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At least 955 records · Page 53Linked to original sources
PubMed1976

Surgical management of impotence using the inflatable penile prosthesis. Experience with 36 patients.

Inflatable hydraulic penile prostheses were implanted in 36 patients who had organic impotence. Selection of patients was based on a series of guidelines that included the historical aspects of the patient's initiative, acceptance of the device by patient and partner, motivations, and psychiatric evaluation. Minor complications after implantation were not associated with the ultimate successful function of the device. Major complications were mainly mechanical in origin and readily corrected by secondary surgical procedures. The single failure in this series was associated with infection around the prosthesis, which necessitated removal of the entire device. A nearly physiologic erection was produced in 375 patients. Functional application of the implanted device was successfully achieved in 34 of 35 patients who retained their device. Patient-partner acceptance has been excellent.

Adult↗
PubMed1976

Psychologic evaluation of impotent men.

Psychologic evaluations have been performed as part of the screening process on men who were candidates for surgical implantation of the inflatable penile prosthesis. Goals and methods of evaluation are discussed, with special attention to the use of interview and psychologic test results. Minnesota Multiphasic Personality Inventory profiles that suggest a psychogenic basis for impotence are presented and discussed.

Adult↗
PubMed2003

[Henry IV de Castilla( 1454-1474). An exceptional urologic patient. Morphological and personality portrait of Henry IV " The impotent" in contemporary chronicles and manuscripts (I)].

OBJECTIVES: To make an update on Gregorio Marañon's work "Biological essay about Henry IV and his time" (Madrid 1930), reviewing the clinical diagnosis made by the famous spanish doctor-historian more than 70 years ago on the last Monarch of the Castilian Trastamara, because we consider that diseases suffered by Henry IV were urologic mainly. METHODS: We reviewed 10 chronicles, 5 contemporary manuscripts, and 25 works about the figure of Henry IV published up to year 2000. For comparisons between works we evaluated not only the chronicles and works used by Marañon, but also the more recent ones of medical character, which have resulted in a significant increase in the amount of data about the figure of the Monarch. Additionally, following our current knowledge we tried to adapt the clinical diagnosis from Marañon--eunucoid dysplasia with acromegalic reaction--to current nomenclature in order to define the kind of endocrinopathy the Monarch suffered. RESULTS: Following a review of contemporary chronicles and recent bibliography about Henry IV, the Monarch was a singular urologic patient. He suffered chronic renal lithiasis, impotence, a presumptive penile anomaly, and almost surely infertility, although all his uro-andrological diseases were part of the endocrinopathy the Monarch suffered, probably a hypophyseal tumor. Included in the work there are descriptions of his physiognomy and psychopathological characters of his personality from the chronicles, commenting on all clinical symptoms the Monarch suffered according to his biographers and present day doctors and historians.

Famous Persons↗
PubMedDate not supplied

[What can be expected from the ligation of the deep dorsal vein of the penis in the treatment of caverno-venous impotence? Report of a series of 21 cases].

21 patients with venous vasculogenic impotence were treated by ligation of the dorsal vein of the penis. 71% of the patients were improved after 8 months, but only 53% were still improved after 25 months. However, this simple operation can be proposed palliatively to patients selected on the basis of cavernosometry, in combination with other medical treatments.

Adult↗
PubMed1992

[Duplex scanner in the diagnosis of vasculogenic impotence].

This paper is reporting the experience of the Authors in the use of Duplex-scanner and eco-color-doppler in the diagnosis of the erectile dysfunctions and particularly in the importance of vascular (arterious and venous) origin. For this purpose, we selected a sample constituted of 41 patients: 22 with psychogenic, 8 with arterial, 5 with venous impotence, 5 patients with Peyronie's disease and 1 patient with posttraumatic arterio-venous fistula. The Authors, while underlining the remarkable accuracy and diagnostic reliability of eco-doppler, emphasize the indication of the method up to consider it "investigation of prime choice", not only in the patients with the dysfunction of vis erigendi but, in the cases in which a morphological evaluation, besides hemodynamical one, become necessary.

Adult↗
PubMed1992

[Selective arteriography in the study of arterial vasculogenic impotence].

