远端分流术治疗缺血性阴茎异常勃起随访分析

Distal cavernosal-glan shunt for ischemic priapism: A long-term follow-up study

目的：回顾本院收治的缺血性阴茎异常勃起（IP）的临床资料和随访结果，为合理治疗IP提供依据。方法：分析自2004年至2010年收治的IP的临床资料，并通过电话和门诊就诊的方式随访。结果：8例IP就诊前均在外院接受过不同方式的减压治疗，失败后转入本院。年龄平均34．5岁，缺血时间平均84．5h（36～132h）。在本院行阴茎海绵体穿刺抽吸冲洗后完全疲软1例，部分疲软7例；进一步行Al-Ghorab分流术，成功2例，失败5例。对失败者施行T型分流术，5例完全疲软。成功随访5例，2例中度ED，3例完全性ED。与中度ED相比，完全性ED者缺血时间较长。结论：减压治疗失败后，早期尝试T型分流术可提高IP治疗的成功率。

[ Abstract] Objective ： To investigate the management of ischemic priapism （IP） by analyzing the clinical and follow-up data of IP patients. Methods ： We retrospectively reviewed the clinical data of 8 IP patients treated in our hospital from January 2004 to June 2010 and analyzed the results of follow-ups by telephone calls and clinic visits. Results ： The average age of the patients was 34.5 （23 -41 ） years and the mean duration of priapism was 84.5 （36 -132） hours. All the patients had received previous detumescence treatment but failed before referred to our hospital. Irrigation/aspiration was performed at first, which achieved complete detumescence in 1 case and partial or transitional detumescenee in the other 7. Subsequently, bilateral A1-Ghorab shunt was tried and succeeded in 2 cases but failed in 5. Finally, T-shunt was conducted, which achieved complete resumption in all the remaining 5 cases. Follow-up da- ta were available in 5 of the cases, which were followed up for 12 - 66 （ mean 54） months. Of the 5 cases, moderate ED occurred in 2, and complete ED in 3. The latter 3 had suffered a longer duration of IP than the former 2. Conclusion ： If detumescence failes, early intervention by T-shunt can improve the success rate of IP treatment. Natl J Androl, 2013, 19 （11） ： 988 -990