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首页> 外文期刊>Advances in Sexual Medicine >Neurovascular Evaluation in Eugonadal Men with Type 2 Diabetes Mellitus and Erectile Disfunction: A Comparative Study between Responders and Not Responders to Phosphodiesterase 5 Inhibitors
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Neurovascular Evaluation in Eugonadal Men with Type 2 Diabetes Mellitus and Erectile Disfunction: A Comparative Study between Responders and Not Responders to Phosphodiesterase 5 Inhibitors

机译：对患有2型糖尿病和勃起功能障碍的正常男性的神经血管评估：对磷酸二酯酶5抑制剂有反应者和无反应者的比较研究

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The aim of our study was to evaluate functional alterations of the corpus cavernusum and its correlation with the lack of response to treatment with PDE5i in eugonadal patients with Type 2 Diabetes Mellitus and Erectile Dysfunction. In this prospective randomized study we included 157 patients. All were treated with 5 mg tadalafil daily and 100 mg sildenafil on demand and the response to treatment was assessed in 6 month by dividing them into 2 groups: G1: Good response. Significative improvement of erectile function according to IIEF-5, and G2: There was not an improvement with the treatment. At the end of the treatment we performed neurological and vascular studies to both groups. Also we performed CC-EMG in order to evaluate penile autonomic neuropathy. 82 patients were included in G1 and 75 in G2. The time evolution of the ED was 1.5 years for G1 and 5 years for G2. Average fasting glucose and glycosilated hemoglobin values were significantly higher in G2 than in G1. Also we observed significant differences in penile vascular parameters between both groups. Peripheral neuropathy parameters did not show differences between both groups. Cavernous smooth muscle electromyography showed asynchronous and asymetric potentials in G1 (minimal autonomic neuropathy) and denervation potentials in G2 characteristic of severe CC damage. It is concluded that vascular and autonomic alterations are causes of severe CC damage and lack of response to treatment with PDE5i in this population. Peripheral neuropathy is not part of this process.
机译：我们的研究目的是评估2型糖尿病和勃起功能障碍的原发性腺癌患者海绵体功能改变及其与对PDE5i治疗缺乏反应的相关性。在这项前瞻性随机研究中，我们纳入了157例患者。所有患者均接受每日5 mg他达拉非和按需100 mg西地那非的治疗，并将治疗分为6组，在6个月内评估其疗效：G1：良好疗效。根据IIEF-5和G2显着改善勃起功能：治疗没有改善。在治疗结束时，我们对两组进行了神经和血管研究。我们还进行了CC-EMG，以评估阴茎自主神经病变。 G1组82例，G2组75例。 ED的时间演变为G1为1.5年，G2为5年。 G2组的平均空腹血糖和糖基化血红蛋白值显着高于G1组。我们还观察到两组之间阴茎血管参数的显着差异。两组之间的周围神经病变参数没有显示差异。海绵状平滑肌肌电图显示出严重的CC损伤特征性的G1（最小自主神经病变）的异步和不对称电位，以及G2的神经支配电位。结论是，该人群的血管和自主神经改变是严重CC损伤和对PDE5i治疗缺乏反应的原因。周围神经病变不是该过程的一部分。

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