According to the fundamental circulatory nature of penile erection, insufficiency of the arterial blood supply to the corpora cavernosa caused by an organic arterial disease is found in a large fraction of case, overall among the patients aged more than 40. It is possible to evaluate arterial origin of erectile dysfunction by using of noninvasive methods, but to obtain the necessary panoramicity and the characterization of the lesions it needs the use of angiography. Performance of standard arteriography leads to insufficient visualization of pudendal and penile vessels and risks false positive results. Because of penile hemodynamic variability in its different states is necessary the use of pharmacologic devices to perform a diagnostic arteriography. For the selective study of the pudenda and peniena vascularization we perform a selective arteriography bilaterally, with the catheter tip placed in the proximal part of the internal iliac artery. We use a contrast medium particularly diluted and mixed with xylocaine. We perform angiographic sequences after intracavernous injection of 8-10 mgr of papaverine to obtain the maximum blood flow and to prevent spasm of the terminal arterioles. Arteriography gives a complete study of the pudenda arterial tree and its terminal ramifications, and it is able to supply all the necessary informations regarding the planning of revascularization procedures. Treatment of arterial lesions is possible with surgical and radiologic methods. As in other arteries, percutaneous transluminal angioplasty (P.T.A.) can be applied in the therapy of impotence caused by arterial insufficiency. P.T.A. is the election treatment in the stenosis of the common iliac and internal iliac arteries.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiography↗
PubMed1992

[The Rigiscan system in the diagnosis of male sexual impotence].

The article reviews historical basis of Nocturnal Penile Tumescence (NPT) test and the evolution of techniques to perform it. From complex and time-consuming instruments, modern technology has brought us to the use of the Rigiscan system. This is a transportable (home or office usable), computerized method to detect change of penile rigidity and circumference during sleep-related spontaneous-or daytime induced-erections. While the instrument was mainly developed to perform NPT tests, it is nowadays used to record penile rigidity in realtime after the intracavernous injection of vasoactive drugs. In our experience, normal parameters to refer for a NPT evaluation are: number of erectile episodes: 4-5 per night; mean duration od episodes: > 30 minutes; increase of penile circumference: > 3 cm (base loop) and > 2 cm (tip loop); maximal rigidity: > 70% (both base and tip). Reference parameters for realtime monitoring after intracavernous injection of PGEI are: latency of response: < 12 minutes; duration (with a stable plateau): > 30 minutes; constant plateau: > 70%; increase of penile circumference: > 3 cm (base) and > 2 cm (tip). The use of these reference parameters, together with the data coming from other procedures (e.g. penile arterial flow with the Doppler), allows a better diagnostic accuracy in the approach to sexual impotence.

Diagnosis, Computer-Assisted↗
PubMed1992

[Ultrasound and color Doppler in the diagnosis of vasculogenic impotence].

Echo-color-doppler is a non invasive diagnostic technique which can provide data about arterial and venous vascular circle of the penis with greater precision than Doppler CW. In the tumescent phase after a PGE1 injection the systolic velocity (SV) reaches a rate higher than 25 cm/sec and the diastolic velocity (DV) higher than 2 cm/sec, resistance index (RI) > to 0.70 with evident colour marked from 1 to 3 KHz. In erection arterial flow decrease and SV is lower than 25 cm/sec with DV lower than 2 cm/sec or with negative values; RI < to 0.70 or negative. The data are confirmed by clinical investigation and traditional diagnostic exams in normal and pathological patients. Echo-color-doppler reduces invasive exams and acquires a primary position on the diagnostic scale of impotence.

Erectile Dysfunction↗
PubMed1992

[Medical treatment and impotence].

After having emphasized the importance of interdisciplinary diagnostic approach to the sexual impotence as a symptom and having made some comments about the erection's physiology, the Authors, according to their experience, take drugs into consideration for elective treatment of sexual intercourse.

Erectile Dysfunction↗
PubMed1992

[Non-surgical therapy of impotence: infiltration, iontophoresis, ultrasound, laser].

Surgical therapy is the only useful correction in congenital fibrosis or in hypoplasia of the 'corpora cavernosa', associated with hypospadia or not. On the contrary in not congenital fibrosis of the 'corpora cavernosa' (Peyronie's disease, consequences of priapism, or trauma, complications of pharmaco-prosthesis) are allowed pharmaco-physical treatments (infiltrations, ionophoresis, ultrasound, laser). Pharmaco-physical therapy can be used as the only treatment, which is often resolutive, but it is also useful before or after the surgical operation of the 'corpora cavernosa'. These diseases can give disorders of the erection, until complete impotence is reached. In fact the erectile tissue can't expand, because of the rising fibrosclerosis. Among acquired fibrosis of corpora cavernosa I.P.P. has surely the greatest recurrent: the consistency of our series made possible to achieve significant results with a unified therapeutical protocol. The same management was applied in other, less frequent, penile fibrosis, always with full positive results even if on a small number of patients. We are evaluating a new drug (defibrotide) in the treatment of cavernosal vasculitis. Another one (hyaluronidase) associated to orgotein, could improve its effect against inflammation especially in chronic evolutions. Besides new treatments, we emphasize the prevention of iatrogenic fibrosis with particular regard to cavernous pharmaco-infusions by autoinjections: the training of the patient and the safety of the autoinjectors must be carefully checked by the andrologist to decrease a large amount of complications.

