Effects of castration and testosterone replacement on veno-occlusion during penile erection in the rat

Aim: To determine if androgens directly regulate veno-occlusion or if androgens act indirectly to maintain the penilestructures which control outflow. Methods: Using CASTRATE and TESTO rats, measurement was made of meanarterial pressure (MAP), intracavernosal pressure (CCP), and intracavernosal flow (CCF) during erection resultingfrom stimulation of the autonomic innervation of the penis. CCP and CCF were also measured during saline infusioninto the cavernosal sinuses before and after treatment with sodium nitroprusside (SNP, a nitric oxide donor drag) tofully relax cavernosal smooth muscle. Penile tissue was also collected to measure the content of α actin and proline andhydroxyproline to determine if brief withdrawal of androgenic support led to changes in the number of smooth musclecells or the collagen content of the tissue. Results: Infusion of saline into the cavernosal sinuses demonstrated thatveno-occlusion was defective in CASTRATE rats while reno-occlusion was fully functional in TESTO animals.Furthermore, veno-occlusion could be induced in CASTRATE rats if they were first treated with SNP. Thisobservation suggests that failure of veno-occlusion in the CASTRATE rats is due to a deficiency in the production of NOresulting in a reduction in the degree of relaxation of the penile smooth muscle. The measurements of smooth muscleα actin and proline and hydroxyproline content of collagen showed that both were unaffected by castration and that thebasic structure of the penis did not degenerate after one week without androgenic support. Conclusion: Theseresults can be interpreted to mean that androgens control the veno-occlusive mechanism indirectly via a NO dependentmechanism and not by maintaining the structures of the penis which are essential to reno-occlusion.

Effect of sildenafil citrate on penile erection of rhesus macaques

Aim: To examine the effect of sildenafil citrate on penile erection of male rhesus macaque. Methods: Twenty Macaca mulatta were divided into the sildenafil treated and the control groups of 10 animals each. The penile size, the corpus cavernosal electromyogram (EMG) and the intra-corpus cavernosal pressure (ICP) were determined. Results: The diameter of penis and the ICP were significantly increased and the corpus cavernosal EMG significantly reduced in the sildenafil group. Conclusion: Sildenafil citrate increases the penile size and ICP and reduces the corpus cavernosal EMG in male rhesus macaque.

Potentiation of apomorphine effect on sildenafil-induced penile erection in conscious rabbits

Aim: To investigate a possible potentiation effect of apomorphine (APO) on sildenafil-induced penile erection in the conscious rabbit. Methods: Erection of male New Zealand White rabbits (3.5-4.0 kg, n=12) was assessed by measuring the length of the uncovered penile mucosa and the duration of erection before and after intravenous administration of agents. After injection of APO (0, 0.05, 0.1 and 0.4 mg/kg), sildenafil was administered intravenously in a dose-response manner (0.5, 1 and 5 mg/kg). In additional experiments, the effect of increasing doses of sildenafil in combination with APO on systemic blood pressure was evaluated. Results: Systemic administration of sildenafil induced a dose-dependent increase in the penile length. Intravenous injection of APO alone did not produce any change in the penile length, while significantly enhanced the penile erection induced by sildenafil. The co-administration of 0.1 mg/kg of APO and 1 mg/kg of sildenafil was found to be the most effective combination in producing penile erection. Intravenous administration of sildenafil caused a concentration-dependent decrease in systemic blood pressure, but no additional decrease was observed with co-administration of APO. Conclusion: APO enhances the penile erection induced by sildenafil in the conscious rabbit without causing an additional decrease in blood pressure.

Possible Function of Frenulum of Prepuce in Penile Erection

Objective To discuss the possible function of frenulum of prepuce in penile erection. Methods Nine patients had premature ejaculation whose frenula were short. Two patients suffered unsatisfied intercourse whose frenula were injured and departed 12 and 6 months ago. Three males endured premature ejaculation whose frenula were hurt in coition 30 min ago.We prolonged short frenulum and reconstructed the ruptured frenulum. To the fresh wound,we debrided the cut,then sutured the injured frenulum vertically. Results Investigated 3 to 6 months,all patients got satisfied sexual intercourse. Conclusion Frenulum is important in erecting time.

