Leiomyoma of the corpus cavernosum of the penis

While soft tissue tumors can occur in the penis, corpus cavernous tumors are rare. Reported cases of corpus cavernous tumors are from metastases of advanced malignancy, such as cancers of the bladder, prostate, rectosigmoid colon, kidney, pancreas, liver, testis and nasopharynx. Primary corpus cavernous tumors are extremely rare and have possibly never been reported before. Herein, we report a case of leiomyoma of the corpus cavernosum. After the diagnosis of leiomyoma was established, total excision of the tumor was not attempted and the tumor remained unchanged in size and shape over a follow-up period of 15 months.     

Microsurgical revascularization of the canine corpus cavernosum penis

The concept of vasculogenic impotence in humans is addressed by attempting to surgically create and correct vasculogenic impotence in healthy dogs. Initial experience reveals that only by extensive pelvic vascular interruption can such impotence be created and that, at best, it is only temporary because of collateralization. Microsurgical revascularization using both direct femoral artery implantation and femoral vein interposition into the corpus cavernosum penis yielded low patency rates. Further studies on this technique are needed before it can be recommended for widespread use in human beings.     

Methylmethacrylate implants: a scanning electron microscopic study

Two methylmethacrylate orbital implants used for 34 and 5 years, respectively, were examined with a scanning electron microscope. One of the implants was a combination of a prosthesis and an implant containing a magnet. The magnetic force had decreased markedly, and rust crystals were apparent. The methylmethacrylate surface was irregular and rough.     

Interaction between human gametes in vitro: a scanning electron microscopic study

Fifteen human oocytes incubated with spermatozoa for 24 hr and cultured for 1-3 days were examined by scanning electron microscopy. Five of the oocytes were preovulatory (3 uncleaved and 2 cleaved after culture) and 10 nonovulatory. There was a wide variation in the number of spermatozoa attached to or penetrating the zona pellucida of the oocytes. On preovulatory oocytes, spermatozoa were observed, ranging in numbers from a few to about 50, while on nonovulatory oocytes they numbered from a few to several hundred. Oocytes may differ with respect to sperm-binding sites on the zona pellucida. After incubation in vitro, spermatozoa with abnormal forms were rarely observed on the oocytes or in between corona cells. Selection of spermatozoa may take place on their interaction with oocytes/cumulus corona cells.     

Androgen and estrogen receptors in the human corpus cavernosum penis: immunohistochemical and cell culture results

Despite the central and peripheral effects of androgens on the nervous system, the local effects of androgens in the corpus cavernosum penis and their importance for erectile function is still unclear. In this study corpus cavernosum biopsies of eight adult potent patients, aged 19–63 years, undergoing penile deviation surgery (group A) and 12 patients undergoing male-to-female transsexual surgery (group B) were immunostained for nuclear androgen and estrogen-alpha receptors. Additionally, primary corpus cavernosum endothelial cell cultures were obtained from six transsexual patients and exposed to testosterone, dihydrotestosterone, estradiol and progesterone likewise for 7 days. Total cell count was performed and cell metabolic activity was measured by a tetrazolium salt-based assay. Androgen and estrogen-alpha receptors were detected in stromal as well as in endothelial cells. Of all cell nuclei, 74.9% (SD 16.4) in group A and 63.5% (SD 17.1) in group B were positively stained for androgen receptors. The respective percentage of estrogen receptors was 11% (SD 9.5) and 21.2% (SD 12.6). An age-dependent difference in receptor distribution was not observed in either group. In the cell culture system only cultures exposed to testosterone and dihydrotestosterone showed a dose-dependent increase of cell metabolic activity compared to the cultures supplemented with estradiol and progesterone. The significant and age-independent high androgen and low estrogen-alpha receptor distribution found in both groups suggests a possible peripheral effect of androgens at the level of the corpus cavernosum penis in adult humans. This is supported by the observed effect of testosterone and dihydrotestosterone on cell count and endothelial cell metabolism in our cell culture system. The role of estrogens remains unclear.     

