前列腺癌根治术后勃起功能障碍预防及治疗的研究进展

发布时间：2018-07-15 16:14

【摘要】：前列腺癌已经成为我国男性泌尿系统中发病率最高的肿瘤。前列腺癌根治术(RP)是治愈局限性前列腺癌最主要手段,并有良好的长期预后。勃起功能障碍(ED)是RP后的常见并发症,严重影响患者术后的生活质量。随着前列腺癌的发病率不断上升以及前列腺癌的早期诊断,年轻男性行RP的比例增加,RP术后ED治疗的重要性随之增加。RP后勃起功能康复与手术方案及方法等术前、术中措施以及阴茎康复介入时机等密切相关。5型磷酸二酯酶抑制剂、经尿道或海绵体内血管活性物质的应用、负压吸引装置、阴茎假体植入仍然是当前RP后ED常用的治疗手段。干细胞、神经移植、低强度体外冲击波、促红细胞生成素等前瞻性治疗在RP后阴茎康复显示出了巨大潜力。目前对于ED的治疗着重于症状的缓解,干细胞治疗可通过逆转ED的病理生理变化达到逆转病因或治愈ED的目的。相关干细胞治疗的临床试验正在进行,已初步证实了干细胞治疗的安全性并能改善RP术后ED患者的勃起功能。本文就RP后ED预防和治疗方面的研究进展作一综述。
[Abstract]:Prostate cancer has become the highest incidence of cancer in the male urinary system in China. Radical prostatectomy (RP) is the main method to cure localized prostate cancer and has a good long-term prognosis. Erectile dysfunction (Ed) is a common complication after RP. With the increasing incidence of prostate cancer and the early diagnosis of prostate cancer, the proportion of young men receiving RP increased the importance of Ed treatment after RP. Intraoperative measures and interventional timing of penile rehabilitation are closely related to the use of type .5 phosphodiesterase inhibitors, the use of transurethral or intracavernous vasoactive substances, negative pressure suction devices, and penis prosthesis implantation, which are still commonly used in the treatment of Ed after RP. Prospective treatments such as stem cells, nerve transplantation, low intensity extracorporeal shock wave and erythropoietin show great potential for penile rehabilitation after RP. At present, the treatment of Ed focuses on the relief of symptoms. Stem cell therapy can reverse the pathophysiological changes of Ed to reverse the etiology or cure Ed. Clinical trials related to stem cell therapy are under way and it has been preliminarily proved that stem cell therapy is safe and can improve erectile function in Ed patients after RP. This article reviews the advances in prevention and treatment of post-RP Ed.
【作者单位】：中南大学湘雅二医院泌尿外科;
【分类号】：R698;R737.25

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