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Ñîãëàñèòüñÿ

2009 ã. ¹4 Òîì 17

ËÅÊÖÈÈ, ÎÁÇÎÐÛ

À.À. ÆÅÁÅHÒßÅÂ, Ñ.Î. ÃÎËÄÛÖÊÈÉ

ÑÎÂÐÅÌÅHHÛÅ ÌÅÒÎÄÛ ÄÈÀÃHÎÑÒÈÊÈ È ËÅ×ÅHÈß ÝÐÅÊÒÈËÜHÎÉ ÄÈÑÔÓHÊÖÈÈ

ÓÎ «Âèòåáñêèé ãîñóäàðñòâåííûé ìåäèöèíñêèé óíèâåðñèòåò»,
Ðåñïóáëèêà Áåëàðóñü

Èññëåäîâàíèÿ, ïðîâåä¸ííûå çà ïîñëåäíèå 15 ëåò, ïðèâåëè ê èçìåíåíèþ òàêòèêè ëå÷åíèÿ ýðåêòèëüíîé äèñôóíêöèè (ÝÄ). Ïîñëå ñîçäàíèÿ òð¸õ èçâåñòíûõ èíãèáèòîðîâ ôîñôîäèýñòåðàçû (ÔÄÝ) 5 òèïà (ñèëäåíàôèë, òàäàëàôèë è âàðäåíàôèë), ñîâðåìåííîå ëå÷åíèå ÝÄ ñòàëî ýôôåêòèâíûì è áåçîïàñíûì äàæå ó ïàöèåíòîâ ñ ñàõàðíûì äèàáåòîì è ïîñëå ðàäèêàëüíîé ïðîñòàòýêòîìèè. Ìíîãèå âðà÷è áåç áàçîâûõ çíàíèé è êëèíè÷åñêîãî îïûòà ïûòàþòñÿ ó÷àñòâîâàòü â äèàãíîñòèêå è ëå÷åíèè ÝÄ. Ïðè íåýôôåêòèâíîñòè (èëè ïðîòèâîïîêàçàíèÿõ) ê îðàëüíîé ôàðìàêîòåðàïèè èñïîëüçóþòñÿ èíòðàêàâåðíîçíûå èíúåêöèè, èíòðàóðåòðàëüíàÿ òåðàïèÿ àëüïðîñòàäèëîì, âàêóóì-òåðàïèÿ è èìïëàíòàöèÿ ïðîòåçîâ ïîëîâîãî ÷ëåíà. Ñëåäóåò ïîä÷åðêíóòü, ÷òî âðà÷, êîòîðûé íàçíà÷àåò ëå÷åíèå ÝÄ, äîëæåí ïðåäóïðåäèòü ïàöèåíòà î òîì, ÷òî ñåêñóàëüíûé êîíòàêò ñ÷èòàåòñÿ çíà÷èòåëüíîé ôèçè÷åñêîé àêòèâíîñòüþ, êîòîðàÿ ïîâûøàåò ÷àñòîòó ñåðäå÷íûõ ñîêðàùåíèé è ðàáîòó ñåðäöà, ïîýòîìó òðåáóåòñÿ îöåíêà ðèñêà ðàçâèòèÿ ñåðäå÷íî-ñîñóäèñòîé ïàòîëîãèè ïåðåä ëå÷åíèåì ÝÄ. Ðåêîíñòðóêòèâíûå ñîñóäèñòûå îïåðàöèè íå ïðèâåëè ê óëó÷øåíèþ îòäàëåííûõ ðåçóëüòàòîâ ïðè ÝÄ. Äàííûå ìíîãî÷èñëåííûõ èññëåäîâàíèé ïðèâåëè ê ñîçäàíèþ ñòàíäàðòîâ äèàãíîñòèêè è ëå÷åíèÿ ÝÄ Åâðîïåéñêîé Àññîöèàöèè Óðîëîãîâ (ÅÀÓ-2009).

