事件记录
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面试官: 佩罗尼氏病 is a very treatable condition, but you have to seek help in order to get that treatment. 多达13%的男性可能患有此病. And those numbers might even be higher because a lot of men just don't even talk about it. 泌尿科医生, Dr. 亚历克斯Pastuszak 是佩罗尼氏病的专家吗, 也叫PD, and has received an NIH grant to investigate the genetics and molecular mechanisms of the condition.
大发娱乐来谈谈这种疾病，因为我在网上快速搜索了一下. 五分钟后，我进入了黑洞. 外面有很多东西. 让大发娱乐澄清这些误解. 让大发娱乐得到好的信息. So a couple of issues first, acknowledging that a man has it and then getting help for it. 这是两件大事.
Dr. Pastuszak: 是的. I think one of the big things with 佩罗尼氏病 that brings guys out of the eaves really is knowing that it's highly treatable and knowing that a lot of other men actually have it, and that they really shouldn't be ashamed to see somebody about it because there are a lot of us that can actually treat it.
面试官: 是的. 你会想，羞耻感就是男人不寻求大发娱乐的原因? 因为你跟我说过很多男人不寻求大发娱乐, 尽管这是一种非常痛苦的状况，也没有多少乐趣.
什么是佩罗尼氏病
Dr. Pastuszak: 所以我要呆一会儿, but up to 50 percent of guys with 佩罗尼氏病 can actually have clinical depression because of it. 所以这不仅仅是羞耻, but there's a lot of psychological issues that can come with having just what somebody can consider penile curvature.
面试官: 好吧. 所以，首先，承认你拥有它，意识到你拥有它. 你觉得大多数男人都知道吗, 所以大发娱乐不需要过多地讨论症状是什么? 这值得深入研究吗?
佩罗尼氏病症状
Dr. Pastuszak: 是的. 这是一个很好的问题. 所以大多数开始有弧度的男人都知道自己有弧度. 一旦他们勃起了，他们就有了弧度，他们就会说，哇. 这和X之前的情况不一样.“有些人会来看你，然后说, “你知道, 医生, 我的阴茎有点痛, 不管是勃起的时候还是没有勃起的时候.“然后你告诉他们，他们需要注意它, 但从定义上讲，他们可能还没有拥有它.
面试官: 好吧. 所以听起来有两种东西需要寻找. 曲率，曲率有多严重?
Dr. Pastuszak: 这对男人来说可能不正常. 这就是你所需要的.
面试官: 好吧，还有疼痛. 疼痛总是伴随这种情况吗?
Dr. Pastuszak: No. 它并不总是伴随着它. And the other thing to look for is sometimes guys find like "a knot" in their penis, a lump. 所以块状、凹凸或曲线有时是大发娱乐所说的. 他们觉得这很麻烦. 他们想，“哦，哇，你知道，嘿，我已经 . . . Oh, shoot, 你知道, maybe I have penile cancer," and they come running. 所以这三件事真的是把男人带到诊所的原因.
面试官: 通常是50、55岁左右的男性?
Dr. Pastuszak: 平均年龄是55岁. 这是全国. 但 there are plenty of younger men who have that and plenty of older men as well. 我看到20多岁的年轻人就有这种病.
导致佩罗尼氏病的原因?
面试官: 好吧. 这是由疤痕组织堆积引起的?
Dr. Pastuszak: 这是正确的. By and large, technically, it's an abnormal scar tissue formation in the penis.
面试官: 这就是你开始感觉到的肿块或肿块?
Dr. Pastuszak: 完全正确. And then that can sometimes increase in size and that curvature can stay the same, 要么变好，要么变坏.
面试官: 好吧. 这是大多数男人都会做的吗 . . . 大发娱乐确实提到过这个, 但这进展得很快吗, 一般, 弯曲的, 还是它太慢了，有一天你会走, “看那个, 这是不对的。”?
Dr. Pastuszak: So everybody's a little different when it comes to how quickly they progress. 有些人进来跟我说过, 你知道, 在两周内感觉疼痛或阴茎上有肿块, 或者诸如此类的, 它们的曲率很差. And there are other guys who come in and say that it's been months or years, 而且情况还在继续恶化，或者很长一段时间都没有变化.
面试官: So, 当你开始注意到这些最初的症状, 马上进去很重要吗, 或者你可以在上面坐一会儿?
Dr. Pastuszak: So I think it really depends on how important it is to you as the patient, because a big part of what defines what we as doctors end up doing in terms of treatment and treatment recommendations is how much it actually bothers you.
面试官: 好吧. 所以如果他感觉不到任何疼痛也不会困扰他, then it's not something you necessarily recommend a patient come in for, 或者它最终会引起问题吗?
Dr. Pastuszak: 这可能是今天最重要的问题了, 某种程度上是因为大发娱乐不知道, 明确, 是否会引起其他问题. 我的一些研究表明，它可能会导致其他问题, but we haven't linked it causally to the problem yet so we don't know for sure.
面试官: If you seek treatment more quickly, is it more likely you're going to have a successful treatment?
什么时候应该接受治疗?
