Testicular microlithiasis and concomitant testicular intraepithelial neoplasia.

We report a case of testicular microlithiasis developing during cancer follow-up in a previously normal testicle. Biopsy revealed testicular intraepithelial neoplasia which was treated with radiotherapy. We believe that especially in cancer follow-up newly developing microlithiasis must lead to biopsy to rule out otherwise undetectable germ cell neoplasia precursor.

Imaging modalities in Peyronie's disease. An intrapersonal comparison of ultrasound sonography, X-ray in mammography technique, computerized tomography, and nuclear magnetic resonance in 20 patients.

Objective: Peyronie's disease is an ill-understood condition afflicting men in their 40s with the reported age ranging from 18 to 68 years. It is characterized by a plaque in the tunica albuginea which leads to penile deformity making sexual intercourse difficult if not impossible and is often accompanied by severe pain upon erection in the early stage; erectile dysfunction is present in about 2% of cases. Diagnosis rests upon medical history, clinical examination with plaque palpation and autophotography in two planes.

Erectile dysfunction due to single vessel failure: diagnosis and surgical treatment.

We report on the successful surgical treatment of venous single vessel disease in a patient presenting with erectile dysfunction. We stress the necessity of accurate diagnostic workup which enables the identification of rare cases that can be cured surgically.

Fournier's gangrene: viability monitoring of subcutaneously transported testis following extensive debridement by color-coded duplex sonography and nuclear magnetic resonance.

We report the case of a subcutaneously transposed testis after surgical depridement for Fournier's gangrene. Its viability was successfully monitored using color-coded duplex sonography and nuclear magnetic resonance.

Assessment of the penile vascular system with color-coded duplex sonography and pharmacocavernosometry and -graphy in impotent men.

Objective: To examine the extent to which color-coded duplex sonography permits complete clarification of vessel-dependent erectile dysfunction (ED).

Material And Methods: A total of 215 patients with ED were examined. All patients underwent pharmacocolor-coded duplex sonography (PHCCDS; 20 micrograms of prostaglandin E1, PGE1, intracavernosally) as well as pharmacocavernosometry and -graphy (PHCM and PHCG; 20 micrograms of PGE1 intracavernosally).

Leydig cell tumor--comparison of results of radical and testis-sparing surgery in a single center.

Between January 1981 and December 1995, 15 patients were treated for Leydig cell tumor at our institution -- 12 by radical orchiectomy, 3 by tumor enucleation. All patients were contacted to assess the long-term outcome depending on the treatment initially chosen. Follow-up ranged from 8 to 161 months (mean 56).

Local interferon-alpha 2b is not an effective treatment in early-stage Peyronie's disease.

Objective: Peyronie's disease is characterized by an acquired penile deviation that may lead to severe penile deformity. It is refractory to most conservative therapy, and surgical correction is therefore the treatment of choice once the disease process has come to a halt. Basic science, as well as our first clinical results on the use of interferons (IFNs), have been promising, suggesting a beneficial effect in the early noncalcified disease stage.

Intravenous urography revisited in the age of ultrasound and computerized tomography: diagnostic yield in cases of renal colic, suspected pelvic and abdominal malignancies, suspected renal mass, and acute pyelonephritis.

The aim of our study was to assess the diagnostic yield of intravenous urography (IVU) compared to ultrasound (US) and computerized tomography (CT) in cases of renal colic, suspected pelvic and abdominal malignancies, suspected renal mass, and acute pyelonephritis. We retrospectively analyzed the case charts of 216 consecutive patients. The patients had been referred to the Department of Radiology by different hospital departments and local general practitioners.

Ultrasound and soft-tissue radiography to monitor local interferon-alpha 2B treatment in Peyronie's disease.

Purpose: We attempted to assess objectively the response of Peyronie's disease plaques to local interferon-alpha 2B.

Material And Methods: Twenty patients were treated with 5 local injections of 1 million units of IFN-alpha 2B into a single designated plaque. Before treatment, and 4 weeks and 6 months after treatment, the plaques were examined ultrasonographically.

Testicular microlithiasis: case report and discussion of management under special consideration of testicular germ cell tumours.

We report a case of testicular microlithiasis in a 24-year-old man who was referred to us for evaluation of unclear ultrasonographic appearance of his testes while being examined for bilateral varicocele and epididymal cysts. Since testicular microlithiasis has been found to be associated with testicular germ cell tumours we suggest a diagnostic work-up with testis biopsy to rule out testicular intraepithelial neoplasia (so-called carcinoma in situ) in otherwise normal appearing testis.

