Amazwana: Ucwaningo olusha lwesi-Italy lithola ukuthi i-25% yeziguli ezintsha kakhulu Ukungasebenzi kahle kwe-erectile kungaphansi kwe-40.
IMIBUZO: Lokhu kuhlaziywa kokuhlola kubonise ukuthi oyedwa kwabaguli abane abafuna usizo lokuqala lwezokwelapha ku-ED olusha olusha kuneminyaka engaphansi kwe-40. Cishe isigamu sezinsizwa zahlushwa yi-ED enamandla, nezinga elilingana neziguli ezindala. Ngokuvamile, amadoda amancane ahluke kubantu asebekhulile ngokwemigomo yemitholampilo neyomphakathi.
I-J Med Med. 2013 Jul;10(7):1833-41. i-doi: 10.1111 / jsm.12179.
I-Capogrosso P, Colicchia M, Ventimiglia E, I-Castagna G, Clementi MC, Suardi N, Castiglione F, UBriangan A, I-Cantiello F, Damiano R, I-Montorsi F, Salonia A.
Umthombo
UMnyango We-Urology, i-University Vita-Salute yaseSan Raffaele, eMilan, e-Italy.
abstract
ISINGENISO:
Ukukhubazeka kwe-Erectile (ED) isikhalazo esivamile kubantu besilisa abaneminyaka engu-40, kanti izinga lokukhula likhuphuka phakathi nesikhathi sokuguga. Izinto ezivame kakhulu nezingozi ze-ED phakathi kwabesilisa abasebasha ziye zahlaziywa kanzima.
AIM:
Ukuhlola isimo sezenhlalakahle kanye nezimo zomtholampilo zezinsizwa (ezichazwe ngokuthi ≤ iminyaka engu-40) zifuna usizo lokuqala lwezokwelapha ukuze ziqalwe kabusha i-ED njenge-primary disorder yabo yesifo socansi.
IZINDLELA:
Ukuqedela ulwazi lwe-sociodemographic kanye nemitholampilo kusuka kwiziguli ze-439 ezilandelanayo zahlaziywa. Ukuncintisana okubalulekile kwezeMpilo kwakunikwe i-Charlson Comorbidity Index (CCI). Iziguli zaqeda i-International Index of Erectile Function (IIEF).
IMINININGWANE YOKUPHUMA:
Izibalo ezichazayo zahlola ukwehluka kwezenhlalo nezemitholampilo phakathi kweziguli ze-ED ED iminyaka engama-40 kanye> neminyaka engama-40.
IZIPHUMA:
Ukuqala okusha kwe-ED njengenkinga eyinhloko kutholakale ku-114 (26%) amadoda ≤ iminyaka engu-40 (kusho ukuguquka okujwayelekile [SD]]: 32.4 [6.0]; ububanzi: iminyaka ye-17-40). Iziguli years iminyaka engama-40 ibinezinga eliphansi lezimo ze-comorbid (CCI = 0 ku-90.4% kuqhathaniswa ne-58.3%; χ (2), 39.12; P <0.001), inani eliphansi lesisindo somzimba (P = 0.005), kanye isilinganiso esiphakeme sokusakazwa kwezinga le-testosterone eliphelele (P = 0.005) ngokuqhathaniswa nalezo> zeminyaka engama-40. Iziguli ezincane ze-ED zivame ukukhombisa umkhuba wokubhema ugwayi kanye nokusetshenziswa kwezidakamizwa ezingekho emthethweni, uma kuqhathaniswa namadoda amadala (wonke ama-P ≤ 0.02). I-ejaculation yangaphambi kwesikhathi yayinamahloni kakhulu emadodeni amancane, kanti isifo sikaPeyronie sasidlange eqenjini elidala (yonke i-P = 0.03). I-IIEF, amazinga we-ED anzima atholakele kuma-48.8% amadoda amancane kanye namadoda angama-40% amadala, ngokulandelana (P> 0.05). Ngokufanayo, amazinga we-ED emnene, amnene kuya kokuphakathi, futhi alinganiseli awehlukile kakhulu phakathi kwala maqembu womabili.
IMIBUZO:
Lokhu kuhlaziywa kokuhlola kubonise ukuthi oyedwa kwabaguli abane abafuna usizo lokuqala lwezokwelapha ku-ED olusha olusha kuneminyaka engaphansi kwe-40. AIsiqephu sezinsizwa ezihlushwa yi-ED enamandla, nezinga elilingana neziguli ezindala. Ngokuvamile, amadoda amancane ahluke kubantu asebekhulile ngokwemigomo yemitholampilo neyomphakathi.
© 2013 International Society for Medical Medicine.
KEYWORDS:
Ubudala, Ukukhubazeka Kwemitholampilo, Ukukhubazeka, Ukuguga, Ukungasebenzi Kwe-Erectile, Isimo Sezempilo, I-Index Yomhlaba Wonke We-Erectile Umsebenzi, Izingozi Zezingozi, Intsha
I-PMID: 23651423
Isingeniso
Ukukhubazeka kwe-Erectile (ED) isikhalazo esivamile kubantu besilisa abaneminyaka engu-40, kanti izinga lokukhula likhula ngesikhathi sonke sokuguga [1].
Iningi lemibhalo yesandla ephathelene ne-ED ivame ukuvuleka ngesitatimende esinjalo, kungakhathaliseki ukucabangela noma yimuphi umphakathi noma ubuhlanga,
kwanoma imuphi umphakathi wesayensi isifundo / umcwaningi ungokwalabo, nanoma yimuphi umagazini wezesayensi lapho imibhalo yesandla ngokwayo ishicilelwe khona. Ngamanye amagama, amadoda amadala athola, lapho beqala ukubhekana ne-ED [2].