Êëþ÷åâûå ñëîâà: ýðåêòèëüíàÿ äèñôóíêöèÿ, ìåòîäû äèàãíîñòèêè, ñòàíäàðòû ëå÷åíèÿ, áëîêàòîðû ôîñôîäèýñòåðàçû 5 òèïà
ñ. 150 – 159 îðèãèíàëüíîãî èçäàíèÿ
Ñïèñîê ëèòåðàòóðû
  1. Epidemiology of erectile dysfunction: results of the ‘Cologne Male Survey’ / M. Braun [et al.] // Int. J. Impot. Res. – 2000. – Vol. 12. – P. 305-311.
  2. Physiology of erection and pharmacological management of impotence / T. F. Lue [et al.] // J. Urol. – 1987. – Vol. 137. – P. 829-836.
  3. Modifiable risk factors and erectile dysfunction: can lifestyle changes modify risk? / C. A. Derby [et al.] // Urology. – 2000. – Vol. 56. – P. 302-306.
  4. Accuracy of the initial history and physical examination to establish the etiology of erectile dysfunction / B. Davis-Joseph [et al.] // Urology. – 1995. – Vol. 45. – P. 498-502.
  5. Epidemiology of erectile dysfunction / R. W. Lewis [et al.] // Urol. Clin. North Am. – 2001. – Vol. 28. – P. 209-216.
  6. The international index of erectile function (IIEF): a multidimentional scale for assessment of erectile dysfunction / R. C. Rosen [et al.] // Urology. – 1997. – Vol. 49. – P. 822-830.
  7. Diagnostic steps in the evaluation of patients with erectile dysfunction / D. Hatzichristou [et al.] // J. Urol. – 2002. – Vol. 168. – P. 615-620.
  8. Summary of the recommendations on sexual dysfunction in men / T. F. Lue [et al.] // J. Sexual Medicine. – 2004. – Vol. 1. – P. 6-23.
  9. Management of sexual dysfunction in patients with cardiovascular diseases: recommendations of the Princeton Consensus Panel / R. DeBusk [et al.] // Am. J. Cardiol. – 2000. – Vol. 86. – P. 62-68.
  10. Nocturnal penile tumescence and rigidity monitoring in young potent volunteers: reproducibility, evaluation criteria and the effect on sexual intercourse / D. G. Hatzichristou [et al.] // J. Urol. – 1998. – Vol. 159. – P. 1921-1926.
  11. Investigation of erectile dysfunction. Diagnostic testing for vascular factors in erectile dysfunction / E. J. Meuleman [et al.] // Urol. Clin. North Am. – 1995. – Vol. 22. – P. 803-819.
  12. Clinical evaluation and management strategy for sexual dysfunction in men and women / D. Hatzichristou [et al.] // J. Sexual Medicine. – 2004. – Vol. 1. – P. 49-57.
  13. Hormonal erectile dysfunction. Evaluation and management / A. Morales [et al.] // Urol. Clin. North Am. – 2001. – Vol. 28. – P. 279-288.
  14. Venous impotence: pathophysiology, diagnosis and treatment / E. Wespes [et al.] // J. Urol. – 1993. – Vol. 149. – P. 1238-1245.
  15. Psychogenic erectile dysfunction. Classification and management / R. C. Rosen [et al.] // Urol. Clin. North Am. – 2001. – Vol. 28. – P. 269-278.
  16. Erectile dysfunction / T. F. Lue [et al.] // N. Engl. J. Med. – 2000. – Vol. 342. – P. 1802-1813.
  17. Sildenafil: a review of its use in erectile dysfunction / H. D. Langtry [et al.] // Drugs. – 1999. – Vol. 57. – P. 967-989.
  18. Sildenafil citrate for treatment of erectile dysfunction in men with type 1 diabetes: results of a randomized controlled trial / B. G. Stuckey [et al.] // Diabetes Care. – 2003. – Vol. 26. – P. 279-284.
  19. Efficacy and factors associated with successful outcome of sildenafil citrate use for erectile dysfunction after radical prostatectomy / R. Raina [et al.] // Urology. – 2004. – Vol. 63. – P. 960-966.
  20. Efficacy of tadalafil for the treatment of erectile dysfunction at 24 and 36 hours after dosing: a randomized controlled trial / H. Porst [et al.] // Urology. – 2003. – Vol. 62. – P. 121-125.
  21. Long-term safety and tolerability of tadalafil in the treatment of erectile dysfunction / F. Montorsi [et al.] // Eur. Urol. – 2004. – Vol. 45. – P. 339-344.
  22. Tadalafil in the treatment of erectile dysfunction following bilateral nerve sparing radical retropubic prostatectomy: a randomized, double-blind, placebo controlled trial / F. Montorsi [et al.] // J. Urol. – 2004. – Vol. 172. – P. 1036-1041.
  23. Vardenafil: a review of its use in erectile dysfunction / G. M. Keating [et al.] // Drugs. – 2003. – Vol. 63. – P. 2673-2703.
