Demonstrated Ability of Penile Erection in Castrate Men with Markedly Low Titers of Urinary Androgens

Abstract

Sexual abilities have been described in castrate men (Rowe and Lawrence, 1 Lange, 2 McCullagh and Renshaw, 3 Kolle 4 ), but the possibility of some degree of stimulation by androgens from extragonadal sources has remained largely an undetermined factor. After removal of both testes men continue to excrete appreciable quantities of urinary androgens (Gallagher and associates, 5 Callow and co-workers, 6 Hamilton and colleagues; 7 see summary of literature by last authors), and in a rare case the amount excreted is within the range observed in normal men (Callow and co-workers 6 ). There is evidence that an androgenic substance found in the urine of normal and castrate men, dehydroisandro-sterone, may be derived from secretions of the adrenal glands (Callow, 8 Fraser and associates 9 ).

Feinier and Rothman 10 attempted to define the quantity of urinary androgens in a 53-year-old castrate who claimed erectile ability, but the description of their findings seems confusing. They reported an entire absence of androgens in the urine, although, as indicated above, some quantity of these substances is found almost invariably witn the use of adequate methods of extraction and assay. Description of their technic was omitted. They commented that neither testosterone nor androsterone was present in extracts obtained apparently from 3,000 cc of urine, an odd statement since testosterone has never been found in urine. It would have been difficult to identify specific compounds present in this small quantity of urine, and since the extract appears to have been used for assay in capons, it is doubtful that the authors intended to imply that the isolation of compounds was attempted.

The present communication pertains to 2 men castrated for 13 and 18 years, respectively, who demonstrated during repeated examinations a pronounced degree of erectile ability despite the absence of any considerable stimulation by androgens from extragonadal sources, as indicated by low titers of urinary androgens and supranormal values for urinary gonadotropins.