PURPOSE: Some patients still complain of a downward urine stream and a poor cosmetic result after the standard surgery, scrotoplasty because many patients with hypospadias basically have a low-set penis. We applied and evaluated a new concept for the surgery to improve the surgical results. MATERIALS AND METHODS: 22 patients underwent surgery for PST from January 1997 to June 2004. We performed transposition of penis in 7 patients, scrotoplasty in 13 and partial wedge resection of the scrotum in 2 who had the mild form of PST. Transposition of the penis is a surgical technique in which the skin of the penoscrotal junction is incised circumferentially and phallus is delivered into the buttonhole that is created in the normal anatomical position for the penis. We evaluated the cosmetic results using a satisfaction scoring system (1 to 5 scores) that was completed by the parents and the functional results by checking the angle of the urine stream in the standing position. RESULTS: There was no major complication for the 7 patients who underwent transposition of the penis. The mean satisfaction score was 4.6+/-0.8 and the angle of the urine stream was above 45 degrees in all patients. In the case of scrotoplasty, the mean satisfaction score was 3.6+/-0.9: half of them showed an angle of urine stream under 45 degrees and they complained of trouble when voiding. CONCLUSIONS: As the anatomical location of the penis, scrotoplasty is good for the normally positioned penis with PST, transposition of the penis for the low-set penis, and partial resection of the scrotal skin for the mild form. This individualized approach could improve the cosmetic and functional results for patients with PST.
Female ; Humans ; Hypospadias ; Male ; Parents ; Penis* ; Rivers ; Scrotum ; Skin ; Urogenital Abnormalities

An increasing use of complementary and alternative medicine(CAM) is apparent both in Asian and in Western countries for the management of numerous diseases to improve symptoms and to improve general health and well being. Many patients with benign prostatitc hyperplasia(BPH) and lower urinary tract symptoms(LUTS), erectile dysfunction(ED), urinary tract infection(UTI) are using CAM. Complementary and alternative medicines for urologic malignancies such as renal cell carcinoma, bladder cancer, and prostate cancer are also one of the important issues in the management of patients. Dietary supplements and nutraceuticals are commonly used modality for the patients with BPH/LUTS or ED. Vegetables and cruciferous fruits showed significant preventive effect on urologic malignancies in many studies. Phytotherapy for BPH including beta-sitosterols, saw palmetto, pygeum, and nettles etc, is under vigorous research for their therapeutic effect. No solid evidence showing better effective treatment modality for ED than placebo was found yet in CAM area. Recently, a potent NO donor, L-arginine is under research with promising results. Cranberry juice has been used for the patients with recurrent UTI but safety was a limit for its use. Various antioxidants have been studied for prevention of urological malignancies. Lycopene, isoflavone, vitamin A, C, and E, and polyphenols showed the possibility of decreasing cancer incidence in many studies but their effect is still controversial. Vitamin D is known to be associated with cancer progression and the effect of combination treatment with other chemotherapeutic agents for advanced cancer is under trial. CAM is used by a number of patients with urological diseases and urologists need to have both accurate knowledge and apprehension of CAM. The possible effects and side effects should be defined and offered to the urologic patients by urologists.
Incidence

