손상과 동반된 발기부전
Erectile Dysfunction associated with Injuries
송희원, 조상호, 박기현,
소속 상세정보
송희원 ( )
연세대학교 의과대학 비뇨기과학교실
조상호 ( )
연세대학교 의과대학 비뇨기과학교실
박기현 ( )
연세대학교 의과대학 비뇨기과학교실
KMID : 0358319990400040512
Abstract
결론
발기부전을 유발하는 손상으로 척수손상과 요도나 골반골절 등의 손상으로 인한 경우가
각각 42% 정도의 빈도로 나타났으며, 그외에 음경손상(8.8%), 골반 및 회음부둔상(6.6%)등
이 원인으로 나타났다. 골반골절 및 요도손상 환자에서는 동-정맥성 원인에 의한 발기부전
이 50%로 가장 많은 것으로 나타났고, 골반 및 회음부둔상 환자에서는 동맥성 발기부전이
67%로 가장 많았으며, 음경손상 환자에서는 63%에서 동맥 또는 정맥성 발기부전을 보였다.
척수손상 환자를 제외한 경우 순수하게 동맥성, 정맥성, 신경인성 또는 심인성 발기부전으로
진단된 경우는 21명(40％)이었고 나머지 31명(60%)은 동맥, 정맥 또는 신경의 복합적 이상
에 의한 발기부전으로 진단되었다. 손상과 동반된 발기부전 환자 중 64%에서 수술적 치료
를 받았으며 그 중 96.6%는 음경 보형물삽입술을 시행받았다. 혈관계 수술을 시행한 4례에
서는 12개월 경과 후 모두 성공적이지 못하였으며 2례에서는 음경 보형물삽입술이 필요하였
다.
#초록#
Purpose : We reviewed recent 10 year experience in the diagnosis and treatment of
patients with erectile dysfunction associated with various injuries.
Materials and Methods : Seven hundred sixty patients were admitted for evaluation of
erectile dysfunction from January 1988 to April 1997. Among the 760 patients, 90
patients had erectile dysfunction associated with injuries. Mean age was 34.1
years(range 20-63). We classified the types of injury and analyzed etiologies of erectile
dysfunction caused by various injuries and treatment modalities.
Results : Spinal cord injury was observed in 38(42.2%) patients, urethral injury in
11(12.2%), pelvic bone fracture in 5(5.5%), urethral injury with pelvic bone fracture in
22(24.4%), penile injury in 8(8.8%) and blunt trauma to the pelvis and perineum in
6(6.6%). Of the patients with spinal cord injury, neurogenic erectile dysfunction was
observed in 36(95%) patients. Erectile dysfunction by hemodynamic abnormalities was
observed in 6(55%), 4(80%), 11(50%), 5(63%) and 6(100%) in patients with urethral
injury, pelvic bone fracture, urethral injury with pelvic bone fracture, penile injury and
blunt trauma to the pelvis and perineum, respectively. Among the 90 patients, 58
received surgical therapy and 21 intracavernosal injection therapy and the others were
only evaluated for accurate diagnosis. Arterialization of deep dorsal vein was performed
in 2 patients, ligation of deep dorsal vein in 2 and penile prosthesis implantation in 56.
Conclusions : A high frequency of hemodynamic abnormalities was observed in
patients with erectile dysfunction caused by various injuries except for spinal cord
injury. Among the patients who were treated surgically, penile prosthesis implantation
was most successfully performed(96.6%).
키워드
Erectile dysfunction; Injury;
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