臨床泌尿器科78巻13号

2024年12月発行

特集 知ってますか?　ED診療の最前線

〈EDの治療〉

骨盤内手術後の陰茎リハビリテーション

著者： 小川総一郎¹ 丹治亮¹ 佐藤雄一¹

所属機関： ¹福島県立医科大学医学部 泌尿器科学講座

ページ範囲：P.1036 - P.1040

文献概要

▶ポイント

・骨盤内手術，特に前立腺全摘除術や膀胱全摘除術，直腸癌手術などは，EDを引き起こすことが報告されている．その機序には神経損傷や血流不全，平滑筋のアポトーシスなどが関与する．

・前立腺全摘除術後のEDに対しては，PDE5阻害薬や陰圧式勃起補助具，PGE₁海綿体注射を用いた陰茎リハビリテーションが効果的であるとされており，早期介入の重要性が指摘されている．

・PDE5阻害薬の投与量や使用方法，陰圧式勃起補助具の効果，PGE₁海綿体注射の長期的な効果についてはさらなる研究が必要とされているが，現状の治療法ではED改善の可能性が示されている．

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