Background： Currently available evaluation criteria lbr penile tumescence and rigidity have been fraught with controversy. In tiffs study, we sought to establish normative Chinese evaluation criteria lbr penile tumes...Background： Currently available evaluation criteria lbr penile tumescence and rigidity have been fraught with controversy. In tiffs study, we sought to establish normative Chinese evaluation criteria lbr penile tumescence and rigidity by utilizing audiovisual sexual stimulation and RigiScanTM test （AVSS-Rigiscan test） with the administration of phosphodiesterase-5 inhibitor. Methods： A total of 1169 patients （aged 18-67 years） complained of erectile dysfunction （ED） underwent AVSS-RigiScan test with the administration of phosphodiesterase-5 inhibitor. A total of 1078 patients whose final etiological diagnosis was accurate by means of history, endocrine, vascular, and neurological diagnosis, International Index of Erectile Function 5 questionnaire, and erection hardness score were included in the research. Logistic regression model and receiver operating characteristic curve analysis were performed to determine the cutoffvalue of the RigiScanTM data. Then, the multivariable logistic analysis was used in the selected variables. Results： A normal restllt is defined as one erection with basal rigidity over 60% sustained for at least 8.75 rain, average event rigidity of tip at least 43.5% and base at least 50.5%, average maximum rigidity of tip at least 62.5% and base at least 67.5%, △tumescence （increase of tumescence or maxinaum-mininaum tumescence） of tip at least 1.75 cm and base at least 1.95 cm, total tumescence time at least 29.75 rain, and times of total tumescence at least once. Most importantly, basal rigidity over 60% sustained for at least 8.75 min, average event rigidity of tip at least 43.5%, and base at least 50.5% would be the new normative Chinese evaluation criteria for penile tumescence and rigidity. By multivariable logistic regression analysis, six significant RigiScanTM parameters including times of total tumescence, duration of erectile episodes over 60%, average event rigidity of tip, Atumescence of tip, average event rigidity of base, and Atunaescence of base contribute to the risk model of ED. In logistic regression equation, predict value P 〈 0.303 was considered as psychogenic ED. The sensitivity and specificity of the AVSS-RigiScan test with the administration ofphosphodiesterase-5 inhibitor in discriminating psychogenic from organic ED was 87.7% and 93.4%,, respectively. Conclusions： This study suggests that AVSS-RigiScan test with oral phosphodiesterase-5 inhibitors can objectively assess penile tumescence and rigidity and seems to be a better modality in differentiating psychogenic from organic ED. ttowever, due to the limited sample size, bias cannot be totally excluded.展开更多
Although elevated prolactin levels have been shown to inhibit penile erection,the relationship between prolactin and erection of the penile tip or base has not been extensively researched.We therefore investigated the...Although elevated prolactin levels have been shown to inhibit penile erection,the relationship between prolactin and erection of the penile tip or base has not been extensively researched.We therefore investigated the prolactin's effects on erecti on of the penile tip and base,with a cross-secti onal study of 135 patie nts with erectile dysfuncti on,based on scores of M21 on the In ternational Index of Erectile Function-5.All patients were tested for nocturnal penile tumescenee,blood pressure,serum glucose,total cholesterol,triglyceride,high-density lipoprotein,low-density lipoprotein,luteinizing hormone,follicle-stimulating hormone,prolactin,estradiol,testosterone,and progesterone.Univariate and multivariate analyses were used to assess the associations between prolactin levels and erection at the penile tip and base.We found no obvious relati on ship between erection time at penile tip and prolactin levels,but observed a negative correlation between base erection time and prolactin level(hazard ratio:-2.68;95%confidence interval[Cl]:-5.13-0.22).With increasing prolactin concentration,multivariate analysis showed obvious reduction in base erection time among patients with normal Rigiscan results(hazard ratio:-3.10;95%Cl:-7.96-1.77;P<0.05).Our data indicate that prolactin inhibits penile erection,particularly at the penile base.In addition,when the effective erection time of the penile base lasts longer than 10 min,prolactin has a more obvious inhibitory effect on penile base erection.展开更多
