PURPOSE: Although prostate specific antigen(PSA) is an excellent tumor marker, it is not prostate cancer-specific but organ-specific. The objectives of this study is to identify the correlation between the nonmalignant elevation of PSA and the characteristics of DRE, TRUS, and histologic features. MATERIALS AND METHOD: Ninety nine patients with elevated PSA were divided into 3 groups of prostatic cancer(46), benign prostatic hyperplasia(46), and infectious prostatic disease(10) according to their clinical history and histology of prostate. RESULTS: There was significant elevation of PSA in order of prostate cancer, infectious disease, prostatic intraepithelial neoplasia(PIN), and benign prostatic hyperplasia(p > 0.01). Episodes of acute urinary retention and pyuria more frequently induced nonmalignant elevation of PSA(p > 0.05). There was no specific correlation between the findings of TRUS and elevation of PSA except intraprostatic calculi and cyst. Irregularity of margin and seminal vesicle on TRUS highly suggested prostatic cancer. On microscopic examination, high grade PIN, enlarged nucleus, prominent nucleoli and perineural invasion were highly correlated with prostatic cancer. CONCLUSIONS: These results suggest that nonmalignant elevation of PSA has following clinical characteristics: episodes of urinary retention, bladder calculi, urinary tract infection, prostatic calculi or cyst, and histologically benign. And the values of PSA in nonmalignant condition is not so elevated as malignancy.
Calculi ; Communicable Diseases ; Humans ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Pyuria ; Seminal Vesicles ; Urinary Bladder Calculi ; Urinary Retention

PURPOSE: Prostate volume has been known to be poorly correlated with other parameters used to assess benign prostatic hyperplasia(BPH), including symptom score, peak flow rate(Qmax), amount of postvoid residuals(PVR). The purpose of this study was to determine if measurement of the transition zone index(TZI) of the prostate correlated well with other clinical parameters in predicting the degrees of obstruction. MATERIALS AND METHOD: We prospectively evaluated 86 men with symptomatic BPH(mean age: 65.4 years) according to symptoms, Qmax, PVR, transrectal ultrasound volume of the entire prostate and the transition zone. TZI was determined as the ratio between transition zone volume(TZV) and total prostate 1 volume(TV). RESULTS: Age correlated with symptoms(r=0.29, p=0.006) and PVR(r=0.466, p=0.001); Qmax negatively correlated with age(r=-0.487, p=0.001), symptoms 1 (r=-0.28, p=0.007) and PVR(r=-0.36, p=0.001). Age also correlated with TV(r=0.4, p=0.001), TZV(r=0.435, p=0.001) and, TZI(r=0.36, p=0.001). There was a weak correlations between TV and symptom r=0.23), Qmax(r=0.28), and PVR(r=0.24); a stronger correlation were noted between TZ and symptoms(r=0.33), Qmax(r=-0.35) or PVR(r=0.28). There were significant correlation between TZI and symptoms(r=0.35), Qmax(r=-0.38) or PVR(r=0.30). Age, PVR, 721, and TZV were significantly greater and Qmax were significantly lower in severe (IPSS > or = 20, N=38) symptom group than in moderate(IPSS < or = 19, N=48) one. (p < or = 0.01). On the other hand, the age, PVR, symptom score, TZI, and TZV in low Qmax( < or = 10ml/sec) group were significantly greater than in high Qmax ( > or = 15m1/sec) group. No significant differences of TV were noted either between moderate and severe symptom group or low and high Qmax group. CONCLUSIONS: Transition zone volume or index are parameters that correlates significantly with evaluated parameters of BPH and may serve as a useful method for evaluating obstruction. Studies are underway to determine if transition zone index can be used prospectively to predict and correlate response with therapies designed to ablate prostatic tissue medically or surgically.
Hand ; Humans ; Male ; Prospective Studies ; Prostate ; Prostatic Hyperplasia* ; Ultrasonography

