以光體積變化描記儀作為男性勃起功能及陰莖血液動力學及性功能客觀指標之探討

以作者查詢圖書館館藏

、以作者查詢臺灣博碩士

、以作者查詢全國書目

、勘誤回報

、線上人數：68

、訪客IP：3.144.102.239

姓名

彭元宏(Yuan-Hung Pong) 查詢紙本館藏

畢業系所

生醫科學與工程學系

論文名稱

以光體積變化描記儀作為男性勃起功能及陰莖血液動力學及性功能客觀指標之探討
(Probing penile hemodynamics by using photoplethysmography as objective indicators for male erection quality and sexual function)

相關論文

★ 不同麻醉深度之相位-振幅耦合量測及強度比較	★ 設計及製作可攜式非侵入性心搏輸出量監測系統
★ 開發可攜式十二導程心電圖和聲學雙功能系統於居家分析心臟電生理訊號	★ 應用非侵入性方法來探究透析過程中血流動力學變化及心血管疾病之預後
★ 開發具深度學習應用於自動追蹤耳膜功能之數位耳鏡於中耳炎輔助系統	★ 反覆編曲結構音樂對人體生理訊號之影響
★ 設計具低功耗無線傳輸及結合人工智慧判讀之長時間聽診監測系統	★ 實踐經驗模態分解於高度非穩態生理訊號之訊號特徵擷取
★ Exploring Beat-to-Beat Photoplethysmography Features at the Upper and Lower Extremities as Potential Biomarkers for Early Diagnosis of Peripheral Arterial Occlusive Disease: A Comparative study with Ultrasound Doppler and Ankle-Brachial Index	★ 應用稀疏時頻表現式解析生理系統間非線性耦合機轉
★ 基於功能性近紅外光腦光譜與腦電圖發展多模態腦活動無線監測系統	★ 脂質奈米顆粒在mRNA疫苗技術應用發展綜述
★ 自12導程心電圖擷取P波特徵辨識竇性心律下之心房顫動高風險病患	★ 探討以非侵入方式的影像心衝擊圖形態特徵來評估左心室射血分數 : 基於數學模型與臨床驗證的初步研究
★ 發展可用於肺部疾病患者呼吸音監測之高解析加速度陣列感測器

檔案

[Endnote RIS 格式]

[Bibtex 格式]

[相關文章]

[文章引用]

[完整記錄]

[館藏目錄]

至系統瀏覽論文 (2026-9-13以後開放)

摘要(中)

男性勃起功能障礙(erectile dysfunction)在全世界影響很多人，造成勃起功能障礙最主要的原因之一就是陰莖血液的灌流不足，在過去二十年間，近紅外光譜測定儀(near-infrared spectroscopy, NIRS)可被用於測量不同血紅素的濃度及動態變化，然而，光體積變化描記儀(photoplethysmography, PPG)可記錄不同血紅素的動態變化但至今仍未應用於監測陰莖勃起狀態及血流動力學，我們的研究主要研究評估光體積變化描記儀紀錄(PPG)的訊號與陰莖勃起時的硬度，男性性功能及血液動力學之間的相關性，本實驗針對六個月以上診斷為血管性性功能障礙需要做陰莖血流超音波的病患，並排除過去陰莖創傷史、接受賀爾蒙療法者、曾經裝置人工陰莖者、靜脈漏型勃起功能障礙及神經性勃起功能障礙，針對血管性性功能障礙這類患者同時接受陰莖血流超音波及光體積變化
描記儀(PPG)紀錄，過程中光體積變化描記儀(PPG)紀錄的訊號皆被整合成一個代表波形進行訊號分析及波型分析，波型分析包括勃起間末期震幅差(amplitude difference index, APD index)、波形反射時間指標(reflection time index, RTI)、擴張指標(augmentation index)及灌流指標(perfusion index)，我們發現勃起末期的振幅與勃起硬度(erection hardness score, EHS)及阻力係數(resistive index, RI)呈反向關係(p < 0.05)，勃起間末期震幅差(APD index)與勃起硬度(EHS),國際勃起功能量表指數(international index of erectile function-5 ,IIEF)及阻力係數(resistive index, RI)呈正向關係(p < 0.05)，波形反射時間指標(RTI)及擴張指標(AI)與國際勃起功能量表指數(IIEF)及阻力係數(RI)呈反向關係(p < 0.05)，就我們所知，這是第一個分析光體積變化描記儀(PPG)紀錄與陰莖勃起狀態及血流動力學關係之研究，以上發現可支持光體積變化描記儀(PPG)可以做為一個非侵入性、安全、可持續監測陰莖勃起狀態及血循動力學的好工具。

