Evoked sacral potentials were used to study the bulbocavernosus reflex in 85 patients with true premature ejaculation (TPE) and in 52 subjects as a control group.In the perineal and perianal recordings the amplitudes of the evoked responses (means * SD) were 70 f 9 1.1 pV and 35.6 f 36 pV in the TPE patients, and 39.2 f 36.8 pV and 26 +_ 21.6 pV in the controls, respectively. Both these differences resulted significant (P < 0.01 and P 0.05, respectively). Our results suggest a reflex hyperexcitability, or an impaired "modulation" of the motor neurons of the pudendal nucleus by the regulating upper centers in the TPE patients. Evozierte sakrale Potentiale bei Patienten rnit echter Ejakulatio praecoxZusammenfassung: Bei 85 Patienten mit einer echten Ejakulatio praecox wird der Bulbo-cavemosus Reflex mittels evozierter sacraler Potentiale gepriift. 52 weitere Miinner dienten als Kontrollgruppe. Bei der pethealen und perianalen Aufzeichnung der evozierten Erregungen betrugen die Amplituden 70 f 9 1.1 pV und 35.6 f 36 pV bei den Patienten mit einer Ejakulatio praecox, bzw. 39.2 f 36.8 pV und 26 f 21.6 pV in der Kontrollgruppe. Bei beiden Gruppen sind diese Unterschiede signifikant. Die Ergebnisse weisen auf eine Reflexubererregbarkeit hin bzw. auf eine beeintriichtigte ,,Modulation" der motorischen Neuronen des Plexus pudendus durch die ubergeordneten Zentren bei Patienten mit einer echten Ejakulatio praecox.

Sporadic cases of a particular group of renal cancers associated with a translocation involving Xp11.2, known as the TFE3 transcription factor gene, have been reported in the last 20 years. The group was also classified in 2004 WHO kidney carcinoma classifications. A 79-year-old male patient was investigated at the outpatient department for gross intermittent hematuria. Sonography showed a spherical left kidney with increased total size, without evidence of the corticomedullary differentiation due to parenchymal dyshomogeneity with a neoplasm aspect. CT confirmed the sonographic left kidney findings and showed gross node involvement. Angiography did not show any pathological arterial circulation, but massive thrombotic involvement of the renal vein was evident. Radical nephrectomy with thrombectomy and staging lymphectomy were performed. At pathological examination the kidney parenchyma was completely substituted by white firm tissue. Microscopically the tumor was composed of papillary structures lined by epithelial cells with a clear cytoplasm. Multiple node metastases were found. Immunohistochemical examination showed negativity for epithelial markers (cytokeratin and epithelial membrane antigen) and reactivity for CD10 and TFE3. The genetic and histological aspects of this rare tumor are reported. In addition, we describe clinical, radiological and surgical findings.

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Motor unit potentials (MUP) of the perineal muscles and in particular of the extcrnal anal sphincter (EA sph.), of the external urethral sphincter (EU sph.) and of the bulbocavernosus muscle (BC) have been seldom analyzed. There is no uniformity of view about amplitude and duration of MUP of these muscles. According to different authors, duration varies from 2 to 10 msec, and amplitude varies from SO pV to 3 mV.In this paper, we studied EMG findings of EU sph., EA sph., and BC in 37 normal men (15 BC, 12 EU sph., and 10 EA sph.). In total we recorded 239 different MUP in BC, 208 in EU sph., and 134 in EA sph. There are no differences among the three groups in amplitude (mean values about 250 pV). On the contrary, EU sph. showed a significantly shorter duration (3.73 msec) compared to BC (5.58 msec) and EA sph. (5.07 msec). Polyphasic potentials range from 2.3% to 5.9%. Gosling et a1 (Br J Urol 53:35-41, 1981) has shown that the striated muscle of EU sph. is made of fibers smaller than those of adjacent periurethral muscles. Possibly, motor units are smaller.

The effectiveness mechanism of the chlomipramine treatment was evaluated by sacral evoked response (SER) and dorsal nerve somatosensory cortical evoked potential (DN-SEP) testings in 15 patients with true premature ejaculation (TPE) . We couldn't demonstrate any significant difference between the values of either latency times or amplitudes of the evoked responses determined just before and at the end of the treatment with chlomipramine in these patients. However, the sensory thresholds were 24.4 * 4.3 V in the pretreatment term and 30.2 f 7.3 V at the end of the treatment. This difference is statistically significant ( P = 0.0031). Our results suggest that chlomipramine increases the sensory threshold for the stimuli in the genital area.