No abstract available.
Humans ; Male* ; Penile Prosthesis*

No abstract available.
Humans ; Male* ; Penile Prosthesis*

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

PURPOSE: Carbon monoxide (CO) is produced during the degradation of hemoglobin to heme (iron protoporphyrin) and present in various tissues including brain. CO is believed to activate soluble guanylate cyclase to exert its action on the smooth muscles. the effects of CO and its relationships to adrenergic or cholinergic mechanisms were studied using the isolated rabbit corpus cavernosal strips, and the effects of CO and NO were further investigated. MATERIALS AND METHODS: Using adult New Zealand rabbits, the corpus cavernosal strip was carefully prepared from rabbit penis and suspended in an 10ml organ bath containing Tyrode solution. When a stable tension level of the strip had been attained, drugs were added to the organ bath the change of motility of the strip was recorded on a computerized polygraph. RESULTS: The NO donor, sodium nitroprusside (SNP) and CO caused a dosedependent relaxation of the cavernosal strip of the rabbit penis. Pretreatment of SNP and CO had no effect on contraction induced by adrenergic drugs and the effects of SNP and CO was not affected by atropine. The relaxation effects of SNP were inhibited by NO scavenger pyrogallol, inhibitor of soluble guanylate cyclase 1H-[1,2,4] oxadiazolo[4,3-a] quinoxalin-1-one (ODQ) and methylene blue. The relaxation effects of CO were significantly inhibited by ODQ and methylene blue. the relaxation effects by acetylcholine were inhibited by NO synthase inhibitor L-nitroarginine methyl ester (NAME) and deendothelialization, but not affected by zinc protoporphyrin (ZnPP), the heme oxidase inhibitor. On the immunostaining of heme oxidase (HO) in corpus cavernosal smooth muscle strip, the positive staining for HO was observed in the perivascular nerve fibers. CONCLUSIONS: The relaxation effect of NO was confirmed, and CO exerts an endothelium dependent relaxing effect on the cavernosal strip of the rabbit penis similar to NO. This action is seem to be mediated by soluble guanylate cyclase, and the actions of CO is also mediated by similar guanylate cyclase system.
Acetylcholine ; Adrenergic Agents ; Adult ; Atropine ; Baths ; Brain ; Carbon Monoxide* ; Carbon* ; Endothelium ; Guanylate Cyclase ; Heme ; Humans ; Male ; Methylene Blue ; Muscle, Smooth ; Nerve Fibers ; Nitric Oxide ; Nitric Oxide Synthase ; Nitroprusside ; Oxidoreductases ; Penis ; Pyrogallol ; Rabbits ; Relaxation ; Tissue Donors ; Zinc

No abstract available.
Humans ; Infant, Newborn ; Infant, Premature* ; Nephroma, Mesoblastic* ; Ultrasonography, Prenatal*

PURPOSE: Androgen plays an important role during penile development and is essential for a normal libido in the male, but its role in the regulation of the androgen receptor and maintenance of erectile response has been controversial. We investigated the effect of androgen on apoptosis, proliferation of the penile erectile tissue and androgen receptor after castration and temporary androgen replacement. MATERIALS AND METHODS: Male adult Sprague Dawley rats were divided into three groups; sham-operation, castration, and androgen replacement after castration. Androgens (testosterone, DHT) were administrated for 7 days at week 1, 2, 3, and 4 after castration. The weight of whole body and corpus cavernosum and serum testosterone concentration were measured. Androgen receptor expression, percentage of proliferating cells incorporating Ki-67(proliferative index) and percentage of apoptotic cells assessed by morphological analysis(apoptotic index, TUNEL) were analyzed in the penile erectile tissue. RESULTS: Castration induced a significant decrease in serum testosterone concentration from day 1 and a progressive decrease in the corpus cavernosal weight from day 14. Androgen receptor expression decreased after androgen depletion and was restored with androgen replacement. The proliferative and apoptotic index varied as follows after castration and androgen replacement: a significant increase was noted for apoptotic index with a decrease in the proliferative index and androgen receptor expression after castration. Replacement of testosterone propionate and DHT after castration decreased the apoptotic index with an increase in the proliferative index and the expression rate of androgen receptor. CONCLUSIONS: The penile erectile tissue of the adult rat was affected by the androgen milieu via the androgen receptor as seen by either cellular apoptosis or proliferation. Therefore, androgens such as testosterone and DHT play a direct role in the erectile function of the rat at the level of the penile erectile tissue.
Adult* ; Androgens ; Animals ; Apoptosis* ; Castration ; Humans ; Libido ; Male ; Rats* ; Rats, Sprague-Dawley ; Receptors, Androgen* ; Testosterone ; Testosterone Propionate

PURPOSE: Prostate tumor volume calculated after surgery using pathologic tissue has been shown to be an independent risk factor for biochemical recurrence. Nonetheless, prostate size varies among individuals, regardless of the presence or absence of cancer. We assumed to be lower margin positive rate in the surgical operation, when the prostate volume is larger and the tumor lesion is same. Thus, we defined the tumor-prostate ratio in the ratio of tumor volume to prostate volume. In order to compensate the prostate tumor volume, the effect of tumor-prostate ratio on biochemical recurrence was examined. MATERIALS AND METHODS: This study included 251 patients who underwent open retropubic radical prostatectomy for prostate cancer in a single hospital. We analyzed the effects of tumor volume and tumor-prostate ratio, as well as the effects of known risk factors for biochemical recurrence, on the duration of disease-free survival. RESULTS: In the univariate analysis, the risk factors that significantly impacted disease-free survival time were found to be a prostate-specific antigen level ≥10 ng/mL, a tumor volume ≥5 mL, tumor-prostate ratio ≥10%, tumor capsular invasion, lymph node invasion, positive surgical margins, and seminal vesicle invasion. In the multivariate analysis performed to evaluate the risk factors found to be significant in the univariate analysis, positive surgical margins (hazard ratio=3.066) and a tumor density ≥10% (hazard ratio=1.991) were shown to be significant risk factors for biochemical recurrence. CONCLUSIONS: Tumor-prostate ratio, rather than tumor volume, should be regarded as a significant risk factor for biochemical recurrence.
Disease-Free Survival ; Humans ; Lymph Nodes ; Multivariate Analysis ; Prostate ; Prostate-Specific Antigen ; Prostatectomy* ; Prostatic Neoplasms ; Recurrence* ; Risk Factors ; Seminal Vesicles ; Tumor Burden