Ngokufana, i-ED iye yathola kancane kancane indima ebalulekile njengesibuko sempilo yamadoda iyonke, kucatshangelwa ukubaluleka okukhulu kwenhliziyo nemithambo yegazi
field [3-6]. Ngakho-ke, kuqinisekile ukuthi i-ED ifinyelele ekubalulekeni okukhulu hhayi emkhakheni wezokwelapha kuphela, kepha nasemkhakheni wezempilo yomphakathi, ngenxa yomthelela wayo ezinhlakeni zenhlalo yempilo yomuntu. Intshisekelo ekhulayo yalesi sihloko iholele ekwakhiweni kweziningi
ucwaninga mayelana nokusabalalisa nezingozi zobungozi be-ED phakathi kwezigaba ezahlukene zeziguli [7, 8]; kulesi simo, iningi lwedatha eshicilelwe ibhekisela kubantu besilisa abaneminyaka ephakathi nendawo ubudala, futhi ikakhulukazi kubantu abangaphezu kweminyaka engu-40 [7-9]. Ngempela, amadoda asebekhulile, futhi ngokuqinisekile asebekhulile, bavame ukubhekana nezimo ze-comorbid-ezifana nesifo sikashukela, ukukhuluphala, izifo zenhliziyo (CVD), kanye nezimpawu ezingaphansi kwe-urinary (LUTS) -zonke zazo ziyizici ezinobungozi ze-ED [7-12].
Ngakolunye uhlangothi, izifo zokusabalalisa nezingozi ze-ED phakathi kwabesilisa abasha zihlaziye ngokujulile. Idatha kule ngqikithi yamadoda ibonise amazinga okukhula we-ED aphakathi kuka-2% futhi acishe abe ngu-40% kubantu abancane kuneminyaka engu-40 ubudala [13-16]. Ngokubanzi, idatha eshicilelwe igcizelele ukubaluleka kwe-ED ezinsizweni ezincane, nakuba lesi sigaba esithile sabantu abonakala singabelane ngezici ezifanayo zezokwelapha zamadoda amadala akhononda ukukhubazeka komsebenzi e-erectile [15, 16], ngaleyo ndlela eholela ekukholweni ukuthi isakhi se-psychogenic sivame ngokwengeziwe kuziguli ezincane ezinezinkinga zokumiswa noma ukucindezeleka okuhlobene nokukhubazeka komsebenzi we-erectile [17].
Ngokuphelele, cishe zonke izifundo zibika ukusabalala kwe-ED ngokuphathelene nomphakathi jikelele, futhi ngalomqondo akukho okuhlobene kwedatha ehlobene
kumkhuba wokwelapha wansuku zonke; Ngokufanayo, akukho datha etholakala ngokucacile ngalezo ziguli ezincane ezifuna empeleni usizo lwezokwelapha esimweni sezokwelapha ngenxa yenkinga ehlobene nekhwalithi yokwakhiwa kwawo. Kule ndlela, sifuna ukuhlola ukusabalalisa nokubikezela kuka-ED ezinsizweni ezincane (okuchazwe ngokweqile ≤ iminyaka engu-40) njengengxenye yeqembu elilandelanayo leziguli zaseCaucasus-European ezifuna usizo lokuqala lwezokwelapha ekusebenziseni ngokocansi esikhungweni esisodwa sezemfundo.
izindlela
Population
Ukuhlaziywa kwakusekelwe eqenjini lama-790 alandelanayo aseCaucasian-Europe aphethwe iziguli ezisebenza ngokocansi efuna usizo lokuqala lwezokwelapha ekusebenzeni okusha kobulili phakathi kokuqala kukaJanuwari 2010 noJuni 2012 emtholampilo owodwa wezikole eziphuthumayo. Ngenhloso ethize yalolu cwaningo lokuhlola, idatha kuphela evela kuziguli ezikhononda nge-ED yayicatshangelwe. Kule njongo, i-ED ichazwe ngokuthi ayikwazi ukufeza noma ukugcina ukulungiswa okwanele kokwenza ucansi olwanelisayo [18].
Iziguli zazihlolwa ngokucophelela ngomlando ophelele wezokwelapha kanye nocansi, kufaka phakathi idatha ye-sociodemographic. Amakhomikhali aqhathaniswa nempilo atholakele nge-Charlson Comorbidity Index (CCI) [19] kokubili njengokuhluka okuqhubekayo noma okuhlukaniswe (okungukuthi, i-0 vs. 1 vs. ≥2). Sisebenzise le Ukuhlukaniswa Kwezifo Zomhlaba Wonke, Ukubuyekezwa kwe-9th, ukuguqulwa komtholampilo. Ukulinganisa kwenani lomzimba (BMI),
echazwa njengesisindo ngo-kilogram ngokuphakama kumamitha ayizikwele, kwakucatshangelwa isiguli ngasinye. Ku-BMI, sasebenzisa ama-cutoffs ehlongozwayo
Izikhungo Zikazwelonke Zempilo [20]: isisindo esijwayelekile (18.5-24.9), ukukhuluphala ngokweqile (25.0-29.9), nesigaba ≥1 ukukhuluphala (-30.0). Umfutho wegazi ophakeme wachazwa lapho kuthathwa imithi eqeda umfutho wegazi ophakeme kanye / noma yengcindezi ephezulu yegazi (≥140 mm Hg systolic noma ≥90 mm Hg diastolic). I-Hypercholesterolemia yachazwa lapho kuthathwa ukwelashwa okwehlisa i-lipid futhi / noma i-cholesterol ephakeme kakhulu (i-HDL) cholesterol yayingu- <40 mg / dL. Ngokufanayo, i-hypertriglyceridemia yachazwa lapho i-plasma triglycerides yayingu-150 mg / dL [21]. Uhlelo lwezemfundo lukazwelonke lwe-Cholesterol-I-Panel Treatment Panel III [21] Izindlela ezazisetshenziswe ngokuphindaphindiwe ukuze zichazwe ukusabalalisa kwe-syndrome (MeTs) kuwo wonke amaqembu amadoda ane-ED.
Ngenhloso ethize yalolu cwaningo nokubonisa umkhuba ojwayelekile welabhoratri ye-biochemistry laboratory, sikhethe ukukala amazinga ajikelezayo e-testosterone (tT) ngokusebenzisa izindlela zokuhlaziya ezitholakalayo. I-Hypogonadism ichazwe njenge-tT <3 ng / mL [22].
Iziguli zazinqunywa ngokobuhlobo bazo (okuchazwe ngokuthi "ubudlelwane obuhle bocansi" uma iziguli zinezihlobo ezifanayo
izinyanga eziyisithupha noma ngaphezulu ezilandelanayo; kungenjalo "akukho ubuhlobo obuqinile" noma ubufelokazi). Ngokufanayo, iziguli zahlukaniswa ngokuvumelana nesimo sabo semfundo esikoleni esiphansi semfundo (isib., Imfundo yesikole esiphansi), iqembu lesikhulu esiphakeme esikoleni, kanye namadoda anezinga eliphezulu lemfundo (isib. Idivesithi / i-postgraduate degree).
