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目的:探讨分析腹壁下动脉-阴茎背深静脉吻合术治疗血管性勃起功能障碍的近、远期疗效与并发症。方法:2005~2015年我院通过腹壁下动脉-阴茎背深静脉吻合手术治疗血管性勃起功能障碍患者共5例,对其进行随访。手术将阴茎背深静脉近心端结扎,并进行腹壁下动脉-阴茎背深静脉远心端吻合。分析患者在术前、术后的IIEF-5评分、晨勃频率(n次/10d)、阴茎硬度、性生活质量以及术后并发症的发生情况。结果:5例勃起功能障碍患者均顺利完成手术,患者术后IIEF-5评分显示勃起功能恢复正常[术前(5.2±0.45)vs.术后(23.60±1.34),P<0.05)],勃起硬度改善明显。手术后患者晨勃频率明显增加[术前(1.2±0.84)vs.术后(6.4±1.14),P<0.05]。多普勒彩超术前术后对比:左侧PSV[(38.0±13.10)vs.(55.6±14.97),P<0.05];右侧PSV[(27.8±13.88)vs.(50.6±21.18),P<0.05];左侧EDV[(6.0±1.41)vs.(3.8±0.84),P<0.05];右侧EDV[(4.4±0.89)vs.(2.4±1.67),P<0.05]。1例患者术后出现包皮水肿、阴茎头过度充血伴黏膜糜烂,1例患者出现勃起疼痛,对症治疗后均好转。结论:腹壁下动脉-背深静脉吻合术治疗血管性ED,能明显提高患者长期勃起功能。
Objective: To explore the short-term and long-term effects and complications of inferior abdominal artery-penis dorsal vein anastomosis in the treatment of vascular erectile dysfunction. Methods: From 2005 to 2015, 5 cases of vascular erectile dysfunction were treated by inferior abdominal artery - penis dorsal vein anastomosis in our hospital. All patients were followed up. Surgery will be penis dorsal deep vein proximal ligation, and the inferior abdominal artery - penile dural deep vein distal anastomosis. The preoperative and postoperative IIEF-5 scores, morning nap frequency (n times / 10 days), penile stiffness, quality of life and postoperative complications were analyzed. Results: All 5 patients with erectile dysfunction successfully completed the operation. The postoperative IIEF-5 score showed that erectile function returned to normal (preoperative 5.2 ± 0.45 vs postoperative 23.60 ± 1.34, P 0.05) Hardness improved significantly. The frequency of morning nap increased significantly after surgery (preoperative 1.2 ± 0.84 vs postoperative 6.4 ± 1.14, P 0.05). (P <0.05); PSV [(27.8 ± 13.88) vs. (50.6 ± 21.18) vs. P (P), P <0.05]. The left EDV [(6.0 ± 1.41) vs. (3.8 ± 0.84), P <0.05]; the right EDV [(4.4 ± 0.89) vs. (2.4 ± 1.67), P <0.05]. One patient had foreskin edema, excessive glaucoma with mucosal erosion, and one patient showed erectile pain after symptomatic treatment. Conclusion: The treatment of vascular ED by the inferior abdominal artery - dorsal deep vein anastomosis can significantly improve long-term erectile function.