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中華民國泌尿科醫學會雜誌

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篇名 Efficacy and Safety of Intracavernosal Alprostadil in Hypertensive Patients with Erectile Dysfunction
卷期 10:3
並列篇名 海綿體內Alprostadil在高血壓合併勃起功能障礙病人之療效及安全性
作者 黃昱璋林信男林永明蔡育賢
頁次 103-108
關鍵字 勃起功能障礙高血壓海綿體內注射前列腺素E1或alprostadilerectile dysfunctionhypertensionintracavernosal injectionprostaglandin El or alprostadilTSCI
出刊日期 199909

中文摘要

高血壓病人合併有勃起功能障礙是相當常見的問題。目前有許多方法可用於治療勃起功能障礙,包括藥物治療、真空吸引器、海綿體內注射血管活性藥物及手術治療等。海綿體內alprostadil(含前列腺素El)在高血壓合併勃起功能障礙患者之療效及安全性,至目前很少被提及。我們選擇二十位高血壓合併勃起功能障礙之患者,進行本研究。經過海綿體內注射alprostadil 之劑量滴定後,有16人接受訓練並進行在家自我注射階段的研究。而有4人因為對藥物無效而退出。在16人中只有12人(75 %)完成為期三個月的在家自我注射alprostadil 療程。另有4人(25 %)因發生併發症而終止治療。其勃起的程度及性交的滿意度由病人和其性伴侶評估並且記錄。而注射後之副作用亦由病人記錄下來。共有256次自我注射後並進行性交,其中有187次(73.3 %)讓病人感到滿意,有172次(62.2 %)讓其性伴侶感到滿意。疼痛是主要的副作用,但都很輕微。有30%的病人曾經有過陰莖疼痛。持久性勃起者l人(5%),但是沒有陰莖纖維化及痛性勃起。其他的副作用包括有包皮瘀血者l人(5%),陰莖水腫者1人( 5 % ),及鼠蹊部疼痛l人(5%)。還有l人發生全身性蕁麻疹。在本研究進行中,有l人罹患中風,唯這與alprostadil 並無關聯。總之,海綿體內alprostadil 在高血壓合併勃起功能障礙患者,具有療效而且安全。

英文摘要

Erectile dysfunction (ED) is a common problem in men with hypertension. To date, few reports have focused on the efficacy and safety of intracavernosal alprostadil in hypertensive patients with ED. We prospectively enrolled 20 hypertensive patients with ED in this study. After titration of intracavernosal injection of alprostadil (containing prostaglandin El), 16 patients were trained and entered the home phase of self-injection. Four patients withdrew due to a lack of efficacy. Only 12 of 16(75%) patients completed a 3-mo home treatment; the other 4 patients (25%) dropped out because of adverse events. Out of a total of 256 injections, 187(73.3%) participants and 172(67.2%) partners assessed the treatment as producing satisfactory sexual intercourse. Penile pain, usually mild, was the major side effect, occurring in 30% of patients. Prolonged erection occurred in I patient(5%). There was no priapism or penile fibrosis in this study. Other complications included preputial ecchymosis in 1(5%), penile swelling in 1(5%), and inguinal pain in 1(5%), respectively. One patient had generalized urticaria after injection. One patient suffered from a CVA attack during the study but this seemed unrelated to the alprostadil. In conclusion, intracavernosal alprostadil in hypertensive patients with ED is effective and safe.