Primary small cell carcinoma of the prostate is a rare and very aggressive disease with a poor prognosis, even in its localized form. We managed a case of primary small cell carcinoma of the prostate. The patient was treated with robot-assisted laparoscopic radical prostatectomy and adjuvant chemotherapy. Herein we report this first case of robot-assisted laparoscopic radical prostatectomy performed in a patient with primary small cell carcinoma of the prostate.
Carcinoma, Small Cell ; Chemotherapy, Adjuvant ; Humans ; Prognosis ; Prostate ; Prostatectomy ; Prostatic Neoplasms ; Robotics

A 63-year-old male patient visited our hospital with a right incidental renal tumor, which was found by ultrasonography for the follow-up study of chronic hepatitis B virus infection and diabetes mellitus. Consecutive computed tomography revealed a right renal tumor and two left adrenal tumors. Further systemic imaging study and hormonal examination suggested one right renal cell carcinoma and left adrenal metastases. We performed right nephrectomy and left adrenalectomy. The pathological diagnoses of all resected tumors were renal cell carcinoma. The patient has been in good health without any recurrence for 12 months since the operation. In patients with renal cell carcinoma, contralateral adrenal metastasis is usually associated with multiple metastases to other organs. There are a few cases of solitary and synchronous contralateral adrenal metastasis in the English literature. To our knowledge, this is the first report of a case of renal cell carcinoma with double synchronous contralateral adrenal metastases.
Adrenal Glands ; Adrenalectomy ; Carcinoma, Renal Cell ; Diabetes Mellitus ; Follow-Up Studies ; Hepatitis B, Chronic ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasms, Multiple Primary ; Nephrectomy ; Recurrence ; Viruses

Extramammary Paget's disease is rare malignant condition. We report three caees or Paget's disease on penis and scrotum.
Male ; Paget Disease, Extramammary ; Penis* ; Scrotum*

Priapism is a relatively rare condition of persistent painful erection unaccompanied by sexual desire. We report two cases of priapism, one etiology is related to leukemia and the other is idiopathic. The former was treated with continuous Hemo-Vac drainage, the latter with corporal cavernosum spongiosum shunt, and the results were good.
Drainage ; Leukemia ; Priapism*

The major role of treatment for impotence is played by vasoactive intracavernous pharmacotherapy or penile prosthesis during last decades. However, the former has a high risk of cavernosal fibrosis-and priapism, and the latter, also infection. We applied the Vacuum Constrictor Device to fifty of organic, 2 of old age, and 2 of unknown. Of 53 cases, 47 encountered the desirable erection were able to secure the vaginal penetration. Of 5 failed cases, 4 were because of maladjustment due to slim body and 1 was of pain on the pubic area due to previous old pelvic bone fracture. Of 17 cases with poor erection by vasoactive intracavernous pharmacotherapy 15 encountered good erection by means of Vacuum Constrictor Device and no significant complications were observed. Of 14 self-acquired Vacuum Constrictor Davicl which were used in which frequency of 10 to 17 times, 10 cases were shown to be satisfactory and the rest were not. Of 4 unsatisfactory cases, 2 were leakage of congested blood during intercourse, 1 was difficulty in intercourse due to pivot and the other one was of mild suprapubic pain due to previous pelvic bone fracture. Although Vacuum Temescence Enhancement Therapy is cumbersome in manipulation prior to sexual intercourse and has time limitation, it is easy to learn and has less complications than vasoactive intracavernous pharmacotherapy. Therefore Vacuum Tumescence Enhancement Therapy is thought to a preferable therapeutic alternative prior to vasoactive intracavernous pharmacotherapy and surgical treatment in impotence in spite of these disadvantages.
Coitus ; Drug Therapy ; Erectile Dysfunction* ; Estrogens, Conjugated (USP) ; Male ; Pelvic Bones ; Penile Prosthesis ; Priapism ; Vacuum*

A total or 76 patients of erectile dysfunction were treated with intracorporeal self-injection of Papaverine hydrochloride(30mg/ml) and Phentolamine mesylate(1mg/ml) from Feb. 1986 to Aug. 1988. The results were obtained as follows: 1. The average patient age was 48.1 years, with a range of 26 to 72 years. The etiology of impotence were psychogenic in dosages patients (47.4 %), vasculogenic in 32 (42.1 %) and neurogenic in 4 (5.3%). 2. The average effective dosages were 0.44ml in psychogenic impotence, 0.69ml in vasculogenic and 0.16ml in neurogenic. 3. The erection time was 60 minutes in 14 (70.0%) out of 20 psychogenic impotence, 30-60minutes in 8 (50.0% ) out of 16 vasculogenic and 90-120 minutes in all neurogenic. 4. The durations of treatment were 1-3months in 12 patients (33.3% ) and 12-24months in 7(19. 5%). The average duration of treatment was 6.9months. 5. Complications included priapism in 7 patients, subcutaneous hematoma in 2, induration of injection site in 1 and fibrous plaque on cavernosal body in 1. 6. Of the 76 patients, 40 patients discontinued injection due to improved potency in 14 patients, penile prosthesis in 4, refusal of treatment in 3 and failure to follow-up in 19. Therefore, intracorporeal self-injection of Papaverine hydrochloride and Phentolamine mesylate seems to be safe and effective primary choice of treatment for selective impotence.
Erectile Dysfunction* ; Follow-Up Studies ; Hematoma ; Humans ; Male ; Papaverine* ; Penile Prosthesis ; Phentolamine* ; Priapism ; Treatment Refusal

