阴茎假体的植入被认为是第三线治疗,适用于对药物治疗没有充分反应或需要明确治疗的患者。目前,最常用的装置是三组件阴茎假体,目前占所用植入物的90%以上。
我们回顾了临床实践指南中关于勃起功能障碍患者手术的证据和建议。
关于勃起功能障碍患者手术的临床实践指南的建议总结如下:男性勃起功能障碍患者应了解阴茎假体植入治疗的选择,评论好处,风险和后果;同意接受阴茎假体的勃起功能障碍男性应建议手术后的期望;阴茎假体植入物不应在全身,皮肤或尿路感染;在患有勃起功能障碍和局灶性阴茎或盆腔动脉阻塞的年轻男性中,没有全身性血管疾病或静脉闭塞功能障碍,阴茎动脉重建可以考虑;在男性勃起功能障碍,不建议进行阴茎静脉手术。
阴茎假体的使用为患者和他的伴侣提供了很高的满意度。然而,充分告知和警告患者可能的并发症和后果至关重要。
The implantation of a penile prosthesis is considered a third-line treatment and is indicated in patients who do not respond adequately to pharmacotherapy or require definitive treatment. Currently, the most used devices are 3-component penile prostheses, which presently account for more than 90% of the implants used.
We reviewed the evidence and the recommendations of the clinical practice
guidelines regarding surgery in patients with erectile dysfunction.
The recommendations of the clinical practice
guidelines on surgery in patients with erectile dysfunction are summarized as follows: men with erectile dysfunction should be informed about the option of penile prosthesis implant treatment, commenting on the benefits, risks and consequences; men with erectile dysfunction who have agreed to receive penile prosthesis should be advised on post-surgical expectations; penile prosthesis implants should not be performed in patients with systemic, cutaneous or urinary tract infection; in young men with erectile dysfunction and focal penile or pelvic arterial obstruction who do not have generalized vascular disease or veno-occlusive dysfunction, penile arterial reconstruction can be considered; in men with erectile dysfunction, penile venous surgery is not recommended.
The use of penile prostheses offers high satisfaction rates to both the patient and his partner. However, it is crucial to adequately inform and warn patients about possible complications and consequences.