The effects of androgen on penile reflex, erectile response to electrical stimulation and penile NOS activity in the rat

Aim: To investigate the effects of androgen on penile erection through the reflex arc and penile corpus cavernosum,and study the respective roles of testosterone (T) and dihydrotestosterone (DHT) in penile erection in rats. Methods:Male Sprague-Dawley rats were castrated and implanted with silastic brand silicone tube containing T or DHT, with orwithout daily injections of a 5α-reductase inhibitor, MK-434. The penile reflex, erectile response to electrical stimula-tion (ES) of the cavernous nerves and penile nitric-oxide synthase (NOS) activity were observed under varying andro-genic status. Results: Penile reflex erection in the rat was, on the whole, related to serum T levels though the numberof glans engorgements was not. The number of cups and flips was significantly decreased by castration, and restoredto the control level by T supplementation. Erectile response to ES and NOS activity in penile tissue was also related toserum T level. T administered together with a 5α-reductase inhibitor no longer restored the number of reflex erection,erectile responses to ES and NOS activity in the corpus cavernosum. Conclusion: Androgen influenced the penile re-flex arc, corpus cavernosum, and the perineal striated muscles. In reflex erection, erectile response to ES and penileNOS activity in the rat, T seems to be first converted to DHT, the more active androgen modality. (Asian J Androl1999 Dec; 1: 169-174)

Studies on self-esteem of penile size in young Koreanmilitary men

Aim: To investigate the flaccid and stretched penile sizes of young Korean men and their complexes or pride about their penile size. Methods: After an explanation and agreement to the purpose and methods of this study, 123 Korean men in their early 20's visiting the Jinhae Military General Hospital were included in the study. The flaccid penile length, flaccid mid-shaft circumference, stretched length and pre-pubic bone fat pad depth were measured in a warm comfortable environment. The accuracy the subjects assessed their penile size was investigated by asking them to rate their penile size, as 'very small', 'small', 'normal', 'large' or 'very large'. All subjects were asked to complete the Minnesota multiphasic personality inventory (MMPI) test. Results: The mean flaccid length, flaccid circumference, stretched length and fat pad depth of the 123 subjects were (6.9 ± 0.8) cm, (8.5 ±1.1) cm, (9.6 ± 0.8) cm and (1.1 ± 0.4) cm, respectively. The answer distribution on penile size was 1 (0.8 %) 'very small', 29 (23.6 %) 'small', 86 (69.9 %) 'normal', 6 (4.9 %) 'large' and 1 (0.8 %) 'very large'. Subjects who underestimated their penile size showed significantly higher scores on the hypochondriasis (Hs), depression (D) and psychasthenia (Pt) subscales of the MMPI than those in the Unbiased Group (P<0.05). Conclusion: In consultation, with a patient requesting penile augmentation, the urologist should consider the psychologic attitude of the patient to his penile size.

Characteristics of sildenafil erections in healthy young men

Aim： To determine the effect of sildenafil citrate on the nocturnal penile erections （i.e. time to onset, the duration of erection, and the interval between first and second erections） of healthy young men. Methods： Twenty-two potent men, 23-29 years old, were recruited for the study. All subjects completed three sessions over consecutive nights using the RigiScan monitoring device （Dacomed, Minneapolis, USA）. After a first night of adaptation, night 2 records were their baseline values, and on night 3 they received 100 mg of sildenafil citrate. Statistical comparisons were done between the second and third night data. Results： The mean time to onset of the first erection with sildenafil citrate was （34 ± 18） min, whereas it was （74 ± 24） min （P 〈 0.001） without sildenafil citrate. The number of erections observed during the first 5 h after sildenafil citrate medication was 3.6 ± 0.5 in contrast to 2.4 ± 0.5 with no medica- tion （P = 0.001）. The interval between first and second erections was shorter with sildenafil citrate： （52 ± 26） min vs. （85 ± 34） min （P = 0.01）. The duration of the last erection was statistically significantly longer with the sildenafil citrate： （64 ± 33） min vs. （42 ± 28） min （P 〈 0.01）. Conclusion： Healthy young men achieved erection within 34 min after sildenafil citrate administration, which is shorter than the 1 h interval proposed by the manufacturer. The interval between the first and second erections was shorter and the duration of the last nocturnal erection was longer.

Role of the brain in the control of erection

In contrast to the spinal control of erection, relatively little is known about the brain control. In the present review, we have outlined the role of brain structures involved in penile erection and provided a synopsis on the brain circuit of erection. Findings from both animal and human studies are discussed. Evidence suggests that the most important structures are the frontal lobe, cingulate gyrus, amygdala, thalamus and hypothalamus. Within the brain circuit of erection, the thalamus serves as a gate-controller in which all relevant information is evaluated and further processed to higher and lower centres.