Efficacy of linsidomine chlorhydrate, a direct nitric oxide donor, in the treatment of human erectile dysfunction: results of a double-blind cross over trial.

Recent experimental work has demonstrated that nitric oxide (NO) is the neurotransmitter responsible for cavernous smooth muscle relaxation. Different studies on the performance of the direct NO-donor SIN-1 (linsidomine chlorhydrate) in patients with erectile dysfunction have come to conflicting results. We have performed a double-blind cross over trial in 40 patients with erectile dysfunction of mixed etiology comparing SIN-1, SIN-1 plus the alpha-blocker Urapidil, and prostaglandin E1 (PGE1) in order to determine the effectiveness of SIN-1.

Evaluation of penile arteries with color-coded duplex sonography: prevalence and possible therapeutic implications of connections between dorsal and cavernous arteries in impotent men.

Penile revascularization for cases of arteriogenic impotence is based on the assumption of hemodynamically relevant connections between the dorsal penile and cavernous arteries. In 325 clinically impotent patients color-coded duplex sonography was performed with the penis flaccid and tumescent after intracavernous injection of 10 micrograms prostaglandin E1. We measured peak flow velocity, end diastolic flow velocity and resistance in the dorsal arteries, deep cavernous arteries and connections perforating the tunica albuginea between the 2 systems.

Nitric oxide donor, linsidomine chlorhydrate (SIN-1), in the diagnosis and treatment of erectile dysfunction: critical appraisal and review of the literature.

Recent experimental work has demonstrated that nitric oxide (NO) is the neutrotransmitter responsible for cavernous smooth muscle relaxation. Different studies on the performance of the direct NO-donor linsidomine chlorhydrate (SIN-1) in patients with erectile dysfunction have come to conflicting results ranging from highest praise to complete dismissal. We reviewed all published studies on the use of SIN-1 for intracorporeal injection in erectile failure including our own.

Treatment of Peyronie's disease with local interferon-alpha 2b.

Peyronie's disease is an illdefined condition that often leads to severe penile deformity. Various conservative treatments have failed to have any impact, and surgery remains the mainstay of therapy in advanced cases. Recent reports of successful treatment of related diseases, notably keloid formation, with interferons (INF) have prompted us to use this biologic response modifier to alter the behavior of the myofibroblast, the cell most likely responsible for the development of Peyronie's disease.

Laparoscopic pelvic lymphadenectomy in prostatic cancer: an analysis of seventy consecutive cases.

From July 1992 to April 1994, 70 patients with prostatic cancer underwent laparoscopic pelvic lymph-node dissection (LPLD) before retropubic radical prostatectomy or afterloading therapy in our clinic. After an initial learning phase, the accuracy of LPLD was excellent, with only 3.0% residual nodes and no false-negative results due to LPLD.

Testicular dermoid cyst in a 10-year-old child: case report and discussion of etiopathogenesis, diagnosis, and treatment.

The case of testicular dermoid cyst in a 10-year-old boy who presented for evaluation of a presumed testicular neoplasm is reported. The dermoid cyst was confirmed histologically on frozen section and local excision was performed. Only 5 cases of testicular dermoid cysts in children have been reported so far.

Nitroxergic innervation of the human ureterovesical junction.

Nitric oxide synthase (NOS) immunohistochemistry and nicotinamide adenine dinucleotide phosphate diaphorase (NADPH-d) histochemistry were used to investigate the distribution of nitroxergic, i.e., nitric oxide-synthesizing, neuronal perikarya and processes in the human ureterovesical junction (UVJ).

Paratesticular epidermoid cyst and ipsilateral spermatic cord dermoid cyst: case report and discussion of pathogenesis, diagnosis and treatment.

We report a case of a paratesticular epidermoid cyst with a concurrent dermoid cyst of the ipsilateral spermatic cord at the internal inguinal ring. The patient presented for evaluation of a presumed testicular neoplasm. Epidermoid and dermoid cysts were confirmed histologically after local excision.

Multiple primary neoplasms in patients with testicular germ cell tumor.

The study of multiple primary neoplasms may provide more insight into the pathogenesis of specific cancers and, secondly, it addresses the issue of treatment-related induction of second tumors. 584 consecutive patients with testicular germ cell tumors treated during 1969-1992 in Berlin were retrospectively analyzed for the prevalence of multiple primary neoplasms. 23 patients (16 pure seminoma, 7 nonseminoma) developing nontesticular malignancies in addition to testis cancer were identified (3.