The Effects of 5-alpha Reductase Inhibitor on Contr action of Erectile Tissue and Secretion of Seminal Fluid in Male Rabbits: Preliminary Study / 대한남성과학회지

PURPOSE: Adverse sexual experiences such as erectile dysfunction (ED), loss of libido, and ejaculation disorders have been consistent side effects of 5-alpha reductase inhibitors (5ARI). The aim of this study was to evaluate the effects of 5ARI (finasteride) treatment on semen parameters and contraction of the corpus cavernosum and seminal vesicles in male rabbits. MATERIALS AND METHODS: Adult male New Zealand White rabbits (n=10) were randomized into 2 groups: finasteride-treatment (5ARI) group and vehicle-treatment (control) group. The 5ARI group received daily oral finasteride (10 mg/day) by gavage for 4~6 weeks, and the control group received the same concentration of the vehicle. The semen volume and semen parameters between the 2 groups were compared; thereafter, contraction or relaxation responses of smooth muscle strips of the corpus cavernosum and seminal vesicles were observed in an organ bath. RESULTS: Semen magnesium (14.2 vs 5.1 mg/dl) and protein (2.2 vs 1.6 g/dl) concentrations were significantly lower in the 5ARI group than in the control group. The concentrations of other parameters such as electrolytes (Na/K/Cl), fructose, and citrate did not differ between the 2 groups. The contractile responses to norepinephrine (NE) significantly increased in the 5ARI group compared to the control group and the relaxation responses to acetylcholine (ACh) or sodium nitroprusside (SNP) also increased in the 5ARI group. The contractile responses of the seminal vesicular strips to NE significantly decreased in the 5ARI group compared with the control group. CONCLUSIONS: The results suggest that finasteride may decrease contraction of seminal vesicle tissue and alter semen parameters. The effect of finasteride on erectile tissue was double-faced; enhancing both contraction and relaxation. Further study is needed in this respect.

Warfarin-Induced Penile Necrosis in a Patient with Heparin-Induced Thrombocytopenia

A 56-yr-old man with lung adenocarcinoma presented with subsegmental pulmonary thrombosis. Platelet count on presentation was 531x10(9)/L. The patient was anticoagulated with subcutaneous low molecular weight heparin (LMWH). Next day, oral anticoagulation was initiated with 5 mg of warfarin once daily with LMWH and LMWH was discontinued at third hospital day. On the third day of oral anticoagulation therapy, he complained of left leg swelling and prolonged painful penile erection of 24 hr-duration. His platelet count reached a nadir 164x10(9)/L at that time, and the patient had a deficiency of protein C and S, with an activity level of 16% and 20% of normal value. Warfarin was stopped and he underwent penile aspiration. The next day, left leg edema and penile erection was disappeared, but penile and glans penis necrosis was started. This case illustrates that processes underlying heparin-induced thrombocytopenia (HIT) may also underlie warfarin-induced skin necrosis.

Comparison of the Short Term Results of Monarc and TVT-O Transobturator-tape Procedures for the Treatment of Stress Urinary Incontinence

PUROPOSE: Transobturator sling is a new minimally invasive treatment for female stress urinary incontinence. We compared the efficacy and safety of the two procedures, Monarc and TVT-O. MATERIAL AND METHODS: We included 110 patients with stress urinary incontinence who underwent the Monarc (n=52) or TVT-O (n=58) procedure and followed up at least for 1 year. Preoperative evaluations, the indices of voiding and postoperative complication were investigated. They were analyzed by Student's t-test, Paired t-test and chi-square test. RESULTS: There were no significant difference in the preoperative patients' characteristics, postoperative complication and success rate between the two groups. The preoperative and postoperative storage symptoms between two groups had no significant difference but the patients of both groups had significant improvement in storage symptoms such as frequency and urgency after surgery. CONCLUSIONS: The Monarc and TVT-O is equally effective and safe procedures as a treatment method of female stress urinary incontinence.