We report two cases of acute urinary retention in women with urethral diverticulum. Cystoscopy were performed all patients. But diverticular opening was not found. All patients failed voiding by a bladder outlet obstruction. In one case, bladder outlet obstructive symptom resolved completely after the surgical removal of the diverticulum. In another case, patient refused operation.
Cystoscopy ; Diverticulum* ; Female ; Humans ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Retention*

There are 3 surgical treatments for the management of post-prostatectomy incontinence, including endoscopic injection of periurethral bulking agent, perineal sling procedure, and artificial urinary sphincter (AUS). 4 patients with post-prostatectomy incontinence in our hospital underwent sling procedure using polypropylene mesh. All patients were evaluated for urodynamic result, pad count, operative time, hospital stay, complication, success, and satisfaction. Mean age was 67.8years (64-75). Mean follow-up time was 38.5months (30-51). 2 patients underwent radical prostatectomy, and other 2 patients underwent transurethral prostatectomy. Of the 4 patients, 3 (75%) were successful. In satisfaction, 2 (50%) were unsatisfied due to recurrent incontinence and erectile dysfunction. The male sling procedure using polypropylene mesh is a simple, effective treatment and an additional therapeutic option.
Erectile Dysfunction ; Follow-Up Studies ; Humans ; Length of Stay ; Male ; Operative Time ; Polypropylenes ; Prostatectomy ; Suburethral Slings* ; Transurethral Resection of Prostate ; Urinary Sphincter, Artificial ; Urodynamics

We experienced the case of infected mesh with subsequent infective cellulitis of obturator foramen after a TOT procedure. We reported our case of a 47-year-old woman who presented with persistent vaginal discharge, pain and motion limitation of left leg after having a TOT placed for stress incontinence. Inflammation around obturator foramen was demonstrated on computed tomography (CT) scan. We performed total excision of the mesh material. She ultimately had an uneventful postoperative course and no recurrence of incontinence after follow-up 1 month.
Cellulitis* ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Leg ; Middle Aged ; Recurrence ; Suburethral Slings* ; Vaginal Discharge

PURPOSE: Benign prostatic hyperplasia (BPH) with prostatitis is a common clinical problem. There have been no previous reports of the effect of pathologic prostatitis on the improvement of lower urinary tract symptoms (LUTS) preceded by transurethral resection of prostate (TURP). Therefore, the purpose of this study was to determine the effect of pathologic prostatitis on improvement of LUTS after TURP. MATERIALS AND METHODS: From March 1996 to December 2006, 237 patients who received TURP were divided into two groups of with mild or severe pathologic prostatitis according to the pathological results of prostate tissue evaluation, International Prostate Symptom Score (IPSS), quality of life (QoL), maximum flow rate (Qmax) and the development of complications were recorded before and at 3 months follow up after surgery. RESULTS: No statistically significant differences were identified in the two groups with regard to Qmax, resection rate and complications (p>0.05). However, the IPSS and QoL were significantly different in comparisons between the two groups (p<0.05). CONCLUSIONS: Therefore, the results of this study show that BPH accompanied by pathologic prostatitis affects the improvement of LUTS, after TURP, and treatment of prostatitis may increase patients' satisfaction after surgery.
Follow-Up Studies ; Humans ; Lower Urinary Tract Symptoms ; Prostate ; Prostatic Hyperplasia* ; Prostatitis* ; Quality of Life ; Transurethral Resection of Prostate

PURPOSE: Urodynamic study (UDS) is widely used to evaluate voiding dysfunction, however, it is invasive and bothersome for patients because it requires catheterization into the urethra and anus. We assessed patients' anxiety and pain levels caused by UDS. MATERIALS AND METHODS: A total of 60 female patients who were undergoing UDS were included in the study on a prospective basis. Anxiety level was taken prior to the procedure and pain level was taken immediately after the procedure by visual analogue scale (VAS). Just after the procedures, they were asked if they were willing to undergo the same procedure and if they could recommend the procedure to another people if medically indicated. 60 patients were divided into 2 groups: urodynamic urethral catheters (9Fr, PVC, n=30) were used in group I and Foley catheters (10Fr, Silicon, n=30) were used in group II. RESULTS: The mean age of both groups were 45.5+/-5.3 (group I)and 45.5+/-3.8 (group II)years old. The anxiety and pain levels were relatively high, but there was no significant difference between both groups in pain level. Anxiety level prior to UDS was correlated with pain level (r=0.492, p<0.001). 42 out of 60 patients (70.0%) answered they were willing to undergo UDS if they were asked again and 37 patients (61.7%) answered they could recommend the procedure to another people. 21 patients (35.0%) were menopausal women and they showed higher anxiety level compared to non-menopausal women. CONCLUSION: Female patients felt anxiety before UDS and pain immediately after UDS, especially in menopausal women, and the more anxious they were, the more painful they felt. Therefore, we need to provide sufficient explanation with regard to the procedure for patients prior to UDS to diminish patients' anxiety and pain.
Anal Canal ; Anxiety* ; Catheterization ; Catheters ; Female ; Humans ; Prospective Studies ; Silicones ; Urethra ; Urinary Catheters ; Urodynamics*