Ngaphezu kwalokho, iziguli zacelwa ukuqedela i-International Index of Erectile Function (IIEF) [23]; ukuhlinzeka uhlaka lokubhekisela ekuchazeni ngokucacile ukuqina kwe-ED, sasebenzise ukuhlukaniswa kwesizinda semisebenzi ye-IIEF-erectile njengoba kuhlongozwa nguCapelleri et al. [24].
Izinkinga zokubhala nokunye izinkinga zokufunda nokubhala azifakiwe kuzo zonke iziguli.
Ukuqoqwa kwedatha kwenziwa ngemuva kokulandela izimiso ezichazwe ku-Declaration of Helsinki; zonke iziguli zisayine imvume evumelweneyo zivuma ukuletha imininingwane yazo engaziwa ngezifundo zesikhathi esizayo.
Izindlela Eziyinhloko Zomphumela
Isiphetho esiyinhloko sesifundo samanje kwakuwukuhlola ukukhula nokubikezela kokuqala okusha kwe-ED kumadoda amasha afuna usizo lwabo lokuqala lwezokwelapha
esimisweni somtholampilo kwansuku zonke, ngokusho kwe-cutoff esetshenzisiwe kakhulu ye-40 yeminyaka ubudala. Isiphetho sesibili sokugcina ukuhlola ukuthi ngabe ukusebenza kocansi jikelele, njengoba kukhishwe ngezizinda ezihlukahlukene ze-IIEF, kwabekwa ngokuhlukile kumadoda amancane kuneminyaka eyi-40 uma kuqhathaniswa neziguli ezindala.
Ukuhlaziywa kwesitatimende
Ngenhloso ethile yalokhu kuhlaziywa, iziguli ezinokuqala okusha kwe-ED futhi ezifuna usizo lokuqala lwezokwelapha ngokulandelana zahlukaniswa zaba ngamadoda ≤ iminyaka engu-40 nabantu ngabanye> iminyaka engu-40 ubudala. Izibalo ezichazayo zisetshenzisiwe ukuqhathanisa izici zomtholampilo nezenhlalo yabantu
amaqembu amabili. Idatha ishiwo njengencazelo (ukuphambuka okujwayelekile [SD]). Ukubaluleka kwesibalo sokwehluka kwezinto kanye nokulinganisa kwakukhona
ihlolwe nge-tailed ezimbili t-ukuhlolwa kanye ne-chi-square (χ2) ukuhlolwa, ngokulandelana. Ukuhlaziywa kwesitatimende kwenziwa nge-version 13.0 (IBM Corp., Armonk, NY, USA). Zonke izivivinyo zazinhlangothini ezimbili, enezinga lokubaluleka elibekiwe ku-0.05.
Imiphumela
Ukuqala okusha kwe-ED njengesifo esiyinhloko kutholakala ezigulini ezingama-439 (55.6%) kweziguli ezingama-790. Kubo, i-114 (25.9%) ibineminyaka engu- ≤40 ubudala. Ithebula 1 izici zenkambiso yabantu kanye nezibalo ezichazayo zeqembu lonke leziguli ezine-ED, njengoba zihlukanisiwe ngokweminyaka eyi-40 ehlukumezayo. Kulo mongo, iziguli ≤40 ubudala ubudala ngesikhathi sokufuna kwabo usizo lokuqala lwezokwelapha ze-ED zibonisa
izinga eliphansi lemibandela ye-comorbid (njengoba kuqondwe ngenye indlela ne-CCI), inani eliphansi elingu-BMI, inani eliphansi labantu abane-BMI okuphakamisa ukwedlula ngokweqile kanye neklasi ≥I-1 ukukhuluphala, isilinganiso esingaphansi somfutho wegazi ophezulu kanye ne-hypercholesterolemia, nesilinganiso esiphezulu esisakaza izinga le-TT uma kuqhathaniswa nalabo asebekhulile kuneminyaka eyi-40 (konke P ≤ 0.02). Ngakolunye uhlangothi, akukho mehluko obonwe phakathi kwamaqembu ngokwamazinga we-hypertriglyceridemia, MetS, ne-hypogonadism (Ithebula 1). Ngaphezu kwalokho, iziguli ezincane ze-ED zibonisa izinga eliphezulu lobuhlobo bobulili obufanayo nobungqingili bobudlelwano bobulili obuzinzile (konke P ≤ 0.02). Akukho mehluko omkhulu obonwe ngokwesimo semfundo phakathi kwamaqembu. Izinga eliphakeme kakhulu le-comorbid ejaculation ngaphambi kwesikhathi (kungaba impilo yonke noma okutholakele) kwabonwa ezigulini ezincane kunasebekhulile; ngakolunye uhlangothi, isifo sikaPeyronie sasikhona kakhulu eqenjini elidala (konke P = 0.03), ngenkathi bekungekho mehluko ekusabalaleni kwesifiso sobulili esiphansi phakathi kwala maqembu amabili (Ithebula 1).
