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Biomedical subjects

R E Berger

Publications and source records attributed to R E Berger.

At least 19 recordsLinked to original sources
PubMed1995

Prostatodynia and interstitial cystitis: one and the same?

OBJECTIVES: To investigate further the observation that men with prostatodynia may represent a subset of patients with interstitial cystitis. METHODS: The charts of 20 patients with the diagnosis of nonbacterial prostatitis or prostatodynia who underwent cystoscopy and bladder hydrodistention were retrospectively reviewed. RESULTS: The primary complaint of all 20 patients was genital or rectal pain, or both. Ten patients reported irritative voiding symptoms. Twelve of the 20 patients developed petechial hemorrhages involving the bladder uroepithelium on hydrodistention. Bladder biopsies revealed no significant histopathologic abnormalities. Nine of the 12 patients who developed petechial hemorrhages reported symptomatic improvement at 2- to 3-week follow-ups compared with none of the 8 patients without petechial hemorrhages. CONCLUSIONS: These findings suggest that the diagnosis of interstitial cystitis should be considered in patients with nonbacterial prostatitis or prostatodynia.

Adult↗
PubMed1995

Corrective procedures for penile shortening due to Peyronie's disease.

Peyronie's disease is a poorly understood scarring condition of the tunica albuginea that often causes pain and deformity of the penis. When Peyronie's disease is present predominantly unilaterally, bending of the penis to 1 side occurs. With bilateral or circumferential disease the tunica albuginea does not expand, and penile shortening and/or narrowing occurs. We performed unilateral or bilateral penile lengthening procedures on 22 patients with penile shortening due to Peyronie's disease who refused a procedure, such as tucks or the Nesbit operation, that might result in further penile shortening. Five men underwent incision of the plaque and dermal patch without implantation of a penile prosthesis, while 8 underwent penile implantation plus incisions in the tunica albuginea without patches, and 5 underwent circumferential incision of the tunica albuginea and its septum with patching and placement of a penile implant. (Average length gain with circumferential incision was 1.5 inches with this procedure.) There were 18 patients available for followup: 1 had penile skin slough secondary to a compression dressing, 2 required removal of the implant and replacement at a later date, and 2 had progressive penile shortening after dermal patch requiring subsequent prosthesis implantation. Penile lengthening procedures to correct functionally significant penile shortening can be performed successfully, although significant complications were experienced.

Adult↗
PubMed1995

Premature emission after spinal cord injury.

Physicians and psychologists almost always treat premature emission or ejaculation as a psychological problem. We report on 6 men who had sudden onset of severe premature emission after spinal cord injury. All men suffered spinal cord injury related to trauma at the T12-L1 level, and had areflexic bladders after the injury. Two men had normal penile sensation. None of the men had premature ejaculation before injury with average time of intercourse of 10 to 20 minutes before organsm. After the injury they noticed emission before or at vaginal entry. Two patients reported emission with any sexual thoughts and 1 had emission when started in a nonsexual manner. Sexual therapy using squeeze and stop/start techniques was unsuccessful in all cases. Patients were started on phenoxybenzamine, terazosin or prazosin and reported slight improvement. We believe that injury in the conus area of the spinal cord may disinhibit the ejaculatory mechanism and allow for premature emission.

Adult↗
PubMed1995

Microwave-induced lethal heat stress: effects of phentolamine, prazosin and metoprolol.