阴茎包埋对海绵体形态结构的影响

目的:探讨阴茎包埋对大鼠阴茎海绵体形态结构的影响。方法:通过建立隐匿阴茎大鼠模型获得实验标本,分2月组、4月组进行观测,每组25只大鼠。各阶段又分包埋组(15只)、正常组(10只),光镜和电镜下观察海绵体形态结构的改变。结果:阴茎包埋2月组海绵体形态结构无明显变化,4月组病理改变较为明显,光镜下见大鼠阴茎海绵体平滑肌细胞,内皮细胞分布杂乱,细胞间大量间质组织增生,海绵窦狭窄;电镜下见阴茎海绵体平滑肌细胞及内皮细胞萎缩、线粒体退变、内质网扩张,致密体及收缩纤维减少,脂滴增加,空泡形成。包埋组与正常组阴茎海绵体在外观和重量上无明显差异(P>0.05)。结论:阴茎包埋对海绵体外观和重量无明显影响,但随着包埋时间的延长,海绵体组织发生超微结构上的病理改变。     

Replacement of tunica albuginea of corpus cavernosum penis using human dura. Experimental study on dogs.

The tunica albuginea of corpus cavernosum penis was excised and replaced with human dura in experiments on 11 dogs. The surface of the implant epithelialized within three weeks, and later the implant was replaced by autologous tissue with no scarring and shrinkage. After resection of placques in Peyronie's disease the tunica albuginea can be replaced with specially treated human dura.     

Electrical activity of corpus cavernosum during flaccidity and erection of the human penis: a new diagnostic method?

We investigated 7 normal men and 1 diabetic patient with erectile dysfunction. Electromyography electrodes were placed in the corpus cavernosum of the penis and electrical activity was recorded during flaccidity. With sexual arousal the activity decreased and tumescence was initiated. During tumescence and full erection the electrical activity of the corpus cavernosum almost ceased but in the diabetic patient (neurogenic impotence) an increase was observed. This discoordination might be the cause of the erectile dysfunction. Recording the electrical activity of the corpus cavernosum in patients with suspected neurogenic erectile dysfunction could become clinically valuable, since this is the first test possible to study the function of the autonomic motor system that normally regulates penile function.     

Gene expression of the phosphodiesterases 3A and 5A in human corpus cavernosum penis

OBJECTIVE: The following study was performed to evaluate the importance of phosphodiesterases 3A (PDE3A) and 5A (PDE5A) for the regulation of penile smooth muscle tone. Furthermore, indications of side effects of specific inhibitors in certain tissues as well as of a possible relation between the level of PDE3A and PDE5A gene expression and erectile dysfunction should have been deduced from the results obtained. METHODS: Total ribonucleic acid was isolated from different human tissues (urogenital tract, gastrointestinal tract, cardiovascular system and central nervous system) and subjected to RTPCR analysis and Northern blotting using primers and probes specific for PDE3A and PDE5A. RESULTS: As shown by RT-PCR and Northern blotting, PDE3A and PDE5A mRNAs exhibit a distinct distribution throughout the tissues examined but were 2-fold higher in cavernous tissue than in all other tissues investigated. However, there were no significant differences in the levels of gene expression between the two subgroups of patients. CONCLUSIONS: Very high expression levels of PDE3A and PDE5A in human cavernous tissue underscore the physiological importance of these enzymes for the regulation of penile erection, emphasizing their therapeutical and pharmacological relevance. The distribution pattern of the mRNA for the isoenzymes PDE3A and PDE5A may explain the pharmacological effects as well as the side effects of milrinone and sidenafil.     

Vascular corrosion casts of the dog testis after experimental microvascular surgical orchiopexy. A scanning electron microscope study

Five mongrel dogs underwent microvascular surgical orchiopexy by anastomosing the testicular artery and vein with the respective caudal epigastric vessels. In order to assess the effect of a 40 to 50-min period of warm ischaemia (the time required to make the anastomosis) on the testicular blood vasculature, plastic corrosion casts were made of the operated testes and compared with non-operated control specimens. The resulting blood vessel casts were inspected in the scanning electron microscope. One case of testicular atrophy developed, caused by a postoperative wound abscess. Comparing operated with non-operated testes, no differences in vascularisation, pattern or density of arterial supply, capillary network and venous drainage were seen. These findings are in agreement with data from the literature concerning histological, hormonal and clinical results.     

