Intracavernosal Needle breakage developed during Self-injection of Vasoactive Agent : Two case reports / 대한남성과학회지

Currently intracavernous pharmacotherapy is the second common therapeutic modality for erectile dysfunction after the introduction of Viagra. Nevertheless, intracavernous pharmacotherapy has increased in popularity for the past 15 years. While having an overwhelming safety after complete training in injection method, this treatment option can reveal unexpected complications related to self-injection. We report two cases of intracavernous needle breakage associated with alprostadil (Caverject , Pharmacia-Upjohn) and trimix self-injection therapy with a brief review of the literature.

Experimental study of the role of nitric oxide of cavernous smooth muscle relaxation / 대한비뇨기과학회지

Relaxation of penile cavernous smooth muscle is controlled by nerve and endothelium derived substances. Externally applied acetylcholine in human corpus cavernosum has been shown to cause endothelium dependent smooth muscle relaxation and nitric oxide(NO) is known as an endothelium derived relaxing factor(EDRF). NO has been identified as an endothelium derived relaxing factor in blood vessels. We tried to determine whether it is involved in the relaxation of the corpus cavernosum that allows penile erection. The changes of isometric tension in rabbit cavernous smooth muscle strips mounted in organ bath chambers after the addition of drugs were monitored on the biophysical recording system. Acetylcholine induced a dose-dependent relaxation and atropine at 5 x 10(-5) M almost abolished the effects of acetylcholine. N(c)-nitro-L-arginine (L-NOARG) at 5 x 10(-5) M almost abolished the effects of acetylcholine. The subsequent addition of L-arginine at 5 x 10(-5) M further restored to the effect of acetylcholine, but these effect did not occur if D -arginine was substituted for L-arginine. Methylene blue at 10-5 M markedly inhibited effects of acetylcholine. These data suggest that acetylcholine endothelial formation of NO via muscarinic receptor and NO from L-arginine leads to the relaxation of cavernous smooth muscle via activation of guanylate cyclase in rabbit.

Clinical Review of Honeymoon Impotence / 대한비뇨기과학회지

Recently, with the influence of mass media and sexual liberation, the patients have been increasing to visit the impotence clinic with male sexual dysfunction during early married period. We studied twenty five patients suffering from honeymoon impotence from Jan. 1985 to Mar. 1990. The results were as follows : 1. Age distributions were 25 to 40 years old with a mean of 30. The interval of impotence prior to visit were 2 days to 3 years after marriage and the 17 patients ( 68.0% ) were within 3 months. 2. There was no significance according to the school career and the occupations of patients. 3. Except 5 patients, 20 were primary impotences that were possible premarital sexual coitus on history. One of these had the history of psychiatric consultation by sexual problems and another had moderate mental retardation. 4. On first visit, 11 of 25 were on doing the separation or divorce suits. 5. Except 1 with Klinefelter's syndrome, all were organically normal erectile function tests including nocturnal penile tumescence test. 6. Of 14 patients who accepted to therapy, 10 were able to gel desirable sexual life with one or the combination of following : supportive psychotherapy, yohimbine administration, intracavernous pharmacotherapy and vacuum tumescence enhancement therapy. The rest 4 were able to get penile erection, but sexual life was also failed with their wives. The honeymoon impotence is mostly pychogenic and also easily curable with its recent increasing frequency. However, because of the associating problems of separation, divorce and alimony, we think that the diagnosis and treatment of honeymoon impotence might be performed with prudent approach.

A Clinical Experience of Vacuum Tumescence Enhancement Therapy for Impotence / 대한비뇨기과학회지

The major role of treatment for impotence is played by vasoactive intracavernous pharmacotherapy or penile prosthesis during last decades. However, the former has a high risk of cavernosal fibrosis-and priapism, and the latter, also infection. We applied the Vacuum Constrictor Device to fifty of organic, 2 of old age, and 2 of unknown. Of 53 cases, 47 encountered the desirable erection were able to secure the vaginal penetration. Of 5 failed cases, 4 were because of maladjustment due to slim body and 1 was of pain on the pubic area due to previous old pelvic bone fracture. Of 17 cases with poor erection by vasoactive intracavernous pharmacotherapy 15 encountered good erection by means of Vacuum Constrictor Device and no significant complications were observed. Of 14 self-acquired Vacuum Constrictor Davicl which were used in which frequency of 10 to 17 times, 10 cases were shown to be satisfactory and the rest were not. Of 4 unsatisfactory cases, 2 were leakage of congested blood during intercourse, 1 was difficulty in intercourse due to pivot and the other one was of mild suprapubic pain due to previous pelvic bone fracture. Although Vacuum Temescence Enhancement Therapy is cumbersome in manipulation prior to sexual intercourse and has time limitation, it is easy to learn and has less complications than vasoactive intracavernous pharmacotherapy. Therefore Vacuum Tumescence Enhancement Therapy is thought to a preferable therapeutic alternative prior to vasoactive intracavernous pharmacotherapy and surgical treatment in impotence in spite of these disadvantages.

