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Biomedical subjects

R M Engel

Publications and source records attributed to R M Engel.

At least 19 recordsLinked to original sources
PubMed1992

Objective double-blind evaluation of erectile function with intracorporeal papaverine in combination with phentolamine and/or prostaglandin E1.

We performed a double-blind, crossover study using objective measurements to compare maximum rigidity and duration of erections with papaverine hydrochloride in combination with phentolamine mesylate and/or prostaglandin E1. The rationale for the protocol was to combine a smooth muscle relaxant (papaverine) with either or both vasodilating agents (phentolamine and prostaglandin E1) commonly used for injection therapy. The 7 volunteer patients with organic impotence documented by abnormal nocturnal penile tumescence testing were injected with 0.5 to 1.0 ml. papaverine (30 mg./ml.) in combination with phentolamine (0.5 mg./ml.) and/or prostaglandin E1 (5 micrograms./ml.). Each patient received 2 injections on each of 2 testing dates; injection 2 was given after tumescence resulting from injection 1 had subsided completely. The medications were given in a randomized, counterbalanced order following double-blind procedures. Patients evaluated the erections subjectively. In addition, the RigiScan device was used to measure maximum rigidity and duration of erections. All patients observed increased duration of erections with both combinations containing prostaglandin E1. Analysis of RigiScan measurements showed no statistically significant differences for maximum rigidity (p greater than 0.1) but significantly greater duration of erections with papaverine plus prostaglandin E1, and papaverine plus phentolamine plus prostaglandin E1 compared to papaverine plus phentolamine (p less than 0.001). There was no statistical difference in rigidity or duration of erections between papaverine plus prostaglandin E1 and papaverine plus phentolamine plus prostaglandin E1. No patient reported significant penile pain with any of the injections. We conclude that the combination of papaverine and prostaglandin E1 produces erections of longer duration than papaverine plus phentolamine and that no additional benefit is gained by adding phentolamine to a combination of papaverine and prostaglandin E1. Further studies are in progress to define optimal dose response curves for papaverine and prostaglandin E1 as individual agents and in combination.

Alprostadil↗
PubMed1990

Mentor GFS inflatable prosthesis.

A new inflatable penile prosthesis is described. The operative approaches, infrapubic and scrotal, are discussed and compared. The results of 56 successive implants are presented. The simplicity of the device which combines the usual intra-abdominal reservoir and the scrotal pump into a scrotal "resipump" is discussed. The device has shown a good performance and is a valuable addition to the varieties of penile implants.

Aged↗
PubMed1987

Mentor inflatable penile prosthesis.

Technical complications requiring frequent surgical revision of the most commonly used penile component prosthesis have led to the development of a new inflatable device that has been implanted in 202 patients. This hydraulic device provides excellent functional qualities; no connector separations, aneurysms, or ruptures have been encountered in these patients. Reoperations became necessary in 8 per cent of these patients. Cosmetic and functional results are good, and patient acceptance has been excellent.

Erectile Dysfunction↗
PubMed1986

Experience with the Mentor inflatable penile prosthesis.

We present our experience with the new Mentor inflatable penile prosthesis for the treatment of organic impotence. Technical complications requiring frequent revision of the most commonly used inflatable prosthesis have led to the development of a new device, which we have used in 116 patients. This hydraulic device provides excellent functional qualities. No connector separations, aneurysms or ruptures have been encountered. Reoperations became necessary in 10.5 per cent of the patients. Cosmetic and functional results were good, and patient acceptance has been excellent.

Erectile Dysfunction↗
PubMed1978

Endocrine tests in phenotypic children with bilateral impalpable testes can reliably predict "congenital" anorchism.

Congenital anorchism is a rare condition. Bilateral impa-pable undescended testes are relatively common by comparison. Surgical exploration has been regarded as the final arbiter between anorchism and bilateral cryptorchism. Exploration has not proved completely reliable in making this differentiation. Endocrine studies, particularly the human chorionic gonadotropin (HCG) stimulation test together with measurements of basal plasma gonadotropins, can reliably exclude "functioning" testicular tissue. Eleven fully evaluated and operated cases support this contention. In the specific clinical setting of a normal phenotypic male child with a 46XY karyotype and no müllerian structures palpable on rectal examination, nonfunctioning testes on endocrine testing means congenital anorchism and surgical confirmation is unnecessary. In contradistinction, a positive HCG test would appear to mandate through and extensive surgical exploration.

Child↗
PubMed1976

Unusual presentation of Wilms' tumor.

A Wilms' tumor, completely filling the collecting system of a kidney, led to nonfunction of the involved kidney. Histologic examination proved absence of renal vein involvement. Review of our case material and discussions with other centers showed that this unusual presentation has been seen elsewhere.

Child, Preschool↗
PubMed1976

Prostatic needle biopsy: comparison of needles.

To clarify the advantages of the 2 most commonly used biopsy needles results of 100 routine needle biopsies of the prostate are evaluated. The series includes patients selected for study concerning the medical treatment of benign prostatic hyperplasia.

Biopsy, Needle↗
PubMed1975

Treatment of cryptorchidism. Long-term prospective study.

We have presented preliminary findings on a long-term prospective study designed to (1) assess timing of orchiopexy, (2) eliminate unnecessary abdominal exploratory surgery, and (3) determine efficacy of orchiopexy on subsequent fertility and on malignant degeneration. Some suggestions for the management of this common congenital defect can be provided, but long-term results are lacking. A significant drop-out rate from this prospective study is expected with time; therefore, large patient numbers are needed to draw any valid conclusions at the time of postpubertal reassessment.

Chorionic Gonadotropin↗
PubMed1974

Exstrophy of the bladder and associated anomalies.

Bladder exstrophy is a rare malformation of the urogenital tract. Its incidence is about one per 25,000-40,000 births, with a two to one ratio of males over females. No hereditary factors have been established, and it has been stated in the literature repeatedly that this defect does not occur with an increased frequency in the same family. However, Higgins reports bladder exstrophy in twins on two occasions, and twice in brothers and sisters.

Adult↗