[阳痿的非手术治疗:浸润、离子导入、超声、激光]。

F Mantovani, G Mastromarino, F Colombo, E Patelli, A Cazzaniga, E Austoni
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引用次数: 0

摘要

手术治疗是先天性纤维化或海绵体发育不全的唯一有效矫正方法,无论是否伴有尿道下裂。相反,对于非先天性海绵体纤维化(Peyronie病、阴茎勃起的后果或创伤、药物假体并发症),允许进行药物物理治疗(浸润、离子电泳、超声、激光)。药物-物理治疗可作为唯一的治疗方法,这通常是解决的,但它也适用于“海绵体”手术前后。这些疾病会造成勃起障碍,直至完全阳痿。事实上,勃起组织不能扩张,因为纤维硬化症的增加。在海绵体获得性纤维化中,I.P.P.的复发率肯定是最高的:我们系列的一致性使得统一的治疗方案有可能取得显著的结果。同样的治疗方法也适用于其他不太常见的阴茎纤维化,即使在少数患者身上也能得到完全阳性的结果。我们正在评估一种治疗海绵体血管炎的新药(去纤维肽)。另一种(透明质酸酶)与卵磷脂相关,可以改善其抗炎症的作用,特别是在慢性进化中。除了新的治疗方法,我们强调预防医源性纤维化,特别是关于海绵体自体注射药物输注:必须由男科医生仔细检查患者的培训和自体注射器的安全性,以减少大量并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Non-surgical therapy of impotence: infiltration, iontophoresis, ultrasound, laser].

Surgical therapy is the only useful correction in congenital fibrosis or in hypoplasia of the 'corpora cavernosa', associated with hypospadia or not. On the contrary in not congenital fibrosis of the 'corpora cavernosa' (Peyronie's disease, consequences of priapism, or trauma, complications of pharmaco-prosthesis) are allowed pharmaco-physical treatments (infiltrations, ionophoresis, ultrasound, laser). Pharmaco-physical therapy can be used as the only treatment, which is often resolutive, but it is also useful before or after the surgical operation of the 'corpora cavernosa'. These diseases can give disorders of the erection, until complete impotence is reached. In fact the erectile tissue can't expand, because of the rising fibrosclerosis. Among acquired fibrosis of corpora cavernosa I.P.P. has surely the greatest recurrent: the consistency of our series made possible to achieve significant results with a unified therapeutical protocol. The same management was applied in other, less frequent, penile fibrosis, always with full positive results even if on a small number of patients. We are evaluating a new drug (defibrotide) in the treatment of cavernosal vasculitis. Another one (hyaluronidase) associated to orgotein, could improve its effect against inflammation especially in chronic evolutions. Besides new treatments, we emphasize the prevention of iatrogenic fibrosis with particular regard to cavernous pharmaco-infusions by autoinjections: the training of the patient and the safety of the autoinjectors must be carefully checked by the andrologist to decrease a large amount of complications.

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