PURPOSE: Transurethral resection of the prostate (TURP) is the gold standard treatment for symptomatic benign prostate hyperplasia, but significant complications are associated with this procedure. The aim of this study was to compare the standard TURP with the high power (80W) potassium-titanyl-phosphate laser (KTP/532; Greenlights PVTM laser system; Laserscope, San Jose, USA) to elucidate the efficacy and safety of laser treatment. MATERIALS AND METHODS: 47 consecutive men with symptomatic BPH underwent PVP with an 80W KTP laser. All underwent preoperative and postoperative evaluation, including assessments of international prostate symptom score (IPSS), quality of life (QOL), peak urinary flow rate (Qmax), post-void residual volume (PVR), prostate specific antigen (PSA), and ultrasound prostate volume (PV). Secondary outcome parameters included surgical time, anesthesia, and length of catheterization. Follow-up assessment occurred at 3 and 12 months. RESULTS: Mean age was 68+/-1.1 years. Mean operative time was 58+/-15.4 minutes. Mean catheterization times were 12.3+/-1.6 hours. All efficacy parameters were significantly improved compared to those obtained preoperatively. Complications included hematuria lasting 1 and 3 months (4.2%), transient incontinence (4.2%), transient dysuria (10.6%), frequency (21.2%), urgency (12.7%) and retrograde ejaculation (51%). CONCLUSIONS: These results demonstrate that PVP is safe and efficacious for the treatment of symptomatic BPH. Long follow-up will further validate this new modality as the standard for surgical treatment of BPH.
Anesthesia ; Catheterization ; Catheters ; Dysuria ; Ejaculation ; Follow-Up Studies ; Hematuria ; Humans ; Hyperplasia ; Laser Therapy* ; Lasers, Solid-State ; Male ; Operative Time ; Prostate* ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Quality of Life ; Residual Volume ; Transurethral Resection of Prostate ; Ultrasonography ; Volatilization

PURPOSE: The change of quality of life following a tension-free vaginal tape (TVT) and transobturator vaginal tape (TVT-O) procedure was investigated in patients with stress urinary incontinence. MATERIALS AND METHODS: We included 86 women with stress urinary incontinence who underwent the TVT or TVT-O procedure and followed up for at least 1 year. Preoperatively, the patients were evaluated with history taking, physical examination, urodynamics to determine abdominal leak point pressure (ALPP) and pre- and postoperative quality of life was evaluated by incontinence quality of life questionnaire (I-QoL). The success after operation was defined as the absence of any subjective complaint of leakage. RESULTS: The rate of cure of TVT and TVT-O procedure were 84%, 92% and the rate of improvement of them were 16%, 8%, respectively. Preoperative patient characteristics including uroflowmetric parameters and ALPP were comparable in the two groups. The I-QoL parameters one year after surgery were statistically significant increase in I-QoL scores in each groups. There were no serious or long-term complications related to both procedures. CONCLUSIONS: These data suggest that the TVT and TVT-O procedure are effective for treating female stress incontinence and also in the aspect of improving quality.
Female ; Humans ; Physical Examination ; Quality of Life* ; Surveys and Questionnaires ; Suburethral Slings* ; Surgical Mesh ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urodynamics

