Outcomes of lateral retroperitoneal reservoir placement of three-piece penile prosthesis in patients following radical prostatectomy.

While placement of a three-piece inflatable penile prosthesis (IPP) with a midline reservoir can be performed with favorable outcomes after radical prostatectomy (RP), postoperative fascial scarring can introduce surgical complexity, increase intra-operative complications and/or potential obstacles for future inguinal and/or perineal surgeries. We describe the implantation of the IPP with lateral reservoir placement through a separate incision to avoid surgical complications. We obtained clinical characteristics of all patients (1998-2009) who underwent RP before IPP placement with lateral reservoir placement (cases). For comparison, patients who underwent IPP placement with midline reservoir placement were also identified (controls). Thirty-one patients with a history of RP underwent IPP placement using the lateral placement technique without intra-operative or post-operative complications. There were no significant differences in the intra-operative complication rate among 31 control patients. However, at a median follow-up of >2 years, there was a significantly higher rate of post-operative complications in controls, likely reflecting the increased co-morbidities in this group. The results of this study suggest that three-piece IPP with lateral retroperitoneal reservoir implantation is associated with comparable long-term outcomes and can be performed safely in patients who have previously undergone RP.

Cimetidine therapy in nonsteroidal anti-inflammatory drug gastropathy. Double-blind long-term evaluation.

To assess the efficacy of cimetidine in treating and preventing gastric mucosal lesions associated with nonsteroidal anti-inflammatory drug (NSAID) therapy (NSAID gastropathy), we endoscopically studied 104 patients taking NSAIDs for a variety of rheumatic diseases. Fifty-six percent (22/43) of patients randomized to cimetidine 300 mg four times a day and 52% (22/42) of those randomized to placebo showed progression of endoscopic lesions during the eight-week short-term phase. Thirty-nine patients whose endoscopic lesions improved were then randomized to a ten-month maintenance regimen of either cimetidine 400 mg at bedtime or placebo. Fifty percent (7/14) of placebo-treated and 42% (5/12) of cimetidine-treated patients showed progression of lesions during the maintenance phase. The failure of cimetidine to offer any significant benefit under these protocol conditions reflects the fundamental difference in pathophysiologic features between classic acid-mediated ulcer disease and NSAID gastropathy.

Behavioral effects of drugs as a function of maternal polybrominated biphenyl body burden.

Prior to breeding, female rats were dosed orally for 20 days with either 0.5 mg/kg polybrominated biphenyl (PBB), 5.0 mg/kg PBB, or the lecithin liposome vehicle. Male offspring of these 3 treatment groups did not differ with respect to the learning of an operant discrimination task. However, administration of phenobarbital or d-amphetamine impaired the behavior of the offspring of low-dose PBB dams less than that of the offspring of controls. The behavioral effects of the drugs were generally inversely related to levels of liver PBB and activities of liver aryl hydrocarbon hydroxylase (AHH).