患者与提供者评估勃起质量的差异
Matthew S Lee1, Matthew J Ziegelmann1, Luqman M Ellythy1
1Department of Urology, Mayo Clinic Rochester, Rochester, MN.
Urology
|October 31, 2024
概括
患者对勃起刚性的感知往往不同于提供者评估,即使阴茎血液动力学正常. 解决主观问题是成功治疗勃起功能障碍的关键.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 性医学性医学性医学性医学
- 医疗成像医学成像
背景情况:
- 勃起功能障碍 (ED) 诊断依赖于客观测量和主观患者报告.
- 患者和提供者对勃起刚性的评估之间的差异可能会影响治疗结果.
- 阴茎多普勒超声波是评估勃起功能的关键诊断工具.
研究的目的:
- 调查患者和提供者对勃起刚性的评估之间的差异的流行率和特征.
- 确定这些差异与患者人口统计和阴茎超声检查结果的关联.
- 了解在勃起功能障碍中主观知觉的临床影响.
主要方法:
- 对接受阴茎多普勒超声波的患者的回顾性审查 (2022年7月 - 2023年10月).
- 患者和提供者在内腔内注射后对勃起刚性的独立评估 (1-10级).
- 差异的定义是患者和提供者评级之间的差异≥2分.
- 使用千平方和曼-惠特尼U测试进行统计分析.
主要成果:
- 22%的患者 (65/297) 在勃起刚性评估中显示出差异.
- 大多数不一致的患者 (89%) 评价他们的勃起低于他们的提供者.
- 不一致的患者在初级诊断时出现更高的ED发病率 (P=.01) 和超声波上的更高的电阻指数 (P=.04).
- 两组之间在缩速度峰值或缩速度结束时没有发现显著差异.
结论:
- 勃起硬度感知上的差异很常见,通常是由于患者的自我评估较低,尽管阴茎的血液动力学正常.
- 主观感知显著影响ED患者的性功能和治疗期望.
- 临床医生必须识别与客观发现不成比例的知觉差异患者,并为最佳结果提供量身定制的咨询和辅助疗法.
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