Corporeal blood gas changes according to duration of drug-induced prolonged erection

The corporeal blood gas changes in accordance with the duration of the prolonged erection which developed after intracorporeal pharmacotherapy with papaverine and phentolamine were investigated in 62 impotence patients. The picture of the corporeal blood taken from 15 psychogenic impotence patients (a control group) at 10 minutes after intracavernous injection when they showed full erections was arterial but there was pCO2 rise and pH drop compared to femoral artery blood taken simultaneously. As the erection lasted longer, significant gas changes of the cavernous blood began to appear (p<0.0001): increase in pCO2 and decrease in pO2 from 4 hours, decrease in pH from 5 hours, decrease in O2 saturation from 6 hours. Erections lasting for more than 16 hours showed significantly worse hypoxia (p<0.05). Therefore, to prevent hypoxia and metabolic acidosis, drug-induced prolonged erection would be better decompressed before it lasts for more than 4 hours.

Diagnostic value of penile duplex sonography for arteriogenic impotence / 대한비뇨기과학회지

Penile duplex sonography with intracorporeal papaverine injection has been proposed as a reliable noninvasive method to evaluate the cavernosal arteries. To provide insight into the clinical value of this test. penile duplex sonography was comparatively analyzed with penile brachial index. nocturnal penile erection and selective internal pudendal pharmacoangiography in 60 patients suggestive of arteriogenic impotence. The duplex sonogram, penile brachial index and angiogram of both cavernosal arteries were evaluated separately and compared each other. Cavernosal arteries were interpreted as normal by duplex scanning if the artery demonstrated a 75% or greater increase in diameter and systolic peak flow velocity of greater than 25 cm/sec after intracorporeal injection of 60 mg or papaverine HCI. There was no significant difference between the degree of arterial dilatation and peak flow velocity on penile duplex sonogram. Arterial dilatation and peak flow velocity did not correlate with nocturnal penile erection and cavernosal arteriogram. But peak flow velocity correlate with penile brachial index. In conclusion. although penile duplex sonography is a useful method to evaluate the cavernosal arteries. it alone can make an error to misdiagnose the arteriogenic impotence. Therefore supplementary tests should be added to the duplex sonography to avoid this error.

Patient satisfaction after penile prosthesis: a statistical comparison of the malleable, infantable and hydroflex prosthesis / 대한비뇨기과학회지

To assess the sexual activity, physical adjustment. quality of erection and sexual satisfaction after penile prosthesis, 50-item questions were made up by mailing or interview. Out of 140 patients, 61(40 malleable, 10 inflatable, 11 hydroflex) replied to the questionnaire. Partner`s attitude frequency of intercourse and premature ejaculation were significantly improved postoperatively. More than half of the patients complained of reduced penile size, whereas 72% of the patients got increased rigidity postoperatively. For the penile size and rigidity, inflatable prostheses took the first place, and next came the malleable and then hydroflex prostheses. Concealment problems of the malleable, inflatable and hydroflex prostheses were 85%, 20%, and 46%. respectively. Satisfaction rate of the malleable, inflatable and hydroflex prostheses was 70%. 50%, and 46%, respectively. Over all satisfaction rate was 62% and dissatisfaction rate was 13%. The satisfaction rate of the unmarried young or traumatic impotent patients was particularly lower. There was no relationship between satisfaction rate and duration of impotence. In conclusion, postoperative quality of erection, concealment problems and physical adjustment should be explained and informed to patients to avoid unrealistic expectations before implantation.

Patient satisfaction after penile prosthesis: a statistical comparison of the malleable, infantable and hydroflex prosthesis / 대한비뇨기과학회지

To assess the sexual activity, physical adjustment. quality of erection and sexual satisfaction after penile prosthesis, 50-item questions were made up by mailing or interview. Out of 140 patients, 61(40 malleable, 10 inflatable, 11 hydroflex) replied to the questionnaire. Partner`s attitude frequency of intercourse and premature ejaculation were significantly improved postoperatively. More than half of the patients complained of reduced penile size, whereas 72% of the patients got increased rigidity postoperatively. For the penile size and rigidity, inflatable prostheses took the first place, and next came the malleable and then hydroflex prostheses. Concealment problems of the malleable, inflatable and hydroflex prostheses were 85%, 20%, and 46%. respectively. Satisfaction rate of the malleable, inflatable and hydroflex prostheses was 70%. 50%, and 46%, respectively. Over all satisfaction rate was 62% and dissatisfaction rate was 13%. The satisfaction rate of the unmarried young or traumatic impotent patients was particularly lower. There was no relationship between satisfaction rate and duration of impotence. In conclusion, postoperative quality of erection, concealment problems and physical adjustment should be explained and informed to patients to avoid unrealistic expectations before implantation.

Complications of Indwelling Double-J Ureteral Stents / 대한비뇨기과학회지

The silicone rubber double-J ureteral catheter has been popularized as an ideal internal ureteral stent for temporary or permanent urinary diversion and generally is considered to be free of side effects. We review our use of the double-J ureteral stent in 42 patients during a recent 2-year period. 1. Of 42 patients evaluated, the complicated urologic symptoms were revealed ; frequency in 15 ( 35.7% ) patients, lower abdominal pain in 15, flank pain in 10, gross hematuria in 9, nocturia in 8, dysuria in 7, nausea in 2, fever in 1 and urinary debris in 1. The early removal of stent was required in 5 (11.9% ) patients because of severe vesical irritability. 2. Of 31 patients whom indwelled stent less than 6 months, encrustation was occurred in one patient but stent fracture, encrustation and bladder stone formation were developed in 8 (72.7 %) among 11 patients whom kept more than 6 months. Therefore, despite the undoubted benefit in many patients, troublesome symptoms were common. We recommend that a shorter period of double-J stenting or more frequent catheter changes than 6 months may prevent stent fracture, encrustation and bladder stone formation.