[New findings on the physiology of erection or the concept of the active sponge]. / Nouvelles données sur la physiologie de l'érection ou le concept de l'éponge active.

Until these last years, erection was mainly explained by neurovascular mechanisms. The erectile bodies were assimilated as a simple sponge passively filled or emptied by an unbalance between the arterial and venous flows. In fact, the erectile bodies themselves control the erection thanks to their potent smooth musculature. By contracting, they induce both flaccidity and detumescence, since their relaxation releases the erection. The erectile bodies work really as a kind of active sponge having the property to be autonomous and distortionable. However, the contractility of the erectile bodies cannot alone explain all the erection. This complex hydraulic process requires also complementary vascular mechanisms (cavernous outflow blockade, arteriodilatation) and tissular mechanisms (extrinsic compression of erectile striated muscles, specific distortion of each erectile body) under both hormonal and neuro-psychic control. By pointing up the fact that the active and passive tissue mechanisms play a major role for erection, this active sponge concept underlines the necessity for investigating the erectile tissues and allows to reconsider both physiopathology and treatment of dyserections.

[Old theories and present-day hypotheses for the mechanisms of erection]. / Théories anciennes et hypothèses actuelles des mécanismes de l'érection.

On the basis of old theories and recent observations, the authors discuss the real nature of the activity of the erectile tissue of the corpora cavernosa and spongiosa. Is erection simply produced by passive injection of spongy tissue? Or is erectile tissue like a real live "sponge" which is capable, on its own, of producing and eliminating erection? If this is the case, where is the intra-tissue motor apparatus located? A new hypothesis is proposed.

[Intracavernous injections of vasoactive drugs. Contribution to the study of their value in erectile impotence]. / Les injections intracaverneuses de drogues vasoactives. Contribution à l'étude de leur valeur dans l'impuissance érectile.

The obtention of an artificial erection with a single intracavernous injection (ICI) of vasoactive drugs, has upset our conceptions about erection and the approach for erectile failure. If this pharmacologic stimulation increases the reliability of some erection tests, their diagnosis value is still questioned. The complexity of both erection and vasomotricity pharmacology, make difficult the understanding of the mechanisms of these ICI. Their therapeutic value is reduced to the method by self injections, new treatment for impotence, even if it concerns only few impotent patients. Finally, the experimental feature and the unquestionable morbidity of these ICI, mainly priapism, impede their large diffusion. However, in spite of these doubts, this intracavernous pharmacology is a real progress for erection and its troubles.

[Peyronie's disease. Our therapeutic experience. Apropos of 182 cases]. / Maladie de la Peyronie. Notre expérience thérapeutique. A propos de 182 cas.

182 patients with Peyronie's disease have been treated over the last 18 years. The aetiology of this disease remain a mystery, but its slow progression over time and its spontaneous tendency towards improvement in a number of cases suggest the need for cautious treatment, essentially based on psychotherapy and the prescription of vitamin E, with surgery reserved for the rare very severe cases.

[Injections into the corpora cavernosa. The pros and cons]. / Les injections dans les corps caverneux. Le pour et le contre.

The authors summarize five years' experience of the therapeutic, diagnostic and physiological research use of intra-cavernous injection of vasoactive drugs, particularly papaverine and dipyridamole.

[Hemodynamics of erection: current pharmacological findings]. / Hémodynamique de l'érection: nouvelles données pharmacologiques.

Over twenty drugs were injected into the corpora cavernosa. Pharmacologically these drugs come under seven therapeutic categories. Two types of pharmacodynamics explain the mode of action of these agents on the erectile tissues. The discovery of these drugs can be added to the array of investigations and actions normally used to study and remedy the problems of organic impotence, as well as a new test which may provide a therapeutic base for vascular rehabilitation and, in some cases, a substrate for a pharmacological prosthesis.