A.M.B. Goldstein

THE MICROARCHITECTURE OF THE INTRACAVERNOSAL SMOOTH MUSCLE AND THE CAVERNOSAL FIBROUS SKELETON

The bulk of the parenchyma of the corpora cavernosa consists of bundles of smooth muscle fibers. These bundles are oriented in all directions and establish at least 2 insertions upon elements of the fibrous skeleton of the corpora. The fibrous skeleton includes the tunica albuginea and its fibrous columns, the intracavernous fibrous framework, and the periarterial and perineural fibrous sheaths. The cavernous vascular spaces (sinusoids) form an intercommunicating network embedded within the mass of smooth muscle. Thus, the smooth muscle does not form a muscular wall proper for each sinusoid.

New observations on microarchitecture of corpora cavernosa in man and possible relationship to mechanism of erection

Abstract Controversies and insufficient anatomic information on the microarchitecture of the corpora cavernosa and their role in the mechanism of erection still persist. A total of 2,690 serial cross sections of the corpora cavernosa of ten men were studied. The observations made seem to support the hypothesis of an intrinsic-mechanism of erection rather than a pure vascular one. Unpublished preliminary physiologic studies also support the existence of such a mechanism.

Histologic Appearance of the Intestinal Urinary Conduit

The histology of intestinal urinary conduits (8 ileal and 2 sigmoid) in place for 10 months to 10 years was studied in 10 patients between 20 and 65 years old. It is concluded that the ileum and the large intestine do not undergo adaptive metaplastic transformation. The only changes observed are related to a condition of chronic irritation to which the response is a chronic inflammatory reaction. Structures proving to be the most resistant were the cells of Paneth. The latter were not damaged in appearance and number as compared to normal, even when the conduit was in place for 10 years.

High pressure within corpus cavernosum in man during erection its probable mechanism

Corpus cavernosum pressure in man during erection has not been measured previously with a noninvasive technique. Using such a technique it has been shown that during erection in young men intracavernosal pressure has peaks of at least ten times higher than the systemic systolic pressure. These findings indicate that during erection the intracavernosal circulation is contained, at least partially, within a closed system, separated from the general circulation. Also erection cannot be the result of circulatory function only.

Prostatic urethral polyps in adults: histopathologic variations and clinical manifestations.

Abstract Prostatic urethral polyps in adults may be more frequent than suspected. They appear to be finger-like prostatic hyperplastic protrusions in the prostatic urethra. Different histologic forms described may be, in fact, variations of similar structures. The polyps are benign and do not require treatment if not symptomatic.

Special Microanatomical Features Surrounding the Intracorpora Cavernosa Nerves and their Probable Function During Erection

The nerves of the corpora cavernosa have anatomical characteristics different from other nerves. The intracavernous nerves are located in fibrous tunnels into which numerous fibrous bundles establish attachments. These bundles are part of the fibrous meshwork included in the corpora cavernosa. We suspect that during erection, when the corpora fill with blood and high intracavernous pressure develops, the aforementioned meshwork of fibrous bundles attached to all fibrous elements of the corpora, including the tunica albuginea and the perineural fibrous tunnels, stretches and prevents compression of the intracavernous nerves.

Clinical aspects of granulomatous orchitis.

Granulomatous orchitis can present in a variety of forms varying from acute to chronic. Clinically, testicular neoplasm is usually diagnosed and radical orchiectomy is performed, with the correct diagnosis being made on microscopic examination. In this article 6 cases of granulomatous orchitis are presented, with a variety of clinical presentations varying from acute to the more chronic forms.

Cholesterol granuloma of tunica vaginalis simulating testicular tumor

Abstract A case of cholesterol granuloma of the tunica vaginalis simulating a testicular tumor is reported. This appears to be the third such case reported in the literature.

Papillary adenocarcinoma of prostate.

Papillary adenocarcinomas of the prostate are rare tumors which may arise from the prostatic ducts and the utricle; 2 cases are described. The diagnosis of these tumors is best established by cystourethroscopy and transurethral resection. The more common prostatic acinar adenocarcinoma is frequently associated with these tumors. The histopathologic recognition of papillary adenocarcinoma of the prostate and its differentiation from acinar adenocarcinoma is important since the natural history and response to treatment may be different.

Prostate carcinoma-therapeutic considerations in the management of gross lymph node metastases

Abstract Of 126 patients with prostate carcinoma seen for definitive irradiation, 25 patients had gross lymph node metastases and were treated with a combination of estrogens and irradiation. Estrogen therapy was given for 2 months prior to radiotherapy to reduce the tumor buFden in the lymph nodes, thereby increasing the probabilities of tumor sterilization by radiotherapy. Estrogens were continued throughout radiotherapy and usually discontinued within 6 months. Megavoltage radiotherapy was delivered to the primary tumor, pelvic and periaortic lymph nodes. Serial X-rays and computerized axial tomograms demonstrated the response of the lymph nodes to hormone therapy and to radiotherapy. Patients were followed-up for 1.5-7 years. Seventeen of 25 (68%) patients have remained free of disease at this writing. Eight patients had failure of primary tumor control or developed distant metastases. Three patients died of cancer related death and one from intercurrent death.