[Peyronie's disease: comparative results of conservative treatment].

Long-term clinical experience with conservative treatment of Peyronie's disease has demonstrated that clinical efficacy of this therapy comprises maily anesthesia while erectile problems are not solved. Introduction of the drugs into the fibrous plaque is not adequate and hard to perform. Some drugs affect only some components of pathogenesis. For stabilization of the process it is recommended to use transdermal electrophoresis or phonophoresis. The search for new effective drugs and methods continues.

[The method of a complete one-stage urogenital reconstruction in extrophy of the urinary bladder and total epispadia in the adults].

In the context of surgical treatment of bladder extrophy/epispadia in the adults, the authors offer one-stage urogenital reconstruction, i.e. urethro-corporo-glanulo-sphyncteroplasty with penile preparation. Long-term results were analysed in adult patients with total epispadia and urine incontinence. Intact erectile function was observed in all 25 patients. An adequate function of the artificial muscular sphyncter was registered in 20 patients. The length of the penis increased from 2.5 to 5 cm. Sexual adaptation was achieved in 88% cases. Social adaptation occurred in all the cases.

[Congenital penile deviation: an integral diagnostic approach to correction].

A comparative analysis of diagnostic examination of 130 men with isolated congenital erectile penile deviation (EPD) aged 14-22 years (mean age 17 years) has demonstrated that true EPD can be determined objectively only at adequate erection. Therefore, the diagnosis should be based not on subjective opinion of the patient but on the results of artificial pharmacological erection or viagra-test in combination with visual erotic and genital stimulation. Vacuum erection test is not justified. In patients with congenital EPD rigidity depends much on correlation between perfusion volume and functional volume of the penis (cavernous volume). The problem of congenital EPD can be formulated as the problem of "long penis". Measurements of the penis in the group of 54 patients with congenital EPD registered a low penile coefficient in 67% cases while a mean length of the penis in all the examinees was longer than a mean standard one and was about 13 cm in relaxed condition. EPD patients often suffer from asthenodepressive disorders deteriorating the copulative function. Psychotherapy and medication of the depressive syndrome result in stabilization of the psychological condition improving quality of life 1.3 times. Thus, an integrative diagnostic and therapeutic approach, due selection of the patients for operative correction of penile deviation can improve quality of the treatment aimed both at correction of erectile malformation and psychosexual adaptation of the patients.