PURPOSE: We wanted to analyze the oncologic and functional outcomes of radical cystectomy and creation of an orthotopic ileal neobladder with a serous-lined extramural tunnel. MATERIALS AND METHODS: There were 110 patients and 101 patients were male(mean age: 58.7 years, age range: 35-78 years). All these patients underwent radical cystectomy and creation of a ileal W-shaped neobladder with a serous-lined extramural tunnel, and all the procedures were done by one surgeon. The median period of follow-up was 28.9(range: 6-95) months. The Assessing the patients' clinical history, physical examinations, complete laboratory tests, CT scans and bone scans were performed postoperatively for the evaluation of recurrence and complications. The voiding patterns of 77 patients of the 110 patients were surveyed. RESULTS: Five-year-overall survival was 56% and the median survival period was 66.1 months. The tumor recurrence rate was 39.1%(43 patients) and 21(19.1%) patients died due to progression of cancer. The daytime and nighttime urinary continence rates at postoperative 1 year were 87% and 79%, respectively. Sixty three(81%) patients among the 77 patients had no voiding problems after the procedures. Nine patients still had severe incontinence and 5 patients still suffered from voiding difficulty. Renal functional deterioration developed in 3 patients(2.8%); however, no patients were on dialysis. Acute pyelonephritis was observed in 12 patients and recurrent pyelonephritis occurred in 6 patients. Ureter-ileal anastomosis site stricture was occurred in 5 renal units. No reflux from the ileal bladder into the ureter was observed. CONCLUSIONS: Radical cystectomy and an orthotopic ileal neobladder using a serous-lined extramural tunnel for patients with invasive bladder cancer were effective and durable procedures in terms of the oncologic and functional outcomes.
Constriction, Pathologic ; Cystectomy ; Dialysis ; Follow-Up Studies ; Humans ; Physical Examination ; Pyelonephritis ; Recurrence ; Ureter ; Urinary Bladder ; Urinary Bladder Neoplasms

Porcine deltacoronavirus (PDCoV) has emerged in several pig-raising countries and has been a causative pathogen associated with diarrheal diseases in South Korea since 2014. In the present study, we were able to isolate and cultivate a Korean PDCoV strain (KNU16-07) in cell culture and investigate its pathogenicity. PDCoV-inoculated piglets showed watery diarrhea accompanied by acute enteritis in the natural host. Sequencing analysis demonstrated the genetic stability of KNU16-07 for at least thirty serial passages.
Cell Culture Techniques ; Diarrhea ; Enteritis ; Korea ; Serial Passage ; Virulence

PURPOSE: To evaluate the feasibility of the interferon-gamma release assay (IGRA) as a supplementary diagnostic tool for the diagnosis of genitourinary tuberculosis (GUTB). MATERIALS AND METHODS: Fifty-seven patients who were tested with the IGRA to diagnose GUTB were included. All patients had clinical or radiologic features suspicious for GUTB. Signs and symptoms included chronic dysuria with long-standing sterile pyuria, renal calcification with distorted renal calyces and contracted renal pelvis, and chronic epididymitis. Patients who had a history of tuberculosis in other organs were excluded. Tests including IGRA, urine acid-fast bacilli (AFB) stain and culture, urine tuberculosis polymerase chain reaction (UT-PCR), and radiological examinations were performed to confirm GUTB. The medical records of the patients were reviewed retrospectively. RESULTS: The IGRA result was positive in 30 patients (52.6%). The results of the urine AFB stain and culture were positive in 5 patients (8.8%) and 7 patients (12.2%), respectively. The results of UT-PCR were positive in 9 patients (15.8%). The 7 patients who showed positive results in the urine AFB stain and culture also had positive results on the IGRA. A UT-PCR-negative patient was diagnosed with GUTB by positive results on both the IGRA and AFB stain and culture. CONCLUSIONS: The IGRA might feasibly be used as a supplementary or screening tool for the diagnosis of GUTB in addition to urine AFB stain and culture. Further studies for statistical evaluation of its sensitivity, specificity, and efficacy are needed.
Contracts ; Dysuria ; Epididymitis ; Humans ; Interferon-gamma ; Interferon-gamma Release Tests ; Kidney Pelvis ; Male ; Mass Screening ; Medical Records ; Polymerase Chain Reaction ; Pyuria ; Sensitivity and Specificity ; Tuberculosis ; Tuberculosis, Urogenital