Erectile Dysfunction↗
PubMed1992

The use of hypnosis in the treatment of impotence.

This chapter describes the use of hypnotherapy in the treatment of psychogenic impotency. A listing of etiological factors common to this problem are described. Appropriate case histories are presented.

Depressive Disorder↗
PubMedDate not supplied

[The study of arteriogenic erectile impotence by noninvasive methods].

With the development of noninvasive haemodynamic methods, recognition of arterial insufficiency signs is possible also in cases in which, in old times, we just could suspect a psychogenic cause. Although this advance, discrimination permitted by this method can be improved. Eighty-eight supposed healty patients and eighty-four patients with arteriogenic erectile impotency (tested by arteriography) were included into an study, which results are presented in here. Analysis made, avoided the effect of envelleiment on haemodynamic parameters interpretation. For identification of patients which obstructive arterial defect can be cause of sexual disfunction, combination of systolic pressure determination and arterial flow velocity curves (by Doppler ultrasonography) is proposed. We recommend this method as a part of the multifactorial examen required by such type of patients.

Adult↗
PubMedDate not supplied

[Evaluation of papaverine in treatment of impotence].

The results of therapy of 52 male patients with impotence with papaverine are presented. The drug was injected by the intra-cavernous route. Recovery has been achieved in all of them with marked improvement of sexual functions in 73%.

Adult↗
PubMed1991

[Drugs, impotence and infertility].

The Authors report the results of a study on 87 patients; among them some were drug dependent and others were already drug-free. This study has in object the consequences of some drugs use (psycoanaleptics, psycoleptics, psychodysleptics) in the sexual behavior and male fertility. Abuse of these drugs seems to be able to cause impotence by psychologic and organic factors. As it concerns the drugs effects on male fertility, we have observed O.T.A. during the dependence period, that seems to be reversible after detoxification. Our purpose is to further investigate the andrological aspects of drug dependence.

Adolescent↗
PubMed1992

[Intracavernous self-injection in impotence].

On the basis of new diagnostic methods, 50 to 80% of impotent men show organic changes which are potentially responsible for erectile dysfunction. In our institution 409 consecutive patients have been submitted to the programme of intracavernous self-injection of papaverine. In 11% of the patients erectile function was normalized after a series of self-injections. 25% use papaverine regularly at home, and 64% discontinued the self-injections. Many of these patients did not accept this form of therapy. Side effects are rare and harmless. Early information about the intracavernous self-injection therapy by the physician can help to avoid unnecessary investigations.

Adult↗
PubMedDate not supplied

Analysis of sympathetic skin responses in a group of healthy subjects and in patients affected by sphincter disorders and impotence.

Bilateral palmar and plantar sympathetic skin responses (SSRs) to pudendal and median nerves stimulation have been recorded in a population of 10 healthy adult subjects. A group of 11 patients affected by sphincter disorders and/or impotence of neurological origin (diabetic neuropathy, ischaemic myelopathy, myelitis, cauda aequina syndrome) was investigated and results were compared with normal values obtained from the control group. The technique is focused on the vegetative component of innervation and is shown to give complementary information on sympathetic dysfunction, in addition to traditional techniques relating to somatic innervation (electroneurography, electromyography, somatosensory evoked potentials.

Adult↗
PubMedDate not supplied

Anatomo-functional considerations on venogenic impotence.

The authors report their clinical experience with cavernosography and cavernosometry on impotent patients. The indications of method and its correct place in the diagnostic workup are underscored. The methods of evaluation are described, highlighting the advantages of a diagnostic pharmacological approach in respect to a near as possible physiological haemodynamic evaluation. Finally they propose a future development for the method, such as the use of PGE1 instead of the commonly employed drugs, and a new classification for the veno-occlusive disease with stage and grade.

Alprostadil↗
PubMed1991

[Duplex ultrasound before and after intracavernous papaverine injection in the diagnosis of impotence].

The study of impotentia coeundi requires separating the organic from the psychogenic cause. Arteriogenic impotence falls within the first group and has been assessed with the papaverine test, simple Doppler and arteriography. Currently, more sophisticated techniques such as the pulsed Doppler permit noninvasive assessment of the blood supply to the penile arteries. Intracavernous injection of vasoactive substances such as papaverine cause vascular changes. Evaluation of these changes permits making the diagnosis of arterial insufficiency without recurring to more invasive diagnostic techniques such as arteriography. Currently, this invasive technique is only justified in revascularization surgery but not for diagnosis. The availability of color Doppler facilitates arterial evaluation even further.

Adult↗