选择性阴部动脉栓塞治疗创伤性高流量阴茎异常勃起的疗效评价

Selective pudendal artery embolization treatment of traumatic high-flow priapism

目的探讨选择性阴部动脉栓塞治疗创伤致高流量阴茎异常勃起的疗效。方法回顾我院2017年~2021年收治7例因创伤致动脉高流量性阴茎异常勃起患者,所有患者皆保守治疗1~3周无明显效果后行选择性阴部动脉栓塞术,术后随访12个月统计复发及勃起功能障碍等情况,对其中6例有性生活患者进行国际勃起功能调查问卷(IIEF-5)、勃起硬度评价(EHS)问卷调查评估(包括术前、术后6个月、术后12个月共3次)。结果7例患者全部栓塞成功,勃起异常症状皆得到缓解,于栓塞后经保守治疗0.5~72 h[(25.9±26.0)h]阴茎完全疲软。6例有性生活史患者创伤前勃起功能正常(IIEF-5评分23.8±1.2,EHS评分4),术后6个月(IIEF-5评分23.0±1.3,EHS评分3.8±0.4),术后12个月(IIEF-5评分23.5±0.8,EHS评分4)均与术前无明显差异(P>0.05),随访12个月,复发率0%,勃起功能障碍发生率14.3%。结论选择性阴部动脉栓塞治疗创伤性高流量阴茎异常勃起具有高效、安全、复发率低及勃起功能障碍发生率低等优点,值得临床推广。

Objective To investigate the efficacy of selective pudendal artery embolization for traumatic high-flow priapism.Methods Seven patients with traumatic high-flow priapism unresponsive to 1-3 weeks of conservative treatment underwent selective pudendal artery embolization followed by conservative treatment from 2017 to 2021.All patients were followed up for 12 months.Six patients completed the International Index of Erectile Function-5(IIEF-5)and the Erection Hardness Score(EHS)questionnaire assessment before,6 months,and 12 months after the procedure.Results Embolization was successful in all 7 patients with amelioration of erectile dysfunction and the penis was completely soft after embolization followed by 0.5-72 h[(25.9±26.0 h)]of conservative treatment.Six sexually active patients with normal erectile function before trauma(IIEF-5:23.8±1.2,EHS:4.0)recovered completely without significant difference(P>0.05)in the IIEF-5 and EHS scores at 6 months(23.0±1.3,3.8±0.4)and 12 months(23.5±0.8,4.0)after embolization.In the 12-month follow-up,there was 0%recurrence and 14.3%incidence of erectile dysfunction.Conclusion Selective pudendal artery embolization is highly effective and safe for treatment of traumatic high-flow priapism with low recurrence rate and low incidence of erectile dysfunction.