摘要(英)

Erectile dysfunction (ED) influences a large population worldwide. The failure of sustaining penile rigidity is mostly due to the lack of blood flow into the penis. In the past 20 years, near-infrared spectroscopy (NIRS) was used in measuring the concentrations and temporal dynamics of different hemoglobin types. However, the dynamics of the light absorption (photoplethysmography; PPG) have not been applied to survey penile hemodynamics and erection quality. Our study is to evaluate the correlations between PPG and penile hemodynamics and erection quality. We compared the use of photoplethysmography (PPG) to study vascular ED with standard penile Doppler ultrasonography. Men diagnosed with vascular ED for at least 6 months and nominated for penile ultrasonography were included. Otherwise, patients were excluded with previous penile trauma, history of hormone replacement therapy, post-penile prosthesis, venous leak-type ED, and neurological ED. The PPG signals were collected during the ultrasound examination. All beat-to-beat PPG waveforms were aligned with the peak and averaged to one representative template waveform for feature analysis, including amplitude differences (APD) index, reflection time index (RTI), augmentation index (AI), and perfusion index (PI). An inverse correlation was found between end-erection amplitude and both erection hardness score (EHS) and resistive index (RI) (p < 0.05). APD index and EHS as well as the international index of erectile function-5 (IIEF) and RI were positively correlated (p < 0.05). RTI and AI were inversely correlated to IIEF and RI (p < 0.05). PI was positively correlated to RI (p < 0.05). To the best of our knowledge, we are the first analyzed the dynamics of arterial PPG monitored via NIRS and derived several waveform characteristics and present several findings. These findings support that the PPG may be useful as a non-invasive, novel technique to evaluate erection quality and men’s health given advantages such as low-cost, transportability, continuous data acquisition, and safety.

關鍵字(中)

★ 光體積變化描記
★ 近紅外光譜測定
★ 勃起功能障礙
★ 陰莖血流超音波
★ 男性性功能

關鍵字(英)

★ photoplethysmography
★ near infrared
★ erectile dysfunction
★ penile doppler
★ male sexual function

論文目次

Chapter 1 Introduction ………………………………………………………………………...1
1.1 Background ………………………………………………………………………………1
1.2 Epidemiology of erectile dysfunction ……………………………………………………1
1.3 Pathophysiology of erectile dysfunction …………………………………………………2
1.3.1 Penile anatomy and physiology …………………………………………………….2
1.3.2 Pathophysiology and risk factors …………………………………………………...3
1.4 Current diagnostic tools of erectile dysfunction …………………………………………5
1.4.1 Basic workup ……………………………………………………………………….5
1.4.2 Special diagnostic tests ……………………………………………………………..6
1.4.2.1 Nocturnal penile tumescence (NPT) test ………………………………………6
1.4.2.2 Penile doppler ultrasound ………………………………………………………7
1.4.2.3 Arteriography …………………………………………………………………..8
1.5 Literature review …………………………………………………………………………9
1.6 Motivation and hypothesis ………………………………………………………………10
1.7 Objectives ……………………………………………………………………………….10
1.7.1 Basic patient demographics ……………………………………………………….10
1.7.2 The amplitude correlative series and sexual function ……………………………..11
1.7.3 The waveform characteristics and sexual function ………………………………..11

Chapter 2 Materials and Methods ……………………………………………………………12
2.1 Experimental subjects and paradigm …………………………………………………..12
2.2 Experimental setup ……………………………………………………………………..13
2.3 The PPG system and PPG waveforms …………………………………………………14
2.4 PPG signal preprocessing and features extraction ……………………………………..15
2.5 Statistical analysis ……………………………………………………………………...17