PURPOSE: To compare the clinical efficacy and safety of three phosphodiesterase type 5 (PDE5) inhibitors in the treatment of mele erectile dysfunction according to patient preference. MATERIALS AND METHODS: Between January 2004 and August 2005, 113 male erectile dysfunctional patients were enrolled to this randomized, prospective, comparative, open-label, triple-crossover study of three PDE5 inhibitors. Patients were assigned to one of six medication schedules, and were prescribed a full dose of the drugs for 8 weeks, with a week of washout period prior to the next drug cycle. The International Index of Erectile Function (IIEF) scores and side effects related with each medication were obtained at the end of study. 48 patients finished all the medications, and completed the study with a global assessment questionnaire on their drug preference and reasons for that preference. RESULTS: The mean age of the patients was 54.6 (33-73) years. The mean pre-treatment IIEF and EF domain scores (+/-S.D.) were 28.2+/-14.7 and 10.6+/-6.6, respectively. The scores were significantly improved, to 47.9+/-14.6 and 19.9+/-6.6 with sildenafil, to 49.7+/-12.3 and 21.3+/-5.8 with vardenafil, and to 47.9+/-14.9 and 19.8+/-7.2 with tadalafil (p < 0.01). There were no significant differences in the scores or frequencies of side effects between the drugs. The preference percentages were 29.2, 29.2 and 35.4% for sildenafil, vardenafil and tadalafil, respectively. Patient preference was mainly due to improvement in erectile function (70.9%), such as rigid erection, prolonged erection and fast erection, and not to the infrequent rate of side effects (20.8%). CONCLISIONS: There were no significant differences of the efficacy and safety among the three PDE5 inhibitors. The preference for a drug for the treatment of erectile dysfunction was mainly related to the efficacy on the improvement of erectile function rather than the less frequent side effects.
Appointments and Schedules ; Erectile Dysfunction* ; Humans ; Male ; Patient Preference* ; Phosphodiesterase 5 Inhibitors* ; Phosphodiesterase Inhibitors ; Prospective Studies ; Questionnaires

PURPOSE: This study aimed to improve prostate biopsy compliance by analyzing the factors that influence the acceptance of prostate biopsy by patients to whom transrectal ultrasound (TRUS)-guided prostate biopsy is recommended for suspected prostate cancer. MATERIALS AND METHODS: The subjects of this study were 268 patients to whom TRUS-guided prostate biopsy was recommended from January to June 2011 and who completed a questionnaire. Patients who showed a prostate-specific antigen (PSA) increase to more than 4.0 ng/mL or abnormal findings on a digital rectal examination and TRUS were recommended to undergo prostate biopsy. The questionnaire consisted of 9 questions about the subjects' demographic characteristics and 15 questions that assessed their knowledge of prostate disease. Fisher exact probability test was conducted to assess the influence of the demographic characteristics and levels of knowledge of prostate disease on acceptance of prostate biopsy. RESULTS: The mean age of the subjects was 66.2 years (range, 43-83 years). Of the cohort, 188 patients (70.7%) agreed to the prostate biopsy and 78 patients (29.3%) refused. In terms of demographic characteristics, the patients' acceptance of prostate biopsy was associated only with education level. Patients with relatively lower education levels had a higher acceptance rate for prostate biopsy (80.0% vs. 65.9%, p=0.018). Other demographic factors, as well as the degree of knowledge of prostate disease, had no significant effect on the acceptance rate. CONCLUSIONS: The patients' acceptance of prostate biopsy can be influenced by demographic characteristics, especially education level. Therefore, when prostate biopsy is recommended to patients, their demographic characteristics should be taken into consideration.
Adult ; Aged ; Aged, 80 and over ; Biopsy, Needle/methods/psychology ; Health Knowledge, Attitudes, Practice ; Humans ; Kallikreins/blood ; Male ; Middle Aged ; *Patient Acceptance of Health Care ; Prospective Studies ; Prostate-Specific Antigen/blood ; Prostatic Neoplasms/*pathology/psychology/ultrasonography ; Republic of Korea ; Socioeconomic Factors ; Ultrasonography, Interventional