PURPOSE: To compare symptoms of prostatism and their causes between two occupation groups with different working environment and position: one group of tarsi drivers working mainly in sitting position under constant stress and another group of barbers working mainly in standing position. MATERIALS AND METHOD: 405 taxi drivers and 110 barber participated in prostatic disease screening program. 93 patients with prostatic symptom were also enrolled in this study. All participants underwent IPSS self-assessment, digital rectal examination, urinary flow rate, transrectal ultrasound and prostatic cancer screening test (PSA, and if necessary, prostatic biopsy). RESULTS: IPSS were similar in taxi drivers group and patient group, whereas it was significantly lower in barbers group. Mean maximal flow rate was similar in both taxi drivers and patient groups, but significantly higher in barbers group. Incidence of abnormal voiding pattern was significantly higher in taxi drivers group compared to other groups. TRUS showed higher incidence of calcification and ejaculatory duct abnormality in taxi drivers group compared to other groups. Prostatitis and prostatodynia combined were more prevalent in taxi drivers group than in barbers groups. CONCLUSIONS: Taxi drivers working in a constrained environment of prolonged sitting exposed to a lot of stress, pelvic floor tension and abstinence of urine had more diverse voiding symptoms and greater prevalence of prostatitis and prostatodynia than barbers group.
Digital Rectal Examination ; Ejaculatory Ducts ; Humans ; Incidence ; Male ; Mass Screening ; Occupations* ; Pelvic Floor ; Prevalence ; Prostatic Diseases* ; Prostatic Neoplasms ; Prostatism ; Prostatitis ; Self-Assessment ; Ultrasonography

PURPOSE: The authors evaluated of the efficacy of Genestone 190 lithotriptor (Genemed company) for the treatment of the patients with urinary calculi. MATERIALS AND METHOD: From August, 1995 to February, 1997, Seventy patients with venal stones and 103 patients with ureteral stones underwent SWL using fluoroscopy targeting, under intramuscular analgesics. Characteristics of site and size of stones, number of SWL sessions according to the size of stones, success rate according to site or size of stones, and their complications were analysed. RESULTS: The cumulative stone-free rates of first, second, and third SWL session of renal stones were 47%, 74%, and 86% and the cumulative stone-free rates of ureter stones were 65%, 79%, and 87% respectively. As the size of urinary calculi increased, the numbers of SWL sessions increased, but, the success rates were reduced. Success rate of calyx stone was lower than that of pelvis and multiple stone. Post-SWL complications were transient gross hematuria in 161 cases, steinstrasse in 18 cases, renal colic in 15 cases, and fever in one case. CONCLUSIONS: SWL monotherapy with Genestone 190 lithotriptor is a effective, safe and useful treatment modality which can resolve almost all cases of urinary calculi without any clinically significant complications.
Analgesics ; Fever ; Fluoroscopy ; Hematuria ; Humans ; Lithotripsy* ; Pelvis ; Renal Colic ; Shock* ; Ureter ; Urinary Calculi

PURPOSE: Although simple renal cysts are benign and most of them do not require treatment, intervention is needed when symptom or urinary obstruction appears. Sclerotherapy of renal cyst is usually performed in conjuction with aspiration in simple renal cyst because of the high recurrence rate of 30-70% in aspiration alone. We compared the results of single and repeated percutaneous slcerotherapy in patients with simple renal cyst. MATERIALS AND METHOD: Sixty three patients with symptomatic or urinary obstruction causing simple renal cysts received ultrasound guided needle aspiration and sclerotherapy between March 1990 to December 1996. 42 patients received sclerotherapy once immediately after aspiration(group 1), and 21 patients received sclerotherapy at least twice after indwelling a 6.0 Fr pigtail catheter into the renal cyst(group ll). Follow-up with ultrasonography was performed in a 3 month internal for at least 6 months. Disappearance of the renal cyst was considered as complete regression and more than 50% reduction in the diameter of the remaining cyst as partial regression. RESULTS: The mean diameter of the renal cyst in group 1 (6.12cm) and 2(6.75cm) were not significantly different. Complete and partial regression were 8/42 (19.0%), 16/42(38.1%) for group 1 and 15/21(71.4%), 5/21(23.8%) for group 2, respectively. The overall success rate was significantly better in group 2(95.2%) compared to group 1(57.1%)(p<0.001). The pre-operative size of the cyst was not related to recurrence rate(p=0.184). CONCLUSIONS: These data suggest that repeated sclerotherapy using a pigtail catheter is better than single session for reducing the recurrence of simple renal cyst.
Catheters* ; Follow-Up Studies ; Humans ; Needles ; Recurrence ; Sclerotherapy* ; Ultrasonography