| Iziguli ≤ iminyaka engu-40 | Iziguli> iminyaka engama-40 | P Inani* | |
|---|---|---|---|
| |||
| Ayikho yeziguli (%) | 114 (25.9) | 325 (74.1) | |
| Ubudala (iminyaka; kusho i- [SD]) | 32.4 (6.0) | 57.1 (9.7) | |
| Ibanga | 17-40 | 41-77 | |
| I-CCI (ayikho [%]) | <0.001 (χ2, 39.12) | ||
| 0 | 103 (90.4) | 189 (58.3) | |
| 1 | 6 (5.3) | 62 (19) | |
| 2+ | 5 (4.4) | 74 (22.7) | |
| I-BMI (kg / m2; lisho i- [SD]) | 25.1 (4.1) | 26.4 (3.7) | 0.005 |
| I-BMI (i-NIH isigaba) (ayikho [%]) | I-0.002 (χ2, 15.20) | ||
| 1 (0.9) | 0 (0) | ||
| 18.5-24.9 | 63 (56.5) | 126 (38.7) | |
| 25-29.9 | 34 (29.6) | 157 (48.3) | |
| ≥30 | 16 (13) | 42 (13) | |
| I-Hypertension (No. [%]) | 6 (5.3) | 122 (37.5) | <0.001 (χ2, 42.40) |
| I-Hypercholesterolemia (No. [%]) | 4 (3.5) | 38 (11.7) | I-0.02 (χ2, 5.64) |
| I-Hypertriglyceridemia (No. [%]) | 0 (0.0) | 10 (3.1) | I-0.12 (χ2, 2.37) |
| I-MeTs (ayikho [%]) | 2 (1.8) | 10 (3.1) | I-0.57 (χ2, 0.74) |
| tT (ng / mL; kusho [SD]) | 5.3 (2.0) | 4.5 (1.8) | 0.005 |
| I-Hypogonadism (inani elingu- <3 ng / mL) (Cha. [%]) | 12 (10.3) | 54 (16.6) | I-0.14 (χ2, 2.16) |
| Isimo socansi (No. [%]) | I-0.02 (χ2, 5.66) | ||
| Heterosexual | 109 (95.6) | 322 (99.1) | |
| Ubungqingili | 5 (4.4) | 3 (0.9) | |
| Isimo sobudlelwano (No. [%]) | <0.001 (χ2, 27.51) | ||
| Ubuhlobo bobulili obuqinile obuqinile ≥ izinyanga ezingu -6 | 81 (71.4) | 303 (93.2) | |
| Ayikho ubudlelwane obuhle bezocansi | 33 (28.6) | 22 (6.8) | |
| Isimo sezemfundo (No. [%]) | I-0.05 (χ2, 9.30) | ||
| Isikole sokuqala | 0 (0) | 22 (6.8) | |
| Isikole sebanga eliphezulu | 20 (17.5) | 64 (19.7) | |
| Isikolo sebanga eliphezulu | 51 (44.7) | 141 (43.4) | |
| I-University degree | 43 (37.7) | 98 (30.2) | |
| Izikhalazo zocansi ezihambisanayo (No. [%]) | |||
| PE | 14 (12.4) | 20 (6.2) | I-0.03 (χ2, 4.55) |
| I-libido ephansi | 10 (8.8) | 23 (7.1) | I-0.55 (χ2, 0.35) |
| Isifo se-Peyronie | 5 (4.4) | 37 (11.4) | I-0.03 (χ2, 4.78) |
Ithebula 2 libala izidakamizwa ezithathwe yiziguli zala maqembu womabili, ezihlukaniswe ngumndeni wezidakamizwa. Ngokufanayo, iTable 2 futhi imininingwane yemikhiqizo yokuzijabulisa ebikwe iziguli futhi
ihlukaniswe yiqembu lobudala. Abaguli abadala base-ED babethatha njalo
imishanguzo emilonyeni yomndeni ngamunye kanye ne-thiazide
izidakamizwa ze-diuretics kanye ne-lipid-ukwehlisa izidakamizwa uma kuqhathaniswa namadoda ≤ iminyaka engu-40 (konke P
≤ 0.02). Ngokufanayo, iziguli ezindala zazivame ukuthatha njalo
ama-antidiabetics kanye nemithi ye-uricosuric, i-alpha-blockers ye-LUTS, ne-proton
i-pump inhibitors iqhathaniswa namadoda amancane (konke P ≤ 0.03).
| Iziguli ≤ iminyaka engu-40 | Iziguli> iminyaka engama-40 | P Inani* | |
|---|---|---|---|
| |||
| Ayikho yeziguli (%) | 114 (25.9) | 325 (74.1) | |
| Izidakamizwa ezingenamandla | |||
| I-ACE-i | 1 (0.9) | 47 (14.5) | <0.001 (χ2, 14.62) |
| Abaphikisi be-Angiotensin-II abamukelayo | 2 (1.8) | 41 (12.6) | I-0.002 (χ2, 9.95) |
| Ababambi be-Beta-1 | 2 (1.8) | 44 (13.5) | I-0.0009 (χ2, 11.12) |
| Abaphikisi bakaCalcium | 0 (0.0) | 39 (12.0) | I-0.002 (χ2, 13.57) |
| isisu | |||
| I-Loop diuretics | 0 (0.0) | 6 (1.8) | I-0.33 (χ2, 0.94) |
| Thiazide diuretics | 0 (0.0) | 18 (5.5) | I-0.02 (χ2, 5.20) |
| Ezinye izidakamizwa zenhliziyo | |||
| Digoxin | 0 (0.0) | 7 (2.2) | I-0.24 (χ2, 1.36) |
| Izidakamizwa zokulwa ne-Antiarrhythmic | 1 (0.9) | 6 (1.8) | I-0.82 (χ2, 0.05) |
| Izidakamizwa ze-Anticoagulant | 1 (0.9) | 10 (3.1) | I-0.35 (χ2, 0.89) |
| Izidakamizwa ze-Antiplatelet | 1 (0.9) | 1 (1.8) | I-0.82 (χ2, 0.06) |
| Izidakamizwa zokwehlisa i-lipid (ama-statins & / noma ama-fibrate) | 0 (0.0) | 43 (13.2) | I-0.0001 (χ2, 15.21) |
| Izidakamizwa zesistimu ezisemkhatsini | |||
| Izidakamizwa ze-Anticonvulsant | 1 (0.9) | 6 (1.8) | I-0.82 (χ2, 0.05) |
| I-Barbiturates | 0 (0.0) | 2 (0.6) | I-0.99 (χ2, 0.00) |
| Benzodiazepine | 2 (1.8) | 15 (4.6) | I-0.29 (χ2, 1.11) |
| Neuroleptics | 2 (1.8) | 3 (0.9) | I-0.79 (χ2, 0.07) |
| Izidakamizwa ze-opioid | 0 (0.0) | 2 (0.6) | I-0.99 (χ2, 0.00) |
| I-SNRIs | 1 (0.9) | 1 (0.3) | I-0.99 (χ2, 0.00) |
| SSRIs | 8 (7.0) | 8 (2.5) | I-0.06 (χ2, 3.65) |
| Izidakamizwa ze-endocrinological | |||
| Imithi ye-Antiandrogenic | 0 (0.0) | 3 (0.9) | I-0.73 (χ2, 0.12) |
