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Objectives: To document the penile vascular and erectile response to intracavernous injection (ICI) of vasoactive agent in hypogonadal men with micropenis., Methods: A total of 15, previously untreated, hypogonadal men with micropenis (stretched penis length less than 2.5 SD below the mean of the normal population) underwent a detailed urologic and endocrinologic evaluation. Their mean age was 21.2 +/- 4.2 years. Penile hemodynamics were assessed by color Doppler ultrasonography before and after ICI of 5 microg of prostaglandin E(1) combined with manual genital self-stimulation., Results: Endocrinologic evaluation revealed that hypogonadism was hypogonadotropic in 10 (66.7%) and hypergonadotropic in 5 (33.3%). Karyotype analysis showed 46XY in all. Their mean stretched penile length was 6.2 +/- 1.4 cm (range 3 to 7.5) and increased to a mean of 6.96 +/- 1.5 cm (range 4 to 8.5) after ICI. The serum free testosterone levels ranged from 0.2 to 3.2 pg/mL (mean 1.9 +/- 0.92). None had had any previous sexual experience, and 14 (93.3%) reported a history of nocturnal erections. Penile color Doppler ultrasonography demonstrated a normal penile vascular system in 7 (46.7%) and penile arterial insufficiency in 4 (28.6%). All 11 of these patients (73.3%) achieved an adequate erectile response to ICI combined with manual stimulation. Mixed vascular disease was observed in the remaining 4 patients (28.8%), and they did not have a sufficient erectile response to ICI. Color Doppler ultrasonography revealed similar results in the hypogonadotropic and hypergonadotropic men., Conclusions: Our data suggest that the erectile response to ICI combined with manual genital self-stimulation is effective in most hypogonadal men having a micropenis with low serum androgen levels.

Objectives: To evaluate the role of polytetrafluoroethylene (Gore-Tex) as a ureteral substitute in dogs after resection of a 5 to 8-cm-long middle segment., Methods: Five mongrel dogs underwent resection of the middle segment of the left ureter and segmental replacement of the resected part with segments of Gore-Tex over a double-J catheter. The double-J stents were removed at 21 days and the dogs were evaluated by excretory urography and abdominal ultrasonography 12 weeks after surgery. They were then killed and the ureters and the kidneys examined both grossly and microscopically., Results: There was radiologic evidence of advanced hydronephrosis on the left side in all 5 dogs. Grossly, the left kidneys showed marked pelvic and proximal ureteral dilatation and atrophy of parenchyma. Severe stricture at the anastomotic sites and marked fibrous tissue around the prostheses were found. No cellular lining was found in the Gore-Tex lumen., Conclusions: There is no potential for ureteral replacement by Gore-Tex tube graft.