Selective control by posterior spinal nerve roots of micturition and erection in rats

The posterior rootlets in L6 and S1 spinal cord of adult male Sprague-Dawley rats underwent electrostimulation. The bladder pressure, urethral perfusion pressure and intracavernous pressure were recorded. When some posterior rootlets of L6 and Sl were electrostimulated, the intracavernous pressure peaked rapidly, but the bladder pressure and the urethral perfusion pressure curve did not show great change. When other rootlets were stimulated, the bladder pressure changed greatly, but the urethral perfusion pressure and the intracavernous pressure did not show great change. When different rootlets were stimulated, the urethral perfusion pressure changed maximally, but there were no great changes in bladder pressure or intracavernous pressure. Furthermore, stimulation of some rootlets produced simultaneous changes in two or three different pressure measures mentioned above. The results demonstrate that regulation by L6 and S1 posterior rootlets of the rat bladder detrusor, external urethral sphincter and penis cavernous body are significantly distinct. Different rootlets can be distinguished by electrostimulation.

Role of the brain in the control of erection

In contrast to the spinal control of erection,relatively little is known about the brain control.In the present review,we have outlined the role of brain structures involved in penile erection and provided a synopsis on the brain circuit of erection.Findings from both animal and human studies are discussed.Evidence suggests that the most important structures are the frontal lobe,cingulate gyrus,amygdala,thalamus and hypothalamus.Within the brain circuit of erection,the thalamus serves as a gate-controller in which all relevant information is evaluated and further processed to higher and lower centres.

硝西泮对RigiScan检测夜间阴茎肿胀和硬度结果的影响

目的 探究硝西泮能否通过改善患者的睡眠质量,增加RigiScan夜间阴茎肿胀和硬度(NPTR)检测结果的准确性。方法 所有参与者均连续监测两晚NPTR。在试验1中,125名正常志愿者被随机分至对照组(n=68)和试验组(n=57),于第2晚NPTR检测睡前分别予口服安慰剂或10 mg硝西泮,观察硝西泮对正常人群NPTR检测结果的影响。在试验2中,128例勃起功能障碍患者被随机分至对照组(n=64)和试验组(n=64),在NPTR检测前分别服用安慰剂或10 mg硝西泮,观察硝西泮对NPTR检测参数值[包括尖端冠状沟(tip)和阴茎底部(base)的有效勃起次数(EEE)、总勃起时间(TED)、勃起硬度≥60%的勃起持续时间(D60)、平均勃起硬度(AER)、平均勃起胀大周长(AET)、勃起硬度活动单位(RAU)和勃起胀大活动单位(TAU)]和检测结果正常率的影响。结果 在试验1中,对照组和试验组第2晚的NPTR所有参数检测结果及正常率比较差异均无统计学意义(P> 0.05);试验组的理查兹-坎贝尔睡眠问卷(RCSQ)评分高于对照组(P <0.001)。在试验2中,对照组第1晚的NPTR参数值(D60tip、D60base、AERbase、RAUtip、TAUtip)均低于第2晚(P <0.05),组内两晚检测结果正常率比较差异无统计学意义(67.2%vs.78.1%,P=0.065);试验组除了AETtip值[7.85(6.83,8.98) cm vs. 8.10(7.50,8.90) cm,P=0.014],两晚的其他参数检测结果及检测正常率比较差异均无统计学意义(P均>0.05)。组间比较显示,试验组第1晚参数值(EEE、D60tip、RAUtip以及TAUtip)及第2晚参数值(EEE、D60tip、D60base、TED、RAUtip、RAUbase、TAUtip以及TAUbase)均低于对照组(P均<0.05),2组第1晚的NPTR检测结果正常率比较差异无统计学意义(67.2%vs. 65.6%,P=0.852),而第2晚试验组的NPTR检测结果正常率低于对照组(78.1%vs. 57.8%,P=0.014);试验组两晚的RCSQ评分均高于对照组,且试验组和对照组的第1晚评分均低于第2晚评分(P均<0.05)。结论 NPTR检测存在“首夜效应”。硝西泮会明显抑制夜间阴茎勃起,不能通过改善睡眠质量消除“首夜效应”的影响,反而增加NPTR检测的假阴性率。对于睡眠正常者行NPTR检测时应避免使用硝西泮;而对于睡眠障碍或者难以入眠的患者,可权衡对患者的利弊后使用硝西泮。