| Izidakamizwa ze-Antithyroid | 0 (0.0) | 1 (0.3) | I-0.57 (χ2, 0.33) |
| I-Thyroxin | 2 (1.8) | 17 (5.2) | I-0.20 (χ2, 1.61) |
| Corticosteroids | 3 (2.6) | 12 (3.7) | I-0.80 (χ2, 0.07) |
| Darbepoetin | 0 (0.0) | 1 (0.3) | I-0.57 (χ2, 0.33) |
| Desmopressin | 0 (0.0) | 2 (0.6) | I-0.99 (χ2, 0.00) |
| Ama-dopamine agonists | 2 (1.8) | 4 (1.2) | I-1.00 (χ2, 0.00) |
| Abaphikisi beDopamine | 4 (3.5) | 3 (0.9) | I-0.14 (χ2, 2.19) |
| Imithi ye-hypoglycemic | |||
| Izidakamizwa ze-antidiabetic | 3 (2.6) | 32 (9.8) | I-0.02 (χ2, 5.05) |
| insulin | 3 (2.6) | 23 (7.1) | I-0.13 (χ2, 2.31) |
| Izidakamizwa zesistimu yokuphefumula | |||
| Ama-Antihistamine | 4 (3.5) | 12 (3.7) | I-0.85 (χ2, 0.04) |
| I-Beta2-agonist | 1 (0.9) | 3 (0.9) | I-0.56 (χ2, 0.33) |
| Imithi ehlobene ne-BPH / LUTS | |||
| I-5-alpha reductase inhibitors | 1 (0.9) | 6 (1.9) | I-0.77 (χ2, 0.09) |
| Alpha-blockers | 1 (0.9) | 41 (12.6) | I-0.0005 (χ2, 12.04) |
| Ezinye izidakamizwa | |||
| Imithi e-Anticholinergic | 1 (0.9) | 1 (0.3) | I-0.99 (χ2, 0.00) |
| Immunomodulators / immunosuppressors | 3 (2.6) | 12 (3.7) | I-0.80 (χ2, 0.07) |
| I-Proton pump inhibitors | 2 (1.8) | 33 (10.2) | I-0.008 (χ2, 6.98) |
| Izidakamizwa eziphikisana nezidakamizwa | 7 (6.1) | 14 (4.3) | I-0.60 (χ2, 0.27) |
| I-Triptans | 0 (0.0) | 1 (0.3) | I-0.57 (χ2, 0.33) |
| Vitamins | 2 (1.8) | 11 (3.4) | I-0.59 (χ2, 0.30) |
| Izidakamizwa ze-uricosuric | 0 (0.0) | 17 (5.2) | I-0.03 (χ2, 4.84) |
| Ukubhema ugwayi (No. [%]) | I-0.02 (χ2, 7.56) | ||
| Ababhemayo bamanje | 43 (37.8) | 80 (24.6) | |
| Ababhemayo abedlule | 1 (0.9) | 7 (2.2) | |
| Ungalokothi upheze | 70 (61.3) | 238 (73.2) | |
| Utshwala udla (noma yiliphi ivolumu / isonto) (Cha [%]) | I-0.52 (χ2, 0.41) | ||
| Njalo | 88 (77.2) | 262 (80.6) | I-0.16 (χ2, 1.93) |
| Ukudla utshwala (1-2 L / isonto) | 26 (22.8) | 98 (30.2) | I-0.96 (χ2, 0.00) |
| Ukuphuza utshwala (> 2 L / isonto) | 4 (3.6) | 10 (3.1) | |
| Izidakamizwa ezingekho emthethweni (noma yiluphi uhlobo) (No. [%]) | 24 (20.9) | 11 (3.4) | <0.001 (χ2, 34.46) |
| I-cannabis / ijuju | 24 (20.9) | 9 (2.8) | <0.001 (χ2, 37.29) |
| cocaine | 4 (3.5) | 0 (0.0) | I-0.005 (χ2, 37.29) |
| Heroin | 0 (0.0) | 3 (0.9) | I-0.73 (χ2, 7.92) |
Akukho mehluko otholakele komunye umndeni wezidakamizwa (Ithebula 2).
Younger
Iziguli ze-ED zivame ukubonisa umkhuba wokubhema ugwayi
nokusetshenziswa kwezidakamizwa ezingekho emthethweni (kokubili i-cannabis / i-marijuana ne-cocaine) njenge
kuqhathaniswa namadoda amadala kunama-40 iminyaka (konke P ≤ 0.02). Akukho mehluko otholakele maqondana nokuphuza utshwala phakathi kwamaqembu (Ithebula 2).
Ithebula 3 imininingwane isho (SD) izibalo zezigaba ezinhlanu ze-IIEF; cha
Ukungafani okuphawulekayo kuboniswe kunoma iyiphi i-IIEF domain phakathi
iziguli ezintsha ze-ED ezisanda kudala nezindala. Ngokufanayo, amadoda ≤ kweminyaka engu-40 ubudala
wabonisa ukusabalalisa okufanayo nokuqhathaniswa kwe-ED eqondile uma kuqhathaniswa
neziguli ezindala. Ngokufanayo, amazinga omnene, omnene-kuya-olinganisiwe, futhi
ukulinganisa i-ED kwakungeyona ehluke kakhulu phakathi kwamaqembu amabili
(Ithebula 3).
| Izizinda ze-IIEF (zisho [SD]) | Iziguli ≤ iminyaka engu-40 | Iziguli> iminyaka engama-40 | P Inani* |
|---|---|---|---|
| |||
| I-IIEF-EF | 12.77 (8.7) | 14.67 (8.4) | 0.23 |
| I-IIEF-IS | 5.9 (4.2) | 6.69 (4.1) | 0.33 |
| I-IIEF-OF | 7.51 (3.2) | 7.06 (3.5) | 0.49 |
| I-IIEF-SD | 6.98 (2.3) | 6.57 (2.1) | 0.36 |
| I-IIEF-OS | 4.95 (2.6) | 5.06 (2.5) | 0.82 |
| Ubukhulu be-IIEF† (Cha [%]) | |||
| I-EF evamile | 11 (9.3) | 39 (11.9) | I-0.73 (χ2, 2.01) |
| I-ED efudumele | 16 (14.0) | 55 (16.8) | |
| I-ED elula kuya kokulinganisa | 10 (9.3) | 51 (15.8) | |
| I-Moderate ED | 21 (18.6) | 48 (14.9) | |
| I-ED ekhulu | 56 (48.8) | 132 (40.6) | |
Ingxoxo
We
ukuhlolwa ngokuphindaphindiwe iqembu elilandelanayo laseCaucasian-European
amadoda asebenza ngokocansi afuna usizo lokuqala lwezokwelapha ukuze aqale kabusha ED ku-a
insizakalo eyodwa yokufunda iziguli ezingaphezu kwezikhathi ze-30 ukuze
hlola ukuphakama kanye nezici zabantu ngabanye ≤ iminyaka engu-40 ubudala
uma kuqhathaniswa nalabo besilisa abadala kunama-40 eminyakeni ngesikhathi sokuhlolwa kwe-ED.
