可以插入阴茎假体(PP)以用于患有脊髓损伤(SCI)的男性的勃起功能障碍(ED)和/或泌尿管理。这组患者由于其活动性和感觉降低而被认为是并发症的高风险。
确定SCI患者插入PP后的并发症和满意率。
根据PRISMA检查表对文献进行了系统回顾。截至2021年7月27日,搜索了Medline/PubMed和EMBASE数据库。纳入对≥18岁男性因SCI继发ED插入PP的研究。两名审稿人独立筛选所有文章,评估偏倚风险并进行数据提取。
11项研究包括475例男性SCI患者进行分析。总并发症发生率为4.2~61.1%。具体的并发症包括感染,0-16%;侵蚀,3.7-11.1%和机械故障,0-16.7%。外植率为2.1-16.7%,翻修率为2.7-44.4%。总的来说,79.2-92.9%的男性对他们的PP感到满意,36-86.1%的性交令人满意。在那些使用PP进行泌尿管理±ED的人中,86.5--92.8%满意。与没有SCI的男性相比,有SCI的男性有更高的并发症发生率(感染,2.1-9.1%与非SCI,0.8-5.7%;侵蚀,2.1-8.3%与非SCI,0%;解释,2.1-8.3%与非SCI,0.8-5.7%)。
PP是SCI患者管理终末期ED或泌尿功能的一种选择,但是感染率,与没有SCI的男性相比,侵蚀和植入物的植入更高。充气阴茎假体(IPP)是首选PP,因为它具有较低的侵蚀风险,然而,他们容易出现机械故障,需要良好的手的灵活性。彻底的术前咨询至关重要。PangKH,MuneerA,AlnajjarHM,etal.脊髓损伤患者阴茎假体插入的系统评价。《性爱医学修订版2022》;10:461-470。
A penile prosthesis (PP) may be inserted for erectile dysfunction (ED) and/or urinary management in men with spinal cord injury (SCI). This group of patients is considered high risk for complications due to their reduced mobility and sensation.
To identify the complication and satisfaction rates following PP insertion in patients with SCI.
A systematic
review of the literature was performed according to the PRISMA checklist. The Medline/PubMed and EMBASE databases were searched up to July 27th 2021. Studies on men ≥18 years who had a PP inserted for ED secondary to SCI were included. Two reviewers independently screened all articles, assessed for risk of bias and performed data extraction.
Eleven studies including 475 men with SCI were included for analysis. The overall complication rate was 4.2-61.1%. Specific complications included infection, 0-16%; erosion, 3.7-11.1% and mechanical failure, 0-16.7%. The explantation rate was 2.1-16.7% and the revision rate was 2.7-44.4%. Overall, 79.2-92.9% of men were satisfied with their PP and, 36-86.1% were having satisfactory sexual intercourse. In those who used the PP for urinary management ± ED, 86.5--92.8%% were satisfied. Men with SCI had higher rates of complications compared to those without SCI (infection, 2.1-9.1% vs non-SCI, 0.8-5.7%; erosion, 2.1-8.3% vs non-SCI, 0%; explanation, 2.1-8.3% vs non-SCI, 0.8-5.7%).
PP is an option for SCI patients for the management of end-stage ED or urinary function, but the rate of infection, erosion and implant explantation is higher compared with men without SCI. Inflatable penile prosthesis (IPP) is the preferred PP due to the lower risk of erosion, however, they are prone to mechanical failure and require good hand dexterity. A thorough pre-operative counselling is essential. Pang KH, Muneer A, Alnajjar HM, et al. A Systematic
Review of Penile Prosthesis Insertion in Patients With Spinal Cord Injury. Sex Med Rev 2022;10:461-470.