利用微弹簧圈选择性动脉栓塞治疗高流量阴茎异常勃起患者勃起功能观察

Erectile function after superselective arterial embolization with microcoils in patients with high-flow priapism

目的观察利用微弹簧圈超选择性动脉栓塞治疗高流量阴茎异常勃起对患者勃起功能和性生活质量的影响。方法会阴部外伤引起阴茎异常勃起患者8例,平均年龄(33.38±12.42)岁,发病距就诊时间2d～8年。根据病史、临床表现、阴茎海绵体血气分析和彩色多普勒超声,诊断为高流量阴茎异常勃起,均在知情同意下通过阴部内动脉造影明确破损动脉,同时利用微弹簧圈选择性动脉栓塞治疗,栓塞后阴茎恢复疲软状态,临床治愈。采用国际勃起功能评分表(IIEF-5)和性生活质量调查表(SLQQ-QOL)对患者发病前,栓塞术后6个月、18个月随访评价勃起功能和性生活质量。结果患者栓塞后3个月开始有规律性生活,6个月和18个月IIEF-5评分分别为(19.57±5.35)分和(19.14±5.24)分,与异常勃起发病前(19.86±4.84)分相比无统计学差异(P>0.05)。患者栓塞后6个月和18个月SLQQ-QOL评分分别为(34.14±7.73)分和(32.43±8.66)分,与发病前比较无显著差异(P>0.05)。结论微弹簧圈超选择性阴茎海绵体动脉栓塞术对治疗高流量阴茎异常勃起安全有效,术后对年轻患者勃起功能无显著影响。

Objective To observe the erectile function and sexual life quality of high-flow priapism patients treated by superselective cavernous artery embolization with microcoils. Methods Eight cases with priapism suffered from perineal trauma were enrolled in the study and their mean age was （33.38±12.42） years old.The mean duration of onset priapism was ranged from 2 days to 8 years. All patients were diagnosed as high-flow priapism by history, clinical findings , intracavernous blood gas analysis and color duplex sonography. Selective arteriography were performed to confirm the ruptured artery and superselective cavernous artery embolization with microeoils was performed in all patients with successful detumescence. The 5-item International Index of Erectile Function （IIEF-5） and the Sexual Life Quality Questionnaire （SLQQ）-Quality of Life （QoL） domain were used to evaluate the erectile function before the onset of priapism, 6 months and 18 months after embolization. Results Patients regained regular intercourse after 3 months embolization. The IIEF-5 score after 6 months and 18 months embolization were （19.57±5.35） and （19.14±5.24） respectively, there was no significant difference compared with the IlEF-5 score before the onset of priapism（19.86±4.84） （P〉0.05）. The SLQQ-QOL score after 6 months and 18 months embolization was （34.14±7.73） and （32.43±8.66）, there was no significant difference compared with that before the onset of priapism（P〉0.05）. Conclusion Superselective cavernous artery embolization with microcoils for treatment of patients with high-flow priapism was safe and effective, and furthermore,no significant influence was found on erectile function in younger patients.