After two years, did Viagra live up to its expectations?

Sildenafil (Viagra) is the first on-demand oral medication approved for treatment of male erectile dysfunction (ED). Since the unprecedented release of sildenafil, the initial surge of 'Viagra craze' has subsided and there is a considerable decline in world-wide prescriptions. We did a long-term efficacy study of sildenafil in our community practice to assess the discontinuation rate and the etiologic factors causing discontinuation.

Plasma androgens and estrogens in paraplegic men.

The plasma testosterone, estrone (E1), and estradiol (E2) levels were measured in paraplegic men and age-matched controls. Sephadex LH-20 columns and the celite technique were used to extract the sex steroids and a radioimmunoassay was used to measure them. Leydig cell stimulation was achieved with human chorionic gonadotropin administration.

Familial occurrence of testicular neoplasms (in cousins).

Testicular malignancies in closely related family members rarely occur. Only 18 cases have been reported in the literature. Our cases concern two families with testicular tumors occurring in cousins. This is the first such incidence reported. The need for a thorough checkup of other family members is reiterated.

[Hydraulic haemostasis in transurethral resection of the prostate (author's transl)]. / L'hémostase hydraulique dans la résection transurétrale de la prostate

The method described for T.U.R. of the prostate merits the name of hydraulic haemostasis. Its principle consists of placing the irrigation recipient at a height of 90 cm, using it in combination with the Iglesias continuous irrigation-suction resector with a low intravesical pressure. Per- and postoperative bleeding is minimised and the "T.U.R.", syndrome is absent, despite reports in the world literature. Two modifications to the Iglesias resector are presented: the optic protector and a new system of suction orifices.

The importance of continuous pump suction in TUR hydraulic hemostasis.

An intravesicoprostatic hydrostatic pressure below 10 mm Hg maintains normal anatomy and physiology of the muscular and vascular prostatic structures by continuous pump suction. An increase of the hydrostatic intravesicoprostatic pressure above 10 mm Hg produces a distortion in the musculature of the prostate, especially at the true capsule, opening the cut vessels, making possible the absorption of the irrigant free of electrolytes (TUR syndrome). A low hydrostatic intravesicoprostatic pressure permits the compression of cut vessels by the inflow hydraulic pressure of 90 cm H2O achieving hydraulic hemostasis during TURP reducing the bleeding and operative time by more than 50% and making hemostasis easier. In our last 400 TURs, blood transfusions have been unnecessary. Less electrocoagulation is required, resulting in a more rapid recovery.

Serratia marcescens and the urologist.

Serratia marcescens, long considered a non-pathogen, is now found to be responsible for outbreaks of nosocomial infections. An outbreak of Serratia infection at 2 institutions is reported, in which 253 cultures of Serratia were grown and 115 patients were involved. The 3 most important conditions that preceded isolation of Serratia were the use of indwelling urethral catheters, antibiotic therapy and operation. All infections were acquired in the hospital. An epidemiological survey showed that the organism is present in the environment, even in the absence of active infection.