  24. The efficacy and tolerability of vardenafil, a new, oral, selective phosphodiesterase type 5 inhibitor, in patients with erectile dysfunction: the first at-home clinical trial / H. Porst [et al.] // Int. J. Impot. Res. – 2001. – Vol. 13. – P. 192-199.
  25. Novel phosphodiesterase type 5 inhibitors: assessing hemodynamic effects and safety parameters / R. A. Kloner [et al.] // Clin. Cardiol. – 2004. – Vol. 27. – P. 120-125.
  26. Simultaneous administration of vardenafil and tamsulosin does not induce clinically significant hypotension in patients with benign prostatic hyperplasia / S. M. Auerbach [et al.] // Urology. – 2004. – Vol. 64. – P. 998-1003.
  27. Apomorphine: an update of clinical trial results / J. P. Heaton [et al.] // Int. J. Impot. Res. – 2000. – Vol. 12. – P. 67-73.
  28. Pharmacotherapy for erectile dysfunction / H. Padma-Nathan [et al.] // J. Sexual Medicine. – 2004. – Vol. 1. – P. 128-140.
  29. Therapeutic effects of high dose yohimbine hydrochloride on organic erectile dysfunction / C. Teloken [et al.] // J. Urol. – 1998. – Vol. 159. – P. 122-124.
  30. Oral trazodone is not effective therapy for erectile dysfunction: a double-blind, placebo controlled trial / R. A. Costabile [et al.] // J. Urol. – Vol. 161. – P. 1819-1822.
  31. Goldstain, I. Oral phentolamine: an alpha-1, alpha-2 adrenergic antagonist for the treatment of erectile dysfunction / I. Goldstain // Int. J. Impot. Res. – 2000. – Vol. 12. – P. 75-80.
  32. A double-blind crossover study evaluating the efficacy of Korean red ginseng in patients with erectile dysfunction: a preliminary report / B. Hong [et al.] // J. Urol. – 2002. – Vol. 168. – P. 2070-2073.
  33. Current status of local penile therapy / F. Montorsi [et al.] // Int. J. Impot. Res. – 2002. – Vol. 14. – P. 70-81.
  34. Vacuum constriction and external erection devices in erectile dysfunction / L. A. Levine [et al.] // Urol. Clin. North Am. – 2001. – Vol. 28. – P. 335-341.
  35. Intracavernosal injection and intraurethral therapy for erectile dysfunction / S. Leungwattanakij [et al.] // Urol. Clin. North Am. – 2001. – Vol. 28. – P. 343-354.
  36. Efficacy and safety of intracavernosal alprostadil in men with erectile dysfunction / O. I. Linet [et al.] // N. Engl. J. Med. – 1996. – Vol. 334. – P. 873-877.
  37. Improved vasoactive drug combination for a pharmacological erection program / A. H. Bennett [et al.] // J. Urol. – 1991. – Vol. 146. – P. 1564-1565.
  38. Treatment of intracorporeal injection non-response with sildenafil alone or in combination with triple agent intracorporeal injection therapy / C. G. McMahon [et al.] // J. Urol. – 1999. – Vol. 162. – P. 1992-1997.
  39. Treatment of men with erectile dysfunction with transurethral alprostadil. Medicated Urethral System for erection (MUSE) / H. Padma-Nathan [et al.] // N. Engl. J. Med. – 1997. – Vol. 336. – P. 1-7.
  40. Intracavernous alprostadil alfadex is more efficacious, better tolerated, and preffered over intraurethral alprostadil: a comparative, randomized, crossover, multicentre study / R. Shabsigh [et al.] // Urology. – 2000. – Vol. 55. – P. 109-113.
  41. Penile prosthesis implantation / D. K. Montague [et al.] // Urol. Clin. North Am. – 2001. – Vol. 28. – P. 355-361.
  42. Assessment of psychosexual adjustment after insertion of inflatable penile prosthesis / M. V. Tefilli [et al.] // Urology. – 1998. – Vol. 52. – P. 1106-1112.
  43. Safety and efficacy outcome of mentor alpha-1 inflatable penile prosthesis implantation for impotence treatment / I. Goldstein [et al.] // J. Urol. – 1997. – Vol. 157. – P. 833-839.
  44. Efficacy of antibiotic impregnation of inflatable penile prostheses in decreasing infection in original implants / C. C. Carson [et al.] // J. Urol. – 2004. – Vol. 171. – P. 1611-1614.
  45. Long-term experience with salvage of infected penile implants / J. J. Mulcahy [et al.] // J. Urol. – 2000. – Vol. 163. – P. 481-482.
Àäðåñ äëÿ êîððåñïîíäåíöèè:
2210023, Ðåñïóáëèêà Áåëàðóñü, ã. Âèòåáñê, ïð-ò Ôðóíçå 27, Âèòåáñêèé ãîñóäàðñòâåííûé ìåäèöèíñêèé óíèâåðñèòåò, êóðñ óðîëîãèè,
e-mail: jvapost@mail.ru,
Æåáåíòÿåâ À.À.
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