Hemihypertrophy of the human corpus cavernosum.

Hemihypertrophy of the right corpus cavernosum and its accompanying thickened tunica albuginea are responsible for the left lateral deviation in congenital curvature of the penis. Surgical correction is more predictable when the lengths of the dorsal and ventral curvatures of the corpora cavernosa are known.     

Complete rupture of the urethra and bilateral fracture of the corpus cavernosum penis

The authors report a case of complete rupture of the urethra with bilateral fracture of the corpora cavernosa caused by a faux pas during coitus and emphasize the importance of early surgical treatment which allows a precise evaluation of the lesions and immediate repair, which are the best guarantees of a good functional prognosis.     

Fine structure of the human corpus cavernosum

This paper demonstrates the ultrastructure of the human corpus cavernosum from eight male transexuals (aged 20 to 30 years) undergoing penectomy. The presence of collagen, smooth muscle, endothelial cells lining cavernous spaces, mast cells, and different types of nerve terminals, including those of a nonadrenergic and noncholinergic type, are illustrated.     

Functional evidence for nitrergic neurotransmission in a human clitoral corpus cavernosum: a case study

Although the presence of neuronal nitric oxide synthase (nNOS) has been demonstrated in human clitoral corpus cavernosum, functional evidence for the nitrergic neurotransmission as a nonadrenergic noncholinergic (NANC) transmitter has been limited to animal studies. Here we show that electrical field stimulation elicited reproducible NANC relaxation responses in a clitoral corpus cavernosum, obtained from a 38-y-old woman undergoing clitoral reduction surgery. These relaxation responses were abolished by an inhibitor of NO synthase or tetrodotoxin proving that they were nitrergic in nature and neuronal in origin. Large and small calibre nitrergic nerves were demonstrated with immunohistochemistry using nNOS antibody, which were also immunostained with cholinergic nerve markers. nNOS expression was confirmed using Western blotting. This is the first report to show that NO produced by nNOS within the cholinergic-nitrergic nerves is responsible for the NANC relaxation responses in a human clitoral corpus cavernosum.     

阴茎包埋对海绵体内勃起通路的影响

目的 观察阴茎包埋对海绵体内勃起通路的影响.方法 通过建立大鼠隐匿阴茎模型获得实验标本,分2、4、6个月组进行观测.各阶段中包括包埋组、假手术组和正常组.采用紫外分光光度计检测海绵体内一氧化氮合酶(NOS)的活性,免疫组织化学法显示雄激素受体(AR)在海绵体内的表达水平.结果 3个时间段内包埋组NOS活性分别为1.79、1.67、1.24 U/mg·prot,与正常组和对照组比较,酶活性降低随包埋时间延长逐渐显著(2个月组P>0.05,4个月组P<0.05,6个月组P<0.01),但包埋对各阶段大鼠阴茎海绵体内AR表达水平无影响.结论 阴茎包埋可直接影响勃起通路中最重要的神经递质一氧化氮合成的关键酶-NOS的活性来影响勃起通路,且这种影响与阴茎包埋时间正相关.     

阴茎包埋对海绵体结构和发育的影响

目的探讨阴茎包埋对海绵体结构和发育的影响。方法通过建立隐匿阴茎动物模型获得实验标本，分2个月组、4个月组和6个月组进行观测。检测海绵体质量和大鼠体重，观察发育情况；Masson染色分析海绵体内平滑肌和纤维结缔组织的含量来了解海绵体结构的变化。结果各阶段包埋组动物阴茎海绵体质量、体重及两者的比值与正常组和假手术组两两比较差异均无统计学意义（P〉0．05）；各阶段中包埋组的海绵体平滑肌面积下降（2个月组P〉0．05，4个月和6个月组P〈0．05），纤维结缔组织面积增加（2个月和4个月组P〉0．05，6个月组P〈0．05）血管窦的面积减少（2个月和4个月组P〉0．05，6个月组P〈0．05），且组织的正常形态发生改变。结论阴茎包埋可影响海绵体内平滑肌和纤维结缔组织的含量及组织排列的正常形态，且与包埋时间正相关，但对海绵体的大体观无明显影响。