PURPOSE: Endopyelotomy is a minimally invasive surgical alternative to the classic open surgery in the treatment of ureteropelvic junction obstruction with similar success rates. We analyzed factors influencing success rates after endopyelotomy based on clinical data. MATERIALS AND METHOD: Between 1989 and 1997, we performed percutaneous antegrade endopyelotomy in 53 cases of ureteropelvic junction obstructions. Among these patients, 47 patients have been followed with range from 3 to 70 months(mean 18.1 months). Of the 47 patients, 36 had primary UPJ obstruction and 11 had secondary UPJ obstruction. A rigid urethrotome(cold knife) was employed in 31 cases, a electrotome(hot knife) in 10 and a balloon dilator in 6. A stent(14/7Fr endopyelotomy stent or 6Fr double-J stent) was placed for 4 to 12 weeks after the procedure. Coexisting stones or infundibular strictures were managed simultaneously. RESULTS: Overall success rate(measured by symptom-free status and improved uroradiographic findings) was 80.9%(86.1% in primary and 63.6% in secondary cases). Success rates related to the method of incision were as follows; 87.1% with a cold knife, 80% with a electric knife and 50% with a balloon dilator only. 14/7Fr endopyelotomy stent was used in 21 patients with a successful outcome in 19(90.5%), while 25 received 6Fr double stent with a successful outcome in 18(72%). Success rates according to the duration of stenting were as follows; 86.7% in the 8-week group, 78.6% in the 6-week group and 66.7% in the 4-week group. CONCLUSIONS: Our experience indicates that endopyelotomy can be selected as the initial procedure of choice for the selected patients with UPJ obstruction. The small number of patients in each parameter did not reach statistical significance. However, there was a trend for better results in patients with primary UPJ obstruction and with the use of 14/7Fr endopyelotomy stent.
Constriction, Pathologic ; Humans ; Stents

PURPOSE: To assess the ability of scrotal Doppler ultrasonography to confirm the diagnosis of clinical varicoceles and detect subclinical varicoceles. MATERIALS AND METHOD: Sixty patients with clinically evident varicocele were examined by scrotal doppler ultrasonography(gray scale: 60 patients, spectral Doppler: 35 patients, color Doppler: 22 patients). A control group of 21 patients with no suspected scrotal pathology also were studied. The age range of the varicocele group was 12-49 years. The normal group consisted of 21 subjects aged 19-23 years. Ultrasonographic measurement of scrotal vein diameter of patients before and during Valsalva maneuver, and scrotal vein blood flow reversal with Valsalva maneuver was compared with the findings of varicocele by physical examination. RESULTS: Significant differences were found in scrotal vein diameter before and during Valsalva maneuver between normal and varicocele testicular units. Cut-off points were selected in an arbitrary fashion on the basis of scattergram. Using this cut-off points and blood flow reversal, we found that 12(23%) of 53 patients with a clinically palpable left unilateral varicocele had an ultrasonographically positive subclinical right varicocele. 8(38%) of 21 patients without a clinical varicocele had a positive scrotal ultrasound. CONCLUSIONS: We suggest that scrotal doppler ultrasonography is a reliable means of confirming the clinical varicocele and screening the subclinical varicoceles.
Diagnosis ; Humans ; Mass Screening ; Pathology ; Physical Examination ; Ultrasonography ; Ultrasonography, Doppler* ; Valsalva Maneuver ; Varicocele* ; Veins

