Small percentages of tertiary grade 5 patterns in Gleason score 7 radical prostatectomy specimens are associated with aggressive pathological features predictive of advanced pathological stage and biochemical recurrence-free survival.

Introduction Despite previous reports showing consistently elevated patient satisfaction with penile implantation, it is our impression that patients who have had a prosthesis placed often complain of penile shortening postoperatively. Aim We sought to evaluate if the release of the penoscrotal web would optimize patient perception and satisfaction regarding penile length after such procedure. Main Outcome Measure Utilizing a questionnaire, we evaluated patient satisfaction, focusing on phallic size. Methods Ninety patients (mean age 62) underwent penile prosthesis placement during a 17-month period. Forty-three were carried out with takedown of penoscrotal web during a 17-month period (group 1). Of group 1, 39 patients had an inflatable implant placed (inflatable penile prosthesis) and 4 had a semirigid implant. The patients were directly inquired with a seven-item questionnaire 3 months after the procedure. These results were then compared to a group of 37 patients that had penile implants placed without release of the penoscrotal web (group 2). All the patients involved in the study had a high insertion of the scrotum ventrally (penoscrotal web). Results Of the patients, 42/43 (98%) (group 1) reported good overall satisfaction of the surgical procedure; 36/43 (84%) reported some degree of increase in penile length; 5/43 (12%) reported no significant change in their perception of penile length postoperatively. The remaining two patients reported a decreased penile length. The clinical records from group 2 demonstrated 31/37 (84%) of the patients complained of penile shortening, and only one patient reported an increase in penile length. Postoperative complications in group 1 consisted of wound hematoma (2/43) and focal superficial wound dehiscence (3/43). The operative time for group 1 patients was approximately 12 minutes (mean 11.7) longer. Conclusions Release of penoscrotal web is a simple, safe, and reproducible procedure that can enhance patient perception of penile length and further improve satisfaction.

Additional research is needed to obtain further data concerning sexual dysfunction in both men and women following radical pelvic surgeries. Modification of surgical techniques, the use of various treatment modalities for sexual dysfunction, and the development of new agents will help to successfully minimize or prevent damage and restore normal sexual function after local surgical therapy for prostate or bladder cancer in the future.

Background: This work examines the central nervous system distribution of virus-labeled neurons from the rat urinary bladder and the prostate simultaneously within the same tissue sections. Two immunohistochemically distinct pseudorabies virus strains were simultaneously injected into male Sprague Dawley rats (~280 gm). One virus was injected into the bladder and the other into the prostate. After incubation intervals of 2.25, 2.5, 2.75, 3 and 4 days, sections from the spinal cord and brain were processed immunohistochemically to detect cells, within a single section, which were labeled separately by each virus or were labeled by both viruses.

Background: A previous report showed that the atypical neuroleptic clozapine resulted in marked changes in urodynamic parameters and greatly inhibited the activity of the external urethral sphincter in anesthetized rats. Such findings may help explain the high incidence of urinary disturbances reported during clozapine therapy. In an effort to extend our observations to other atypical neuroleptic agents, the present study investigated the effects of two newer atypical antipsychotics, olanzapine and risperidone, on the bladder and external urethral sphincter during cystometry in anesthetized rats.

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Background : We previously showed that systemic administration of the atypical neuroleptic clozapine in the rat altered a number of urodynamic variables and inhibited the external urethral sphincter. Since clozapine acts at several receptor types both at the periphery and the central nervous system, the site of action remained uncertain. Therefore, the purpose of this study was to determine the effects of central administration of clozapine on the bladder and the external urethral sphincter during cystometry and to examine differences in spinal versus supraspinal administration. We extended our observations by delivering clozapine centrally in anesthetized rats instrumented with either an intrathecal (L6-S1 spinal segment) or an intracerebroventricular (lateral ventricle) catheter.

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