Robert S. Hotchkiss

Carcinoma of penis treated surgically Analysis of 100 cases

A retrospective study of 100 cases of carcinoma of the penis is presented. The cases are reviewed with respect to age and the time of diagnosis, the presence of inguinal adenopathy, the type of surgical therapy employed, and the postoperative complications. The controversial subject of inguinal lymphadenectomy is discussed.

Plastic reconstructive surgery after total loss of the penis

Summary Plastic reconstructioe surgery after total loss of the penis not only affords the patient the opportunity of continued sex life but also corrects the psychologic, social and esthetic sequelae of such deficiency. The new penis can be constructed by raising a tubed pedicle graft from the thigh and attaching it to the pubic region in staged operations. A simpler method is to elevate the tube from the scrotum. Creation of a new urethral channel is not necessary and only complicates the procedure. Experiences with surgical reconstruction of the penis and its end results. as observed in five patients are presented. Sexual function was restored in four patients and a fifth patient is still in the hospital. The use of splints is not necessary because a pseudoerectile state, sufficient to permit intromission, is present whenever the penis is allowed to remain in a dependent position.

Panel discussion on the clinical management of prostatic disease.

Moderator: WILLIAM WALLACE SCOTT, M.D., Professor of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland. Panelists: ROBERT S. HOTCHKISS, M.D., Professor of Urology and Chairman, Department of Urology, New York University-Bellevue Medical Center, New York, N.Y. PERRY B. HUDSON, M.D., Associate Professor of Urology, Columbia University College of Physicians and Surgeons, New York, N. Y. JOHN K. LATTIMER, M.D., Professor of Urology, Columbia University College of Physicians and Surgeons, New York, N. Y. WILLET F. WHITMORE, JR., M.D., Associate Professor of Clinical Surgery, Cornell University Medical College, New York, N. Y.

The endocrines and spermatogenesis

Abstract 1. 1. The basophilic cells of the anterior pituitary gland are intimately concerned with elaboration of gonadotropic hormones. 2. 2. Two fractions of gonadotropic hormones are recognized: the follicle stimulating and the luteinizing fractions. These act on the interstitial and spermatogenic cells of the testes. 3. 3. There are three principal sources of gonadotropic hormones in the normal human: (a) anterior pituitary extract; (b) pregnancy urine; (c) castrate urine. 4. 4. All of these have varying amounts of the two fractions and act accordingly. 5. 5. Biologic activity of these hormones is substantiated by animal experiments and human studies. 6. 6. Androgens are derived from the gonads and are now synthetically prepared. 7. 7. Androgens effect secondary sexual characteristics and genital structures, but probably have little action on human spermatogenic tissue. 8. 8. Anti-hormone response may be a foreign protein immunity. 9. 9. Minor endocrine disturbances may account for a certain percentage of seminal deficiencies. 10. 10. Problems of treatment are discussed. 11. 11. Three cases are presented illustrating improvement, coincidental to use of the gonadotropic principles.

The Effects of Prostaglandins on Sperm Motility**Presented at the Thirty-Second Annual Meeting of The American Fertility Society, April 5 to 9, 1976, Las Vegas, Nev.††American Cystoscope Makers, Inc., Urology Prize Essay of 1976.

Inflammatory exudates around intrauterine devices were found to produce large concentrations of prostaglandin F2alpha. To evaluate the effect of this substance, 100 semen specimens were incubated in concentrations 100 times greater than that found in normal semen. Motility indices were calculated, and significant inhibition of sperm motility was found. The effect of prostaglandin E on sperm motility is also reviewed. The physiology of prostaglandins and their mechanism of action via the cyclic nucleotide system are discussed.