No abstract available.
Erectile Dysfunction* ; Evoked Potentials, Somatosensory* ; Male

Urinary incontinence is a relatively common and potentially disabling disease affecting the life quality of a patient. Many successful series in the treatment of incontinence by medical or surgical therapy using autologous materials have been reported. However, those who have structural abnormalities, injury around the urethra, and derangements in the nervous system could not be benefited by such treatments. In other countries, the artificial urethral sphincter, introduced in 1972, have achieved satisfactory results and then increased in use; but in Korea, it was not widely used because of many limitations and obstacles. Based on our ten-year experience with 10 cases of implantation of artificial urethral sphincter from 1987 to 1996, we tried to elucidate the present status, problems, and the possible ways of improvements of its use within this country. A total of ten male patients underwent implantations of the AMS Model 800 artificial urethral sphincter. Mean age was 34.5 (17-43) years. Mean follow-up was 4.2 (0.5-10) years. Two patients were spinal cord injury patients, 2 meningomyeloceles, and 6 posterior urethral injuries. Two patients had the prosthesis removed due to infection and cuff erosion. In the other 8 patients, 6 were dry (75.0 %) and 1 was improved (12.5 %) and 1 was wet (12.5 %). The revision rate was 20% (2/10) and overall improvement of incontinence was observed in 7 (87%) patients. The reasons for the low incidence of the implantation of artificial urinary sphincter in this country are as follows. According to the other reports, the most common application of artificial urinary sphincter in the west is in the post-prostatectomy incontinence accounting for about 60% of artificial urinary sphincter implantation whereas in this country, the majority of cases are patients who had trauma. Since radical prostatectomy has not been established well in the country (in the recent 4 years, totally only 53 cases were performed) and also the excellent performance of the transurethral surgery making the incidence of incontinence low, could be one of the reasons. In addition, the high price of the prosthesis over 4 million won and operation fee of 3 to 6 million won is a formidable burden to most patients. In the view of mechanical problem, the cuff size of the urethra in the oriental people is observed smaller than the western, and we must let the company prepare the cuff set of smaller size. In conclusion, if we solve those problems in our country, the artificial urethral sphincter is an effective device for treatment of urinary incontinence in patients who have failed more conservative modes of therapy.
Fees and Charges ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Linear Energy Transfer ; Male ; Meningomyelocele ; Nervous System ; Prostatectomy ; Prostheses and Implants ; Quality of Life ; Spinal Cord Injuries ; Urethra* ; Urinary Incontinence ; Urinary Sphincter, Artificial

Twenty vesicoureteral reflux patients with 31 reflux renal units were treated with endoscopic Teflon injection. Twenty one reflux renal units were cured and the success rate after first injection was 67.7 %. In 5 more renal units the second injection was done and the refluxes were subsided in all cases. The overall success rate was 83.9 %. Teflon injection was also effective in vesicoureteral reflux with neurogenic bladder. There are many benefits of endoscopic Teflon injection in the treatment of vesicoureteral reflux but long term follow-up is needed and we must consider the possibility or complication especially in child.
Child ; Follow-Up Studies ; Humans ; Polytetrafluoroethylene* ; Urinary Bladder, Neurogenic ; Vesico-Ureteral Reflux*

We studied 33 patients with acute urinary retention due to benign prostatic hyperplasia for evaluating the recovery of the detrusor muscle function and its affecting factors through the serial urodynamic studies prospectively. And ninety nine patients were studied for risk factors of acute urinary retention retrospectively. Among the 33 patients studied prospectively, detrusor contraction at immediate decompression was observed in 20 cases(60.7%) and was not observed in 13 cases (39.3%), and there was statistically significant difference in the retained volume and duration of retention between two groups. In 10 cases of non-contraction group at immediate decompression, serial urodynamic studies showed that detrusor contraction recovered within 2 days in 4 cases, but in 6 cases no detrusor contraction was found upto 5 days. Overall, detrusor function recovered in 80% or patients within 2 days. Among the patients studied for risk factors, hesitancy and interruption were the most common symptoms whereas urgency and urge incontinence were the least common. In conclusion, it is thought that acute urinary retention due to benign prostatic hyperplasia is resulted from temporary or permanent loss of detrusor muscle function due to overdistension, and the degree of retention duration and retained volume expressly affect the severity of loss of detrusor muscle function. The risk of acute urinary retention is higher in benign prostatic hyperplasia patients with obstructive symptoms rather than irritative symptoms.
Decompression ; Humans ; Prospective Studies ; Prostatic Hyperplasia* ; Retrospective Studies ; Risk Factors ; Urinary Incontinence, Urge ; Urinary Retention* ; Urodynamics

