丛,监视下按5:1比例注入无水乙醇及造影剂,直至静脉漏显示消失。结果随访4～24个月,7例术后恢复勃起,2例口服万艾可有效,1例无效,6例治愈无复发,均无严重并发症。结论本研究表明栓塞阴茎背深静脉治疗静脉性ED简单易行、创伤小、安全价廉,有显著的疗效,尚需扩大样本进一步长期随访观察疗效。

Objective To evaluate the effect of deep dorsal vein embolization for the treatment of venogenic erectile dysfunction. Methods A total of 10 patients with veno-occlusive dysfunction underwent deep dorsal vein embolization. The diagnosis of venogenic erectile dysfunction was made by means of penile Doppler ultrasonography and pharmacocavernosography. After exposure of the deep dorsal penile vein, an intravenous catheter was inserted directly into the deep dorsal penile vein and advanced into just front of the preprostatic plexus. A mixture of absolute ethanol and contrast medium （5：1） was used as a sclerosing agent. Under fluoroscopic control, the sclerosing agents were injected into the deep dorsal vein. The procedure was finished when disappearance of venous leakage was.confirmed. Results The follow-up period was 4-24 months. Of 10 patients, 7（70.0%） regained sexual activity. 2 patients （20.0%） reported sufficient erections after sildenafil used. Only one case showed insufficient potency. Long-term therapeutic effect was confu-med for 6 cases. No serious complication occurred for all patients. Conclusion Deep dorsal vein embolization for venogenic erectile dysfunction is simple, mini-invasive, effective and safe, and appears to be cost-effective treatment for venogenic erectile dysfunction. However, cases enlargement and long-term follow-up studies are necessary to confirm its effectiveness.