Herbert F. Newman

Mechanism of human penile erection: An overview

Abstract The vascular anatomy of the penis is reviewed. Theories regarding the mechanism of human erection are discussed. Evidence is offered favoring the concept that increased arterial inflow and shunting t6thout the necessity for venous restriction suffice. Applications to diagnosis and treatment of impotence and priapism are presented.

Erectile dysfunction in diabetes and hypertension

By direct interrogation and specific questions, the erectile function of 1,128 male adults, aged sixteen to eighty years and over, was elicited. The erectile function was based on ability to develop an erectile angle of 90 degrees and more, and this was used for classification purposes. Three hundred seventeen consecutive, unselected male diabetics and 117 nondiabetic male hypertensives were compared with 635 consecutive adult males with neither diabetes nor hypertension. Our results indicate that erectile dysfunction, partial or complete, is more prevalent in diabetics compared with nondiabetics of the same age groups. An unexpected finding was a meager relationship between hypertension and erectile disability. Antihypertensive drugs were responsible for only 2 cases of erectile dysfunction in our male hypertensive patients. The negative impact of age was noted in all age groups and in those with or without diabetes or hypertension.

Problems in male organic sexual physiology

Prior to the era of Masters and Johnson,’ our knowledge of male sexual physiology was largely confined to inferences drawn from animal experiments and anatomic studies. At present, we have reached the stage of knowing the proper questions to ask, and we try to place them in perspective. There is need for unanimity in terminoloa. Libido is sexual desire, devoid of exogenous content, and calling for relief through orgasm. Sexual response represents the reaction to specific erotic stimuli. One of its components is arousal, the conscious awareness of the sexual excitement. It may or may not be accompanied by one or more physical manifestations. Conversely, erection, the obvious expression, may occur without arousal. Impotence is the inability to secure and maintain erection until orgasm. This meaning should be inflexibly preserved. In medical circles, the criteria for the diagnosis of impotence has varied from clinic to clinic. One investigator may consider a man potent if he has had satisfactory coitus once a year while others demand erectile success in between 25 and 75 per cent of attempted copulations. Orgasm is the pleasurable sensation marking the climax of sexual activity and mav occur independent of erection. emission, or ejaculation.

Method for exposure of cavernous artery

Abstract We have developed a simplified dorsal approach to expose the deep arteries of the penis which can be used for direct arterial repair or revascularization of the cavernous artery.

Female urinary stress incontinence.

Abstract 1. 1. The anatomy and normal closing mechanisms of the bladder are described. 2. 2. The abnormal anatomy and defects of these forces in stress incontinence are described. 3. 3. The rationale of operations designed for its relief are discussed and a choice of procedure recommended.

Clinical observations in patients with myoma of the uterus with particular regard to changes in size and indications for surgery

Abstract A series of 755 consecutive cases of myoma of the uterus were analyzed from the standpoint of age, racial incidence, symptoms, and course. Surgery was recommended in only 19 per cent of the cases with satisfactory management of the rest without operation.

Ovulation studies with direct current potentials

Abstract With the Schorr-Lamport millivoltmeter method of registering potential, ovulation could not be determined in the human being.

Impotence Testing and Age

Four major components of the erectile process are usually investigated to learn the cause of a patients organic impotence; serum testosterone, arterial inflow, venous outflow and neural competence. This study of several tests, commonly used for this purpose, was undertaken to learn the criteria to claim a specific defect as the sole or partial cause of erectile disability and whether they vary with the age of the subject. The male sexual response embraces two sequential phases, the development of an erection and its maintenance during coitus. This investigation was only concerned with the former and not with its duration. The latter involves the many variables of a dyadic situation, the two individuals and the relation between them. Satisfactory coital erection calls for sufficient penile rigidity to overcome introital resistance and a penile angle permitting entrance. Rigidity is also a function of the penile angle except in patients with intracorporeal contractures preventing maximal elevation. Therefore subjects were divided arbitrarily into three classes according to the maximal angle attained by the erect penis during the six months prior to examination; normals capable of an erection of 90 ° or higher, those who were incapable of any degree of erection,