PURPOSE: International guidelines and national laws have been formulated to protect human subjects in research. Recently, many efforts have been tried to contribute to better awareness and knowledge about the link between quality systems and protection to develop better quality procedures in health research. In this study, to improve the understandings about health research, awareness about health research was evaluated with questionnaires for patients and care-givers in our institute. MATERIALS AND METHODS: 339 persons responded to the questionnaires. 128 persons were patients with mild symptoms and 69 were caregivers. 123 were male and 179 were female. Dominant educational level was college graduates and were 166 and economic status was middle-class (247). Questionnaires was composed of 18 items; 7 demographical characteristics items, 7 understanding of clinical trials items, 4 understandings of IRB (Institutional Review Board) concepts items. RESULTS: 71.7% of responder have informations about clinical trials by TV and 23.9% by newspapers. 22.3% have never heard about clinical trials. Knowledge level about clinical trials was thought to be a middle level and subjects of clinical trials were animals (62.5%), patients (54.9%), normal persons (25.4%), plants (11.8%). Objects to be included in clinical trials were pharmaceuticals (62.2%), cell therapy (58.7%), medical device (30.4%), health promotion foods (14.5%). Answer about 'Intention to be the participant" were no in 56% and yes in 34.5%. CONCLUSIONS: Although mass media contributed to the spread of understandings about clinical trials, 22.3% did not know about health research. To improve the awareness and understandings about health research, television (TV) can be the most effective method and the safety about human subject protection should be certified.
Animals ; Caregivers ; Cell- and Tissue-Based Therapy ; Ethics Committees, Research ; Female ; Health Promotion ; Humans ; Jurisprudence ; Male ; Mass Media ; Periodicals ; Surveys and Questionnaires ; Television

PURPOSE: 5alpha reductase, dutasteride, has widely used to treat enlarged prostate (BPH). By suppressing the conversion of testosterone to dihydrotestosterone it decreases serum prostate-specific antigen (PSA) which is very important screening marker for prostate cancer. We evaluate the early serum PSA changes after dutasteride treatment to Korean BPH patients. MATERIALS AND METHODS: A total 159 men with a clinical diagnosis of BPH and no evidence of prostate cancer were enrolled. They were treated with dutasteride 0.5mg daily for 12 months. Serum PSA was evaluated at 2, 6, and 12 months after the medication. RESULT: Dutasteride statistically significantly reduced serum PSA to 0.70+/-0.52, 0.64+/-0.35, and 0.59+/-0.49 from baseline level at 2, 6, and 12 months after the medication, respectively. However, there was no statistical significance among the three groups in serum PSA changes after dutasteride. There were statistically significant correlations between a high pre-treatment serum PSA level and a large reduction of follow-up PSA levels at 2, 6, and 12 months after dutasteride treatment. CONCLUSIONS: The reduction of serum PSA is variable in patients to patients at 2, 6, and 12 months after dutasteride treatment. The patient with high initial serum PSA revealed a large reduction of serum PSA level after treatment. The traditional concept that follow-up serum PSA level should be doubled for prostate cancer screening may overestimate real serum PSA level within 12 months in Korean men receiving 5alpha reductase inhibitors.
Diagnosis ; Dihydrotestosterone ; Follow-Up Studies ; Humans ; Hypertrophy* ; Male ; Mass Screening ; Oxidoreductases ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Testosterone ; Dutasteride

OBJECTIVE: This study is to evaluate the efficacy of terazosin in the treatment of overactive bladder (OAB) symptoms and sexual dysfunction in patients with symptomatic benign prostatic hyperplasia (BPH) and OAB. METHODS: Of 200 men aged 50-80 years with symptomatic BPH, an International Prostatic Symptom Score (IPSS) > or =8 accompanied by OAB symptoms, 185 patients completed treatment with terazosin 2-5 mg once daily for 8 weeks. Patients were asked to complete a voiding diary, the International Index of Erectile Function (IIEF) questionnaire, and the IPSS at baseline, 4 and 8 weeks. RESULTS: 8-week terazosin treatment improved OAB symptoms as well as reducing IPSS (19.8 to 12.7) and IIEF (34.4 to 37.4) scores. OAB symptoms improved significantly, irrespective of symptom severity by the IPSS, but the IIEF score only increased in patients with severe symptoms. CONCLUSIONS: Additional studies are needed to further evaluate the placebo effect. However, terazosin monotherapy is effective in patients with symptomatic BPH and OAB, and may increase sexual function in patients with severely symptomatic BPH.
Adrenergic alpha-Antagonists ; Humans ; Male ; Placebo Effect ; Prospective Studies* ; Prostatic Hyperplasia* ; Surveys and Questionnaires ; Urinary Bladder, Overactive*