PURPOSE: To analyze the relationship of age to serum prostate-specific antigen (PSA) levels among Koreans without clinically evident prostate cancer in a community-based study. MATERIALS AND METHOD: A total of 375 healthy men aged 50 to 79, residing in the small farming villages of Jeong-Eup county, Korea were examined with serum PSA(Hybritech Tandem-R) and digital rectal examination. One case of patient with prostate cancer was excluded. RESULTS: The serum PSA concentration is correlated with patient age(In PSA=-1.56+0.0257 x Age, r=0.32, p-value<0.0001). The recommended age-specific reference ranges of serum PSA(95th percentile) for men aged 50-59 years is 0-2.80ng/m1; for 60-69 years,0-3.56ng/m1; and for 70-79 years, 0-4.57ng/m1. CONCLUSIONS: The serum PSA concentration is correlated with patient age in Korean men and the age-specific PSA reference ranges for Korean are lower than those for Caucasian.
Digital Rectal Examination ; Humans ; Jeollabuk-do ; Korea ; Male ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Reference Values*

PURPOSE: Is there any relationship between penile size and physical stature? This study was performed to answer this question and provide guidelines of penile size to assist in counseling patients for penile augmentation. MATERIALS AND METHOD: Penile size, body weight and height were measured in 150 young healthy men, and the body mass index(BMI) was calculated in weight(kg)/height(m)2. The penile length and circumference were measured with tape in flaccid and erect states. The 'lengthening ratio' was calculated by 'erect length/flaccid length', and 'tumescent ratio' was calculated by 'erect circumference/flaccid circumference'. All the data was statistically evaluated and the following results were obtained. Result : The average length and circumference were 8.26+/-1.07cm and 8.34+/-1.03cm respectively in the flaccid state, and 13.42+/-1.38cm and 11.17+/-1.05cm in the erect state. The average lengthening and tumescent ratios were 1.64+/-0.22 and 1.35+/-0.08, and were negatively correlated to the flaccid penile length and circumference. Height was positively correlated to erect penile length and lengthening ratio. There was a relationship between body weight and erect penile length in a positive direction, but with other penile parameters there were none. There was no relationship between BMI and any parameters of penile size. However, the erect penile length of the normal BMI group was longer than that of the lower BMI group. CONCLUSIONS: The results show that the flaccid penile size is related to the erect penile size and there is some relation between penile size and physical stature. We believe these results will be applicable to the penile augmentation.
Body Size ; Body Weight* ; Counseling ; Humans ; Male

PURPOSE: Renal oncocytoma has been a focus of interest in urologic oncology. The biologic and molecular characteristics of this disease remains ill defined due to paucity of ideal in vitro model. In this present study a new cell line of human renal oncocytoma, CURO, has been established and characterized. MATERIALS AND METHOD: The CURO cells were cultured from tissues obtained from radical nephrectomy specimen of incidentally found renal oncocytoma. The cellular and molecular biological characleristics of CURO cells were analyzed. RESULTS: CURO cells grew in monolayer with a rapid doubling time of 20 hours. The cells showed abundant mitochondria and well developed microvilli, and expressed cytokeratin, epithelial membrane antigen, and lectins of distal renal tubular and collecting duct origin. The cells showed aneuploidy with high proportion of cells in G2+M phase(27%) on flow cytometric analysis. Karyotyping study revealed clonal heterogeneity: Majority showed normal 46XX, whereas, 12% of cells showed deletion or translocation of chromosome 19, but none of the cells showed abnormality of 3p. The cells neither showed mutation of p53 gene and nor expressed two major angiogenic factors of renal cell carcinoma: vascular endothelial growth factor and basic fibroblast growth factor. The CURO cells didn't show tumorigenecity in athymic nude mouse on either subcutaneous or subrenal capsular implantation. CONCLUSIONS: The results of this study suggest that CURO may be a valuable model to study renal oncocytoma. Renal oncocytoma may be a benign tumor of distal renal tubular or collecting duct origin, but it may contain clone with high proliferative activity. Change of chromosome 19 may be a marker of development or proliferation of renal oncocytoma.
Adenoma, Oxyphilic* ; Aneuploidy ; Angiogenesis Inducing Agents ; Animals ; Carcinoma, Renal Cell ; Cell Line ; Chromosomes, Human, Pair 19 ; Clone Cells ; Fibroblast Growth Factor 2 ; Genes, p53 ; Humans* ; Karyotyping ; Keratins ; Lectins ; Mice ; Mice, Nude ; Microvilli ; Mitochondria ; Mucin-1 ; Nephrectomy ; Population Characteristics ; Vascular Endothelial Growth Factor A