Ghislain Vandenbosch

The effect of papaverine on arterial and venous hemodynamics of erection

The aim of this study was to establish how much of the erectogenic effect of papaverine is due to arterial dilatation and how much to venous obstruction during artificial erection. Three consecutive cavernosographies were done on each of 10 psychogenic impotent patients: a baseline run without papaverine; a run with papaverine (60 mg. intracavernously) after occlusion of arterial supply to the corpora cavernosa with balloon catheters inflated at the origin of the hypogastric arteries; and a third run after restoring arterial blood supply to the corpora. The measured flow rates indicated that during cavernosography in papaverine-induced erection, the major effect of papaverine is to increase the resistance to venous outflow from the corpora cavernosa.

Opacification of the Glans Penis During Cavernosography

Cavernosography and cavernometry were performed in 150 impotent patients and 10 normal potent volunteers. Opacification of the glans penis was noted in 5 normal volunteers, while among the impotent patients it was noted in 53 per cent of those with venous leakage and in 36 per cent of those without leakage. We believe that opacification of the glans during cavernosography must be regarded as a normal variant rather than as a sign of pathological shunts between the glans and the corpora cavernosa.

Cavernosography and cavernosometry in the evaluation of impotence

Vascular problems represent the most frequent cause of organic impotence. Abnormal venous drainage from the corpora cavernosa is now widely accepted as the major cause of vasculogenic impotence. Based on our experience with more than 450 radiologic procedures, we describe the technique of cavernosography and cavernometry, the effect of papaverine injection, and we review the literature.

Spontaneous vertebrovertebral arteriovenous fistula treated by steel coil embolization: Case report

The authors report 1 case of a spontaneous vertebrovertebral arteriovenous fistula in a fifty-seven-year-old woman. Embolization with a steel coil resulted in complete occlusion of the fistula while maintaining vertebral artery patency.

Long-Term Follow-Up of Intraarterial Infusion of Streptokinase in Acute Lower Limb Ischemia

Twenty-two patients suffering from acute ischemia of the lower limbs were treated with local selective low-dose streptokinase, 2,000 U/min, with a maxi mum dose of 200,000 U, the average time of fibrinolytic infusion being 1.8 hours. Bleeding problems were minimized because of the low dose of fibrino lytic agent. Lysis, demonstrated by radiology, was achieved in 73%, but a good clinical result was obtained only when local fribrinolysis was associated with percutaneous transluminal angioplasty or surgery. Whether or not they had some lytic response, 16 patients required surgical intervention. Limb salvage was achieved in all cases. The long-term follow-up (twenty-six months) in 19 patients was entirely satisfactory with further surgery required later in only 2 cases.