Dr. Pastuszak: 最终, you need to seek treatment or the best time to seek treatment is when your curvature is no longer getting worse because that's what's considered the stable phase of the condition. 这可能需要6到18个月的时间, 至少从大发娱乐目前的研究来看是这样的. 所以，如果你在病情稳定的时候接受治疗，那很好. There's a little bit more of a risk that you take if you're treated when you're in what we call the active or developing phase.
面试官: 哦,好吧. 好吧，大发娱乐来谈谈 治疗. 你告诉过我，有四种不同的类型. 大发娱乐继续往下看.
佩罗尼氏病的治疗
Dr. Pastuszak: 好吧. 我要从牵引疗法开始. 因此，退一步说，这四个类别是：
- 牵引疗法,
- 口服治疗,
- 注射疗法，以及
- 手术.
回家治疗
好吧? 有了牵引疗法，男性可以在家里做. 我会提前告诉他们, “如果你现在不想让医生参与你的治疗, 那我就告诉你去哪里买这个装置. 你可以上网下载，然后开始你的牵引治疗.“就疗效而言，大发娱乐不知道它到底有多有效. There are some early studies now that show that it can help improve curvature, 但目前尚无定论.
面试官: 是的. 我现在正看着其中一个设备. 它们看起来一点都不好玩. 看起来有点像刑具.
Dr. Pastuszak: So you're 可能 looking at RestoreX or what's called the Andro-Penis. 这些东西都有很好的名字.
面试官: 当然，他们有，对吧?
Dr. Pastuszak: The one I actually 可能 recommend the most to my patients is called the Penimaster PRO. 没错，你可以停下来傻笑. 没关系.
面试官: 我是说，拜托. This is an embarrassing enough situation and some company named it that?
Dr. Pastuszak: 嗯,是的. 但最重要的是，这个东西是有效的.
面试官: 好吧. 好吧，你得熬过去 . . . 好吧.
口服疗法
Dr. Pastuszak: 但它们可能是有效的. 好吧. 接下来是口腔疗法. 所以我其实不怎么用口腔疗法, and we don't use them very much in our practice here in Utah because our professional society, 美国泌尿学协会, in 2015, 得出的结论是，它们并不真正起作用. Well, let me back that up, that there's no evidence that they work right now. That doesn't mean that some of these don't work, it's just that we can't prove it.
面试官: 让你.
Dr. Pastuszak: 好吧? 所以我要提醒那些考虑口服治疗的男性, because some of these can be nutraceutical stuff you get over the counter, to think twice before they use it just based on the evidence that we have.
面试官: 你担心有什么副作用吗? 因为我会考虑, 你知道, 没有证据表明它们有效, 但也许在某些情况下他们会, 那我就得看看, “嗯, 如果我吃这个有什么缺点?" Are there some drawbacks to these oral therapies if a man did decide to try them?
Dr. Pastuszak: So, 最终, 任何你想要的, 具有药物潜力, 会有副作用, 这是另一个需要考虑的问题. 说得好.
注射
面试官: 好吧. 第三种是注射.
Dr. Pastuszak: 是的. So injection therapies are drugs that we inject directly into this scar tissue that can either help dissolve it or prevent more of it from forming. 有三种, 特别是, 有很好的临床证据证明它们有效, and we offer those here at the University of Utah and at other major centers.
手术
面试官: 好了，第四个是手术.
Dr. Pastuszak: 手术，有很多手术选择. 这个话题最好和你的 泌尿科医生, particularly a 泌尿科医生 who has done this a lot because the surgeries can get somewhat complicated.
And the right option should be really an intimate discussion between you and your 泌尿科医生. 但是这些都是, 非常有效的, 你几乎可以直接从手术室出来.
面试官: If you're counseling a patient on these options, what's your hierarchy of where do you start? 你会在哪里结束? 你是直接从手术开始，还是先打针?
Dr. Pastuszak: No. 所以我认为共同决策是可行的. You need to talk to your patient and figure out how much they want treatment, 有多快, 你知道, 最终决定他们愿意花多少时间在治疗上, and how aggressive they want to get will help determine what they end up doing.
面试官: 好吧, 听起来像是, 如果你是认真的, 你真的应该去看泌尿科医生, 看看注射或手术, 可能, 你有两个最好的选择吗. 这就是我从这次谈话中得出的结论.
Dr. Pastuszak: 是的. And I think the traction therapies are really good options for guys who don't want to seek help from a physician right now. 但, 你知道, 我会鼓励大家来参加, at least have a discussion because that way you can know what the evidence is, 不管怎样, 在公平竞争的基础上做出决定.
面试官: 最后一个问题是, 很多时候，当你在互联网上搜索的时候, 你会看到有些人有问题，他们说, “我看过各种各样的医生，但都不起作用.“如果一个男人去看了泌尿科医生，结果没有好转怎么办? 这时候你会怎么做?
Dr. Pastuszak: 所以我认为如果一个男人去看泌尿科医生, 这已经是朝着正确方向迈出的一步, 但并非所有泌尿科医生都是平等的. 泌尿外科中肯定有亚专科. 所以，如果一个男人没有见过一个男人 性功能障碍专家, so somebody who is specifically trained in managing these types of conditions, 全国各地都有这样的人, 那他们应该去找这样的人.
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