Sithole ukuthi owesilisa phakathi kwamadoda amane ane-ED wayengaphansi kweminyaka engu-40.
Ngaphezu kwalokho, inani elifanayo labalimi abancane nabakhudlwana be-ED benza
sikhononda nge-ED enzima. Ngokufanayo, iziguli ezincane nezindala ezilinganayo
ilandelwe kwisizinda ngasinye se-IIEF, ngaleyo ndlela kufaka isifiso sobulili, i-orgasmic
umsebenzi, nokwaneliseka jikelele. Ngakho-ke, ukubhekwa njengokuthi
konke kubonakala kithi njengesithombe esibuhlungu kusukela emitholampilo yansuku zonke
sebenzisa.
I-ED yisimo esinalo
izimo ezibucayi zezokwelapha nezomphakathi ezenzekayo
kuhlolwe kabanzi ezikoleni ezahlukene [7-10, 13, 14, 25]. Ngokubanzi, iminyaka ibhekwa njengethonya elikhulu kunazo zonke, ngezifundo eziningana ezibonisa ukwanda okukhulu kwe-ED kuneminyaka yobudala [7, 8, 26];
isibonelo, idatha evela ku-Massachusetts Male Aging isifundo iphelile
leyo minyaka yayiyi-variable ehambisana kakhulu ne-ED [7]. Ngaphandle kweminyaka, ezinye izimo eziningi zezokwelapha ziye zahlotshaniswa kakhulu ne-ED [7, 10, 12-14, 26].
Phakathi nesikhathi sokuguga, abantu besilisa bavame ukubhekana nesinye
noma ngaphezulu kwezimo ze-comorbid ezibalulwe ngenhla futhi, hhayi
Ngokumangazayo, bavame ukukhononda futhi nge-ED. Ngenxa yalezi zizathu, iningi la
izifundo ze-epidemiological ezibhekene nokusabalalisa kwe-ED nokubikezela
kwenziwa ngamadoda amadala kuneminyaka eyi-40;
Ngakolunye uhlangothi, izifundo ezimbalwa kuphela zihlanganisa idatha kusuka kuncane
ngabanye [14-16, 26, 27].
Ngokubanzi, idatha evela kulezi zinsuku zakamuva ibonise ukuthi i-ED ayiyona into engavamile
isimo ngisho naphakathi kwamadoda amancane. UMilon et al., Isibonelo, kubikiwe
ukuthi ukusabalala kwe-ED kwakuyi-29.9% eqenjini lamadoda aseSwitzerland asebasha [15]. Ngokufanayo, uPonholzer et al. [14] uthole amanani afanayo we-ED kuhlu olulandelanayo lwamadoda aneminyaka engu-20-80
iminyaka iqhaza ohlelweni lokuhlola impilo endaweni yaseVienna.
Ngokufanayo, uMartins no-Abdo [16] isetshenzisiwe idatha kusuka ocwaningweni oluhlukaniswe ngezansi lapho amadoda e-1,947 aneminyaka engu-18-40 iminyaka
abadala baxhunyaniswe ezindaweni zomphakathi ze-18 amadolobha amakhulu aseBrazil futhi
baxoxwa ngokusebenzisa i-questionnaire engaziwa; jikelele, i-35% yalabo
abantu baye babika amanye amanani ezinkinga ze-erectile.
A
Amandla amakhulu ekuhlaziyweni kwethu avela eqinisweni lokuthi thina ngokuqondile
ukuhlolisisa ukuhlolwa kanye nezici ze-ED emadodeni amasha aphuthumayo
kusuka eqenjini leziguli ezilandelana ngokulandelana
umtholampilo ufuna usizo lokuqala lwezokwelapha ku-ED; kulo mongo, sithole lokho
isigamu seziguli ezibhekene ne-ED emisebenzini yemitholampilo yansuku zonke
bangamadoda angaphansi kweminyaka engu-40. Lokhu kuqinisekisa ngokucacile ngaphambilini
idatha ye-epidemiological evela kwizifundo ezisekelwe kubantu, ngaleyo ndlela ichaza lokho
I-ED akuyona nje ukuphazamiseka komuntu osekhulile kanye nomsebenzi we-erectile
ukukhubazeka kwamadoda amasha akufanele kubekwe ngaphansi kwemithi. Wethu
Ukuboniswa kwendlela yokwelapha yansuku zonke kwenza okuningi ngokuphathelene
ucabangela ukuziphatha kwansuku zonke odokotela abaningi abangenalo
ukujwayela impilo yezocansi zesilisa; Ngempela, kunikezwe okuncane kakhulu
amazinga okuhlolwa kwe-ED ngabasebenzi abajwayelekile ezigulini ezindala kunaleyo
iminyaka 40 [28], sesaba kakhulu ukuthi i-ED noma ukusebenza ngocansi nge-se kungase kuphindwe kuphindwe kumadoda amasha [29].
The
ukutholakala kokuhlaziywa kwethu kwabonisa ukuthi iziguli ezincane zazingamazwe omhlaba
okunempilo uma kuqhathaniswa namadoda amadala kuneminyaka engu-40, ekhombisa i-CCI ephansi
izibalo-kanye nenani elincane lemithi, ikakhulukazi
I-CVDs, i-BMI ephansi, nesandulela esiphansi se-hypertension.
Ngokufanayo, futhi akumangalisi ukuthi abantu abasha babe ne-TT ephakeme
amazinga uma kuqhathaniswa neziguli ezindala kuneminyaka eyi-40, ngaleyo ndlela ivumelanisa
iningi lezinhlolo ze-epidemiological phakathi kwamadoda aseYurophu asebekhulile [2].
Ngokuphelele, le datha yomtholampilo iqinisekisa labo abayitholayo kusukela
Ucwaningo lwaseBrazil, oluhlulekile ukuthola noma iyiphi inhlangano ebalulekile
ukuqinisekisile izifo ezibangelwa yi-ED ezifana nesifo sikashukela nama-CVD emadodeni
uneminyaka engu-18-40 ubudala [16].
