Perineal body (central perineal tendon) is not the site of insertion of perineal muscles but the site along which muscle fibers of these muscles and the external anal sphincter pass uninterrupted from one side to the other. Such a free passage from one muscle to the other seems to denote a "digastric pattern" for the perineal muscles. Perineal body is subjected to injury or continuous intra-abdominal pressure variations, which may eventually result in perineocele, enterocele, or sigmoidocele.

BackgroundEtiology of venogenic erectile dysfunction is not exactly known. Various pathologic processes were accused but none proved entirely satisfactory. These include presence of large venous channels draining corpora cavernosa, Peyronie's disease, diabetes and structural alterations in fibroblastic components of trabeculae and cavernous smooth muscles. We investigated hypothesis that tunica albuginea atrophy with a resulting subluxation and redundancy effects venous leakage during erection.Methods18 patients (mean age 33.6 ± 2.8 SD years) with venogenic erectile dysfunction and 17 volunteers for control (mean age 31.7 ± 2.2 SD years) were studied. Intracorporal pressure was recorded in all subjects; tunica albuginea biopsies were taken from 18 patients and 9 controls and stained with hematoxylin and eosin and Masson's trichrome stains.ResultsIn flaccid phase intracorporal pressure recorded a mean of 11.8 ± 0.8 cm H2O for control subjects and for patients of 5.2 ± 0.6 cm, while during induced erection recorded 98.4 ± 6.2 and 5.9 ± 0.7 cmH2O, respectively. Microscopically, tunica albuginea of controls consisted of circularly-oriented collagen impregnated with elastic fibers. Tunica albuginea of patients showed degenerative and atrophic changes of collagen fibers; elastic fibers were scarce or absent.ConclusionStudy has shown that during erection intracorporal pressure of patients with venogenic erectile dysfunction was significantly lower than that of controls. Tunica albuginea collagen fibers exhibited degenerative and atrophic changes which presumably lead to tunica albuginea subluxation and floppiness. These tunica albuginea changes seem to explain cause of lowered intracorporal pressure which apparently results from loss of tunica albuginea veno-occlusive mechanism. Causes of tunica albuginea atrophic changes and subluxation need to be studied.

Electric waves could be recorded from the vagina. They spread caudad. A pacemaker was postulated to exist at the upper vagina evoking these waves. The electric waves seem to be responsible for the vaginal contractile activity. Large-volume vaginal distension effected an increase in the vaginal electric waves and pressure which probably denotes increased vaginal muscle contraction. It appears that penile thrusting during coitus stimulates the vaginal pacemaker which effects an increase in vaginal electric activity and muscle contractility and thus leading to an increase in sexual arousal. The vaginal pacemaker seems to represent the G spot, which is claimed to be a small area of erotic sensitivity in the vagina. The electrovaginogram may act as a diagnostic tool in the investigation of sexual disorders.

The cause of diverticular disease (DD) is not exactly known, although colonic motor disorder has been proposed as a factor in the pathogenesis of the condition. We investigated the hypothesis that disordered colonic electrical activity is responsible for the colonic motor dysfunction and the development of DD. The electromyographic (EMG) activity and pressure of the sigmoid colon (SC) were recorded in 36 patients [16 early cases, 20 advanced cases; age (mean +/- SD) 53.3 +/- 5.6 years; 19 women, 17 men] and 22 healthy volunteers. The percutaneous route was used for recording the SC EMG. The healthy volunteers exhibited SC slow waves with a regular rhythm and the same frequency, amplitude, and conduction velocity from the three electrodes in the same subject. The SC basal pressure (7.9 cm H(2)O) was interrupted by bouts of high pressure (26.8 cm H(2)O). The early-DD cases showed slow waves with an irregular rhythm and significantly higher variables ( p < 0.05) than the volunteers. Action potentials followed randomly or were superimposed on the slow waves. The SC basal pressure was significantly higher than that of the volunteers (21.4 cm H(2)O, p < 0.01). Bouts of pressure (58.6 cm H(2)O) coupled with action potentials were recorded. No waves were recorded from 15 of 20 of the advanced-DD patients. In 5 patients, slow waves with an irregular rhythm and lower variables ( p < 0.05) than those of the volunteers were recorded. The basal SC pressure was significantly above normal. Three electrical activity patterns could be identified in DD patients: "tachyrhythmic" in the early-DD patients and "bradyrhythmic" or "silent" in the late-DD patients. These dysrhythmias may result from a disordered colonic pacemaker. The similarity between early DD and the irritable bowel syndrome suggests that DD is an advanced stage of the irritable bowel syndrome; studies are required to investigate this hypothesis further.

Several techniques have been developed to measure the amount of sperm DNA damage in an effort to identify more objective parameters for evaluation of infertile men. The integrity of sperm DNA influences a couple's fertility and helps predict the chances of pregnancy and its successful outcome. The available tests of sperm DNA damage require additional large-scale clinical trails before their integration into routine clinical practice. The physiological/molecular integrity of sperm DNA is a novel parameter of semen quality and a potential fertility predictor. Although DNA integrity assessment appears to be a logical biomarker of sperm quality, it is not being assessed as a routine part of semen analysis by clinical andrologists. Extensive investigation has been conducted for the comparative evolution of these techniques. However, some of these techniques require expensive instrumentation for optimal and unbiased analysis, are labor intensive, or require the use of enzymes whose activity and accessibility to DNA breaks may be irregular. Thus, these techniques are recommended for basic research rather than for routine andrology laboratories. Sperm chromatin structure evaluation is applied to detect male factors that may affect the chance of success with IVF as well as natural fertility. Further research is needed to define the optimal test of sperm chromatin structure. The clinical application of this test will evolve as well.