During the period 1985-1989, 101 patients of urinary tuberculosis were treated at our hospital. Fifty-one of these patients were found to have obstructive dilatation of the urinary tract on pyelography. We reviewed these cases according to treatments for preservation of renal function. Twelve of these 51 cases were managed by chemotherapy only despite of the presence of obstructive dilatation. Eighteen of 51 cases required reconstructive treatment by partial nephrectomy (2), reimplantation of ureter into bladder (3), ileocystoplasty (2) and ileal conduit urinary diversion (1). In 24 of 51 cases, endourologic procedures were performed by stent indwelling (13), ureteral dilatation (7), endopyelotomy or endoinfundibulotomy (4). Seven cases had permanently a percutaneous nephrostomy to prevent further deterioration in renal function. In the cases that were managed only medically, 3(25.0%) improved, but, in reconstructive surgeries, improvement was noted in all cases and surgical morbidity was low. In 19 endourologic cases (79.2%), there has been a substantial improvement in renal function. Thus, in order to save more kidneys from destruction by tuberculosis despite of modern drug treatment, surgical or endourologic interventions are required when scar or stricture threatens to obstruct urinary flow.
Cicatrix ; Constriction, Pathologic ; Dilatation ; Drug Therapy ; Humans ; Kidney ; Nephrectomy ; Nephrostomy, Percutaneous ; Replantation ; Stents ; Tuberculosis* ; Ureter ; Urinary Bladder ; Urinary Diversion ; Urinary Tract ; Urography

Electrical ejaculation is widely used for semen collection in ejaculation failure patients with various causes including spinal cord injury. Semen collected by this method show sperm with low quality, and decrease in sperm motility is especially evident; multifactors are responsible but there are some reports that electrical current and increased temperature during electrical ejaculation are the cause. To confirm this theories, we observed the direct effect of variable electrical current and temperature to the motility of normal sperm in vitro. Semen analysis was performed after temperature was maintained at 37, 39, 41, and 43 `C for 10 minutes and electrical current at 5, 10, 15, 20 Volts for 3, 7, and 10 minutes. 1. Sperm motility change with temperature: The ratio of motile sperm decreased significantly (n=32, p<0.01) from 82.20, 70.12, 60.93, 48.87% as the temperature rose 37, 39, 41, 43 `C, respectively. Factors related to motility (distribution of progressive form and rapid velocity) decreased as well and the distribution of static velocity increased. However, additional semen analysis 20 minutes after rests were not significantly different in sperm motility before and after any temperature changes. 2. Sperm change with electrical energy: The motility of the sperm decreased significantly according to increasing volts and time, which showed a time-dependent and voltage-dependent decrease. The ratio of motile sperm decreased significantly to increasing volts and time and factors related to motility (distribution of progressive form and rapid velocity) also decreased. The distribution of static velocity increased. However, additional semen analysis 20 minutes after rests were not significantly different in sperm motility before and after inducing electrical energies. These data suggest that the effect of electrical current and temperature to sperm motility is temporary and that the low quality of sperm collected by electrical ejaculation in patients with ejaculation failure may not be due to the effect of electrical ejaculation but the various conditions of the patients themselves.
Ejaculation ; Hot Temperature ; Humans ; Male ; Semen ; Semen Analysis ; Sperm Motility* ; Spermatozoa* ; Spinal Cord Injuries

Over the years, several surgical modifications have been incorporated into radical prostatectomy in order to improve the surgical outcome. Despite the rapid dissemination of robot-assisted laparoscopic prostatectomy (RALP) through the urologic community, comparative studies on the practicality of RALP compared to open radical prostatectomy (OP) are lacking. Thus, it remains difficult to draw any conclusions regarding cancer control and postoperative morbidity. This review will introduce the evolution of surgical technique and the current status of RALP in relation to OP in the management of localized prostate cancer focusing on the perioperative, oncological and functional outcomes. Based on the review of literatures, perioperative outcomes, such as blood loss, transfusion rates, hospitalization duration and complication rates, all favored RALP. The positive surgical margin rates of RALP were similar to those of OP with regard to the oncological outcomes. With regard to the functional outcomes, OP and RALP also showed similar continence and potency rates. However, refinements in technique employed during RALP have improved the early return of continence postoperatively. Although OP remains the gold standard treatment in localized prostate cancer, robotic surgery and continued technical advancements will ultimately improve patient outcomes. However, further prospective randomized comparative clinical trials with a long-term follow-up utilizing validated questionnaire are needed to prove the superiority of either surgical approach in terms of functional and oncological outcomes. In addition, RALP technique will need a substantial decrease in the cost of the robotic system to achieve wider global acceptance and application.
Erectile Dysfunction ; Hospitalization ; Humans ; Male ; Prostatectomy ; Prostatic Neoplasms ; Surveys and Questionnaires ; Robotics ; Urinary Incontinence