PURPOSE: The purpose of this study was to identify the preoperative factors that predict a positive frozen section during radical prostatectomy for prostate cancer. MATERIALS AND METHODS: We retrospectively analyzed preoperative prostate-specific antigen (PSA), prostate volume, Gleason score, the number or percent (%) of cancer-positive cores from prostate biopsy, and the clinical stage of 364 patients who underwent radical prostatectomy between 1993 and 2007. We compared these parameters between patients who had positive frozen sections in specimens from the urethra or bladder neck with those who had negative frozen sections. RESULTS: The PSA and Gleason score were significantly higher and prostate volume was significantly smaller in patients with positive frozen sections in the urethra than in patients with negative frozen sections. The results were the same for the bladder neck. In multivariate analysis, PSA was the only independent predictor for positive frozen sections at the bladder neck, and the cutoff value was 8.71 ng/ml. CONCLUSIONS: Preoperative PSA may be a potent factor for predicting positive frozen sections during radical prostatectomy, especially in the bladder neck. Therefore, it may be beneficial to prepare frozen sections of the bladder neck during the operation to reduce the positive resection margin when PSA is higher than 8.7 ng/ml.
Biopsy ; Frozen Sections ; Humans ; Multivariate Analysis ; Neck ; Neoplasm Grading ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms ; Retrospective Studies ; Urethra ; Urinary Bladder

PURPOSE: The aim of this study is to develop an evaluation tool for operation of food safety and nutrition education projects for middle class elderly using the concept of the balanced score card. METHODS: After the draft of the evaluation tool for the elderly training projects was completed, it was revised into the questionnaire and the validity of the indicators was tested by the Delphi group. The validity of the indicators was rated using a 5-point scale. The Delphi group consisted of 26 experts in the education sector, 16 government officials, and 24 professionals of the related area in communities. The first round test was conducted from July 9 to July 17, 2012, and 45 persons responded. The second round test was conducted from July 18 to July 25 and 32 persons responded. RESULTS: The indicators, which were answered by more than 75 percent of the experts as 'agree' (4 points), 'strongly agree' (5 point) were included as the final indicators for the evaluation tool: 28 items out of 36 in outcome perspectives, 9 items out of 12 in process perspectives, and 17 out of 20 items in structure perspectives. The score was allocated as 50 points for outcome indicators, 20 points for process indicators, and 30 points for structure indicators. CONCLUSION: Completion of the evaluation tool is a prerequisite to determine whether the program is effectively implemented. The monitoring tool developed in the study could be applied for identification of the most optimal delivery path for the food safety and nutrition education program, for the spread of the food safety and nutrition education program for middle class elderly.
Aged* ; Education* ; Food Safety* ; Humans ; Occupational Groups

PURPOSE: To evaluate the clinical factors that impact ureteral stent-related lower urinary tract symptoms (LUTS) after ureteroscopic ureterolithotomy, including the stent position and medication. MATERIALS AND METHODS: Fifty-three patients who underwent ureteroscopic ureterolithotomy with indwelling a stent were distributed into three groups. On demand analgesics were given to the group 1 (n=18). Daily tamsulosin 0.2 mg was added for group 2 (n=15) and daily tamsulosin 0.2 mg and tolterodine 4 mg was added for group 3 (n=20). The patients were also subclassified into appropriate or inappropriate group according to stent position. All the patients completed a visual analogue scale (VAS) and International Prostate Symptom Score (IPSS) on the 1st and 7th postoperative days. The VAS and IPSS were analyzed according to the medication groups and the stent position. RESULTS: In the appropriate stent potion group, only the storage symptom scores of groups 2 and 3 on the 1st postoperative day were significantly lower than those of the group 1 (p=0.001). This medication effect on LUTS was not observed in the inappropriate stent position group. In this group, total IPSS (p=0.015) and storage symptom scores (p=0.002) were higher than in the appropriate stent position group on the 7th postoperative day. CONCLUSIONS: Correct placement of the stent was more important than medication for lessening stent-related storage symptoms.
Adrenergic alpha-Antagonists ; Analgesics ; Benzhydryl Compounds ; Cholinergic Antagonists ; Cresols ; Humans ; Lower Urinary Tract Symptoms ; Phenylpropanolamine ; Prospective Studies ; Prostate ; Stents ; Sulfonamides ; Ureter ; Ureteroscopy ; Urinary Catheterization ; Urological Manifestations ; Tolterodine Tartrate