Chapter 3 Results …………………………………………………………………………….18
3.1 Patient demographics …………………………………………………………………..18
3.2 Amplitude correlative series and sexual function ……………………………………...22
3.3 The waveform characteristics and sexual function …………………………………….23

Chapter 4 Discussion ………………………………………………………………………...25
4.1 The current findings ……………………………………………………………………25
4.2 The current non-invasive devices for erectile information …………………………….26
4.3 Current studies of near infrared spectroscopy and male sexual health ………………...28
4.4 Differences between our findings and other NIRS series ……………………………...32
4.5 Possible clinical applications of photoplethysmography in sexual function evaluation .33
4.6 The limitations of our study and future works …………………………………………34

Chapter 5 Conclusions ……………………………………………………………………….36

Appendix A …………………………………………………………………………………..37
Appendix B …………………………………………………………………………………..38
Appendix C …………………………………………………………………………………..41
Appendix D …………………………………………………………………………………..42
References ……………………………………………………………………………………44

參考文獻

REFERENCES
1. McCabe MP, Sharlip ID, Atalla E, Balon R, Fisher AD, Laumann E, Lee SW, Lewis R, Segraves RT: Definitions of Sexual Dysfunctions in Women and Men: A Consensus Statement From the Fourth International Consultation on Sexual Medicine 2015. The journal of sexual medicine 2016, 13(2):135-143.
2. Krane RJ, Goldstein I, Saenz de Tejada I: Impotence. The New England journal of medicine 1989, 321(24):1648-1659.
3. Fugl-Meyer AR, Lodnert G, Bränholm IB, Fugl-Meyer KS: On life satisfaction in male erectile dysfunction. International journal of impotence research 1997, 9(3):141-148.
4. Shamloul R, Ghanem H: Erectile dysfunction. Lancet (London, England) 2013, 381(9861):153-165.
5. Ayta IA, McKinlay JB, Krane RJ: The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int 1999, 84(1):50-56.
6. Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB: Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. The Journal of urology 1994, 151(1):54-61.
7. Melman A, Gingell JC: The epidemiology and pathophysiology of erectile dysfunction. The Journal of urology 1999, 161(1):5-11.
8. Rosen RC, Fisher WA, Eardley I, Niederberger C, Nadel A, Sand M: The multinational Men′s Attitudes to Life Events and Sexuality (MALES) study: I. Prevalence of erectile dysfunction and related health concerns in the general population. Current medical research and opinion 2004, 20(5):607-617.
9. Lindau ST, Tang H, Gomero A, Vable A, Huang ES, Drum ML, Qato DM, Chin MH: Sexuality among middle-aged and older adults with diagnosed and undiagnosed diabetes: a national, population-based study. Diabetes care 2010, 33(10):2202-2210.
10. Kubin M, Wagner G, Fugl-Meyer AR: Epidemiology of erectile dysfunction. International journal of impotence research 2003, 15(1):63-71.
11. Udelson D, Nehra A, Hatzichristou DG, Azadzoi K, Moreland RB, Krane J, Saenz de Tejada IS, Goldstein I: Engineering analysis of penile hemodynamic and structural-dynamic relationships: Part I--Clinical implications of penile tissue mechanical properties. International journal of impotence research 1998, 10(1):15-24.
12. Gimpl G, Fahrenholz F: The oxytocin receptor system: structure, function, and regulation. Physiological reviews 2001, 81(2):629-683.
13. Kim N, Vardi Y, Padma-Nathan H, Daley J, Goldstein I, Saenz de Tejada I: Oxygen tension regulates the nitric oxide pathway. Physiological role in penile erection. The Journal of clinical investigation 1993, 91(2):437-442.
14. Gratzke C, Angulo J, Chitaley K, Dai YT, Kim NN, Paick JS, Simonsen U, Uckert S, Wespes E, Andersson KE et al: Anatomy, physiology, and pathophysiology of erectile dysfunction. The journal of sexual medicine 2010, 7(1 Pt 2):445-475.
