The Relationship of Penile Rigidity and Intracavernous Vascular Resistance in Potent Men during Intracavernous Pharmacological Testing
Jyh-Horng Chen, Shih-Ping Liu and Ju-Ton Hsieh Department of Urology, Hsin-Chu Hospital, Department of Health, Executive Yuan and National Taiwan University Hospital, Taipei, Taiwan, Republic of China.
Journal of Urology. 166:1762-1765, 2001
Purpose: We studied the relationship of penile rigidity and intracavernous vascular resistance in potent men during intracavernous pharmacological testing.
Materials and Methods: Enrolled in our study were 19 potent men undergoing intracavernous pharmacological testing for various reasons. Hemodynamic changes in response to the intracavernous injection of 20 µg. prostaglandin E1 were assessed by color Doppler sonography with simultaneous RigiScan (Dacomed Corp., Minneapolis, Minnesota) monitoring of penile rigidity. The relationship of penile rigidity and intracavernous vascular resistance was determined by correlating hemodynamic data with recorded penile rigidity values.
Results: Maximal mean rigidity plus or minus standard deviation of the penile tip and base after intracavernous injection of prostaglandin E1 was 76.8% ± 8.5% and 97.3% ± 4.7%, respectively. Penile tip and base rigidity correlated positively with the resistive index (r = 0.69 and 0.75, p <0.0001) and negatively with end diastolic velocity (r = -0.62 and -0.70, respectively, p <0.0001). The formula, rigidity = -128 + 195 × resistive index, was derived to describe the linear regression of penile base rigidity and the resistive index. The formula, rigidity = 59.8 - 3.3 × end diastolic velocity, was derived to describe the linear regression of penile base rigidity and end diastolic velocity.
Conclusions: Penile rigidity correlated strongly with intracavernous vascular resistance in potent men during intracavernous pharmacological testing. The resistive index and end diastolic velocity of the cavernous arteries may each be used to estimate penile rigidity quantitatively.
男性學論文獎臨床組2
Reoperative Snodgrass Procedure Stephen Shei Dei Yang, Shyh Chyan Chen,Cheng Hsin Hsieh and Yung Tai Chun Department of Urology, National Taiwan University Hospital and En Chu Kong Hospital, College of Medicine, National Taiwan University and Taipei Medical University, Taipei, Taiwan
Journal of Urology. 166:2342-2345, 2001
Purpose: We examine the results of a reoperative Snodgrass procedure for complex hypospadias.
Materials and Methods: A total of 25 patients with hypospadias in whom repair had failed underwent a reoperative Snodgrass procedure. Mean patient age and number of prior repairs were 11.4 years and 2.5, respectively. Before this treatment the meatus was at the distal shaft in 10 cases, mid shaft in 9, proximal shaft in 4 and penoscrotal junction in 2. Preoperatively the associated complications were fistulas in 13 patients, residual chordee in 12 and diverticulum in 1. In 8 cases the fistula was incorporated into the hypospadiac opening and treated as a longer defect. The urethral plates were, subjectively, surgically altered or unaltered in 7 and 18 patients, respectively. In 8 patients (group A) the previous repair(s) did not involve dissection of the urethral plate (unaltered) nor was there a fistula. The remaining 17 patients were classified as group B. The neourethra was then reconstructed as the Snodgrass technique. Followup urethral calibration was performed in 17 patients.
Results: Mean followup period was 13.7 months. Mean length and size of neourethra were 19.9 mm. and 14Fr, respectively. There were 7 (28%) postoperative fistulas of the neourethra. The incidences of postoperative fistula of the neourethra were 0% and 41.2% in groups A and B, respectively (p <0.01). Statistically the surgically altered urethral plate and the presence of a preoperative fistula were 2 independent factors predicting a higher postoperative fistula rate. The overall postoperative meatal stenosis rate was 13 (52%) with 3 (37.5%) in group A and 10 (58.8%) in group B, respectively (p >0.05). The meatal stenosis was treated with simple dilation in 11 cases and meatoplasty during subsequent fistula repair in 2. Stricture at the anastomostic site between the normal urethra and neourethra was noted in 2 patients. Fistula repair was successfully performed 6 months later in 4 patients.
Conclusions: The Snodgrass procedure is a viable option for the treatment of previously failed hypospadias repair. It was highly effective in patients with a surgically unaltered urethral plate and no preoperative fistula.
男性學論文獎基礎組
Effects of Extracellular Matrix Proteins on Mouse Epididymal Epithelial Cell Attachment in Vitro
Guang-Huan Sun 1*, Hwan-Wun Liu2,3 Sheng-Tang Wu 1, Dah-Shyong Yu1,Chung-Yang Yen1, Hong-I Chen1, and Sun-Yran Chang4
1Division of Urology, Department of Surgery, Tri-Service General Hospital, 2Department of Biology and Anatomy, 3Institute of Preventive Medicine, National Defense Medical Center, 4National Defense Medical Bureau, Taipei, Taiwan, Republic of China.
Journal of Medical Sciences, 22(5): 199-206
Objective: Appropriate extracellular matrix (ECM) molecules have been reported to produce significant improvement in the attachment, growth, and differentiation of many types of cell cultures. In this study, the effects of four ECM proteins (type IV collagen, type I collagen, fibronectin, and laminin) on the attachment of epididymal epithelial cells in culture were investigated.
Materials and Methods: The epithelial cells were obtained from corpus epididymides of 4- and 6-week-old BALB/c mice and cultured with RPMI 1640 medium supplemented with 10% fetal calf serum in ECM-coated dishes at 37OC. The epithelial nature was determined by an indirect immunocytochemical staining technique. The attachment assay was performed and proteins in the cultured cells were analyzed by SDS-PAGE and autoradiography.
Results: Type IV collagen was determined to significant improve the cell attachment whereas as a plastic surface without the ECM coating or coated with the remaining three ECM proteins exhibited relatively poor effects. Moreover, the epididymal epithelial cells from 4-week-old mice exhibited better attachment and proliferation than their 6-week- old counterparts with sperm in the epididymal tubules. On day 4, most of the cells revealed epithelial cell-specific keratins. WGA-binding proteins (GP-83 and GP-49) were found in the cell extracts and cultured media by isolation with WGA-agarose. However, there were no apparent differences in the pattern of protein synthesis between cells isolated from the 4- and 6-weeks-old mice.
Conclusions: This culturing model with epididymal cells recovered from the corpus epididymis of 4-week-old mice and cultured in type IV collagencoated dish is suitable for the investigation of epididymal physiology and sperm maturation in vitro.