Ngokuvamile, lokhu kungalingani kulindeleke, kunikeze ukuthi i-ED in
insizwa ivame ukuxhunyaniswa nokuzivocavoca okuningi futhi
izici zobuntu ezivame ukudala izimbangela ezingase zenzeke
[8, 30, 31]. Ngaphezu kwalokho, uMialon et al. [15] wabonisa ukuthi umehluko omkhulu phakathi kwabesilisa abancane nabakhudlwana be-ED babenjalo
impilo yengqondo kanye nesimo sengqondo ngemithi. Esikhathini sethu se-ED
iziguli, sathola ukuthi amadoda amancane ayevame ukujwayela
ukubhema ugwayi kanye nezidakamizwa ezingekho emthethweni (okungukuthi, i-cannabis / marijuana kanye
cocaine) kuneziguli ezindala. Idatha yangaphambilini yokusetshenziswa okungapheli
izidakamizwa-ikakhulukazi i-cannabis, opiates, ne-cocaine-zibonise cha
ubufakazi obungabonakali bokuxhumanisa ne-ED [32-34],
futhi ngokuqinisekile ukubonwa eziningana kusikisela indima causative for
ukubhema okungapheli ukubhema ekukhuthazeni ukukhubazeka komsebenzi erectile ngisho
kubantu abasha [7, 34-37].
Ngenxa yesimo esichazayo sesifundo sethu, asikwazi ukucabanga
uma lezi zindlela zokuphila zokugcina zingase zihlotshwe ngokucacile ne
ukuqala kwe-ED kumadoda amasha, kodwa ngokuqinisekile kunengqondo ukucabangela
ukuthi bobabili bangase badlale indima ndawonye nezinye izici
ukugqugquzela ukukhubazeka komsebenzi we-erectile. Ngakolunye uhlangothi, lokhu kungapheli
ukulutha ngokweqile izinto zokuzilibazisa-okungase kube khona
ukulimaza hhayi kuphela impilo yezocansi-kuqinisa ngokwengeziwe ukukhathazeka kukaJehova
uhlaka oluvela ekuboneni kwethu, okungukuthi, ingxenye yesine yamadoda
eze ukufuna usizo lokuqala ku-ED lingaphansi kweminyaka engu-40, futhi ibika njalo
ukusetshenziswa okungapheli kwezinto eziyingozi, kaningi ngisho nangemthetho.
Ekugcineni,
silinganisela ngokwezinga le-psychometrically izinga lobuqili be-ED kulawo maqembu amabili;
Ukulinganiswa okulinganayo kwama-ED okuphazamiseka kutholakala phakathi kwamaqembu. Of
ukubaluleka okukhulu, cishe isigamu sabantu abangaphansi kweminyaka engu-40
wahlukunyezwa yi-ED ngokusho kukaCappelleri et al. [24],
njengoba lokhu kulinganiswa ngokuphelele nalokho okubonwa kumadoda amadala.
Ngokombono wethu, lokhu okutholakele kuzogcina kugcizelela ukuthi
ukukhubazeka kokwakhiwa kungahle kubonakale njengokungasebenzi ngendlela encane
iziguli njengamadoda amadala, ngakho-ke ukusekela ukuthi lokhu kobulili
inkinga izofanelwa ukunakekelwa okwanele kumkhuba wokwelapha nsuku zonke
bonke ubudala. Ngokufanayo, sihlolisise ukuthi iziguli ze-ED ezincane nabakhudlwana
ilandelwe ngokuvumelana nokusebenza kocansi jikelele, njengoba kuchaziwe kusetshenziswa i-
izizinda ezahlukene ze-IIEF. Ngokuhambisana nedatha edlule ebonisa lokho
Izinguquko ze-longitudinal kulezi zizinda ezinhlanu zomsebenzi wezocansi zihamba ndawonye
ngokuhamba kwesikhathi [38],
asizange sibone umehluko ophawulekayo kusizinda ngasinye se-IIEF
phakathi kwamaqembu. Ngalo mqondo, kungenzeka ukuthi ucabange ukuthi,
ngisho nangezimbangela ezihlukahlukene ze-ED, ithuluzi le-IIEF alikwazanga
uyakwazi ukubandlulula ngokucacile i-pathophysiology ngemuva kwe-ED. Ngempela,
nakuba i-ED, njengokuchazwa ngokucacile nge-IIEF-erectile function
isizinda, siboniswe ku-akhawunti ye-CCI ephakeme, okungenzeka ibe
kuthathwa njengommeli onokwethenjelwa wesimo sempilo esiphezulu sabantu besilisa,
kungakhathaliseki ukuthi i-etiology ye-ED [3], UDeveci et al. [39] ngaphambili behluleka ukukhombisa ukuthi i-IIEF ingahle ikwazi
ukubandlulula phakathi kwe-ED ephilayo kanye nengqondo. Nokho, kunjalo
Ngokuqinisekile kuyiqiniso ukuthi izifundo eziningi zaphakamisa ukuthi i-ED ingaba
ukubonakaliswa okujwayelekile kwemicimbi ye-CVD [40, 41]. Phakathi kwabo, u-Chew et al. [41],
isibonelo, uphenyo lwe-ED njengendlela yokwenza imicimbi ye-CVD ku-a
inani lamadoda ane-ED ephakathi kwe-20 ne-89 yeminyaka ubudala; lezi
abalobi bathola ingozi enkulu engozini yezehlakalo ze-CVD eziguli ze-ED
kuncane kuneminyaka engu-40. Ngakolunye uhlangothi, inani elinciphile lokubikezela lika-ED
ngoba izenzakalo ze-CVD zibonwa kubantu abadala [41].
Ngokubanzi, le miphumela yangaphambilini kanye nokuthola kwethu kwamanje kungase kusiphakamise
ukuthi ukuhlolwa kwe-ED kuyindlela ebalulekile yokukhomba abancane futhi
amadoda angama-middle age abalingani abawusizo ngenxa yengozi yenhliziyo
ukuhlolwa kanye nokungenelela kwezokwelapha okulandelayo. Ngisho noma iningi la
iziguli kule nkathi yobudala cishe ziyobhekana ne-ED engahleliwe,
kungaba khona inani labo abakhononda nge-organic organic ED
i-broad-spectrum etiologies, ne-ED ibe yedwa umaka we-sentinel we-an
ukuwohloka kwempilo okungenayo (ie, isifo sokuphefumula kwamathambo). Kulokhu
umongo, Kupelian et al., isibonelo, ukutadisha inani lamadoda we-928
ngaphandle kwaMeTs, wabonisa ukuthi i-ED yayibikezela ukuthuthukiswa okulandelayo
I-METS ezigulini ezine-BMI evamile ekuqaleni [42],
ngaleyo ndlela kugcizelela ukubaluleka kwe-ED njengenkinga yokusiza abasilisa abasha
ukuba nenqubo yokuphila enempilo ende yesikhathi eside, okungase kulungiselele ingozi
izifo ezifana nesifo sikashukela kanye ne-CVD, phakathi kwabanye.
