Blood gas changes in the corpora cavernosa: metabolic and histomorphometric implications in the patient with erectile dysfunction.

PURPOSE: We evaluated corpora cavernosa metabolism in flaccidity and in erection, analyzing some blood gas analytical parameters and comparing them by histomorphometric examination to find a direct relation between biochemical-metabolic parameters and histological data. MATERIALS AND METHODS: We selected 33 patients with erectile dysfunction and divided them into 2 groups, including 1-those with congenital penile deviation who were responders to prostaglandin E1, and 2-those with severe organic erectile dysfunction who were not responders to prostaglandin E1. We evaluated O(2) and CO(2) pressure, pH and O(2) saturation in blood samples. We then made a histomorphometric study of cavernous tissue. We obtained specimens by cavernous biopsies and calculated O(2) and CO(2) exchange, the Haldane effect and the respiratory quotient into the corpora cavernosa. All data were evaluated by statistical analysis. RESULTS: Mean O(2) arterial pressure and saturation +/- SD were lower in group 2 than in group 1 (74.85 +/- 8.78 versus 96.43 +/- 14.87 and 94.98 +/- 1.4 versus 97.35 +/- 0.83, respectively). Mean CO(2) arterial pressure was 35.59 +/- 4.78 group 1 versus 38.8 +/- 2.71 in group 2 with borderline statistical significance. The Haldane effect was superior in flaccidity than in erection because of the influence of arterial-venous O(2) difference and the respiratory quotient, which was also an inverse ratio. Cavernous histomorphometry showed that in group 1 smooth muscle was a mean of 38.8 +/- 8.94% of cavernous tissue versus 24.9% in group 2. CONCLUSIONS: Our study shows that starting with blood gas analytical data we can completely study the metabolism of the corpora cavernosa and its relationships to erectile dysfunction. Cavernous histomorphometry can suggest the presence of smooth muscle into cavernous tissue, whereas our mathematical elaboration allowed us to evaluate all data in a more complete manner.

Bacterial prostatitis: urine and spermatic fluid culture.

To evaluate in a prospective study the sensitivity of urine and spermatic fluid cultures in identifying the presence of infection compared to Meares-Stamey's test (MSt) results. Fourty patients were diagnosed having bacterial prostatitis following MSt. They underwent both urine and spermatic fluid cultures after MSt results and immediately before antibiotic treatment. All the patients were asked which of the three examens was the least tolerable. Urine and spermatic fluid culture were negative in 36 and 4 cases respectively. Spermatic fluid culture identified infection in 36 out of 40 patients who underwent MSt (90%) and was more acceptable for the patients. Urine culture is a less accurate way of identifying the infective agent in prostatitis, compared to spermatic fluid culture. The latter procedure is similar to the MSt.

Leiomyoma of the testis.

Testis leiomyoma is a very rare neoplasm. It is very difficult to perform an exact preoperative diagnosis; only histological examination can prove the presence of a leiomyoma. In our case radical orchidectomy was performed because of complete substitution of normal parenchyma, the extreme rarity at long-term follow-up of a reported benign intratesticular neoplasm, and the imperfect sensitivity of the extemporary histological examination.

[Staghorn kidney calculi. A very unusual case of bilateral fistulization and abscess]. / Calcolosi renale a stampo. Un rarissimo caso di fistolizzazione ed ascessualizzazione bilaterale.

A rare case of bilateral pararenal abscess secondary to staghorn calculi is reported. It is characterized by a singular evolution in both side, with fistulization along iliopsoas muscle until the Scarpa triangle. Considering the seriousness of this illness, the importance of an early surgical therapy of complicated staghorn lithiasis is underlined.

Spontaneous partial fibrotic regression of a primary renal carcinoma: a case report.

Spontaneous regression of non metastatic renal carcinoma is a very unusual finding in daily urologic practice. Furthermore this is the first case of a partial primary renal cancer remission documented by hystopathological specimens. Current hypothesis were discussed.

Terazosine and tamsulosin in non bacterial prostatitis: a randomized placebo-controlled study.

Eighteen patients with inflammatory process of the prostate met criteria for the inclusion in the study: 1) non bacterial prostatitis; 2) no previous treatment. Then they were randomized into three groups as it follows: terazosine, tamsulosin and placebo. Alpha-blockers and placebo were given for two months, after which further uroflowmetry was performed. Symptom score was evaluated before and after treatment. Terazosine was effective in reducing TO (p = 0.01) as tamsulosin and placebo did not. Both terazosine (p = 0.034) and tamsulosin (p = 0.006) reduced max TQ as placebo did not. Symptom score significantly improved in patients receiving terazosine (p = 0.0002) and tamsulosin (p = 0.001) while insignificantly in whose receiving placebo.

Two atypical cases of renal leiomyosarcoma: clinical picture, diagnosis and therapy.

The Authors report two cases of renal leiomyosarcomas with atypical clinical features. Despite a malignant histological picture, nephron-sparing surgery was performed. The two patients are alive and disease-free at six years and fifteen months respectively. Specific radiologic findings, indications and rationale for conservative treatment are discussed.