Spontaneous and prolonged drug-induced erection in a patient with inflatable penile implant.

Achievement of spontaneous tumescence after penile implant surgery has already been reported. However, regular spontaneous full, rigid erection upon sexual arousal that is adequate for vaginal penetration and tumescence for satisfactory sexual performance is an extremely rare condition in men with three-piece hydraulic implants. Similarly, prolonged erection is not expected in such implant cases even with the use of erectogenic agents. We report this interesting phenomenon confirmed by magnetic resonance imaging technique in a patient with inflatable device.

Low sperm recovery from the undescended testis with testicular sperm extraction in postpubertal cryptorchids: preliminary report.

As postpubertal cryptorchid testes are generally atrophic and have high malignancy risk, orchiectomy is recommended as the treatment method. However, a few case reports advocated orchiopexy due to finding sperm afterwards. The present clinical study aimed at determining the possibility of finding spermatozoa in postpubertal cryptorchid testis with testicular sperm extraction (TESE). Initially testicular biopsy and later TESE was performed in the undescended testis of 22 unilateral postpubertal cryptorchids and in one of the testes of three bilateral postpubertal cryptorchids. Histopathological assessment of testicular biopsy specimen showed that three patients had maturation arrest and 22 had seminiferous tubular atrophy. By TESE, spermatozoa were found in only one specimen of 25 testes. Our results show that the expectancy to find spermatozoa in postpubertal cryptorchid testis is extremely low by current sperm recovery methods and orchiectomy is still the accurate method of treatment.

Tubularized incised plate urethroplasty for distal and mid-penile hypospadias.

Tubularized incised plate urethroplasty was performed to repair 20 distal and 5 mid-penile hypospadias cases. In distal hypospadias repair meatal stenosis occurred in 1 patient and urethral fistula in another. The overall complication rate in this group was thus 10%. Among midpenile hypospadias cases meatal stenosis was observed in 1 (20%) patient. As a conclusion, tubularized incised plate urethroplasty was found to be a successful method for treating distal hypospadias and encouraging results were obtained in mid-penile hypospadias cases.

Extragonadal germ cell tumors: clinicopathologic findings, staging and treatment experience in 14 patients.

Extragonadal germ cell tumors (EGCT) are a rare group of neoplasms histologically identical to testicular counterparts. Fourteen cases of primary mediastinal and retroperitoneal germ cell tumors were treated with chemotherapy and radiotherapy between 1987 and 1999 in Ankara Oncology Hospital. There were 9 (64%) complete remissions (CR),one (7%) partial remission (PR) and 2 (14%) stable diseases (SD). The remaining 2 patients were lost due to dissemination of disease. The median duration of response was 19 months. Our modified chemotherapeutic results were similar to original doses of PVB and BEP but toxicity was less. The neccesity of a uniform staging system and treatment programs are discussed.

A new approach to bladder augmentation in children: seromuscular enterocystoplasty.

OBJECTIVE: To report the use of seromuscular enterocystoplasty (SE) combined with detrusorectomy, in children. PATIENTS AND METHODS: Between 1993 and 1998, SE was performed in 10 children (aged 10-17 years) with a spastic neurogenic bladder resulting from spinal trauma. Before surgery all children were incontinent and despite anticholinergic medication and clean intermittent catheterization, their bladder capacity was 60-100 mL and their intravesical pressure 40-60 cmH2O. RESULTS: Before surgery, the mean end-filling intravesical pressure was 47.7 cmH2O and the mean bladder capacity 82.9 mL. At 3 months after surgery the mean end-filling intravesical pressure was decreased to 21.1 cmH2O and the mean bladder capacity increased to 319.6 mL. One patient (a 14-year-old girl) had urinary retention soon after surgery and has since used clean intermittent catheterization. The other children were able to void successfully using the Valsalva manoeuvre; none were incontinent. All patients were followed and there were no changes in intravesical pressure and bladder capacity. CONCLUSION: In providing most of the desired features of an ideal augmentation segment, SE is a good and effective method of bladder augmentation.

Embolization therapy in two subtypes of priapism.

Two subtypes of priapism have been described based on the pathophysiologic mechanism. The more common type, termed stasis priapism, is characterized by a low flow state in which inadequate venous outflow creates an acidotic hypoxic environment leading to a painful prolonged erection. The other less common subtype, high flow priapism, is arteriogenic. We used embolization therapy in one case with long lasting stasis priapism and in the other with high flow priapism due to bilateral arteriosinusoidal fistulae in the penis. In both cases we used polyvinyl alcohol for embolization and sexual potency preservation. Priapism is the persistence of erection that does not result from sexual desire. Hauri et al. described two variants of priapism. In high flow priapism (non-ischaemic) there is unregulated arterial inflow to the lacunar spaces due to a lacerated cavernous artery associated with previous perineal and penile trauma. In stasis priapism, the second type, the basic abnormality could be due to a more pronounced or prolonged blood entrapment inside the vascular spaces of the corpora cavernosa sustained by an unknown cause. There are many treatment methods especially for low flow ischaemic variant. We report two different kinds of priapism and embolization therapy in both of them with polyvinyl alcohol.

[Serum antibody levels of cytomegalovirus, herpes simplex type I and adenovirus in patients with benign or malignant prostatic neoplasms]. / Prostatin benign ve malign büyümelerinde serum sitemegalovirus, herpes simpleks tip i ve adenovirus antikor düzeyleri.

The serum antibody titers of cytomegalovirus (CMV), Herpes Simplex Type I (HSV-L) and Adenovirus (ADV) were detected by complement fixation technique in 40 patients with benign hyperplasia of prostate (BPH), and prostatic carcinoma. The control group consisted of healthy 20 military personnel. While, antibody levels of CMV and HSV-I was found to be elevated in BPH, the titers of ADV was elevated in protatic cancer patients. The verify the relation between virus-prostatic cancer relation further clinical and laboratory researchers are needed.

Varicocele and antisperm antibodies.

Semen analysis and immunofluorescent antisperm antibodies were tested in 65 patients with varicocele. The mean sperm count and motility values in our study were 36.8 +/- 2.9 million per ml and 38.4 +/- 2.5 per cent, respectively. Both parameters were found not to differ significantly in three grades of varicocele. Immunofluorescent antisperm antibodies were detected in 24.6 per cent of the cases. A significant correlation was demonstrated between the presence of the antibodies and genital infection.