Reestablishment of male sexual function and appearance 23 years after alligator induced traumatic orchiectomy and penile lacerations.

We report a case of traumatic sexual dysfunction and genitalia deformity successfully treated with dorsal vein excision, spongiolysis, rotational flaps, split thickness skin grafts, testicular prosthesis implantation and penile autologous fat augmentation 23 years after an alligator attack resulted in amputation of the testes and half of the scrotum, and denudation of the penis with corpus cavernosum to spongiosum fistula formations.

Potentiation of drug-induced erection with audiovisual sexual stimulation.

Twenty-five patients underwent audiovisual sexual stimulation (AVSS) after pharmacologically-induced erection. Grade of erection and cavernosal blood flow were assessed after intracorporeal (IC) injection of TRI-MIX or prostaglandin E1, and then after AVSS, using pulsed Doppler ultrasonography (PDUS). After IC injection, 5 patients had a Grade II erection, 8 had Grade III, 10 had Grade IV, and 2 had Grade V. There was an increase in peak arterial flow and arterial diameter which corresponded with the grade of erection obtained. After addition of AVSS, 56.5 percent of patients experienced improved erection. The improvement from Grade III to IV in 13 percent is especially significant because it showed the attainment of adequate erection when IC injection alone failed. Penile blood flow improved among AVSS responders but not in nonresponders. AVSS may enhance pharmacologically-induced erection and may improve the diagnostic accuracy of PDUS.

Stress incontinence secondary to a vesicourethral fistula: case report.

A previously unreported case of vesicourethral fistula in a female is presented. Its possible etiology and recommendations are discussed.