有效利用阴茎多普勒超声检查男性勃起功能障碍。

IF 3.3 3区 医学 Q1 UROLOGY & NEPHROLOGY
Jose M Flores, Michael West, John P Mulhall
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引用次数: 0

摘要

背景:血管源性勃起功能障碍是最常见的勃起功能障碍类型,阴茎多普勒超声(PDUS)是临床医生在与患者讨论预后和管理策略时评估勃起血流动力学的有用工具:我们介绍了本机构使用 PDUS 的经验,并结合当代文献综述讨论了这一研究:结果:我院的 PDUS 规程:要正确实施 PDUS,充分的培训、设备、环境、技术和解释至关重要。PDUS 的准确性完全取决于海绵体平滑肌是否完全松弛。重新给药方案可优化 PDUS 采集的血液动力学数据的可靠性和可重复性。根据患者达到的勃起硬度(完全坚硬)或使用最大剂量的血管活性剂对其进行扫描。收缩期峰值速度被认为是动脉内流的测量值(正常,大于 30 厘米/秒),而舒张末期速度则评估静脉闭塞机制(正常,大于 30 厘米/秒):在海绵体平滑肌完全松弛的情况下,PDUS 是进行勃起血液动力学评估和准确评估的重要微创工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficient use of penile Doppler ultrasound for investigating men with erectile dysfunction.

Background: Vasculogenic erectile dysfunction is the most common type of erectile dysfunction, and penile Doppler ultrasound (PDUS) is a useful tool to assess erectile hemodynamics in the clinician's effort to discuss prognosis and management strategies with the patient.

Aim: We herein describe the PDUS protocol used at our center, including indications, technique, and data interpretation.

Methods: We describe our institutional experience with PDUS and discuss it in the context of a contemporary review of the literature for this investigation.

Outcome: Our institutional PDUS protocol.

Results: To perform PDUS properly, adequate training, equipment, setting, technique, and interpretation are critical. The accuracy of PDUS is entirely predicated on achieving complete cavernosal smooth muscle relaxation. A redosing protocol optimizes the reliability and reproducibility of the hemodynamic data acquired during PDUS. A rigidity-based assessment is performed, and patients are scanned according to the erection rigidity achieved (full hardness) or by administration of maximum dose of the vasoactive agent. Peak systolic velocity is considered a measure of arterial inflow (normal, >30 cm/s), while end diastolic velocity evaluates the veno-occlusive mechanism (normal, <5 cm/s). After the procedure, the patient is evaluated to confirm detumescence. If the patient has a persistent penetration rigidity erection, intracavernosal phenylephrine is administered; however, if detumescence is not achieved with intracavernosal phenylephrine injections alone, corporal aspiration is potentially performed.

Conclusion: PDUS is a valuable minimally invasive tool for erectile hemodynamics assessment and an accurate assessment of such, provided that complete cavernosal smooth muscle relaxation is achieved.

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来源期刊
Journal of Sexual Medicine
Journal of Sexual Medicine 医学-泌尿学与肾脏学
CiteScore
6.20
自引率
5.70%
发文量
826
审稿时长
2-4 weeks
期刊介绍: The Journal of Sexual Medicine publishes multidisciplinary basic science and clinical research to define and understand the scientific basis of male, female, and couples sexual function and dysfunction. As an official journal of the International Society for Sexual Medicine and the International Society for the Study of Women''s Sexual Health, it provides healthcare professionals in sexual medicine with essential educational content and promotes the exchange of scientific information generated from experimental and clinical research. The Journal of Sexual Medicine includes basic science and clinical research studies in the psychologic and biologic aspects of male, female, and couples sexual function and dysfunction, and highlights new observations and research, results with innovative treatments and all other topics relevant to clinical sexual medicine. The objective of The Journal of Sexual Medicine is to serve as an interdisciplinary forum to integrate the exchange among disciplines concerned with the whole field of human sexuality. The journal accomplishes this objective by publishing original articles, as well as other scientific and educational documents that support the mission of the International Society for Sexual Medicine.
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