Study of the efficacy of Korean Red Ginseng in the treatment of erectile dysfunction

Aim： To examine the treatment efficacy of Korean Red Ginseng （KRG） in impotent men with erectile dysfunction （ED）. Methods： A total of 60 patients presenting mild or mild to moderate ED were enrolled in a double-blind, placebo-controlled study in which the efficacies of KRG and a placebo were compared. The patients received either 1 000 mg （3 times daily） of KRG or a placebo. Results： The five-item version of the International Index of Erectile Function （IIEF-5） score after the treatment was significantly higher in the KRG group compared with that before the treatment （from 16.4±2.9 to 21.0±6.3, P 〈 0.0001）. In contrast, there was no difference before and after the treatment in the placebo group （from 17.0±3.1 to 17.7±5.6, P 〉 0.05）. In the KRG group, 20 patients （66.6%）, reported improved erection, significant in the global efficacy question （P 〈 0.01）; in the placebo group there was no significance. Scores on questions 2 （rigidity）, 3 （penetration）, 4 and 5 （maintenance）, were significantly higher for KRG than those for the placebo when those questions were answered after 12 weeks of each treatment （P 〈 0.01）. When the score in the KRG group was compared to the placebo group after the treatment, there was a significant improvement in total score （IIEF-5 score） in questions 3 and 5 for the KRG-treated group （P 〈 0.001 and P 〈 0.0001, respectively）. The levels of serum testosterone, prolactine and cholesterol after the treatment were not statistically significant different between the KRG and the placebo group （P 〉 0.05）. Conclusion： Our data show that KRG can be an effective alternative to the invasive approaches for treating male ED.

Erectile potentials of a new phosphodiesterase type 5 inhibitor, DA-8159, in diet-induced obese rats

Aim： To examine the changes in the erectile function in diet-induced obese rats and investigate the oral efficacy of DA-8159, a new phosphodiesterase type 5 （PDE5） inhibitor, on penile erection in obese rats. Methods： The rats were fed a high-energy diet for 12 weeks and divided into three groups： an obesity-resistant （OR） control group, an obesity-prone （OP） control group, and an OP-DA-8159 treatment （DA-8159） group. The electrostimulation-induced erectile responses were measured in all groups. The body weight, plasma cholesterol, triglyceride and glucose levels were also measured. Results： In the OP control group, the maximum intracavernous pressure （ICP） and ICP/blood pressure （ICP/BP） ratio after electric stimulation were significantly lower than those in OR control group. The corresponding area under the curve （AUC） of the ICP/BP ratio, the detumescence time and the baseline cavernous pressure were also lower than those in the OR control group, but this difference was not significant. The body weight gain, plasma cholesterol and triglyceride level in the OP group were significantly higher than those in the OR group. After administering the DA-8159, a significant increase in the maximum ICP and the ICP/BP ratio were observed. The corresponding AUCs in the DA-8159 group were also higher than those in the two control groups. Furthermore, the detumescence time was significantly prolonged after treatment with DA-8159. Conclusion： These results demon- strate that diet-induced obesity affects the erectile function in rats and these erectile dysfunction （ED） can be improved by the treatment with DA-8159, indicating DA-8159 might be a treatment option for ED associated with obesity.

Optimal pressure in penile rehabilitation with a vacuum erection device: evidenee based on a rat model

Vacuum erecti on device(VED),used to treat radical prostatectomy(RP)-associated erectile dysfunction,has attracted con siderable attention.However,the optimal negative pressure remains to be determined.This investigation explored the optimal pressure for VED therapy in penile rehabilitation.Thirty-six 9-week-old male rats were randomly divided into six groups:control groups(sham group,bilateral cavernous nerve crush[BCNC]group)and VED therapy groups(-200 mmHg group,-300 mmHg group,-400 mmHg group,-500 mmHg group).BCNC group and VED therapy groups underwent BCNC surgery.Intracavernosal pressure(ICP)/mean arterial pressure(MAP)ratio was calculated to assess erectile function.Mass on's trichrome(MT)staining,terminal deoxynucleotidyl transferase dUTP nick end labeling(TUNEL)assay,immunohistochemistry,and real-time polymerase chain reaction(RT-PCR)were performed to explore cellular and molecular changes of the penis.Compared to the BCNC group,ICP/MAP ratios in all VED treatment groups were improved significantly(all P<0.05),but there were no statistically significant differences among VED therapy groups.With increased pressure,complications gradually emerged and increased in frequency.Expression of molecular indicators,such as endothelial nitric oxide synthase(eNOS)and alpha-smooth muscle actin(a?SMA),increased after VED therapy,and hypoxia-inducible factor la(HIF-la)and transforming growth factor beta(TGF-p)decreased.In addition,VED therapy improved the outcomes of MT and TUNEL assay.This investigation demonstrated a pressure of-200 mmHg in a rat model is optimal for VED therapy for penile rehabilitation after RP.No further benefits were observed with increased pressure,despite an increase in complications.

