Perspectives of combined doppler wave analysis and intracavernous injection of PGE1 in the diagnosis of vasculogenic impotence

Recent research advances in the neuroanatomy, physiology, hemodynamics and pharmacology of penile erection have provided us with new insights into the pathophysiology of different types of erectile dysfunction. Various non invasive tests are developed to investigate the penile vascular system, but the results of them are less than satisfactory because most of them assess the hemodynamics of the penis in the flaccid state. On the other hand, although intracavernous injection of vasoactive drugs, like prostaglandin El [PGE1] allows the investigation of the penile vascular integrity during erection, yet the test is subjective and is considered non specific. In this study, we investigated the efficacy of the combined use of doppler wave analysis and intracavernous injection of PGE1 to overcome the disadvantages of both tests. The percentage of vasculogenic impotence in the 100 impotent patients studied was increased from 8 to 23 to 40% when we used doppler wave analysis alone, intracavernous injection of PGE1 alone and both in combination respectively. Thus we recommend the combined use of both tests together for diagnosis of vasculogenic impotence and we consider it to be an easy, accurate, satisfactory, screening and diagnostic out-patient clinic test

Simultaneous monitoring of amikacin and gentamycin levels in plasma versus prostatic fluid can predict thir in vivo therapeutic efficacy in chronic bacterial prostatitis

The study was conducted on 20 chronic bacterial prostatitis patients, they were divided into amikacin and gentamycin groups. They received therapeutic doses of i.m. twice daily amikacin and gentamycin. Their peak drug levels and pH measurements in plasma versus prostatic secretion were assessed after the first and last dose of the 7-day course together with post therapeutic bacteriological assessment. Results revealed a positive correlation between beneficial levels of the two aminoglycosides recovered in the prostatic fluid and the absence of bacterial growth in post therapeutic specimens. No definite relationship was correlated between drug levels and pH measurements in prostatic secretion. Therefore, performing initial quantitative detection of peak levels of aminoglycosides in the expressed prostatic secretion after the first dose was recommended, to determine whether the drugs are recovered in beneficial levels. So, the physician could take early decision whether to continue the course or to cut it short when the therapeutic value is not worth the hazards, costs and disappointment of inadequate response