The Comparison of Erectile Function Tests in Patients Complaining of Impotence after Trauma / 대한비뇨기과학회지

We studied 16 male patients complaining of impotence after trauma. Underlying causes of injury were posterior urethral injury (9 patients), pevic bone fracture (3 patients), perineal burn (2 patients), penile fracture (1 patient) and spinal cord injury (1 patient). Rigiscan was used for diagnostic test and compared with other erectile function tests (Papaverine injection test, Snap Gauge test, PBI(penile brachial index) and PDI (penile digital index) test, AVS (audiovisual stimulation) and Erectiometer tests. The results obtained were as follows: 1. In 9 patients shown normal rigiscan, the number of erection was 1.56+/-0.87 times per night, duration was 14.2+/-7.54 minutes at tip and 20.1+/-9.42 minutes at base, tumescence change was 2.30+/-1.64 cm at tip and 3.40+/-0.73 cm at base, rigidity was 66.28+/-13.33% at tip and 78.86+/-21.43% at base. 2. Among 9 patients shown normal rigiscan, 8 patients showed partial to full rigid erection in intracavernous Papaverine injection test. 3. In 7 patients shown abnormal rigiscan, the findings of Snap Gauge test, AVS test and Erectiometer test showed slight to absent responses, but 9 patients shown normal rigiscan presented variable findings. 4. 13 patients with PBI > or=0.75 and 15 patients with PDI > or =0.77 showed normal rigiscan. but patients shown abnormal rigiscan presented variable findings of PBI and PDI tests. Conclusively, rigiscan and intracavernous Papaverine injection test showed high corresponding rate, but other erectile function tests presented variable findings in patients complaining of impotence after trauma.

The Comparison of Erectile Function Tests in Patients Complaining of Impotence after Trauma / 대한비뇨기과학회지

We studied 16 male patients complaining of impotence after trauma. Underlying causes of injury were posterior urethral injury (9 patients), pevic bone fracture (3 patients), perineal burn (2 patients), penile fracture (1 patient) and spinal cord injury (1 patient). Rigiscan was used for diagnostic test and compared with other erectile function tests (Papaverine injection test, Snap Gauge test, PBI(penile brachial index) and PDI (penile digital index) test, AVS (audiovisual stimulation) and Erectiometer tests. The results obtained were as follows: 1. In 9 patients shown normal rigiscan, the number of erection was 1.56+/-0.87 times per night, duration was 14.2+/-7.54 minutes at tip and 20.1+/-9.42 minutes at base, tumescence change was 2.30+/-1.64 cm at tip and 3.40+/-0.73 cm at base, rigidity was 66.28+/-13.33% at tip and 78.86+/-21.43% at base. 2. Among 9 patients shown normal rigiscan, 8 patients showed partial to full rigid erection in intracavernous Papaverine injection test. 3. In 7 patients shown abnormal rigiscan, the findings of Snap Gauge test, AVS test and Erectiometer test showed slight to absent responses, but 9 patients shown normal rigiscan presented variable findings. 4. 13 patients with PBI > or=0.75 and 15 patients with PDI > or =0.77 showed normal rigiscan. but patients shown abnormal rigiscan presented variable findings of PBI and PDI tests. Conclusively, rigiscan and intracavernous Papaverine injection test showed high corresponding rate, but other erectile function tests presented variable findings in patients complaining of impotence after trauma.

Clinical Value of Nocturnal Penile Erection by Rigiscan / 대한비뇨기과학회지

Continuous and simultaneous recording of nocturnal penile rigidity and tumescence is preferred than measuring tumescence alone to define the features of nocturnal penile erection and differentiate psychogenic from organic impotence. Rigiscan is suitable for this purpose. Authors studied to define the features of nocturnal penile erection by rigiscan in 24 normal Koreans and 18 patients with erectile dysfunction. The results were as follows : 1. In normal group, the number of normal erection was 4.2+/-0.9 times per night, duration was 21.1+/-7.4 minutes at tip and 26.3+/-9.8 minutes at base, tumescence change was 1.81+/-0.51 cm at tip and 2.23+/-0.72 cm at base, rigidity was 55.7+/-19.6 per cent at tip and 66.3+/-12.0 per cent at base. Maximal duration was 34.2+/-14.9 minutes at tip and 39.0+/-15.1 minutes at base, maximal tumescence change was 2.28+/-0.83 cm at tip and 2.64+/-0.78 cm at base, maximal rigidity was 65.4+/-11.8 per cent at tip and 75.8+/-12.5 per cent at base. The higher the age, the shorter the duration and number of events were(p<0.05). 2. In patient group, normal rigigram showed in 6 patients(3 of psychogenic, 3 of posterior urethral injury). Event and duration were shorter than normal group(p<0.05). The findings of flat trace or abnormal erection provide valuable information to screen the organic impotence.