15. Wespes E, Amar E, Hatzichristou D, Hatzimouratidis K, Montorsi F, Pryor J, Vardi Y: EAU Guidelines on erectile dysfunction: an update. European urology 2006, 49(5):806-815.
16. Jackson G: Erectile dysfunction and cardiovascular disease. International journal of clinical practice 1999, 53(5):363-368.
17. The process of care model for evaluation and treatment of erectile dysfunction. The Process of Care Consensus Panel. International journal of impotence research 1999, 11(2):59-70; discussion 70-54.
18. Althof SE, Rosen RC, Perelman MA, Rubio-Aurioles E: Standard operating procedures for taking a sexual history. The journal of sexual medicine 2013, 10(1):26-35.
19. King R, Marumo K, Paick JS, Zhang K, Shah R, Pangkahila W, Yip AWC, Jiann BP, Ong ML: Satisfaction with sex and erection hardness: results of the Asia-Pacific Sexual Health and Overall Wellness survey. International journal of impotence research 2011, 23(4):135-141.
20. Dean J, de Boer B-J, Graziottin A, Hatzichristou D, Heaton J, Tailor A: The Role of Erection Hardness in Determining Erectile Dysfunction (ED) Treatment Outcome. European Urology Supplements 2006, 5(13):767-772.
21. Howes RJ: A survey of plethysmographic assessment in North America. Sexual Abuse: A Journal of Research and Treatment 1995, 7(1):9-24.
22. Kuban M, Barbaree HE, Blanchard R: A comparison of volume and circumference phallometry: response magnitude and method agreement. Archives of sexual behavior 1999, 28(4):345-359.
23. Allen RP, Smolev JK, Engel RM, Brendler CB: Comparison of RigiScan and formal nocturnal penile tumescence testing in the evaluation of erectile rigidity. The Journal of urology 1993, 149(5 Pt 2):1265-1268.
24. Hatzichristou DG, Hatzimouratidis K, Ioannides E, Yannakoyorgos K, Dimitriadis G, Kalinderis A: Nocturnal penile tumescence and rigidity monitoring in young potent volunteers: reproducibility, evaluation criteria and the effect of sexual intercourse. The Journal of urology 1998, 159(6):1921-1926.
25. Sikka SC, Hellstrom WJ, Brock G, Morales AM: Standardization of vascular assessment of erectile dysfunction: standard operating procedures for duplex ultrasound. The journal of sexual medicine 2013, 10(1):120-129.
26. Pathak RA, Rawal B, Li Z, Broderick GA: Novel Evidence-Based Classification of Cavernous Venous Occlusive Disease. The Journal of urology 2016, 196(4):1223-1227.
27. Rajfer J, Canan V, Dorey FJ, Mehringer CM: Correlation between penile angiography and duplex scanning of cavernous arteries in impotent men. The Journal of urology 1990, 143(6):1128-1130.
28. Bähren W, Gall H, Scherb W, Stief C, Thon W: Arterial anatomy and arteriographic diagnosis of arteriogenic impotence. Cardiovascular and interventional radiology 1988, 11(4):195-210.
29. Babaev A, Jhaveri RR: Angiography and endovascular revascularization of pudendal artery atherosclerotic disease in patients with medically refractory erectile dysfunction. The Journal of invasive cardiology 2012, 24(5):236-240.
30. Diehm N, Marggi S, Ueki Y, Schumacher D, Keo HH, Regli C, Do DD, Moeltgen T, Grimsehl P, Wyler S et al: Endovascular Therapy for Erectile Dysfunction-Who Benefits Most? Insights From a Single-Center Experience. Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists 2019, 26(2):181-190.
31. Doppalapudi SK, Wajswol E, Shukla PA, Kolber MK, Singh MK, Kumar A, Fischman A, Rastinehad AR: Endovascular Therapy for Vasculogenic Erectile Dysfunction: A Systematic Review and Meta-Analysis of Arterial and Venous Therapies. Journal of vascular and interventional radiology : JVIR 2019, 30(8):1251-1258.e1252.