Previous studies have shown that adrenergic antagonists can alter physiological responses to microwave-induced heating. In the present experiments, 33 ketamine-anesthetized Sprague-Dawley rats were exposed to 2450-MHz microwaves at an average power density of 60 mW/sq cm (whole-body average specific absorption rate of approximately 14 W/kg) until death occurred. The effects of intraarterial injections of the nonselective alpha-adrenoceptor antagonist phentolamine (10 mg/kg body weight), the alpha 1-adrenoceptor antagonist prazosin (5 mg/kg), and the beta 1-adrenoceptor antagonist metoprolol (2 mg/kg) on physiological responses (including changes in body temperature, heart rate, blood pressure, and respiratory rate) were examined. A group of saline-injected animals was included for comparison. There were no significant differences in lethal temperatures, survival times, or rates of temperature change among the different groups. In all groups, heart rate increased continuously during exposure; mean arterial blood pressure increased until colonic temperature reached 41-41.5 degrees C, and then decreased. These heart rate and blood pressure changes were similar to those that occur during environmental heat stress. Despite differences in absolute values of heart rate and mean arterial blood pressure among groups, there were no significant differences in changes from baseline levels among groups. From these results, taken together with previous findings in our laboratory, it may be hypothesized that selective alpha 1 blockade (without concurrent alpha 2 blockade) and beta 2 blockade (with or without concurrent beta 1 blockade) are effective in altering physiological responses to microwave exposure.

Adrenergic alpha-1 Receptor Antagonists↗
PubMed1992

Preliminary report: penile vein occlusion therapy: selection criteria and methods used for the transcatheter treatment of impotence caused by venous-sinusoidal incompetence.

Penile vein occlusion therapy is a fluoroscopic guided technique developed for treating venous-sinusoidal incompetence in patients with erectile dysfunction. We report our experience with 22 patients who have been followed for greater than 1 year. Catheterization of the veins draining the penis was technically possible in 20 of 22 patients (91%). Of these 20 patients 5 (25%) were cured and 9 (45%) had significantly improved erectile function. All 5 patients (100%) with venous-sinusoidal incompetence plus normal cavernous arterial flow, no glans or corpus spongiosal shunts, and bilateral complete coil occlusion of the crural and common crural veins were cured. No deterioration of function was noted at 1 and 2 years. Patient selection and bilateral occlusion of the penile veins are essential to achieve successful penile vein occlusion therapy.

Adult↗
PubMed1991

Controlled trial of infusion cavernosometry in impotent and potent men.

Infusion cavernosometry often is performed to diagnose venous leak impotence. However, normal values have seldom been established in proved potent men. We performed a prospective study of infusion cavernosometry on nocturnal penile tumescence confirmed potent male volunteers and impotent men. Of 20 potent male controls 19 had resistance values of greater than 5 (mm. Hg.minute)/ml. Of 38 impotent men 20 (53%) had resistance values of less than 5 (mm.Hg. minute)/ml. There was considerable overlap between resistance values and infusion rates in potent and impotent men. Impotent men with resistances of greater than 5 (mm.Hg.minute)/ml. more often had normal nocturnal penile tumescence results than men with lower resistance values. Venous leakage is a significant cause of impotence.

Blood Pressure↗
PubMed1991

Antimicrobial tissue penetration in a rat model of E. coli epididymitis.

Following induction of unilateral epididymitis by intratesticular injection of E. coli, a single intraperitoneal dose of amdinocillin, ampicillin, doxycycline, tobramycin, or trimethoprim/sulfamethoxazole was administered to five groups of rats. The animal was sacrificed serially and concentrations of antibiotic in serum, infected epididymides, and non-infected epididymides were determined by high performance liquid chromatography. The ratio of infected to non-infected tissue area under the curve values was 1.05 for trimethoprim, 1.58 for sulfamethoxazole, 1.67 for amdinocillin, 2.01 for tobramycin, 2.25 for doxycycline, and 2.58 for ampicillin. Except for trimethoprim, infected tissue concentrations were significantly greater than compared to uninfected epididymal levels (p less than 0.05). Antibiotic concentrations in infected epididymides compared to serum revealed overall penetration of 34% for amdinocillin, 66% for sulfamethoxazole, 70% for ampicillin, 76% for tobramycin, 256% for trimethoprim, and 257% for doxycycline. In a rat model of epididymitis, trimethoprim and doxycycline demonstrated the greatest degree of epididymal penetration compared to serum. All antibiotics except trimethoprim had significantly greater penetration into infected tissue when compared to non-infected epididymal tissue.

