著者

白井 将文 竹内 睦男 佐々木 桂一

出版者

社団法人 日本泌尿器科学会

雑誌

日本泌尿器科學會雑誌 (ISSN:00215287)

巻号頁・発行日

vol.62, no.3, pp.241-245, 1971 (Released:2010-07-23)

参考文献数

19

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Sexual dysfunction following perineal exposure and removal of the prostate gland is a common occurrence and well documented in urologic literature. The incidence of impaired potency following forms of prostatectomy, especially retropubic resection, however, has received less attention, thereby providing the basis of investigation for this publication. The case materials for this study were patients treated at the Tohoku University Hospital during the period from January, 1962, to March, 1969.Excluded from the study were patirents with prostatic cancer and those over 65 years of age. All data for the study were gathered in a form of questionnaire. In each history, such items as sexual desire, morning erections, frequencies and potency in coitus, condition of ejaculation and orgasm were explored. A total of 72 individuals answered the questionnaire.The operative technic was retropubic prostatectomy. Eighteen patients (25.0 per cent) complained a decrease in sexual desire following prostatectomy.Twenty three patients (31.9 per cent) reported a reduction in activity of erection during intercourse. Of these 23 patients, 14 had diminished potency and the remaining 9 were totally impotent.The mean frequency of intercourse was 2.58 per month before operation. Following prostatectomy, it diminished to 1.99 per month.Fourty-one point seven per cent of the patients (30 individuals) had no ejaculation following operation.Disturbance in orgasm was found in 37 individuals (51.4 per cent) following prostatectomy.

著者

石井 延久 光川 史郎 白井 将文

出版者

社団法人 日本泌尿器科学会

雑誌

日本泌尿器科學會雑誌 (ISSN:00215287)

巻号頁・発行日

vol.68, no.2, pp.136-144, 1977 (Released:2010-07-23)

参考文献数

8

被引用文献数

5 6

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For the differential diagnosis of organic and functional impotence, we have used radioisotope penography to determine their rates of increase in penial blood flow at erection. In a further attempt to achieve the aim more conveniently, we recently tried to trace change in penial skin temperature concomitant with erection in 33 subjects, including 22 with impotence, 5 with Klinefelter's syndrome and 6 control cases.The trace in penial skin temperature—named as penothermocurve—was obtained after a visual sexual stimulation (V. S. S.). By way of comparison, radioisotope penography was applied in 23 of 33 test subjects.The results showed that, 6 among the 22 impotence cases who had no past ailments predisposed to organic impotence, revealed an average rise of 1.58°C in penial skin temperature after V. S. S., of 13 others with past history of trauma or others who were likely to lead to organic impotence revealed an average 0.77°C in penial skin. Of remaining 3 cases with psychotic impotence, an average temperature rise was 0.73°C. An average temperature rise of 5 Klinefelter's syndrome cases was 1.16°C after V. S. S. The 6 control cases revealed an average temperature rise of 1.28°C.In the 23 cases with radioisotope penograms, 15 B-type cases had an average rise of 1.23°C, while 6 A-type cases had an average temperature rise of 0.68°C. The other 2 cases without any responses in radioisotope penogram had an average temperature rise of 0.3°C after V. S. S.It has thus become evident that the cases with increasing penial blood flow with V. S. S. showed proportional increases in penital skin temperatures, indicating a satisfactory consistency between our tracing of penothermocurve and the radioisotope penography test in distinguishing functional from organic impotence. Our penothermocurve method, free of technical difficulties in handling R. I., simple and practicable anywhere, would be worthy of recommendation in objective differential diagnosis between functional and organic impotences.

著者

石井延久 渡辺 博幸 入沢 千晶 菊地 悦啓 川村 俊三 鈴木 騏一 千葉 隆一 常盤 峻士 白井 将文

出版者

社団法人日本泌尿器科学会

雑誌

日本泌尿器科學會雜誌 (ISSN:00215287)

巻号頁・発行日

vol.77, pp.954-962, 1986

被引用文献数

5

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従来より,我々は器質的インポテンスの治療に陰茎プロステーシスの挿入手術を行っていた.しかし,我国では陰茎プロステーシスの挿入手術を希望する患者は実際には余り多くないことから,非観血的な方法が望まれていた.そこで我々は強力な血管平滑筋の弛緩作用を有するProstaglandin E_1(PGE_1)の陰茎海綿体注射が器質的インポテンスの治療に応用できるか否かを検討した.方法は22〜27Gの細い翼状針を用いて,2〜20mlの生理的食塩水に溶解したPGE_1 20μgを注入し,その前後の変化を陰茎温度とErectiometerで観察した.動注は血管カテーテルを用いて生理的食塩水20mlに溶解したPGE_1 20μgを注入した.結果はPGE_1を陰茎海綿体に注射した71例のうち,51例(72%)に完全勃起がみられた.のこる9例(13%)は不完全な勃起,6例(8%)は陰茎の増大のみ,5例(7%)は全く変化がみられなかった.完全勃起はPGE_1注射後2〜3分で陰茎の増大がおこり,約2〜3時間持続した.PGE_1により殆ど勃起のおこらない症例は高齢者や陰茎海綿体の萎縮,血管障害の疑われた症例に多くみられた.しかし,骨盤内手術など末梢神経障害や脳・脊髄など中枢神経に器質的障害のある症例でも,PGE_1の陰茎海綿体注射により,性交可能な勃起がみられたことから,今後はPGE_1の器質的インポテンスヘの治療に応用できることがわかった.一方,PGE_1の陰茎海綿体注射により完全勃起のおこらない骨盤骨折1例と糖尿症の2例の内陰部動脈造影を行ったところ,骨盤骨折症例では内陰部動脈の損傷があり,陰茎動脈は造影されなかった.この症例は血管性のインポテンスの合併があり,PGE_1の内陰部動脈へ注入によっても陰茎の温度は余り上昇せず,勃起も回復しなかった.しかし,糖尿病の2例はいずれも陰茎動脈まで造影され,PGE_1の動注により陰茎の温度の上昇がみられ,一過性ではあるが勃起の回復がみられた.このことから,PGE_1の動注が静注など投与方法を工夫することにより,将来血管性インポテンスの治療に応用できるようになるのではないかと期待される.

著者

永尾 光一 片岡 和義 須山 太助 小林 秀行 加藤 聡彦 田中 祝江 工藤 貴正 吉田 淳 原 啓 三浦 一陽 石井 延久 白井 将文

出版者

一般社団法人 日本泌尿器科学会

雑誌

日本泌尿器科学会雑誌 (ISSN:00215287)

巻号頁・発行日

vol.96, no.2, pp.220, 2005-03-05 (Released:2017-04-07)