Successful treatment of high-flow priapism with radiologic transcatheter embolization of the internal pudendal artery: A case report

Priapism, a relatively uncommon disorder, is divided into ischemic (veno-occlusive, low flow) painful priapism and nonischemic (arterial, high flow) painless priapism.. We report our successful treatment of arterial priapism by means of radiologic selective transcatheter embolization of the internal pudendal artery using micro coil

Elevation of serum lactate dehydrogenase in patients with pectus excavatum

INTRODUCTION: Pectus excavatum is the most common congenital chest wall deformity and the depression of the anterior chest wall, which compresses the internal organs. The aim of the present study is to investigate the effects of pectus excavatum on blood laboratory findings. MATERIAL AND METHODS: From March 2011 to December 2011, 71 patients with pectus excavatum who visited Seoul Saint Mary Hospital for Nuss procedure were reviewed and analyzed. The blood samples were routinely taken at the day before surgery and pectus bar removal was usually performed in 2 to 3 years after Nuss procedure. To investigate the effects on blood laboratory findings, preoperative routine blood laboratory data and postoperative changes of abnormal laboratory data were analyzed. RESULTS: Only lactate dehydrogenase (LDH), one of 26 separate routine laboratory tests, was abnormal and significantly elevated than normal value (age <10, p = 0.008; age ≥10, p < 0.001). However, there was no significant correlation between LDH levels and severities of pectus excavatum. The symmetric subgroup had significantly higher LDH level than the asymmetric subgroup (p <0.001) and there was a significant decrease of LDH level after correction of deformity (p = 0.017). CONCLUSION: In conclusion, only LDH, one of the routine laboratory tests, was significantly elevated than normal value, which was thought to be caused by etiologies of pectus excavatum and the compression of the internal organs. Further studies on LDH including isoenzyme studies in patients with pectus excavatum will be needed, and these studies will provide a deeper and wider comprehension of pectus excavatum

The investigation of corpus cavernosum smooth muscle dysfunction in low-flow priapism.

Prolonged low-flow (ischaemic) priapism results in a progressive alteration of the microenvironment within the corpus cavemosum with the development of hypoxia, acidosis and glucopenia and a reduction in the responsiveness to a-adrenergic receptor agonists. The aim of this study was to investigate the changes in the corporal microenvironment in patients presenting with refractory low-flow priapism and then develop an in vitro model to investigate the effects of hypoxia, acidosis or glucopenia on the tone of the rabbit corpus cavemosum. The recovery of smooth muscle contractility following exposure to these conditions was also investigated. Hypoxia, acidosis or glucopenia alone or in combination showed a sustained and significant reduction in the smooth muscle tone. This was most marked for conditions of hypoxia combined with glucopenia and the combination of hypoxia, acidosis and glucopenia. Reperfusion of tissue strips showed complete recovery of smooth muscle tone for all conditions except when hypoxia and glucopenia were combined or when hypoxia, glucopenia and acidosis were used in combination. Incomplete recovery of tone was not associated with an impairment of nitrergic relaxation responses but was associated with a significant reduction in tissue ATP concentrations and an increase in the number of TUNEL-positive nuclei. This indicates that in the presence of hypoxia, acidosis and glucopenia, failure of conventional a-adrenergic agonists in low-flow priapism is associated with irreversible smooth muscle cell dysfunction which is linked to ATP depletion and smooth muscle cell death

The Natural History of Peyronie's Disease

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Venous Leak Embolization in Patients with Venogenic Erectile Dysfunction via Deep Dorsal Penile Vein Access: Safety and Early Efficacy.

PURPOSE This all-comers registry aimed to assess safety and early efficacy of venous embolization in patients with venogenic erectile dysfunction due to venous leak in an unselected cohort. METHODS Between October 2019 and September 2022, patients with venogenic erectile dysfunction resistant to phosphodiesterase-5-inhibitors were treated with venous embolization using ultrasound-guided anterograde access via a deep dorsal penile vein in a single center. A mix of ethiodized oil and modified cyanoacrylate-based glue n-butyl 2 cyanoacrylate (NBCA) monomer plus methacryloxy-sulpholane monomer (Glubran-2, GEM, Italy) was used as liquid embolic agent. Prior to embolization, venous leak had been verified based on penile duplex sonography and computed tomography cavernosography. Procedural success was defined as technically successful and complete target vein embolization. The primary safety outcome measure was any major adverse event 6 weeks after the procedure. The primary feasibility outcome measure was IIEF-15 (International Index of Erectile Function-15) score improvement ≥ 4 points in ≥ 50% of subjects on 6 weeks follow-up post intervention. RESULTS Fifty consecutive patients (mean age 61.8 ± 10.0 years) with severe erectile dysfunction due to venous leak underwent venous embolization. Procedural success was achieved in 49/50 (98%) of patients with no major adverse events on follow-up. The primary feasibility outcome measure at 6 weeks was reached by 34/50 (68%) of patients. CONCLUSION Venous leak embolization via deep dorsal penile vein access using a liquid embolic agent was safe for all and efficacious in the majority of patients with severe venogenic erectile dysfunction on 6 weeks follow-up

Erectile dysfunction among diabetic patients in Kota Bharu Kelantan

A cross sectional study was conducted among diabetic patients in Kelantan, Malaysia to determine the prevalence of erectile dysfunction (ED),characteristics of diabetic patients with ED and patient's knowledge, attitude and practice towards ED. A total of 156 patients from Diabetic Clinic, Klinik Kesihatan Bandar, Kota Bharu and Hospital Universiti Sains Malaysia (USM), Kubang Kerian were selected into the study by using the availability sampling technique. Respondent were given self-administered questionnaire. ED was determined by using the International Index Of Erectile Function (IIEF-5). Statistical Program for Social Science (SPSS) version 9.0 was used for analyzing the data. The mean age was 53.2 ± 9.18 year. Majority of patients were Type 2 diabetes (97.6%). The overall prevalence of ED was 77.8% in which the prevalence of severe ED was 36.7%. There was significant correlation between age, duration of diabetes, history of smoking and retinopathy with ED (p0.05). Majority of patients (86%) had poor knowledge regarding ED.On comfort discussing about ED with the health provider, 18.2 % felt very comfortable, 32.5% felt comfortable, 15.9% felt quiet comfortable, 15.1% felt between comfortable and uncomfortable, 15.9% felt uncomfortable and 2.4% felt very uncomfortable. Regarding seeking treatment, 57.1% would do so. This study showed a high prevalence of ED in diabetic patients. The main factors associated with ED were age, duration of diabetes, history of smoking and retinopathy. Patients also considered the information on nature of ED and possible treatment were scant and generally inadequate