32. von Allmen RS, Nguyen DP, Birkhäuser FD, Bednar R, Kammer R, Do DD, Diehm N: Lesion Pattern in Patients With Erectile Dysfunction of Suspected Arterial Origin: An Angiographic Study. Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists 2016, 23(1):76-82.
33. Spiliopoulos S, Shaida N, Katsanos K, Krokidis M: The role of interventional radiology in the diagnosis and management of male impotence. Cardiovascular and interventional radiology 2013, 36(5):1204-1212.
34. Beć KB, Huck CW: Breakthrough Potential in Near-Infrared Spectroscopy: Spectra Simulation. A Review of Recent Developments. 2019, 7(48).
35. Capraro GA, Mader TJ, Coughlin BF, Lovewell C, St Louis MR, Tirabassi M, Wadie G, Smithline HA: Feasibility of using near-infrared spectroscopy to diagnose testicular torsion: an experimental study in sheep. Annals of emergency medicine 2007, 49(4):520-525.
36. Burnett AL, Allen RP, Davis, Wright DC, Trueheart IN, Chance B: Near infrared spectrophotometry for the diagnosis of vasculogenic erectile dysfunction. International journal of impotence research 2000, 12(5):247-254.
37. Stothers L, Guevara R, Macnab A: Classification of male lower urinary tract symptoms using mathematical modelling and a regression tree algorithm of noninvasive near-infrared spectroscopy parameters. European urology 2010, 57(2):327-332.
38. Macnab AJ, Stothers LS, Shadgan B: Monitoring Detrusor Oxygenation and Hemodynamics Noninvasively during Dysfunctional Voiding. Advances in urology 2012, 2012:676303.
39. Farag FF, Martens FM, D′Hauwers KW, Feitz WF, Heesakkers JP: Near-infrared spectroscopy: a novel, noninvasive, diagnostic method for detrusor overactivity in patients with overactive bladder symptoms--a preliminary and experimental study. European urology 2011, 59(5):757-762.
40. Kim E, Lee S, Phillips Zt, Kim JG: A discrepancy of penile hemodynamics during visual sexual stimulation observed by near-infrared spectroscopy. BMC urology 2015, 15:11.
41. Paul Kudlow BR: Near-infrared spectroscopy to assess penile blood flow: a possible novel technique for the diagnosis of vasculogenic erectile dysfunction. The University of Western Ontario Medical Journal 2011, 80(1):7-8.
42. Akl TJ, Wilson MA, Ericson MN, Coté GL: Quantifying tissue mechanical properties using photoplethysmography. Biomedical optics express 2014, 5(7):2362-2375.
43. Reisner A, Shaltis PA, McCombie D, Asada HH: Utility of the photoplethysmogram in circulatory monitoring. Anesthesiology 2008, 108(5):950-958.
44. Shelley KH: Photoplethysmography: beyond the calculation of arterial oxygen saturation and heart rate. Anesth Analg 2007, 105(6 Suppl):S31-36, tables of contents.
45. Stein MJ, Lin H, Wang R: New advances in erectile technology. Therapeutic advances in urology 2014, 6(1):15-24.
46. Lavoisier P, Barbe R, Gally M: Validation of a continuous penile blood-flow measurement by pulse-volume-plethysmography. International journal of impotence research 2002, 14(2):116-120.
47. Lavoisier P, Courtois F, Proulx J, Durand LG, de Carufel F: Validation of a non-invasive device to measure intracavernous pressure as an index of penile rigidity. British journal of urology 1990, 65(6):624-628.
48. Davies JI, Struthers AD: Pulse wave analysis and pulse wave velocity: a critical review of their strengths and weaknesses. Journal of hypertension 2003, 21(3):463-472.
49. Kock KS, da Silva JBF, Marques JLB: Comparison of the ankle-brachial index with parameters of stiffness and peripheral arterial resistance assessed by photoplethysmography in elderly patients. Jornal vascular brasileiro 2019, 18:e20180084.
50. Brillante DG, O′Sullivan AJ, Howes LG: Arterial stiffness indices in healthy volunteers using non-invasive digital photoplethysmography. Blood pressure 2008, 17(2):116-123.
