Penile Function Following Intracavernosal Injection of Vasoactive Agents or Saline

1488

ANDROLOGY

AND RO LOGY Penile Function Following Intracavernosal Injection of Vasoactive Agents or Saline

E.

A. KIELY, P. lGNOTUS AND G. WILLIAMS, Department of Surgery, Hammersmith Hospital and Royal Postgraduate Medical School, London, England

Brit. J. Urol., 59: 473-476 (May) 1987 A total of 18 impotent men received corpora cavernosal injections of either 2 cc 30 mg. papaverine and 1 mg. phentolamine or a similar volume of normal saline to assess pharmacologically induced penile erections. The study group included 11 organically and 7 psychogenically impotent men. Saline was ineffective in stimulating an erection. All patients who received papaverine and phentolamine experienced an increase in penile length and rigidity. The study clearly shows the benefits of pharmacologically induced penile erections. G. F. S. 3 tables, 5 references

Accuracy and Reproducibility of Clinical Measures of Testicular Volume

s.

A. RIVKEES, D. A. HALL, P. A. BOEPPLE AND J. D. CRAWFORD, Pediatric Endocrine Unit of the Children's Serv-

ice, Radiology Department and Reproductive Endocri:7-e Unit of the Medical Division, Massachusetts General Hospital, and Departments of Pediatrics, Radiology and Medicine, Harvard Medical School, Boston, Massachusetts

J. Ped., 110: 914-917 (June) 1987 Although important clinically the measurement of testicular volume previously has been inexact. The authors compared conventional testicular volume measurement with the Prader orchidometer to real-time ultrasonography in 12 boys with central precocious puberty. Bovine and canine testicular volumes also were obtained with both modalities and compared to the actual value obtained by direct measurement. Ultrasonic testicular volume was calculated with the equation pi/6 X length x width2 • Regarding the patients, the orchidometer uniformly exceeded ultrasound estimates of volume. The mean orchidometer-to-ultrasound measurement ratio was 1.6 ± 0.81. In the animal gonads the ultrasound volumes closely matched the actual testicular volumes. The orchidometer measurements exceeded actual testicular volume by nearly 30 per cent. The authors conclude that when accuracy of testicular volume measurement is important ultrasound is the method of choice. G.F.S. 2 figures, 11 references Editorial comment. The most important factor to measure the size of the testis is to perform the measurements consistently with the same modality. We agree that ultrasonic measurements probably are more accurate to determine length and width than an orchidometer but ultrasound certainly is more expensive and in most clinical settings the estimates obtained with the Prader beads are adequate, since in most cases sequential estimate of size in the same patient is most important. L. R. K.

Anatomy of the Prostate From Fetus to Adult-Origin of Benign Prostatic Hyperplasia Y. HIRAOKA AND M. AKIMOTO, Department of Urology, Nippon Medical School, Tokyo, Japan

Urol. Res., 15: 177-180 (June) 1987 The anatomy of the prostate was studied in specimens from humans ranging from fetal age to 79 years. At all ages the prostate can be divided into 2 zones (inner and outer). The distribution and relative size of the prostatic lobes are similar in the fetus and adult. In the fetus the inner zone can be subdivided into the lateral, subcervical and anterior lobes, and the mucosal glands. The anterior and subcervical lobes usually disappear before puberty but they may reappear at advanced age. The outer zone can be subdivided into the middle and posterior lobes. Benign prostatic hyperplasia arises from the lateral, subcervical and anterior lobes of the inner zone, and the middle lobe of the outer zone. It is suggested that previous investigators failed to describe a demarcation line or territory between the lateral and posterior lobes. G. P. M. 11 figures, 4 references Effects of Castration Compared With Total Androgen Blockade on Tissue Dihydrotestosterone (DHT) Concentration in Benign Prostatic Hyperplasia (BPH) J. GELLER AND J. ALBERT, Mercy Hospital and Medical Center, San Diego, California Urol. Res., 15: 151-153 (June) 1987 The authors compared the effect of a variety of drug regimens to lower prostatic dihydrotestosterone concentration. Patients with benign prostatic hyperplasia were treated for 1 week preoperatively with either tamoxifen, flutamide, or megestrol acetate alone or with either tamoxifen, diethylstilbestrol or ketoconazole. Dihydrotestosterone concentration in the surgically resected tissue was compared to tissues obtained from untreated patients. The authors also obtained prostatic tissue at the time of relapse in patients with prostate cancer who had been treated with orchiectomy with or without estrogen therapy. Megestrol acetate plus the mini-dose of diethylstilbestrol (0.1 mg.) and ketoconazole decreased dihydrotestosterone concentrations in prostatic tissue to levels significantly below those noted with orchiectomy (O. 79 versus 1.16 ng./gm., respectively). The difference between dihydrotestosterone concentration in the 2 groups (orchiectomy versus total androgen blockade) represents the contribution of adrenal androgens to prostatic tissue dihydrotestosterone. This small amount of dihydrotestosterone (approximately 0.4 ng./gm.) may be biologically important in stimulating prostatic epithelial cell growth. G.P.M. 2 figures, 1 table, 8 references Changes in the Sexual Behavior of Couples After Prostatectomy. A Prospective Study S. CYTRON, D. SIMON, E. SEGENREICH, Z. LEIB AND C. SERVADIO, Department of Urology, Beilinson Medical Cen-

ter, Sackler School of Medicine, Tel-Aviv University, Petah Tiqva, Israel