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- The papaverine test has become established in the investigation of impotence. Although a full response to papaverine excludes a significant vascular lesion, failure to respond may be due to either arterial deficiency or venous leakage. Pharmacocavernometry, which combines the papaverine test and an artificial erection test, was performed in 126 patients. Intracorporeal pressure was monitored following the intracorporeal injection of 80 mg papaverine; 10 min later, saline was infused to determine the presence of a venous leak. Five different responses were observed. Patients with a Type 1 or 2 response were psychogenic or neurogenic. Patients with a Type 3 response were arteriogenic and patients with a Type 4 or 5 response had significant venous leakage. The modified papaverine test permits more information to be gained concerning the aetiology of the impotence. [ABSTRACT FROM AUTHOR]

- Open surgery for large or complex renal calculi may be difficult, particularly in patients with recurrent stones, and may require special operative techniques to preserve renal function. With the advent of percutaneous nephrolithotripsy (PCNL) and extracorporeal shockwave lithotripsy (ESWL) new approaches are now available for the treatment of these difficult cases. A review of 67 patients who presented between November 1984 and May 1986 has shown that it was possible to clear large stones in 71% of patients using a combination of PCN L and ESWL. There was no mortality; the morbidity for both procedures was low and was less than when either procedure was used alone for the treatment of complex stones. [ABSTRACT FROM AUTHOR]

- Extracorporeal shockwave lithotripsy has been shown to be a safe and effective method of treating most upper urinary tract stones. Major complications, although few, include haemorrhage, septicaemia, 'Steinstrasse' formation and cardiac arrhythmias. The experience from 600 consecutive cases is reviewed and methods of prevention are discussed. [ABSTRACT FROM AUTHOR]