51. Barodka VM, Joshi BL, Berkowitz DE, Hogue CW, Jr., Nyhan D: Review article: implications of vascular aging. Anesth Analg 2011, 112(5):1048-1060.
52. Sharman JE, Marwick TH: Arterial stiffness: measurement and significance in management of hypertension. Indian Heart J 2010, 62(5):378-383.
53. Rastrelli G, Maggi M: Erectile dysfunction in fit and healthy young men: psychological or pathological? Translational andrology and urology 2017, 6(1):79-90.
54. Waxman SE, Pukall CF: Laser Doppler imaging of genital blood flow: a direct measure of female sexual arousal. The journal of sexual medicine 2009, 6(8):2278-2285.
55. Wolf M, Ferrari M, Quaresima V: Progress of near-infrared spectroscopy and topography for brain and muscle clinical applications. Journal of biomedical optics 2007, 12(6):062104.
56. Colier WN, Froeling FM, de Vries JD, Oeseburg B: Measurement of the blood supply to the abdominal testis by means of near infrared spectroscopy. European urology 1995, 27(2):160-166.
57. Macnab A, Stothers L, Shadgan B: Dynamic topographic mapping of the human bladder during voiding using functional near-infrared spectroscopy. Journal of biomedical optics 2009, 14(2):020507.
58. Mastoroudes H, Giarenis I, Vella M, Srikrishna S, Robinson D, Cardozo L, Karrouze I, Campbell A, Macnab A: Use of near infrared spectroscopy as an alternative to videourodynamics to detect detrusor overactivity in women with the overactive bladder syndrome. Urology 2012, 80(3):547-550.
59. Macnab AJ, Stothers L: Near-infrared spectroscopy: validation of bladder-outlet obstruction assessment using non-invasive parameters. The Canadian journal of urology 2008, 15(5):4241-4248.
60. Macnab AJ, Shadgan B, Stothers L, Afshar K: Ambulant monitoring of bladder oxygenation and hemodynamics using wireless near-infrared spectroscopy. Canadian Urological Association journal = Journal de l′Association des urologues du Canada 2013, 7(1-2):E98-e104.
61. Macnab AJ, Stothers L: Development of a near-infrared spectroscopy instrument for applications in urology. The Canadian journal of urology 2008, 15(5):4233-4240.
62. Padmanabhan P, McCullough AR: Penile oxygen saturation in the flaccid and erect penis in men with and without erectile dysfunction. Journal of andrology 2007, 28(2):223-228.
63. Elgendi M: On the analysis of fingertip photoplethysmogram signals. Current cardiology reviews 2012, 8(1):14-25.
64. Millasseau SC, Kelly RP, Ritter JM, Chowienczyk PJ: Determination of age-related increases in large artery stiffness by digital pulse contour analysis. Clinical science (London, England : 1979) 2002, 103(4):371-377.
65. Costa RM, Mangia P, Pestana J, Costa D: Heart Rate Variability and Erectile Function in Younger Men: A Pilot Study. Applied psychophysiology and biofeedback 2021.
66. Lee JY, Joo KJ, Kim JT, Cho ST, Cho DS, Won YY, Choi JB: Heart Rate Variability in Men with Erectile dysfunction. International neurourology journal 2011, 15(2):87-91.
67. Harte CB: The relationship between resting heart rate variability and erectile tumescence among men with normal erectile function. The journal of sexual medicine 2013, 10(8):1961-1968.
68. Chen JJ, Lin C, Hsiao WP, Chu TM, Yang HW, Lo MT, Lin LY, Lin SF: Complex dynamics of skin sympathetic nerve activities as a prognostic predictor for critically ill patients. Journal of the Formosan Medical Association = Taiwan yi zhi 2021, 120(1 Pt 3):660-667.
69. Chen JJ, Lin C, Lo MT, Lin LY: Complex dynamics of skin sympathetic nerve activities provides mechanistic insights into critical-illness and are prognostic predictors. Journal of the Formosan Medical Association = Taiwan yi zhi 2021, 120(3):1041-1042.

指導教授

林澂(Chen Lin)

審核日期

2021-9-22

推文