Animals↗
PubMed1991

Office-based testing for antibody to human immunodeficiency virus in urology patients.

Knowledge of the status of a patient regarding antibody to human immunodeficiency virus type 1 (HIV-1) may be important in many clinical situations. Consequently, we evaluated a rapid test for antibody to HIV-1 peptides that might be suitable for a physician office practice. We evaluated the time necessary to learn to do the test, and test performance using a reference panel and a seroconversion panel as well as 200 clinical specimens. Personnel who were previously unfamiliar with immunoassays learned the test procedure within 30 minutes. All reference specimens were interpreted correctly. One clinical sample reacted in the test but the result was not confirmed by Western blot. The rapid, peptide-based test was easy to use and performance was comparable to currently licensed tests performed at clinical laboratories.

AIDS Serodiagnosis↗
PubMed1991

Repair of a traumatically amputated penis with return of erectile function.

Repair of the amputated penis may be successful using macroscopic and microscopic surgical realignments. However, to date, no one has reported return of erectile function documented by nocturnal penile tumescence. We report a case of traumatically amputated penis with microscopic repair and return of erectile function documented by nocturnal penile tumescence. In addition, the current literature regarding microscopic versus nonmicroscopic repair is reviewed.

Adult↗
PubMed1991

Assessment of normal and abnormal erectile function: color Doppler flow sonography versus conventional techniques.

The penile arteries were studied with color Doppler flow sonography in 10 subjects with normal and 39 patients with abnormal erectile function. The relationships of systolic and diastolic velocities to spectral waveform changes in the penile arteries in response to tumescence were studied before and after intracorporal injection of vasoactive medications that induce erection. In normal subjects, a characteristic spectral waveform pattern corresponded to increasing intracorporal pressure. Patients with abnormal arterial inflow and/or abnormal venous sinusoidal leakage demonstrated deviation from the patterns noted in normal subjects. Patients with abnormal arterial inflow had lower mean peak systolic velocities than normal subjects. Patients with severe venous sinusoidal incompetence had an arrest of waveform progression with evolution to but not beyond phases 1 or 2 (diastolic flow remained positive). Patients with abnormal arterial inflow and abnormal venous sinusoidal outflow had waveform changes that reflected both processes. Systolic/diastolic velocity and waveform relationships can be used to define the integrity of both the cavernosal artery inflow and venous sinusoidal outflow occlusion mechanisms.

Adult↗
PubMed1990

Bacterial epididymitis in the rat: a model for assessing the impact of acute inflammation on epididymal antibiotic penetration.

A rat model of bacterial epididymitis was developed and characterized for use in assessing the impact of acute epididymal inflammation on antibiotic penetration into the epididymis. A 0.2 ml. intratesticular injection of a 0.5 McFarland standard suspension of E. coli resulted in histologically confirmed acute epididymitis in all animals studied. Inflammatory changes were detectable as early as 24 hours following inoculation and were progressive to the last assessment point at 11 days. Early testicular infarction was observed in association with epididymal inflammation. Serial transcrotal ultrasounds of infected animals showed progressive increase in epididymal size and a late decrease in testicular size. Serum and epididymal drug concentrations were assayed following a single dose of the antibiotic amdinocillin. Fifteen minutes following the peak serum level, the drug concentration in infected epididymis was 2.3-fold higher than the contralateral, non-infected epididymis. These data suggest that acute inflammation enhances antibiotic penetration into the infected epididymis. The model described provides a rapid, reproducible method to study epididymal drug delivery in normal and diseased states.

Amdinocillin↗
PubMed1990

Cigarettes, alcohol and marijuana are related to pyospermia in infertile men.

