负压勃起装置治疗前列腺癌根治术后的勃起功能障碍

Penile rehabilitation with vacuum erection device for erectile dysfunction after radical prostatectomy

目的:探讨负压勃起装置(VED)治疗前列腺癌根治术(RP)后勃起功能障碍(ED)的有效性和安全性。方法:开放性RP术后ED患者6例,3例于术后3个月内(A组),3例于术后12个月以上(B组)分别进行VED康复治疗,比较两组在VED治疗前,治疗后3个月和6个月的IIEF-5评分的差异,治疗6个月后的阴茎长度和周径变化的差异。评价VED应用的安全性,以及患者和性伴侣的满意度。结果:6例患者VED治疗后3个月和6个月的IIEF-5平均评分均较治疗前提高(P<0.05)。A组患者VED治疗后3个月IIEF-5评分(8.7±0.6)分,治疗后6个月IIEF-5评分(13.0±1.0)分,均高于B组患者[(6.7±0.6)分;(8.3±1.5)分](P<0.05)。VED治疗后6个月,A组患者阴茎长度缩短(0.4±0.1)cm,周径缩短(0.2±0.1)cm,B组患者阴茎长度缩短(1.7±0.4)cm,周径缩短(0.9±0.3)cm,两组相比均有显著差异(P<0.05)。VED治疗后6个月的患者及性伴侣性生活满意率分别为83.3%和50.0%。VED治疗期间,1例患者诉阴茎皮肤发暗,2例诉性交僵硬麻木感,其余无明显不良反应。结论:RP术后ED患者早期进行VED康复治疗,能显著改善勃起功能,减少阴茎萎缩。

Objective： To investigate the efficacy and safety of vacuum erection device （VED） for erectile dysfunction （ED） after radical prostatectomy （RP）. Methods ： Six cases of ED after open RP were reviewed. Three of the patients started a daily rehabilitation protocol using VED 10 min/d within 3 months after RP （group A, early intervention）, while the other 3 initiated the same protocol after 12 months （group B, late intervention）. We compared the IIEF-5 scores as well as stretched penile lengths and mid-shaft circumferences before and after 3 and 6 months of VED rehabilitation. We also assessed the safety of the device and sexual satisfaction of the patients and their partners. Results ： The mean IIEF-5 score of the six cases was remarkably increased at 3 and 6 months of VED rehabilitation （ P 〈 0.05 ）, significantly higher in group A than in B at 3 months （ 8.7 ± 0.6 vs 6.7 ± 0.6, P 〈 0.05 ） and 6 months （ 13.0± 1.0 vs 8.3 ±1.5, P 〈 0.05 ）. After 6 months of VED rehabilitation, there were no significant changes in stretched penile length or mid-shaft circumference in group A, both significantly decreased in group B （P 〈 0.05 ）, and sexual satisfaction of the patients and their partners were 83.3% and 50% , respectively. No serious adverse events were observed except mild complaint of penile skin darkening in 1 case and numb feeling during the intercourse in 2. Conclusion ： Early use of VED after RP improves erectile function and helps to preserve the length and mid-shaft circumference of the penis.