[The value of using a facilitating dose of papaverine chlorhydrate during cavernometry]. / Intérêt de l'utilisation d'une dose facilitatrice de chlorhydrate de papavérine lors de la cavernométrie.

In order to establish diagnostic cavernometric criteria, we selected 63 patients who did not respond positively to visual sexual stimulation. They were subjected to the following protocol including Rigiscan monitoring of 2 or 3 nights erections for, hormonal assays, penile doppler, cavernometry and cavernography. Intracorporeal injection of 8 mg of papaverine was performed during the hemodynamic tests. Our results showed that the erection maintenance blood flow and the maintenance index are statistically reliable diagnostic criteria for venous leaks (the maintenance index is more accurate). The use of 8 mg of papaverine reduces the incidence of false positive results without significant hemodynamic changes. In order to exclude psychogenic false positive patients, it is recommended to select the candidates for cavernometry after papaverine tests and nocturnal penile tumescence and rigidity monitoring.

[Role of pelvi-perineal rehabilitation in the treatment of cavernous venous leakage]. / Apport de la rééducation pelvi-périnéale au traitement des fuites veino-caverneuses.

The pathophysiological mechanisms, investigation and treatment of erectile dysfunction related to venous leakage are highly controversial. Although surgery appears to be the most logical treatment, the results obtained are very uncertain, regardless of the technique, and long-term improvements are rare. In this study, the authors propose an original management based on classical pelvi-perineal rehabilitation techniques combined with low-dose intracavernous injections. The preliminary results appear encouraging with about 50% improvement (improved or cured patients) in the various treated groups with a lasting result. The mechanism of action of rehabilitation is unclear, but this non-invasive technique should be considered prior to more aggressive management.

[Value of the visual stimulation test (VST) as initial paraclinical test in the study of erectile impotence. Classification of psychogenic impotence using computerized rigidimetry. The value of thymoxamine]. / Intérêt du test de stimulation visuelle (TSV) comme premier test paraclinique dans l'exploration d'une impuissance érectile. Classification des impuissances psychogènes à partir de la rigidimétrie informatisée. Intérêt de la Thymoxamine.

Fifty impotent men between 21 and 65 years old, were all evaluated by nocturnal penile rigidity monitoring (NPRM) with Rigiscan on 2 to 3 successive nights. The results showed 37 normal graphs (74%), and 13 abnormal (26%). As these results confirmed the importance of psychogenic impotence, it was interesting to compare the results of nocturnal erections to those produced by the realtime screening test: the Visual Stimulation Test (VST). This test was done after intracavernous injection of Papaverine and Thymoxamine, alone or combined. The VST seems to be a good screening test. According to the response to VST, psychogenic patients were classified in three groups. This new classification had prognostic and therapeutic implications. The use of Thymoxamine alone at 5 mg or in combination with Papaverine (one mg of each), seems to give better results than Papaverine alone, with minimal pain.

[Ultrasonography of subclinical primary testicular tumors. Apropos of a Sertoli cell tumor]. / Echographie des tumeurs testiculaires primitives infracliniques. A propos d'une tumeur à cellules de Sertoli.

The authors report an original case of an adult presenting with a bilateral Sertoli cell testicular tumour in whom one of the impalpable lesions was detected by routine ultrasonography. This appears to be the first reported description of the ultrasonographic appearance of such a subclinical tumour. The review of 20 published cases reporting the appearance of impalpable primary tumours reveals that in the great majority of cases the echostructure is hypoechoic and therefore does not present any histological specificity, and that these tumours tend to be essentially seminomas or Leydig cell tumours. The indications for scrotal ultrasonography in the detection and follow-up of scrotal tumours are discussed.