文摘Background： Currently available evaluation criteria lbr penile tumescence and rigidity have been fraught with controversy. In tiffs study, we sought to establish normative Chinese evaluation criteria lbr penile tumescence and rigidity by utilizing audiovisual sexual stimulation and RigiScanTM test （AVSS-Rigiscan test） with the administration of phosphodiesterase-5 inhibitor. Methods： A total of 1169 patients （aged 18-67 years） complained of erectile dysfunction （ED） underwent AVSS-RigiScan test with the administration of phosphodiesterase-5 inhibitor. A total of 1078 patients whose final etiological diagnosis was accurate by means of history, endocrine, vascular, and neurological diagnosis, International Index of Erectile Function 5 questionnaire, and erection hardness score were included in the research. Logistic regression model and receiver operating characteristic curve analysis were performed to determine the cutoffvalue of the RigiScanTM data. Then, the multivariable logistic analysis was used in the selected variables. Results： A normal restllt is defined as one erection with basal rigidity over 60% sustained for at least 8.75 rain, average event rigidity of tip at least 43.5% and base at least 50.5%, average maximum rigidity of tip at least 62.5% and base at least 67.5%, △tumescence （increase of tumescence or maxinaum-mininaum tumescence） of tip at least 1.75 cm and base at least 1.95 cm, total tumescence time at least 29.75 rain, and times of total tumescence at least once. Most importantly, basal rigidity over 60% sustained for at least 8.75 min, average event rigidity of tip at least 43.5%, and base at least 50.5% would be the new normative Chinese evaluation criteria for penile tumescence and rigidity. By multivariable logistic regression analysis, six significant RigiScanTM parameters including times of total tumescence, duration of erectile episodes over 60%, average event rigidity of tip, Atumescence of tip, average event rigidity of base, and Atunaescence of base contribute to the risk model of ED. In logistic regression equation, predict value P 〈 0.303 was considered as psychogenic ED. The sensitivity and specificity of the AVSS-RigiScan test with the administration ofphosphodiesterase-5 inhibitor in discriminating psychogenic from organic ED was 87.7% and 93.4%,, respectively. Conclusions： This study suggests that AVSS-RigiScan test with oral phosphodiesterase-5 inhibitors can objectively assess penile tumescence and rigidity and seems to be a better modality in differentiating psychogenic from organic ED. ttowever, due to the limited sample size, bias cannot be totally excluded.
基金This work was supported by the National Nature Science Foundation of China(No.81670625 and No.81470969)the Shandong Province Natural Science Foundation(No.ZR2017BH104,No.ZR2018MH006,No.ZR2018BH007 and No.ZR2015PH023)the Youth Foundation and Ybuth Talent Foundation of the Second Hospital of Shandong University(No.2018YT32 and No.Y2015010038).
文摘Although elevated prolactin levels have been shown to inhibit penile erection,the relationship between prolactin and erection of the penile tip or base has not been extensively researched.We therefore investigated the prolactin's effects on erecti on of the penile tip and base,with a cross-secti onal study of 135 patie nts with erectile dysfuncti on,based on scores of M21 on the In ternational Index of Erectile Function-5.All patients were tested for nocturnal penile tumescenee,blood pressure,serum glucose,total cholesterol,triglyceride,high-density lipoprotein,low-density lipoprotein,luteinizing hormone,follicle-stimulating hormone,prolactin,estradiol,testosterone,and progesterone.Univariate and multivariate analyses were used to assess the associations between prolactin levels and erection at the penile tip and base.We found no obvious relati on ship between erection time at penile tip and prolactin levels,but observed a negative correlation between base erection time and prolactin level(hazard ratio:-2.68;95%confidence interval[Cl]:-5.13-0.22).With increasing prolactin concentration,multivariate analysis showed obvious reduction in base erection time among patients with normal Rigiscan results(hazard ratio:-3.10;95%Cl:-7.96-1.77;P<0.05).Our data indicate that prolactin inhibits penile erection,particularly at the penile base.In addition,when the effective erection time of the penile base lasts longer than 10 min,prolactin has a more obvious inhibitory effect on penile base erection.
