정상인과 척수손상환자에서 PGE1의 음경해면체내 주사와 경요도적 주입의 효과비교
Comparison of Transurethral and Intracavernosal Administration of PGE1 in Normal Males and SCI Patients
최재호, 최성, 류현열,
소속 상세정보
최재호 ( )
고신대학교 의학부 비뇨기과학교실
최성 ( )
고신대학교 의학부 비뇨기과학교실
류현열 ( )
고신대학교 의학부 비뇨기과학교실
KMID : 0358319970380080860
Abstract
결론
PGEI의 경요도적 주입은 음경복합초음파촬영술로 평가한 결과 음경해면체내 주사법과 동
일하게 음경해면체의 평균 수축기 혈류속도의 유의한 증가가 관찰되었다. 성교가능한 정도
의 발기는 정상군의 5례 (41.6%)및 척수손상군의 5례 (55.5%)에서 가능하였다. 경요도적 주
입의 부작용으로서는 6례 (28.6%)에서 요도자극증상이 동반된 동통을 호소하였으나 전신적
부작용은 발생되지 않았다.
이상의 결과에서 PGE1의 경요도적 투여는 비록 음경해면체내 주사법에 비해 고비용이고
28.6%에서 요도자극증상이 동반된 통증을 호소하며 그 효과도 떨어지나 현저한 기질적 원
인이 없거나 척수손상으로 인한 신경인성 발기부전환자의 진단 및 치료에 있어서 안전하고
간편하게 사용될 수 있을 것으로 기대된다.
#초록#
Intracavernous self-injection therapy is now being widely used to treat patients with
erectile dysfunction. Many men with erectile dysfunction can achieve normal erection
with this therapy, but about 50% of men using this therapy eventually discontinue
treatment for reasons relating to penile pain, needle-phobia and side effects including
corporeal scarring, penile hematoma and priapism. Therefore, the less invasive route of
drug administration is highly recommended.
We investigated the efficacy and safety of transurethral instillation of PGE1 solution
for the treatment of erectile dysfunction in comparison with an intracavernous injection
of PGE1. Forty seven normal males and nine neurogenic impotent patients due to spinal
cord injury (SCI) were enrolled in this study and all subjects were evaluated with the
penile duplex color doppler ultrasonography before and after the drug administration.
Penile length and circumference were measured before and after the drug administration.
The erectile response was recorded on a five-point erection assessment scale by
Padma-Nathan. Of 12 normal males used transurethral instillation of PGE1 solution 5
(42%) were achieved erection allowing sexual intercourse (score 4 or 5). The mean peak
systolic velocity at 30 minutes was 75.82±56.84㎝/sec, 63.11 ± 48.11㎝/sec and end
diastolic velocity at 30minutes was 3.49±8.10㎝/sec, 10.51 ± 1.12㎝/sec and resistance
index was 0.96±0.15, 0.78±0.15 in normal males and SCI patients respectively. Mean
length and circumference of penile shaft before and after transurethral instillation of
PGE1 showed significant difference. Of 9 patients, 5 (55.5%) were achieved erection
allowing sexual intercourse. With the transurethral instillation of PGE1 solution, urethral
pain and burning sense were noticeable complication but systemic side effect was not
noticed.
In conclusion, transurethral PGE1 instillation can be satisfactorily used for the patients
with erectile dysfunction of less prominent organic and neurogenic origin, although the
effect of transurethral instillation of PGE1 is obviously less than that of intracavernosal
injection.
키워드
Impotence; Transurethral instillation; PGE1;
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