Treating impotence.
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Erectile Dysfunction↗
Biomedical subjects
F M Girdley
Publications and source records attributed to F M Girdley.
Intracavernous self-injection for impotence: a long-term therapeutic option? Experience in 78 patients.
A total of 78 patients 17 to 84 years old reported their experience via questionnaire with the papaverine-phentolamine injection technique for impotence. The mean number of injections used was 30.7. Penile induration occurred in 13 patients (16 per cent) and it was generally of limited extent. A higher incidence of induration was observed in those with vasculogenic impotence. Prolonged erection was reported by 23 per cent of the patients, 8 per cent of whom experienced erection for more than 12 hours. Priapism occurred exclusively in diabetic patients and patients with a neurological etiology of impotence. A total of 22 per cent of the patients reported moderate to severe pain with injection, 35 per cent indicated decreased quality of erection with time in response to the vasoactive agents and 28 per cent believed this therapy to be unsatisfactory. Among those who discontinued the injections 5 cited variability of erectile response (duration or quality) as the reason for discontinuation. A decrease in the effectiveness of the injections with time may be anticipated among some patients. For patients who face a penile implant without other options penile self-injection with vasoactive drugs is a reasonable alternative in that complications do not prevent successful prosthetic implantation.
Consumer Behavior↗
Chronic compartment syndrome: diagnosis, management, and outcomes.
A consecutive operative series of 100 patients with chronic compartment syndrome involving 233 compartments is reported. Seven of every eight were athletes, and runners predominated. Exercise-induced symptoms of consistently recurring tightness, aching (in some, sharp pains) in anatomically defined compartments were pathognomonic. Mean months of symptoms prior to operation was 22; median age was 26 years. Bilaterality occurred in 82. The distribution of compartments was: anterior, 39%; lateral, 12%; and posterior, 48%. Incidental compartment pressures were elevated (mean = 23 mmHg). Fasciotomy using local anesthesia was performed on 70 outpatients. At a median of 4.5 months, over 90% were cured or significantly improved in symptoms and/or function. Median time to walking unassisted was 2 days, and to resumption of conditioned running 21 days. Fasciotomy can be a safe, effective, and economical treatment for chronic compartment syndrome.
Adult↗