Beneficial Effect of Berberis amurensis Rupr. on Penile Erection

Objective： To investigate whether the methanol extract of Berberis amurensis Rupr. （BAR） augments penile erection using in vitro and in vivo experiments. Methods： The ex vivo study used corpus cavemosum strips prepared from adult male New Zealand White rabbits. In in vivo studies for intracavernous pressure （ICP）, blood pressure, mean arterial pressure （MAP）, and increase of peak ICP were continuously monitored during electrical stimulation of Sprague-Dawley rats. Results： Preconstricted with phenylephrine （PE） in isolated endothelium- intact rabbit corus cavernosum, BAR relaxed penile smooth muscle in a dose-dependent manner, which was inhibited by pretreatment with NG-nitro-L-arginine methyl ester （L-NAME）, a nitric oxide synthase inhibitor, and 1H-[1,2,4]-oxadiazole-[4,3-α]-quinoxalin-l-one, a soluble guanylyl cclase inhibitor. BAR significantly relaxed penile smooth muscles dose-dependently in ex vivo, and this was inhibited by pretreatment with L-NAME 1H-[1,2,4]- oxadiazole-[4,3-α ]-quinoxalin-l-one. BAR-induced relaxation was significantly attenuated by pretreatment with tetraethylammonium （TEA, P〈0.01）, a nonselective K＋ channel blocker, 4-aminopyridine （4-AP, P〈0.01）, a voltage-dependent K＋ channel blocker, and charybdotoxin （P〈0.01）, a large and intermediate conductance Ca2. sensitive-K＋ channel blocker, respectively. BAR induced an increase in peak ICP, ICP/MAP ratio and area under the curve dose dependently. Conclusion： BAR augments penile erection via the nitric oxide/cyclic guanosine monophosphate system and Ca2. sensitive-K＋ （BK＋ and IK＋） channels in the corpus cavemosum.

Roles of dopaminergic receptors in bladder and erectile function at the spinal level

1 Introduction At the spinal level, the dopaminergic, the α1adrenergic and the neurokinin receptors play definite roles in the micturition control. From the anatomical point of view, the spinal center of micturition is located close to the center of erectile function. Recently, apomorphine is used for the treatment of erectile dysfunction and its mechanism of action is considered to be mainly through the central nervous system. 2 Dopaminergic receptors and bladder function at the spinal level

Erectile potentials of a new phosphodiesterase type 5 inhibitor,DA-8159,in diet-induced obese rats

Aim:To examine the changes in the erectile function in diet-induced obese rats and investigate the oral efficacy of DA-8159,a new phosphodiesterase type 5(PDE5)inhibitor,on penile erection in obese rats.Methods:The rats were fed a high-energy diet for 12 weeks and divided into three groups:an obesity-resistant(OR)control group,an obesity- prone(OP)control group,and an OP-DA-8159 treatment(DA-8159)group.The electrostimulation-induced erectile responses were measured in all groups.The body weight,plasma cholesterol,triglyceride and glucose levels were also measured.Results:In the OP control group,the maximum intracavernous pressure(ICP)and ICP/blood pressure(ICP/BP)ratio after electric stimulation were significantly lower than those in OR control group.The corresponding area under the curve(AUC)of the ICP/BP ratio,the detumescence time and the baseline cavernous pressure were also lower than those in the OR control group,but this difference was not significant.The body weight gain,plasma cholesterol and triglyceride level in the OP group were significantly higher than those in the OR group. After administering the DA-8159,a significant increase in the maximum ICP and the ICP/BP ratio were observed.The coerrsponding AUCs in the DA-8159 group were also higher than those in the two control groups.Furthermore,the detumescence time was significantly prolonged after treatment with DA-8159.Conclusion:These results demon- strate that diet-induced obesity affects the erectile function in rats and these erectile dysfunction(ED)can be im- proved by the treatment with DA-8159,indicating DA-8159 might be a treatment option for ED associated with obesity.

