Placement of the Small-Carrion penile prosthesis to enable maintenance of an exdwelling condom catheter

Four patients in our Medical Center underwent placement of a Small-Carrion penie prosthesis for the primary purpose of maintaining an exdwelling condom catheter. The major benefits of being able to carry on daily activities, while maintaining satisfactory perineal hygiene, without the need for an indwelling Foley catheter is a most significant factor in the consideration of prosthetic surgery.     

Use of the evoked sacral potential in the diagnosis of male impotence

The study of evoked sacral potentials in men complaining of erectile impotence is a new diagnostic modality. Our early results confirm its usefulness in diagnosing impotence secondary to diseases of the sacral spinal cord or its roots.     

Haemostatic effects in vivo after snakebite by the red-necked keelback (Rhabdophis subminiatus).

We describe a patient who developed a severe coagulopathy after being bitten by a red-necked keelback snake (Rhabdophis subminiatus), a species which is generally considered non-venomous. The patient's blood was incoagulable due to complete depletion of fibrinogen. Comprehensive coagulation studies were performed to identify the mechanism(s) by which the snake toxin caused the coagulopathy. It was found to contain a potent prothrombin activator, probably an activator of protein C and possibly also a factor X activating enzyme. The fibrinolysis was secondary to intravascular fibrin formation; there were no indications for a direct fibrinogenolytic activity in the snake toxin. Remarkably, there was virtually no consumption of antithrombin III, despite extensive thrombin formation; this feature appears to be not uncommon after snake bites, but is still unexplained.     

Possible errors in uroflowmetry

The possibility of alteration of uroflow rates by rapid bladder filling was evaluted in 61 consecutive patients referred for urodynamic evaluation. Nine of the 28 patients who were able to void did in fact demonstrate a significant reduction in uroflow rates after the bladder had been rapidly filled. Thus, the manner of obtaining the uroflow should be taken into account when making a clinical decision based on that test.     

Acute stimulated hormone release from cultured GH3 pituitary cells.

Treatment of cultured rat pituitary GH3 cells with 50 mM KCl in growth medium released 33% of cell PRL and 18% of cell GH with a half-time of 5 min. Hormone in the culture medium was increased 2- to 4-fold over unstimulated levels. The response required calcium; barium and strontium, but not magnesium, could substitute for calcium. Low temperature completely inhibited hormone release, which was also reduced significantly by inhibitors of energy metabolism and by nitrogen. This acute response was similar in ionic requirements, hormones released, and time course to the acute effect of TRH. Like potassium stimulation, TRH resulted in acute release of both PRL and GH. This contrasts with the finding that chronic TRH treatment reduced GH synthesis in GH3 cells. After a 10-min preincubation with potassium, subsequent short incubations with potassium released little hormone unless the cells were allowed to recover by incubation in normal medium for at least 2 h. This acutely releasable hormone pool seems to be located in a membrane-bound subcellular fraction, since GH3 cells did not discharge the cytoplasmic marker enzyme, lactate dehydrogenase, during potassium-stimulated hormone release.     

Interview of wives: A necessary adjunct in the evaluation of impotence

Clinical reports have suggested that involving wives in the evaluation of their husbands' sexual dysfunction is important, but data are scant. Our study shows that interviews with wives (or other significant sexual partners) are essential, not only for assessing the possible role of marital conflict in impotence etiology, but also for correcting patients' misinformation and for gaining insight into the wives' sexual and psychological dynamics which will be necessary for optimal referral if medical treatment for the impotence is not indicated. Over a period of six months, 49 currently married or substantially involved men were evaluated for impotence in our Male Sexual Dysfunction Unit. Forty of their wives or primary sex partners were interviewed by the Unit psychologist yielding significant medical and psychosocial information and concrete details of erectile and ejaculatory performance. In several cases, this information contradicted that obtained from the patients themselves. In many instances, the information was an important supplement and affected treatment recommendations.     

The possible role of the catecholamines of the corpora in penile erection.

The etiology of impotence, which effects 50 per cent of the men with diabetes, is unknown. The neurotransmitter (norepinephrine) released from adrenergic neurons is thought to be the most direct regulator of vascular smooth muscle. We have measured the norepinephrine content of the erectile tissue of diabetic men. Our results indicate the presence of a dual neural regulator mechanism of the corpora that controls penile erection.