高流量阴茎异常勃起的诊断和治疗(附5例报告)

Diagnosis and treatment of high flow priapism(report of 5 cases and literature meta analysis)

目的探讨高流量阴茎异常勃起的诊断和治疗。方法总结我院自2001年至2007年收治的5例高流量阴茎异常勃起病例的病因、诊疗过程,并检索CNKI《中国期刊全文数据库》2001年—2007年文献,荟萃分析高流量阴茎异常勃起的病因、诊断和治疗方法。结果4例患者为会阴部外伤,1例为性交后出现。3例行高选择性阴部内动脉造影术及可吸收性明胶海绵选择性阴部内动脉栓塞术,随访8～12个月,勃起功能恢复;其余2例等待观察,随访12个月,勃起功能恢复。结论高流量阴茎异常勃起诊断主要依据体格检查、阴茎海绵体超声、海绵体血气分析。不需急诊治疗,应依据患者要求,选择保守治疗或动脉栓塞术。

Objective To discuss the diagnosis and treatment of high flow-priapism （HFP）. Methods Clinical data of 5 cases of HFP in our hospital since 2001 to 2007 was summarized and analyzed including etiology, diagnosis, therapy etc, and then published literatures related to HFP from 2001 to 2007coUected in CNKI database were reviewed and meta analysis was done for etiology, diagnosis and clinic treatment of HFP. Results Four of 5 patients with HFP were resulted from perineum injury and the other one was resulted from sexual intercourse. Three of them underwent selective artedography of the pudendal artery and selective artery embolization with absorbable gelatin sponge, and then they were followed up for 3-18 months until the erectile function was recovered. The other two patients received watchful waiting. Their erectile function were recovered after 12 months follow-up. From 2001 to 2007 there were 47 cases of HFP in CNKI database whose etiology were classified as perineum injury, straddle injury, masturbation, kicking injury of penis and no distinct reason. The diagnosis of HFP depended on physical examination, color duplex ultrasonography, cavernosal blood gas analysis and penile arteriography.Seven of them received conservative treatment, and their sexual life were satisfactory. Four of them underwent ligation of sinusoidal fistulas but 2 case presented ED after treatment. Twenty-senven of them received selective artery embolization and one case need to take Viagra for sexual intercourse. Conclusion The diagnosis of HFP mainly depended on physical examination, color duplex ultrasonography, blood gas analysis of penis cavernosa. The observation or selective artery embolization ate all recommended based on the request of the patients.