Role of penile electrodermal activity in the evaluation of autonomic innervation of corpus cavernosum.

Electrodiagnostic tests measuring the activities of cavernous smooth muscle and sudomotor structures of penile skin are used in order to evaluate autonomic innervation of the penis. Owing to closeness of these tissues, the interference of sympathetic activity during recording is a possibility. In this study, we investigated this possibility in 10 patients whose cavernosal tissues were destroyed during penile prosthesis implantation by comparing the pre- and postoperative penile skin electrodermal activities. Penile electrodermal activities were recorded with surface electrodes before and after the operation. All of the patients had spontaneous and evoked penile electrodermal activity (EDA). The mean amplitude of evoked EDA decreased from 2159+/-700 to 1413+/-515 microV following penile prosthesis surgery (P=0.017). The decrease in the amplitude of penile-evoked EDA following penile prosthesis implantation suggests the contribution of cavernous smooth muscle activity to the sudomotor responses prior to operation. Although corpus cavernosum sympathetic activity contributes to the penile skin recordings, these recordings are mostly the result of penile skin sudomotor sympathetic activity. Therefore, surface potentials recorded from penile skin should not be used for the evaluation of autonomic innervation of corpus cavernosum.

The value of the gonadotrophin-releasing hormone test as a prognostic factor in infertile patients with varicocele.

OBJECTIVE: To determine the value of the gonadotrophin-releasing hormone (GnRH) test in selecting which infertile patients with varicocele would benefit from varicocelectomy. PATIENTS, SUBJECTS AND METHODS: The study comprised 30 patients with varicocele who presented between November 1993 and May 1994, and 10 control subjects. The basal serum level of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were determined and all participants given 100 micrograms of GnRH nasally. The levels of FSH and LH were then determined for up to 2 h. The patients then underwent varicolectomy and the response was evaluated by comparing sperm quality before and after treatment and between those with increased or normal FSH and LH levels in response to the GnRH test. RESULTS: Those patients who had increased FSH and LH levels after the GnRH test had a mean 121% increase in sperm density (P < 0.001), a 23% increase in sperm motility (P < 0.001) and a 40% decrease in sperm abnormality (P < 0.05). The respective values for those with normal levels of FSH and LH were 15% (P < 0.05), 11% (P > 0.05) and 11% (P > 0.05). CONCLUSION: The GnRH test is useful for determining those patients who should benefit from varicocelectomy.

Hydronephrotic type of bilateral multicystic dysplastic kidney. An unusual case.

25 year-old pregnant woman was admitted at week 29 of fetal development for routine ultrasonic evaluation of growth. Sonography of the fetal body revealed two cystic anechoic septated structures bilaterally. At autopsy of the stillborn neonate pathology confirmed congenital multicystic dysplastic kidney. We believe this is the first case reported.

Use of random urine samples to estimate total urinary calcium and phosphate excretion.

Calcium-to-creatinine and phosphate-to-creatinine ratios in random single-voided urine specimens were compared with 24-hour calcium and phosphate excretions, respectively, in 67 subjects who were selected prospectively to represent a wide range of renal and parathyroid function as well as urinary calcium and phosphate loss. Simple linear regression analysis revealed significant correlation between the spot urine calcium-to-creatinine ratio and 24-hour total calcium excretion and between the spot urine phosphate-to-creatinine ratio and 24-hour phosphate excretion. Calculating these simple ratios permits easy, rapid, correct, and inexpensive estimation of the daily urinary calcium and phosphate excretion.