睡眠相关性痛性勃起患者与正常男性夜间勃起功能的差异

【目的】探讨睡眠相关性痛性勃起(SRPE)患者夜间阴茎勃起功能和正常男性之间的差异。【方法】从2019年7月1起至2022年12月15日,对来我院泌尿男科就诊的29例SRPE患者(实验组)及58例志愿者(对照组)进行临床对照研究。通过Rigiscan分别监测两组受试者监测当晚总的睡眠监测时间、夜间勃起次数及在阴茎勃起达到60%~79%和80%~100%时勃起平均硬度、持续时间、平均周径增长;嘱咐患者与志愿者觉醒时自行作书面记录醒来的时间及次数,然后结合勃起监测数据,比较两组受试者的总觉醒次数及阴茎勃起达到60%~79%和80%~100%硬度时觉醒次数。【结果】通过匹配的方式消除了年龄的影响。两组夜间总睡眠监测时间、勃起次数和阴茎勃起达到60%~79%及80%~100%时的平均硬度、平均周径增长、持续时间差异均无统计学意义。在睡眠方面,夜间总觉醒次数[3(2~4)vs 0(0~0)],阴茎勃起达到60%~79%硬度时的觉醒次数[1(0~1)vs 0(0~0)]及阴茎勃起达到80%~100%硬度时的觉醒次数[2(1~3)vs 0(0~0)],在实验组和对照组间均有有显著统计学意义(P<0.01)。【结论】Rigiscan监测表明SRPE患者夜间阴茎勃起功能与正常男性之间无差异,而痛醒发生在阴茎勃起达到60%~79%或80%~100%硬度时,这揭示了SRPE可能是患者对夜间勃起的感受异常或者痛觉敏感所致。

健力生机本草菁萃安全性及补肾壮阳功效研究

目的:评价健力生机本草菁萃(JLSJ)的安全性和壮阳功效,初步探讨其作用机制。方法:安全性评价:将JLSJ按5、2.5、1.25 g/kg BW剂量(相当于人摄入量的100倍、50倍、25倍)对SD大鼠连续灌胃30天,观察各剂量组大鼠体质量、摄食量、食物利用率、血液学指标、血液生化学指标、脏器重量和脏/体比值等指标,以此判定JLSJ对大鼠有无明显毒性作用;壮阳功效实验:将SD大鼠分为正常组、阳性对照组和JLSJ低中高剂量组(0.05~0.3 g/mL),观察各组大鼠体质量、脏器指数、PEI值、阴茎勃起潜伏期、血清睾酮水平及精子活力等指标。结果:各剂量组大鼠体质量、摄食量、食物利用率、血液学指标、血液生化学指标、脏器质量和脏/体比值与阴性对照组比较,差异均无显著性意义;JLSJ各剂量组和阳性对照组与正常组相比,体质量和脏器系数增加,PEI值升高,阴茎勃起潜伏期缩短,血清睾酮水平与精子活力均升高。结论:JLSJ对大鼠无明显毒性,其壮阳功效与阳性对照药东革阿里相当甚至更好。

四项行动法延伸模式护理在阴茎型尿道下裂手术患儿中的应用效果

目的:分析四项行动法延伸模式护理在阴茎型尿道下裂手术患儿中的应用效果。方法:选取2020年1月—2022年6月厦门大学附属第一医院收治的60例阴茎型尿道下裂手术患儿作为研究对象,依据家属意愿将其分为研究组(n=30)和参考组(n=30),参考组给予一般性模式,研究组给予四项行动法延伸模式护理。比较两组护理前后疼痛程度、依从性、心理状态、家属满意度及并发症发生情况。结果:护理1周后,两组疼痛程度和依从性较护理前改善,且研究组优于参考组,差异有统计学意义(P<0.05)。护理1周后,两组焦虑、退缩、抑郁评分均低于护理前,且研究组低于参考组,差异有统计学意义(P<0.05)。研究组家属总满意度高于参考组,并发症发生率低于参考组,差异有统计学意义(P<0.05)。结论:四项行动法延伸模式护理能有效减轻阴茎型尿道下裂手术患儿的疼痛程度,改善心理状态,提升家属满意度,减少并发症。