No abstract

To understandbetter the vascular events that occur during normal erection, we used color flow Doppler sonography to examine the erectile process in seven normal subjects. To examine systolic/diastolic velocities and spectral waveform changes before and dunng erection, we used color flow Doppler sonography because of its ability to visualize small vessels with low flow. Subjects and MethodsSeven normal volunteers (age range, 31 -55 years; mean age 40 years) with no known vascular disease or medical conditions were included in the study. All had a history of having normal sexual intercourse as reported by the subjects and their partners, normal erectile response documented by normal nocturnal penile tumescence (NPT), and normal cavemosometry performed after intracorporal injection of papaverine (Eli Lilly, Indianapolis, IN) and Regitine(phentolamine mesylate; Ciba-Geigy; Summit, NJ). Institutional human subjects' approval and informed consent were obtained for all participants.Color flow imaging and spectral waveform analysis of the penile arteries were performed both before and after intracorporal injection of papaverine and Regitmne. Two 21 -gauge needles were placed into the midshaft of the left corpus cavernosum.One needle was used

Urethral injuries are commonly associated with pelvic fractures. The prompt recognition and appropriate management of these injuries may significantly impact subsequent morbidity, yet few studies have addressed the identification of the risk factors for urethral injury in men with pelvic fractures. We reviewed retrospectively the records of 405 men with pelvic fractures seen at our medical center, including 21 (5 per cent) with urethral injuries. Of the 21 men 14 (67 per cent) had fractures involving a pubic ramus and a sacroiliac joint, and 12 (57 per cent) had no physical signs (blood at the urethral meatus, perineal hematoma or a high-riding prostate) that would suggest a urethral injury. The likelihood for the presence of physical signs is directly related to the interval since injury. We believe that men with the combination of rami fractures and sacroiliac disruption should undergo retrograde urethrograms before urethral instrumentation, and that physical signs are unreliable indications for urethral injuries, especially soon after the injury.

Pelvic pain is often a persistent, recurrent condition that can have a significant negative impact on quality of life. The average symptom severity in men with pelvic pain in primary care and urology settings is lower than that in tertiary care samples.