Cavernosography after injection of papaverine was done in 25 impotent patients who showed equivocal evidence for either psychogenic or organic erectile dysfunction and who were strongly suspicious of having vasculogenic impotence. Diagnostic value of the pharmacocavernosography was evaluated. Venous leakages through deep dorsal vein were noted in 13 patients, out of whom 3 patients showed leakage also via deep vein, abnormal cavernosal vein or cavernoso-glans fistula. All the arteriogenic and psychogenic, but 38.5% of the venogenic impotents, showed full erection at 30 seconds after infusion of contrast medium was begun. The response to injection of the papaverine was well correlated with findings of the cavernosogram in venogenic and psychogenic impotents. Therefore, the pharmacocavernosography is valuable in differential diagnosis of the venogenic and arteriogenic impotence as well as in diagnosis of the vasculogenic impotence.
Diagnosis ; Diagnosis, Differential ; Erectile Dysfunction* ; Female ; Fistula ; Humans ; Impotence, Vasculogenic ; Male ; Papaverine ; Veins

Due to the increased awareness of impotence, including primary impotence, in single males, we studied its characteristics and a comparative study was performed with other impotence groups. From March 1986 to February 1989, 53 impotent single males without previous trauma history (Group A) were evaluated and diagnosed by implementing diagnostic procedures when available. During the same period. Rigi Scans were performed in 66 patients with erectile failure (excluding impotent single males, Group B) and AVS penograms were also done in 647 patients belonging to the same group. Of the 53 evaluated patients, twenty were found to have primary impotence which was composed of 9 with organic and 11 with psychogenic impotence. The comparison of 9 Patients with primary organic impotence and 11 patients with primary psychogenic impotence showed significant differences in the results of diagnostic studies, but the data size was insufficient to obtain significance. Comparison of the ratio of organic and psychogenic impotence in primary impotence patients and nonprimary impotence patients among 53 single males revealed these to be almost the same, as 0.82 (45%/55%,9/20 / 11/20) and 0.83 (45.5 %/54.6 %, 15/33 / 18/33) respectively. According to these results, single males with erectile failure including primary impotence can be classified as one of the disease entities. The Rigi Scan classification used in this study was revealed to be significant in comparison of Groups A and B (p=0.02). The type distribution of the AVS penogram was statistically significant in comparing Group A to B (p=0. 004). The difference in Rigi Scan and AVS penogram results between Group A and B signifies psychologic and organic dissimilarity between these groups. The unstable erection seen in Rigi Scan was considered to be due to some organic, especially some form of hemodynamic problem that needs further investigation.
Classification ; Erectile Dysfunction* ; Hemodynamics ; Humans ; Male ; Male*

Vasoseminal vesiculography was performed on 40 asymptomatic men. Considerable variability in the appearance of the normal adult seminal tract was seen. The average lengths of the left and right ampullae were 4.23+/-0.77cm and 4.09+/-0.78cm respectively. Most ampullaes (75%) began at the vesicular fundus; the remainder projected either slightly more lateral (18%) or medial (7%) to the fundus. The average lengths of the left and right vesicle were 3.21+/-0.61cm and 3.24+/-0.49cm respectively ; the average widths were 1.36+/-0.30cm and 1.36+/-0.27cm. Eighty-seven per cent of subjects had symmetric-appearing vesicles. The average lengths or the left and right ejaculatory duct were 12.7+/-0.27mm and 13.0+/-0.59mm respectively; the average widths were 1.9+/-0.59mm and 1.8+/-0.58mm. Two normal configurations were noted; straight (70% ) and curved (30%). All ducts appeared symmetric. Criteria for normality are presented and the radiographic techniques were reviewed.
Adult ; Ejaculatory Ducts ; Humans ; Male

Contraction and epithelization are two phenomena of wound healing which are retarded by steroid. Triamcinolone activates collagenase which enhanced the degradation of scar tissues. All 7 cases were treated with visual urethrotomy and injected triamcinolone into the lesion. The results were excellent :all 7 patients were asymptomatic without need of further management and their peak flow rates were within normal range. No adverse effect of intralesional injection of triamcinolone was seen.
Cicatrix ; Collagenases ; Humans ; Injections, Intralesional* ; Reference Values ; Triamcinolone* ; Urethral Stricture* ; Wound Healing