经皮神经肌肉电刺激治疗勃起功能障碍合并早泄的临床观察

Clinical efficacy of transcutaneous neuromuscular electrical stimulation in the treatment of erectile dysfunction combined with premature ejaculation

目的 探讨经皮神经肌肉电刺激(TNES)疗法治疗勃起功能障碍(ED)合并早泄(PE)的临床疗效及安全性,为TNES治疗ED合并PE提供依据。方法 根据纳入和排除标准,收集2021年6月至2022年2月在男科门诊就诊并接受TNES治疗的25例ED合并PE患者作为研究对象,研究对象在TNES治疗前后行视听性刺激(AVSS)下RigiScan阴茎硬度测量和填写勃起硬度评分(EHS)、勃起功能国际问卷-5(IIEF-5)、阴道内射精潜伏时间(IELT)、早泄诊断工具(PEDT)、抑郁症筛查量表(PHQ-9)及焦虑症筛查量表(GAD-7)。结果 2例研究对象失访,最终,23例研究对象均接受了TNES治疗,同时完成了治疗前后的问卷随访和AVSS下RigiScan阴茎硬度测量,均未出现治疗部位疼痛、皮肤灼伤、电极片皮肤过敏、皮下淤血等不良反应。治疗前后勃起时间、阴茎头端平均与最大硬度、阴茎根部平均与最大硬度均存在显著差异(P<0.05),但是,阴茎头端、根部周径变化治疗前后无显著差异(P>0.05),EHS、IIEF-5评分存在显著差异(P<0.05),评估治疗后IIEF-5评分改善,总有效78.26%。IELT、PEDT存在显著差异(P<0.05)。心理方面,GAD-7焦虑评分、PHQ-9抑郁评分无显著差异(P>0.05)。结论 TNES疗法作为一项无创、有效、安全可行的新兴治疗方式可以改善ED合并PE患者勃起功能及射精能力,为ED合并PE患者的治疗提供新思路。

Objective To evaluate clinical efficacy and safety of transcutaneous neuromuscular electrical stimulation(TNES)in the treatment of erectile dysfunction(ED)combined with premature ejaculation(PE)for obtaining the evidence for clinical application of TNES.Methods Based on the inclusion and exclusion criteria,25 patients with ED complicated with PE,who received TNES treatment in andrology clinic from June 2021 to February 2022,were recruited as the subjects.Before and after TNES treatment,RigiScan penile hardness measurement of the patients under audiovisual sexual stimulation(AVSS)was carried out,and Erection Hardness Score(EHS),International Index of Erectile Function-5(IIEF-5),Intravaginal Ejaculation Latency Time(IELT),Premature Ejaculation Diagnostic Tool(PEDT),Patient Health Questionnaire(PHQ-9)and Generalized Anxiety Disorder Questionnaire(GAD-7)were comparatively analyzed.ResulstsTwo patients were lost during follow up.Other 23 patients,who received TNES treatment,all completed the questionnaire follow-up and RigiScan penile hardness measurement under AVSS before and after treatment.They had no adverse reactions such as pain,skin burn,electrode allergy,subcutaneous congestion and so on at the treatment site.Before and after treatment,there were significant differences in erection time,average and maximum hardness of penis tip and average and maximum hardness of penis root(P<0.05),but no significant differences in circumference of penis tip and root(P>0.05).There were significant differences in EHS and IIEF-5 scores(P<0.05).The total effective rate of IIEF-5 score was 78.26%.IELT and PEDT were significantly different(P<0.05).In terms of psychology,there were no significant differences in GAD-7 anxiety score and PHQ-9 depression score(P>0.05).Conclusion As a non-invasive,effective,safe and feasible new treatment method,TNES can improve the erectile function and ejaculation ability of Patients with ED complicated with PE,and provide a new idea for the treatment of patients with ED complicated with PE.