E Douglas Whitehead

Urologic examination of 48 male patients exposed in utero to diethylstilbestrol showed genital abnormalities in 29. Only 33 per cent of the patients studied had normal semen analyses by Eliasson scoring. Genital abnormalities demonstrated included varicoceles, epididymal cysts, hypoplastic testes and undescended testes among others. None of the patients had elevations of alpha-fetoprotein or beta-subunit human chorionic gonadotropin. The high incidence of the aforementioned abnormalities ...

A series of 32 patients with carcinoma of the prostate who underwent 125iodine interstitial irradiation to the prostate and simultaneous extraperitoneal pelvic lymphadenectomy was reviewed. The patients were segregated into 3 groups: group 1-patients with early localized low grade disease, group 2-patients with advanced localized high grade disease and group 3-patients with early localized high grade disease and those with advanced localized low grade disease. Owing to the high degree of ...

Because many elderly men with chronic illnesses such as diabetes have multiple causes contributing to their impotence and may still retain an interest in sexual activity, those who still are unable to adequately perform sexually after treatment of their medical problems should be informed of the alternative methods of treatment of their impotence or alternative methods of sexual fulfillment and gratification and, when necessary, should be offered supportive counseling and psychotherapy.

A multispecialty approach to diagnosis of impotence is the most appropriate, because many factors may be at work. The expertise of professionals in the fields of urology, sex therapy, psychiatry, family practice, internal medicine, endocrinology, neurology, radiology, sleep evaluation, and vascular surgery may be needed to ascertain the correct organic or psychogenic cause in some cases.

The OmniPhase* penile prosthesis is a new mechanically activated penile implant. The prosthesis can be alternatively flaccid and rigid depending on the tension of a supporting central cable. We report a case of delayed bilateral central cable breakage with subsequent loss of penile rigidity.

More than 10 million men in the United States are chronically impotent. Fortunately, significant advances have been made in psychotherapy, pharmacologic management, arterial and venous surgery, penile prosthesis implantation, and use of external devices so that most find a satisfactory solution. After their dysfunction is sufficiently evaluated and the most appropriate treatment option is applied, most men achieve erectile capability sufficient for intercourse.

The occurrence of condyloma acuminata of the urethral meatus is extremely rare in children. This is the second case in the literature of this type of lesion in a child less than five years of age. This is considered a benign lesion which is best managed by excision and fulguration of its base.

Nonsurgical management of a penile fracture can result in penile deformity due to plaque, and impaired tumescence due to corporeal fibrosis and altered erectile hemodynamics. We describe the correction of penile deformity and impaired tumescence by extensive resection of corporeal fibrosis and insertion of a unilateral unitary inflatable prosthesis. A possible role is proposed for correcting penile angulation secondary to unilateral disease using a unilateral unitary inflatable penile prosthesis.

In recent years considerable endocrinologic and other data has become available, permitting clear definition of many hormonally dependent etiologies for erectile impotence. Today, the clinician, be he an internist or a urologist, has available an extensive diagnostic armamentarium of investigations useful in establishing what may be a hormonal etiology of erectile impotence. In this report the hormonal bases of erectile impotence and currently useful diagnostic investigations to ...