[Choice of surgery in the treatment of recurrent varicocele].

The article presents the results of examination and surgical treatment of 48 patients with varicocele recurrence after Ivanisevich operations. Ultrasound dopplerography revealed principal causes of the recurrences: unperformed ligation of vein-satellites, undetected renospermatic reflux with hypertension in the renal vein, undetected ileospermatic or mixed reflux. Depending on the detected hemodynamic disorders, we made microsurgical ligation of veins-satellites, created proximal vein-veinous testiculosafic or distal testiculosafic anastomoses with good clinical results and correction of pathospermia. Ultrasound dopplerographic control of anastomoses after 1 year of their creation showed satisfactory function of anastomoses in 80.1% cases. Thus, choice of surgical method in varicocele recurrence must be based on assessment of hemodynamic disorders in the territory of genital veins.

[Sildenafil citrate in diagnosis of erectile dysfunction].

We examined 86 patients: 24 with functional and 62 with organic erectile dysfunction (EDF). In functional EDF, sildenafil citrate (SC) in a dose 25-50 mg or intracavernous injection of 2% solution of papaverin always resulted in satisfactory erection. In EDF, SC, papaverin injection and LOD test results were compared. Morphological examinations of cavernous tissue and tunical albuginea of the penis. Correlations were found between clinical findings, results of SC and intracavernous papaverin solution administration, LOD-test, morphological evidence. This provides objective data for classification of EDF into three stages (I, II and III). Stages I and II were defined as compensated, stage III--as a decompensated stage of organic erectile dysfunction. SC has some advantages over other tests, therefore it is recommended as a monomethod for diagnosis of functional forms, indirect staging of organic EDF.