Since March 1978, 78 men, husbands of infertile couples who consulted our Severance Hospital Urologic department were instructed to collect seminal fluid samples after at least 3 days of abstinence. Of these 78 patients 28 (35.9%) demonstrated aspermia. The remaining 50 patients were evaluated with past history and physical examination. The semen was examined for liquefaction, volume, sperm motility, morphology, and WBC count. The results were as follows: 1. The mean age was 31.8 years and mean period of infertility was 3.4 years. 2. 34% of the patients had suffered from urethritis, or epididymitis. 3. Varicoceles were found in 14% of the patients. 4. The mean pH of the specimens was 7.4, time of liquefaction was 13.9 minutes and in all of the patients did liquefaction occur within 30 minutes. 5. The volume of the ejaculate averaged 3.4 ml, and in 6% of the patients the volume was below 1 ml. 6. The sperm concentration averaged 60.5 million/ml and 34% had concentrations less than 20 million. The total number of spermatozoa per ejaculate averaged 205.8 million and 26% had total sperm counts under 50 million. 7. Ployspermia was found in 2 men (4%) 8. The mean percentage of active sperm was 53.7% 9. The motile sperm count averaged 31.1 million/ml and the total motile sperm per ejaculate averaged 107.6 million. 10. The percentage of oval cells or normal sperm averaged 68.1% 11. In patients with WBC more than 5/HPF in semen, mean sperm motility (42.0%) was lower than that of the other group (60.3%) 12. According to the fertility index, infertile was 6%, subfertile 44%, relative fertile 30% and highly fertile 20%. 13. In patients with varicocele, mean of the sperm motility was lower than that of patients without varicocele.
Aspermia ; Epididymitis ; Family Characteristics* ; Fertility ; Humans ; Hydrogen-Ion Concentration ; Infertility ; Male ; Physical Examination ; Semen Analysis* ; Semen* ; Sperm Count ; Sperm Motility ; Spermatozoa ; Spouses* ; Urethritis ; Varicocele

Intercourse without ejaculation may be the result of anejaculation, retrograde ejaculation, nonemission, or aspermia. Twelve patients complaining ofnonejaculatory intercourse were studied. Two of them presented primarily with complaints of sexual dysfunction and 10 with infertility. All of them had primary infertility. Eight patients were anejaculation, which was primary in three and secondary in five. Four patients had nonemission. Six patients wanted early treatment for their infertility and underwent electroejaculation, which produced ejaculates in five. Intrauterine insemination was performed with the processed semen in three of the wives, but there are no pregnancies so far. We intend to keep trying such artificial insemination until we succeed.
Aspermia ; Ejaculation ; Humans ; Infertility ; Insemination ; Insemination, Artificial ; Male ; Pregnancy ; Semen ; Spouses

PURPOSE: The onset and severity of voiding dysfunction in multiple system atrophy(MSA) is more early and severe than that of idiopathic Parkinson's disease(IPD). We compared the voiding symptoms and urodynamic findings in patients with MSA and IPD in order to elucidate the characteristics of their voiding dysfunction. MATERIALS AND METHODS: We reviewed urodynamic data from 19 men and 10 women with parkisonism. Of the 29 patients(mean age 66.5 years), 19 patients (mean age 68.7 years) had IPD and 10 patients(mean age 62.4 years) had MSA. The mean duration of the disease in all patients was 4 years and 10 months, and there was no significant difference between IPD and MSA. RESULTS: Detrusor hyperreflexia(DH) was seen in 8 patients, detrusor hypereflexia with impaired detrusor contractility(DHIC) in 3, detrusor hyperreflexia with bladder outlet obstruction(DHOB) in 4, impaired detrusor contractility(If) in 8, and normal findings in 6. In IPD, DH was noted in 5 patients, DHIC in 3, DHOB in 2, IC in 5 and normal in 4, and a similar distribution was seen in MSA. However, there was no significant difference in the prevalence of involuntary detrusor contraction between IPD and MSA. Irritative voiding symptoms were seen in 11 patients, obstructive symptoms in 10, and both in 8. Obstructive symptoms were dominate in IPD and irritative symptoms in MSA. Impaired relaxation of the voluntary sphincter was seen in 12(41%) patients with parkisonism,8 in IPD, and 4 in MSA. CONCLUSIONS: There was no difference between idiopathic Parkinson's disease and multiple system atrophy in mean age, sex, mean duration of disease, subjective voiding symptoms and urodynamic findings. Disease specific findings were not identified in patients with parkinsonism.
Female ; Humans ; Male ; Multiple System Atrophy* ; Parkinson Disease ; Parkinsonian Disorders ; Prevalence ; Reflex, Abnormal ; Relaxation ; Urinary Bladder ; Urodynamics*

