No abstract

The Authors describe in this work a surgical technique for constructing a penile prosthesis for transsexuals and for reconstructing the penis in patients submitted to post-neoplastic or post-traumatic surgery. This technique consists of 4 stages: in the first, a double-chamber prosthesis with inextensible sheath is placed; in the second and the third, the prosthesis is removed and covered with an abdominal flap after sub-cutaneous expansion; the fourth stage is for aesthetic retouches. The originality of this technique lies in the use of the inextensible sheath (of goretex or similar) and in the preparation of the flap in accordance with the abdominal angiosomes.

The authors report a rare case of spontaneous bladder rupture in a 13-year-old girl who underwent functional closure for bladder extrophy. Although bladder rupture can happen in operations for bladder augmentation, it is very rare in the above cases. The pathogenesis of this complication due to anatomical and functional factors is analysed, emphasising the need for careful long-term urologic follow-up.

In the present work we have studied the success of HCG-PG-1 association in the treatment of male impotence. We recruited (January-June 1990) 60 patients suffering from impotence for at least six months, selected by means of appropriate inclusion criteria. They were subdivided into three groups after standard diagnostic screening. In the first group we employed therapy with HCG 5.000 U.l. a week for four months. In the second group we have made intracavernous pharmaco-therapie weekly with PGE-1 for the same period. In the third group we did both above - mentioned therapies associated. Anamnesics qualitative-quantitative criteria for numeral results determination were adopted. This association produced a better therapeutic result as regards single therapy, with rapid and durable progress and very good follow-up.

Male pathologies are responsible for 40% of cases of infertility in a couple, and with other causes create a reduction in libido. The job, working environment and life style have been considered etiologic factors above all in consideration of ecotoxicologic changes in town and suburban areas. The effects of exposure to various toxic, physical, chemical, infectious, psychic and traumatic agents as well as the effects of stress, are analysed. It is concluded that a precise job history must be obtained from patients with potency and/or fertility problems.