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Biomedical subjects

R L Fein

Publications and source records attributed to R L Fein.

At least 19 recordsLinked to original sources

The G.F.S. Mark II inflatable penile prosthesis.

The G.F.S. Mark II inflatable penile prosthesis was implanted in 80 men who were followed for up to 27 months. In this study there have been no mechanical problems. Of the patients 6 required repositioning of the reservoir pump and 4 required postoperative addition of fluid to the reservoir pump. This study indicates that the revised connectorless G.F.S. Mark II inflatable penile prosthesis has eliminated the previous problems with connectors and tubings. The G.F.S. Mark II inflatable penile prosthesis reservoir pump provides a means of postoperative fluid adjustment within the system performed as an office procedure.

Adult

Mentor GFS inflatable prosthesis.

A new inflatable penile prosthesis is described. The operative approaches, infrapubic and scrotal, are discussed and compared. The results of 56 successive implants are presented. The simplicity of the device which combines the usual intra-abdominal reservoir and the scrotal pump into a scrotal "resipump" is discussed. The device has shown a good performance and is a valuable addition to the varieties of penile implants.

Aged

Intracavernous medication for treatment of premature ejaculation.

Sixteen men complained of premature ejaculation during a five-month period between May, 1987, and October, 1987. Eight patients entered this study using intracavernous vasoactive drugs as treatment for their problem. The patients, ages twenty-four through fifty-eight (average 42 years), were all physically healthy and taking no medications. Five patients had normal findings on nocturnal tumescence monitor, while 3 patients did not use the monitor. A mixture of phentolamine mesylate, 1.0 mg/mL, and papaverine hydrochloride, 30 mg/mL, was used. The dosage required was from 0.10 mL to 0.40 mL. All 8 patients responded successfully to this treatment. Three patients stated they were cured and stopped the treatment. The other 5 patients continued using the medication after fourteen months. The drug-induced erection lasted between two and four hours despite ejaculation. There have been no side effects through April, 1988. All patients report satisfaction with the results of this treatment. The study showed that intracavernous medication therapy can be successful in the treatment of premature ejaculation.

Adult

Classification of sexual dysfunction for management of intracavernous medication-induced erections.

A total of 75 patients was placed into 1 of 3 classes of sexual dysfunction based on nocturnal penile tumescence tracings rather than on etiology of the sexual dysfunction. The patients then were given an intracavernous injection with incremental dosages of 0.2 to 1.0 ml. of a combination of papaverine hydrochloride and phentolamine mesylate vasoactive intracavernous therapy. The results of the study were categorized as class 1--mild sexual dysfunction (100% successful with low dosages of medication), class 2--moderate sexual dysfunction (95% successful but larger dosages of medication were required) and class 3--severe sexual dysfunction (a 50:50 chance of a successful treatment and even higher dosages of medication were required). A portable home nocturnal tumescence monitor classification of severity of sexual dysfunction provided a guideline for the intracavernous pharmacological injection initial dosage and the probability of success or failure in patients who desire this form of therapy for male sexual dysfunction.

Adult

Cylinder problems with AMS 700 inflatable penile prosthesis.

Six cases of cylinder problems encountered in 1986 with the AMS 700 Silastic inflatable penile prosthesis (IPP) were studied in detail. The problems included 1 case of significant penile bending, the development of a cylinder tear, and several cylinder aneurysms. Possible causes of the problems are explored, along with possibilities for prevention of future problems.

Aged

Clinical evaluation of inflatable penile prosthesis with combined pump-reservoir.

Sixteen impotent men were implanted with the Mentor inflatable penile cylinders which were attached to a combination pump-reservoir. The prosthesis is working satisfactorily in 14 patients six months post-implant. A pre-assembly technique accommodated insertion of the prosthesis as a unit. The combination of pump-reservoir appears to adequately replace a separate reservoir and pumping device when attached to inflatable penile cylinders.

Adult

Early problems encountered with the Mentor inflatable penile prosthesis.

We present 9 consecutive patients who underwent insertion of the Mentor inflatable penile prosthesis. Of these patients 3 had successful results after repeated problems with the Scott inflatable penile prosthesis. Complications included spontaneous inflation of the prosthesis, a tubing kink, aneurysmal cylinder ballooning and cylinder disruption. Slow deflation seems to be an inherent problem with the Mentor system. Although penile squeezing may be used to help deflation, traumatic urethritis may occur. However, concealment may not be possible without such squeezing. Interim use of a noninflatable prosthesis to treat a damaged corpus cavernosum is recommended. Although ingenious technology has enabled successful implant surgery, no penile prosthesis yet devised has proven to be ideal. Further refinements are being made. Ultimate evaluation will require years of followup in the spirit of the pre-700 series of Scott inflatable penile prostheses.

Aged

Bladder calculi enveloped by extensive cystitis glandularis: case report.

We report a case of 2 large calculi encased within a 15 gm. tumor of cystitis cystica and cystitis glandularis. The patient presented with acute right epididymitis. An excretory urogram showed 2 bladder calculi. Cystoscopy revealed a mass around the stones resembling adenocarcinoma of the bladder base. Transurethral resection of the tumor and cystolitholapaxy were performed. The final diagnosis was bladder calculi within a mass of cystitis cystica and cystitis glandularis. A review of the literature failed to reveal a similar case.

Adult