While urinary retention secondary to bladder outlet obstruction in the male occurs commonly and re. rely causes difficulty with diagnosis and treatment but acute urinary retention in the female is an uncommon finding, especially if one excludes patients with obvious extrinsic or intrinsic obstruction and neurological disease. We have reviewed 18 women referred to Yongdong Severance Hospital who retained the urine in absence of obvious causes and combination of medical, neurologic, psychiatric and urologic evaluation were performed. In this literature, we aimed to discover the mechanism of acute urinary retention in the female through the investigation of possible causes by urodynamic study and analysis of treatment response as to them.
Diagnosis ; Female* ; Humans ; Male ; Urinary Bladder Neck Obstruction ; Urinary Retention* ; Urodynamics

From January, 1990 to December, 1995, 106 patients received transvaginal bladder neck suspension by Raz. Follow up periods ranged from 3 months to 5 years, and mean age of patients was 52.2 years. Severity of incontinence were grade 1 in 22, grade II in 83, and grade III in 1 patient. After minimum of 3 months follow up, 87 (82.1%) patients were completely cured and 14 (13.2%) patients reported minimal leaking, the final success rate being 95.3% (101/106). Degree of posterior urethral angle and grades of incontinence(classified either by Blaivas or Green) were not significant factors in predicting outcome. Grade of incontinence, preoperative irritative voiding symptoms, previous incontinence surgery, age, and menopause were not correlated with success. However the history of hysterectomy and overweight were related with lower success rate. Mean hospital stay was 6.1 days, and 50 (47.2%) patients performed intermittent catheterization at discharge but later all resumed normal voiding. Among 34 patients with urgency preoperatively 25 (73.5%) improved after operation, and de novo urgency was found in 11 (16.2%). Complications including urinary tract infection blood loss requiring transfusion were seen in one patient respectively, but no case of peritonitis, bladder perforation, and wound perforation was seen. Success rate of Raz operation is more than 90%, which was higher than other types of bladder suspension. Raz colpo-suspension can place bladder neck traction sutures accurately without causing obstruction or significant morbidity, therefore should be recommended as a premier mode of surgical treatment in patients with stress urinary incontinence.
Catheterization ; Catheters ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Length of Stay ; Menopause ; Neck* ; Overweight ; Peritonitis ; Sutures ; Traction ; Urinary Bladder* ; Urinary Incontinence* ; Urinary Tract Infections ; Wounds and Injuries

An objective finding for the diagnosis of interstitial cystitis (IC) is the so called `glomerulation`, petechial hemorrhages that occur after distention of the bladder. Glomerulation occurs in most IC patients and although there are some reports that it occurs in the normal bladder as well, there has been no actual study carried out to confirm this and further study into this matter is needed. Therefore, we induced glomerulations in non-IC patients and compared its frequency and severity with IC patients in order to elucidate the importance of glomerulation in IC. 25 (10 males, 15 females; mean age 44.3 years) IC patients received hydrodistention between Jan 1992 to Sep 1996 at the Department of Urology at Yongdong Severance Hospital. 12 (8 males, 4 females; mean age 47.5 years) non-IC patients who were to receive urological surgery under spinal or general anesthesia were selected for hydrodistention; there were 6 ureter stone, 4 BPH, and 2 stress urinary incontinence patients. 92.0% (23/25) of IC patients and 83.3% (10/12) of non-IC patients showed glomerulation and there was no statistical significance between the two groups. 76.0% (6 grade 2, 13 grade 3 glomerulation) of IC patients and 50.0% (3 grade 2, 3 grade 3) of non-IC patients showed glomerulation of grade 2 or higher. The frequency and severity of glomerulation was in an inverse relationship with trabeculation of the bladder. The sensitivity of glomerulation in the diagnosis of IC was 92.0% whereas the specificity was low with 16.7%. These findings suggest that glomerulation is nonspecific in IC and warrants further investigation.
Anesthesia, General ; Cystitis, Interstitial* ; Diagnosis* ; Female ; Hemorrhage ; Humans ; Male ; Sensitivity and Specificity ; Ureter ; Urinary Bladder ; Urinary Incontinence ; Urology