Sidney Glina

Impact of cigarette smoking on papaverine-induced erection

Owing to the vasoconstrictive effect of nicotine, smoking may potentially interfere in the results of the drug-induced erection test for papaverine hydrochloride. To investigate the effect of smoking on this test, 12 patients between 22 and 65 years old underwent the following protocol: phase 1--intracavernous injection of 100 mg. papaverine hydrochloride with measurement of intracavernous pressure by puncture with a 19 caliber butterfly needle attached to an aneroid manometer and phase 2--1 week after the initial test the procedure was repeated after the patient smoked 2 cigarettes. In phase 1 all men obtained a full erection, compared to only 4 in phase 2. The average intracavernous pressures were 85.83 and 53.50 mm. Hg, respectively, in phases 1 and 2 (p less than 0.01). We conclude that cigarette smoking, probably through nicotine, interferes with the drug-induced erection test, which might explain some false negative results.

Histopathological alterations of the vas deferens in rats exposed to polypropylene mesh.

To assess the histological and physiological effects of polypropylene mesh for inguinal herniorraphy, as it can cause lesions in the vas deferens in 0.3–2.0%, leading to infertility, and induces an inflammatory process and adjacent fibrosis, strengthening the posterior inguinal wall.

Penile prosthesis surgery with the patient under local regional anesthesia

A total of 20 patients underwent penile prosthesis implantation while under local regional anesthesia with a pudendal nerve blockade at the perineum. The method is safe, performed as an outpatient procedure and showed no complication. It avoids the need to inject a local anesthetic intracorporeally, which is risky in elderly patients.