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目的:评价每日小剂量他达拉非治疗骨盆骨折尿道断裂(PFUD)后勃起功能障碍(ED)的疗效。方法:2008年1月至2011年12月共有46例骨盆骨折尿道断裂后ED患者纳入观察。患者年龄25～51(33.9±7.2)岁,受伤时间3～72(19.6±12.7)个月。所有患者自诉受伤前的性功能正常。患者在未服用5型磷酸二酯酶抑制剂的情况下进行夜间勃起周径和硬度测量(NPTR)。根据NPTR检测结果将患者分为有夜间勃起异常组和无夜间勃起组。对所有患者给予每晚他达拉非10 mg治疗3个月,采用IIEF-5评分、性生活日记问题2和问题3评价治疗效果。结果:38例(82.6%)患者完成检查和治疗,8例失访。NPTR检测证实夜间勃起异常26例(68.4%),无夜间勃起12例(31.6%)。他达拉非治疗3个月后,夜间勃起异常组患者IIEF-5改善明显高于无夜间勃起组(P<0.05),夜间勃起异常组患者对SEP2和SEP3回答“是”的比例明显高于无夜间勃起组(76.9%vs41.7%,65.4%vs 25.0%,P<0.05)。结论:每日小剂量他达拉非可有效改善PFUD后ED患者的勃起功能,有夜间勃起的患者治疗效果更明显。
PURPOSE: To evaluate the efficacy of daily small-dose tadalafil in the treatment of erectile dysfunction (ED) after pelvic fracture and urethral rupture (PFUD). Methods: From January 2008 to December 2011 a total of 46 cases of pelvic fracture urethra after ED patients were included in the observation. The patients were 25 to 51 years (33.9 ± 7.2) years old and 3 to 72 (19.6 ± 12.7) months. All patients complained of sexual function before the injury normal. Patients underwent nocturnal erection circumference and hardness measurements (NPTR) without taking type 5 phosphodiesterase inhibitors. Patients were divided into nocturnal erectile dysfunction group and nocturnal erectile group according to the NPTR test results. All patients were given tadalafil 10 mg every night for 3 months. The IIEF-5 score, Sex Diary Question 2 and Question 3 were used to evaluate the treatment effect. Results: 38 patients (82.6%) completed the examination and treatment, and 8 patients were lost. NPTR test confirmed nocturnal erectile dysfunction in 26 cases (68.4%), no nocturnal erection in 12 cases (31.6%). The improvement of IIEF-5 in nocturnal erectile dysfunction group was significantly higher than that in nocturnal erectile group (P <0.05) after three months treatment with tadalafil. The ratio of “yes” to SEP2 and SEP3 was significantly higher in nocturnal erectile dysfunction group Higher than those without nocturnal erection (76.9% vs41.7%, 65.4% vs 25.0%, P <0.05). CONCLUSION: Small daily dose of tadalafil can effectively improve the erectile function of ED patients after PFUD, and the treatment effect is more obvious in patients with nocturnal erectile dysfunction.