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1.
Int. braz. j. urol ; 33(6): 785-794, Nov.-Dec. 2007. ilus, tab
Artigo em Inglês | LILACS | ID: lil-476642

RESUMO

INTRODUCTION: The corpora cavernosa are cylindrical vessels containing fluid under pressure. Thus, if cavernous wall resistance decreases, the radius increases and internal pressure decreases (LaPlace's law). We reasoned that if we decrease the corpus cavernosum radius, by excising a strip from each tunica albuginea, intracavernous pressure would increase during erection. MATERIALS AND METHODS: We treated with this procedure, four patients (mean age 41.5) with long-standing erectile dysfunction due to veno-occlusive dysfunction, non-responders to phosphodiesterase-5 inhibitors and intracavernous PGE1 injection. RESULTS: Two months post-surgery, intracavernous PGE1 (40 mcg) induced a satisfactory erection in two patients and a 45 percent and 58 percent tumescence in the other two. PGE1 responders also responded to 100 mg sildenafil. After 100 mg sildenafil and 20 mg tadalafil, the two non-responders had erections that enabled penetration but were short lasting. CONCLUSION: The procedure described could be more effective than cavernous revascularization operations. The results seem to confirm the mathematical assumptions.


Assuntos
Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Tecido Elástico/patologia , Impotência Vasculogênica/cirurgia , Pênis/cirurgia , Velocidade do Fluxo Sanguíneo , Tecido Elástico/fisiopatologia , Impotência Vasculogênica/fisiopatologia , Período Pós-Operatório , Pênis/irrigação sanguínea
2.
Int Braz J Urol ; 33(6): 785-90; discussion 790-4, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-18199346

RESUMO

INTRODUCTION: The corpora cavernosa are cylindrical vessels containing fluid under pressure. Thus, if cavernous wall resistance decreases, the radius increases and internal pressure decreases (LaPlace's law). We reasoned that if we decrease the corpus cavernosum radius, by excising a strip from each tunica albuginea, intracavernous pressure would increase during erection. MATERIALS AND METHODS: We treated with this procedure, four patients (mean age 41.5) with long-standing erectile dysfunction due to veno-occlusive dysfunction, non-responders to phosphodiesterase-5 inhibitors and intracavernous PGE1 injection. RESULTS: Two months post-surgery, intracavernous PGE1 (40 mcg) induced a satisfactory erection in two patients and a 45% and 58% tumescence in the other two. PGE1 responders also responded to 100 mg sildenafil. After 100 mg sildenafil and 20 mg tadalafil, the two non-responders had erections that enabled penetration but were short lasting. CONCLUSION: The procedure described could be more effective than cavernous revascularization operations. The results seem to confirm the mathematical assumptions.


Assuntos
Tecido Elástico/patologia , Impotência Vasculogênica/cirurgia , Pênis/cirurgia , Adulto , Velocidade do Fluxo Sanguíneo , Tecido Elástico/fisiopatologia , Humanos , Impotência Vasculogênica/fisiopatologia , Masculino , Pessoa de Meia-Idade , Pênis/irrigação sanguínea , Período Pós-Operatório
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