Paraphimosis due to erotic dancing

Paraphimosis usually develops when a tight foreskin is retracted over the glans penis for a prolonged period. Many esoteric aetiologies have been implicated in the development of paraphimosis including piercing the foreskin, Plasmodium falciparum infection, application of celadine juice to the foreskin, chancroid, pessaries and the implantation of pearls. We report the first two cases of paraphimosis developing during wining, an erotic dance native to Trinidad & Tobago.

Advances in the management of erectile dysfunction

The management of erectile dysfunction (ED) is undergoing a metamorphosis. A brief review of the history of ED will be undertaken as a basis for understanding how treatments have evolved. From the 1400s to the Victorian era ED was considered a sign of witchcraft or the result of "evil behaviour". In the 1970s an organic basis for ED was recognised and in the 1980s over 80 percent of cases were identified as having an organic aetiology. The pivotal event for erection is smooth muscle relaxation. For erection to occur the nervous system may be activated centrally by thought, locally by genital stimulation or both. Relaxation of the sinusoidal smooth muscle cells in the aeterioles and trabeculae of the erectile bodies in the penis causes the sinusoids to fill and the suburical vessels to be compressed creating rigidity of the corpora cavernosa. The aetiology of ED is multifunctional and causal factors may be arteriogenic, neurogenic, hormonal, cavernosal and psychogenic or combinations of these. Evaluation includes a medical history, including drug therapy, physical examination, sexual history and diagnostic tests. Current treatment options include counselling, intracavernosal injection therapy, intraurethral medication, vacuum devices, vascular surgery and insertion of prostheses. Finally, as the millenium approaches, research continues to find the "Magic Pill"(AU)

The anaesthesia penile tumescence test - abstract

A simple method of differentiating organic from psychogenic impotence is important if appropriate therapy is to be offered. Prostatic massage under light anaesthesia was consistently found to produce penile tumescence in ten controls. Tumescence usually started within one minute of the onset of prostatic massage, and progressed to a stage adequate for penetration within three minutes. The penile erection was maintained at least until the patient reached the recovery room. Eleven patients being investigated for impotence were subjected to the procedure in conjunction with hormonal and blood flow studies. All patients had nocturnal penile tumescence (NPT) stamp tests and two of those who failed this and the anaesthesia penile tumescence (APT) test, had nocturnal penile tumescence (NPT) strain gauge tests in the U.S.A. Seven patients had good APT results, two fair and two poor. The four patients who had fair and poor results also failed the NPT stamp tests and the NPT strain gauge test where this was done. APT testing therefore correlates well with the accepted standard NPT test, requires no special expensive equipment and allows polaroid documentation of rigidity instead of increase in circumference as in the NPT test. Polaroid documentation also allows patients to realise their potential and facilitates treatment of psychogenic impotence (AU)