The Results of Intracavernous Papaverine Injection: Experience with 92 Patients / 대한비뇨기과학회지

A total of 92 men with impotence underwent a trial of intracavernous injection of papaverine 30mg. Underlying causes of impotence were psychogenic (26 Pts.), posterior urethral injury (28 Pts.), spinal cord injury (15 Pts.), pelvic surgery (14 Pts.) and eldly (9 Pts.). The results were as follows 1. The underlying causes of impotence in papaverine responders were psychogenic 23 (88.5%), posterior urethral injury 19 (67.9%), spinal cord injury 13(86.7%), Pelvic surgery 5 (35.7%) and eldly 3 (33.3%). 2. Fourteen patients of the moderate papaverine responders underwent intracavernous injection of papaverine 30mg with phentolamine 1mg and 8 of them attained full erection. 3. After injection, the erection started in an average of 2.6 minutes, rigidity of penis attained in an average of 7.3 minutes, and erection status sustained for an average of 42.6 minutes in 60 patients. 4. Normal nocturnal penile tumescence monitoring (NPTM) or stamp test was found in 19 of 40 patient and 18 of them (94.7%) were papaverine responders, while 21 had an abnormal NPTM or stamp test and 11 of them were papaverine non-respoders. 5. A penile brachial index (PBI) of 0.6 or more was found in 62 of 73 patients and 53 of them(85.5 %) were papaverine responders, while 11 had an index of less then 0.6 and all of them were papaverine non-responders. 6. Thitry patients had sexual intercourse. Twenty-seven of them had a satisfactory result and 23 of them had ejaculation. 7. Papaverine induced prolonged erection occurred as major complicatiun in 4 patients after trial injection. Erection was subsided after intracavernous phenylepinephrine injection. There were minor complications such as ecchymosis at the injected site on the prepuce but subsided spontaneously in a few days. We conclude that intracavernous papaverine injectiun currently is a good screening technique for the differential diagnosis of severe vasculosenic impotence and is a useful chemical prosthesis of non-vasculogenic impotence.

A Case Report of Simple Unilateral Ectopic Kidney / 대한비뇨기과학회지

Additional a case of ectopic kidney with a literatural review was presented. The terms renal ectopia describe kidneys which are congenitally located in abnormal anatomic positions. Its clinical interest is that it often confused with retroperitoneal tumor and pelvic tumor and other abdominal conditions. We experienced a case of ectopic kidney that was clinically confused with retroperitoneal tumor in 22-year old Korean male.

Excretory Urography with Conray 400 / 대한비뇨기과학회지

No abstract available.

A Case of Congenital Adrenogenital Syndrome / 대한비뇨기과학회지

A 5 year old girl was visited with the chief complaint of abnormal genitalia from birth. Physical examination revealed enlarged clitoris, urogenital sinus formation, increased urinary 17-ketosteroid, Jailer's test positive and sex chromatin positive. Diagnosis was made congenital adrenogenital syndrome.

A Clinical Observation on Injuries of Genitourinary Tract / 대한비뇨기과학회지

A clinical observation was made on the injuries of the genitourinary tract of the inpatient in the Department of Urology, Third Army Hospital during the period from Jan. 1967 to Dec. 1969. The results are as follows: 1. 56.13% of all patient were due to automobile accident and 15.78% were due to gunshot wound and then falls(14.04%), stab wound (8.77%). 2. The most common involvement site was in urethra for 61.15% while external genitalia showing most common site in war wound. 3. In investigating bladder injuries, 63.64% of injuries were associated with pelvic bone fracture and 72.7% was extraperitoneal type and 27.3% was in intraperitoneal type. 4. The complication of urethral injury were urethral stricture (52. 78%) and impotence.

Klinefelter's Syndrome / 대한비뇨기과학회지

Additional two cases of Klinefelter's syndrome with a literatural review was presented Two cases were revealed characteristics of Klinefelter's syndrome such as small testes, hyalinization of seminiferous tubules, azoospermia, increased FSH, normal 17-ketogteroid and positive sex chromatin. One case was associated with left inguinal crytorchidism.