Microphallic hypospadias: testosterone therapy prior to surgical repair.

The surgical repair of hypospadias may be more difficult in boys with microphallus than in those with a penis of normal size. Temporary enlargement of the abnormally small penis can be achieved by local application or systemic administration of testosterone. We have studied the effect of local application of testosterone cream in seven boys with microphallic hypospadias. Serum testosterone levels and penile size were measured before, during and after treatment. The relative advantages and disadvantages of local testosterone application in comparison with injection are discussed.

Syphilitic aneurysms of the innominate artery.

Syphilitic aortitis can cause formation of fusiform or saccular aneurysms of the ascending aorta or transverse arch. The authors report 3 cases in which a saccular aneurysm developed at the origin of the innominate artery and was seen as a mediastinal mass on the chest radiograph.

The use of alpha-system set for arterial catheterization.

The use of a new set for arterial catheterization (Alpha-system) is presented. In fifty patients arterial cannulation was performed (femoral artery was used in 47 cases). The mean duration of cannulation was 6.7 days. Some minor complications, such as haematoma (5 cases), kinking of catheter (2 cases) and technical difficulties are described. Five out of 50 catheter tips were colonized by gram-negative germs. The use of the Alpha-system set avoids to a large extent haematoma, as the tapping hole is completely occluded by the catheter, and the plastic sound (instead of a metallic one) neither perforates the opposite wall nor dislodges an atheromatous plaque. We recommend a careful clinical and arteriographic control of the region supplied by the cannulated artery as well as a strict aseptic technique of puncture and dressing.