脊髓损伤患者勃起功能障碍的治疗

Treatment of erectile dysfunction in patients with spinal cord injury

大多数脊髓损伤(SCI)的男性患者存在不同类型及程度的勃起功能障碍(ED),这主要取决于SCI的部位和严重程度。SCI康复期,部分男性患者可恢复残留的性功能。SCI后ED的治疗包括心理治疗、口服PDE5抑制剂、海绵体注射血管活性药物(ICI)、经尿道给药、真空勃起装置(VED)及阴茎缩窄环、阴茎假体植入手术、骶神经调节等,首选口服PDE5抑制剂治疗。高位SCI患者口服PDE5抑制剂,可能获得较好的疗效;而低位的SCI患者,采用ICI或者联合治疗的效果较好。

The majority of men with spinal cord injury（ SCI） suffer from different types and degrees of erectile dysfunction（ ED）. The impact of SCL on erectile function depends on the severity and location of the injury. Some patients can restore the residual sexual potential in the period of SCI recovery. Treatments of ED in men with SCI include psychotherapy,medication of oral PDE5 inhibitors,intracavernous injection of vasoactive drugs,transurethral medication,application of the vacuum erectile device and penile ring,penile prostheses,sacral neuromodulation,etc.,among which PDE5 inhibitors remain the first option and usually give good clinical results for those with higher SCI. However,intracavernous injection of vasoactive drugs and combined treatment are preferable for those with lower SCI.