A real-world study of nocturnal sleep-related erections(SREs)in ED patients at different altitudes in high altitudearea
Objective To summarize the clinical characteristics of nocturnal sleep-related erections(SREs)in patients with ED(Erectile dysfunction,ED)at different altitudes in high altitude areafor assessing the real world of reduced SREs in ED patients under chronic hypoxic environment.Methods A total of 235 patients with International Index of Erectile Function score(IIEF-5)≤21 and subjective descriptions were accurately diagnosed as ED.The patients at different altitudes were divided into four groups according to the altitude of the place of permanent residence(Xining area).Perform femoral artery oxygen partial pressure measurement on the research subjects.During the ICI examination,the penis was in an erect state and blood samples from the corpus cavernosum of the penis were extracted for femoral arteryblood oxygen partial pressure measurement.Simultaneously,sleep synchronization monitoring using RigiScan in NPTR mode for two consecutive nights were performed.Results ①The mean age of the subjects was(28.5±8.6)years old,and there was no statistical difference in the comparison of the mean age values among the four groups(P＞0.05);(2)IIEF-5 score:77 cases of mild ED(32.7％),121 cases of moderate ED(51.6％)and 37 cases of severe ED(15.7％).There were significant differences in the four groups(P＜0.05).③ The partial pressure of oxygen in the central artery(femoral artery)(Xining area)was(73.9±3.7)mmHg,and was in hypoxia state(≤ 80 mmHg);④The partial pressure of oxygen in penile cavernous blood in erect state over 65 mmHg accounted for 65.5％(154 cases)and below 65 mmHg accounted for 34.5％(81 cases).There was a statistically significant difference between the patients at 2 300～3 500 m and the patinets at 3 500～4 500 m(P＜0.05);⑤There was no statistically significant difference(P＞0.05)in the total number of erections between the first and second groups of SREs at different altitudes throughout the night(more than 8 hours).The maintenance time of the best head hardness ≥ 60％of erectile events for two consecutive nights was less than 600 s,and there was no significant difference between the first group and the second group(P＞0.05).NPTR(two consecutive nights)monitoring data included number of total erectile events during the whole night(sleep 8 h or more),total erection time during the whole night(sleep 8 h or more),total erection time as a percentage of the whole night time(sleep 8 h or more),percentage increase in circumference before and after the best erection at the Penile tip,best erection hardness at the Penile tip.There were statistically significant differences(P＜0.05)between 2 300 m to 3 500 m and 3 500 m to 4 500 m in the observed indexes of Penile tip optimal erection hardness ≥ 60％maintenance time.Conclusion The study suggests that chronic altitude hypoxia is one of the independent risk factors for ED in men who live at high altitude for a long time,and the age of onset is younger.Under the same conditions of changes in sleep quality and sleep structure,the number of SRE decreases and the degree of ED also became more severe with increase of altitude.It is a possible important cause for long-term varying degrees of hypoxia affecting oxygen utilization and delivery in the corpus cavernosum.
different altitudeschronic hypoxiaNPTR monitoringerectile dysfunctionsleep-related erections
郭巍、陈琦炜、严积雄、潘建成、辛钟成、袁亦铭、封玉宏、Zhang Qiang
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西宁市第一人民医院男科(青海西宁 810000)
天津医科大学第二医院天津市泌尿外科研究所(天津 300000)
北京大学第一医院男科中心(北京 100032)
Department of Gynecology,Xining First People's Hospital,Xining 810000,Qinghai,China
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