The relationship of current use of cigarettes, marijuana and alcohol to the parameters of seminal fluid analysis, sperm penetration assay and sperm autoimmunity was studied in 164 men from infertile couples. Current cigarette smokers, marijuana users and heavy alcohol users showed greater numbers of leukocytes in the seminal fluid than did nonusers (p less than 0.02, less than 0.007 and less than 0.01, respectively). In addition, cigarette smokers had lower sperm penetration assay scores than nonsmokers (median 2.5 versus 8.0, p = 0.05). Users of cigarettes, marijuana or alcohol showed no decrease in sperm count, motility or percentage of oval sperm, and no difference in prevalence of antisperm antibodies compared to nonusers. After controlling for past sexually transmitted diseases and multiple substance exposures in a multivariate model, use of cigarettes (p = 0.006), marijuana (p = 0.12) or alcohol (p = 0.098) continued to be associated with a trend toward increased number of seminal fluid leukocytes. Cigarette smoking continued to show a significant decrease in sperm penetration assay score (p = 0.03).

Adult↗
PubMed1990

A comparison of penile brachial index and angiography: evaluation of corpora cavernosa arterial inflow.

We studied 32 impotent patients with angiography. The penile branchial index was calculated from the maximal penile arterial pressure measured from any penile artery. In 15 of the 32 patients an attempt was made to isolate the cavernous artery pressure (cavernous artery penile brachial index). There was a poor correlation between angiography and penile branchial index (r equals 0.314) and between angiography and cavernous penile brachial index (r equals 0.637). We also evaluated 15 normal individuals and a wide range of penile brachial index values was found (0.7 to 1.0). Penile brachial index values from normal patients overlapped with those from impotent patients. Penile brachial index values from impotent patients with normal and abnormal arteries (as determined by angiography) overlapped. The fact that penile brachial index measurements are performed in the flaccid state and without direct visualization of the cavernous arteries accounts for some of the variability of the penile brachial index test.

Adult↗
PubMed1989

Studies of polyglycolic acid hollow self-retaining vasal stent in vasovasostomy.

A simple method of vasovasostomy using a unique hollow, biflanged, hydrolyzable, self-retaining intraluminal stent made of polyglycolic acid (PGA) was evaluated in rat and dog animal models. The stented vasovasostomy was compared with a modified two-layer technique in a randomized prospective trial in rats. Twenty of 22 vasovasostomies using the 0.8890 mm and 0.9398 mm stents were patent, whereas only 4 of 22 vasovasostomies using a modified two-layer anastomosis without a stent were patent (P less than 0.01). Eight dogs underwent implantation of the absorbable vasovasostomy stent on one side and two-layer vasovasostomy on the other. Scanning electron microscopy showed superior re-epithelialization and closer return to normal morphology in the stented vasovasostomies than with the conventional two-layer technique.

Animals↗
PubMed1989

Case-control study of men with suspected chronic idiopathic prostatitis.

We studied prospectively 50 asymptomatic men (24 men from infertile couples and 26 normal volunteers) with no history of genitourinary infection and 34 men referred for symptoms of chronic prostatitis. Both groups were evaluated by urethral and prostatic secretion cultures for Chlamydia trachomatis, 4-glass prostatic localization cultures for facultative aerobic bacteria (Ureaplasma urealyticum, Mycoplasma hominis and selected fungi) and counts of prostatic fluid leukocytes. The men with symptoms of prostatitis had more than 1,000 leukocytes per mm. in prostatic secretions more often than did controls (11 of 27 versus 0 of 44, p less than 0.001). The concentration of Ureaplasma urealyticum in prostatic secretions was 1 log higher in prostatic fluid localization cultures than in first voided urine in 0 of 30 patients versus 13 of 50 controls (p equals 0.0014). Chlamydia trachomatis was not isolated from any patient or control. No other significant differences were found between patients and controls. We did not identify an infectious cause of chronic nonbacterial prostatitis.

Adult↗