Our
Ukutadisha akusikho okulinganiselwe. Okokuqala, iqembu lethu elincanyana
yamadoda inganciphisa ukulinganisa kokuthola kwethu, ngenkathi singena
akhawunti kuphela lezo ziguli ezithunyelwa emithini yezocansi
umtholampilo ophulukisiwe ungase uqinisekise ukukhethwa okukhethiwe ngenxa yobunzima
of ED, ngaleyo ndlela eholela miss inombolo yabantu abane-mild futhi
abangaphansi kakhudlwana ukuthola usizo lwezokwelapha. Nokho, sicabanga ukuthi lokhu
ukuphutha komqondo kuzoba khona ngokufanayo phakathi kokubili, ngakho-ke
hhayi ukwehlisa inani lalezi zithole. Okwesibili, asizange sihlole
amazinga okucindezeleka noma ukukhathazeka ngokusebenzisa izinsimbi eziqinisekisiwe zengqondo.
Kulo mongo, ubuhlobo obuseduze phakathi kwe-ED nokunye
ukucindezeleka noma ukukhathazeka, noma kokubili, mhlawumbe i-bidirectional; Ngempela, i-ED
ingase itholakale ngemva kokucindezeleka noma ukukhathazeka okungenzeka kube khona
umphumela wanoma yikuphi ukungasebenzi kocansi. Ukuba nethuluzi elingakwazi
ukubandlulula lesi simo kungabaluleka kakhulu emtholampilo
ikakhulukazi kubantu abasha. Okwesithathu, ukuhlaziya kwethu akukwenzi
hlola ngqo umlando wezocansi weziguli kanye nezocansi phezu kwe
inkathi yobusha. Kulokhu, uMartins no-Abdo [16] wabonisa ukuthi ukungabi nolwazi kolwazi ngokobulili ezigulini ezincane kakhulu
ehlotshaniswa ne-ED ngenxa yokwesaba nokungabaza okuphakanyiswe ngamathambo
nokulindela okungenangqondo. Iziguli ezinenkinga kulo lonke
ukuqala kokuphila kwabo ngokobulili kubonise ukuvela okuphezulu kwe-ED, mhlawumbe
okhiqizwa umjikelezo wokukhathazeka nokuhluleka okugcina kuphazamise
ukusebenza komuntu ngokocansi [43].
Okokugcina, ukuhlaziywa kwethu akuzange kuqaphele isimo sezomnotho
izici zokuphila; Ngempela, imali engenayo yemindeni yaboniswa
kufanele zihlotshwe ngokuqondile nokuziphatha okufuna ukwelashwa, kanti
ukungahleleki kwezezimali kungase kubonakale kuyimingcele [44].
Nokho, sinqume ukuthi singabizi ulwazi lokuthola imali ngenxa yezinga eliphansi
izinga lokuphendula kumbuzo engenayo esivame ukuwathola empilweni yangempela
umkhuba wokwelapha ngesikhathi sokuvakasha kwamahhovisi ejwayelekile.
iziphetho
In
qhathanisa nalokho okushiwo yizifundo zabantu
ukukhula kwe-ED ezigulini ezincane, ukutholakala kwethu kubonisa ukuthi okukodwa
Amadoda amane afuna usizo lwezokwelashwa ku-ED emtholampilo wansuku zonke
umtholampilo ophuthumayo uyinsizwa engaphansi kweminyaka eyi-40. Ngaphezu kwalokho,
cishe isigamu samajaha ahlushwa yi-ED enamandla, ngokuba lokhu
isilinganiso esilingana nalokho okubonwa kubantu abadala. Iya ku
umkhuba wokwelapha nsuku zonke, ukutholakala kwamanje kusishukumisela ukuba siqhubeke
cacisa ukubaluleka kokuthatha ukwelashwa okuphelele kanye nobulili
umlando nokwenza ucwaningo olunempilo kuwo wonke amadoda analo
ED, kungakhathaliseki ubudala babo. Ngokufanayo, unikezwa izinga eliphansi lokufuna
usizo lwezokwelapha ngezinkinga ezihlobene nempilo yezocansi, le miphumela
ukuveza ngisho nakakhulu isidingo abahlinzeki bezempilo abangase bacele ngokuqhubekayo
mayelana nezikhalo ezingasetshenziswa ngokobulili, futhi futhi nakancane kumadoda amancane kunalokho
Iminyaka engu-40 ubudala. Ngenxa yokuthi usayizi wesampula wamanje ulinganiselwe, cishe
asikwazi ukuthola iziphetho ezijwayelekile; Ngakho-ke, izifundo ezengeziwe ku
amasampuli amakhulu asekelwe emphakathini adingekayo ukuze aqinisekise le miphumela futhi
ukuqhubeka nokuchaza indima engaba khona ye-ED ukucindezela njenge-harbinger
izifo zezokwelapha emadodeni angaphansi kweminyaka engu-40.
Ukungqubuzana kwezintshisekelo: Abalobi babika akukho mpikiswano ezithakazelisayo.
Isitatimende sobunikazi
Isigaba 1
- (A) Ukuklama nokuklamaPaolo Capogrosso; Andrea Salonia
- (B) Ukutholwa kwedathaUMikhele Colicchia; Eugenio Ventimiglia; Giulia Castagna; UMaria Chiara Clementi; Fabio Castiglione
- (C) Ukuhlaziywa nokuchazwa kwedathaNazareno Suardi; U-Andrea Salonia; UFrancesco Cantiello
Isigaba 2
- (A) Ukuhlelwa kwe-ArticlePaolo Capogrosso; Andrea Salonia
- (B) Ukuyibuyekeza Ngokuqukethwe KwengqondoU-Andrea Salonia; U-Alberto Briganti; Rocco Damiano
Isigaba 3
- (A) Ukuvunyelwa kokugcina kwesiGungu esiqediweU-Andrea Salonia; Francesco Montorsi
Okubhekwayo
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