RESUMO
Objectives: Evaluation of the effects of penile fracture on corporal anatomy after primary repair using cavernosography and post-cavemosography CT-scanning to demonstrate healing of tunical tear and its effects on penile shape and penile venous system
Patients: Twenty-one men who underwent primary repair of penile fracture were included in this study. Patients selected had a normal penile anatomy before injury
Methods: Patients were clinically evaluated for erectile function before and after injury. Primary repair was done within 24 hours of injury through a circumferential sub-glandular incision and penile skin de-gloving. Primary repair of the tear was done using continuous 5/0 suture. After a mean period of nine months of follow up, cavemosography was done for eight patients followed by post-cavernosography CT scan of the penis. Post-cavernosography reconstructed CT imaging formates were obtained to demonstrate the corpora in coronal and sagittal views
Results: Two cases only had associated incomplete corpora cavemosal injury. Post-operative period was uneventful in all patients. Twenty patients regained normal erection after primary repair [95%]. One patient only [5%] had erectile dysfunction in the form of failure to sustain erection. Twenty patients had no penile deformity during erection [95%]. Penile curvature developed in one patient but has been insignificant. Cavernosography demonstrated tunica as black line at site of healing. Only one pa tient [4.8%] has venous leakage away from the healed tunical tear
Post-cavemosography CT imaging demonstrated slight irregular indentation at the site of healing in all patients. Postcavemosography reconstructed CT images in both sagittal and coronal views demonstrated distortion of the tunica albuginea at the healed tear as an irregular area and bulging to outside in the coronal views
Conclusion: Primary repair of the penile fracture is effective in restoration of penile anatomy and erection in almost all patients. Cavemosography and CT scan of penis demonstrated the healed tear. Post-cavernosography CT and reconstructed CT views are the best means to demonstrate the healed tear in the tunica albuginea
RESUMO
A total of 126 patients were included in this study. The mean age of patients was 59.7 +/- 9.6 years [range 48-89 years]. All patients had symptoms suggestive of benign prostatic hyperplasia [BPH]. All patients were treated medically for six months with different pharmacological agents: Doxazosin [41], finasteride [33], combined doxazosin with finastride [22] and Seronea repens extract [30]. A control group, given placebo, included 20 patients who were age- matched and had obstructive lower urinary tract symptoms proved to be caused by BPH. All patients in both study and control groups were followed up for a period at least six months. Symptomatic evaluation, sonography and uroflowmetry were done to measure the efficacy of these agents. From the results obtained, it was concluded that, doxazosin is the most rapid single agent to improve the symptoms of BPH. Finasteride relieves both symptoms and prostate size after six months. Combined therapy is more effective and rapid than treatment with either doxazosin or finasteride alone. Seronea repens extract has a clinical efficacy similar to that of finasteride on both symptoms of BPH and reduction in the prostate size