New approach for management of impotence

A new type of topically applied drug [Eroderm-3 cream] for impotence was presented. Eroderm-3 cream contains vasoactive drug that had the ability to penetrate the penile cutaneous issue and facilitate erection. In this study, the usefulness of Eroderm-3 was examined in the treatment of erectile dysfunction. Eroderm-3 contains co- dergocrine mesilate, aminophylline and isosorbide dinitrate. A randomized double-blind controlled trial on 36 patients was performed after the etiology of impotence was investigated. All patients received Eroderm-3 and placebo cream. The patients were randomly divided into two groups each of eighteen patients. The first group received Eroderm-3 in the first month and placebo cream in the second month, while the second group received placebo in the first month and Eroderm-3 in the second month. The patients were advised to apply the cream on the penile shaft quarter of an hour before sexual stimulation and intercourse. The patients reported their experience via questionnaire. Twenty-one patients reported full erection and satisfactory intercourse, two patients reported partial erection and four patients reported just tumescence. Three patients reported full erection and satisfactory intercourse with either cream, while neither Eroderm-3 nor placebo cream produced a noticeable response in nine patients. The highest activity proved to occur in psychogenic impotence, while less rate of success was observed in patients with venous leakage. Laboratory testing of Eroderm-3 showed a high activity in increasing penile arterial flow and induced tumescence in 61% of patients. No marked side effects were recorded

Evaluation of impotent male

This study was performed to asses further the efficacy of the diagnostic modalities in evaluation of men presented with erectile dysfunction. Two hundred and ten impotent males were evaluated. After thorough history taking, clinical examination and basic laboratory investigation; no organic etiology could be elected in 93 patients and they were considered to have psychogenic causes. All the organic group patients [117] were subjected to color duplex study for the cavernosal arteries. Cavernosometry and cavernosography were done for those with suspected venous leakage which was recognized in 60 patients. Prolactin level was done for those with low testosterone level. Forty patients had arteriogenic impotence, thirteen patients had mixed etiologic factors, only three patients had neurogenic etiology and one patient had pure hormonal etiology

TB epididymitis is not uncommon incident

100 cases of epididymitis were randomly chosen provided that they didn't receive antibiotics in the last 48 hours. We categorized the patients into two groups: those presenting with acute painfull scrotal swelling and fever into group A [5 6 patient] and those presenting with painless scrotal lumb of more than 3 months duration into group B [44 patients]. - Full clinical assessment including careful history taking and clinical examination was done to all patients. - Urine smears stained with Z.N. -staining were examined for alcohol and acid fast bacilli for all patients, and similar semen smears for group [B] patients were also done. - Urine culturing on Lowenstein-Jensen medium was done for all patients. - Semenogram was done for group [B] patients. - Semen of group [B] patients was cultured also on Lewenstein-Jensen medium. Abdominal ultrasound together with chest x-ray and plain x-ray abdomen had been performed to all cases. In Group [B] patients, I V.U was routinely done. It is clear that chronic epedidymitis is highly suspecious for T.B. It had been found that semen culturing or smearing by Z-N-Stain gave a better chance-than urine to isolate the T-B bacillus [semen smearing and culturing proved that 15.9% and 29% of patients respectively were positive for T.B. bacilli compared to 13.6% and 25% of patients in case of urine]. Semen parameters had been variably affected in tuberculous involvement of the epididymitis specially in bilateral cases [all bilateral cases and 3 out of 8 unilateral involvement were infertile]. In conclusion, T.B. bacillus is a relatively common causative organism in cases of chronic epididymitis [13% of total cases of epididymitis and 29% of chronic cases]

Substitution urethroplasty using a venous graft: experimental trial in donkeys

Substitution urethroplasty was performed in 9 donkeys. In each donkey a urethral segment was removed and a venous graft from the jugular or saphenous vein was exposed and harvested by ligation of both ends of the vein. In three animals [group I], a suitable sized multifenstrated Ryle tube was introduced to bypass the urethra and the venous graft to drain the urinary bladder. The cut ends of the urethra and those of the graft were approximated and spatulated anastomosis was performed on the tube. In six donkeys [group II] a perineal urethrotomy was done and Foley's catheter was introduced through it to drain the bladder, and the anastomosis was separately stented. In all animals continuous locked 4/0 catgut sutures were used. The animals were observed for 3 mouths and the outcome and complications were recorded. After follow up for 3 months, one animal had a fistula, 2 animals had urethral stricture and the rest of the animals [6 donkeys] had smooth patent pathway. The results indicated that venous graft is a worthy trial for substitution of urethral defects of variable lengths [2-5 cm long]. The anastomosis should be spatulated and stented with proximal urinary diversion

Endourologic management of virtually impassable urethral stricture

Fifty patients with hardly passable or impassable [obliterated] urethral stricture were endourologically managed to get a patent urethra. These strictures, were either post inflammatory [38 cases] or post-traumatic in [12 cases]. A guide wire was introduced [through passable strictures] in retrograde or antegrade directions. Then, visual urethrotomy or guided dilatation by graduated teflon dilators [up to 20 F] followed by blind urethrotomy was performed. Light guide or a curved sound tip were aligned [under fluoroscopy] with the urethrotome peak on both ends of the stricture to guide cutting in cases of complete urethral obliteration. Follow up of those patients for 18 months revealed good results in term of unobstructed flow with no residual urine [in 40 patients]. Revision urethrotomy was necessary in 8 patients and open urethroplasty was performed for 2 patients