PURPOSE: Intracavernosal injection subsequent vibrotactile or audiovisual sexual stimulation (AVSS) have frequently been utilized to produce al maximal erectile response during penile Doppler ultrasonography. However, several studies have shown that erectile quality often decreases following the placement of the sonographic probe. We examined whether real-time AVSS with an eyeglasses-type monitor enhances quality during penile duplex color Doppler ultrasonography. PATIENTS AND METHODS: A total of 32 impotent patients underwent penile duplex color Doppler ultrasonography of the cavernosal arteries after intracavernosal injection of 10 to 20 microgram of prostaglandin E1 and subsequent manual stimulation. Real-time AVSS sas used when the patient failed to achieve a rigid erection or showed abnomal arterial blood flow. The clinical erectile response was assessed by visual inspection and palpation and graded from I to V. Peak blood flow velocities and resistance index of the both cavernosal arteries were monitored continuously. After AVSS, the sexual drive was assessed as grade I (poor), II (moderate), or III (good). RESULTS: After intracavernosal injection and genital stimulation, 3 patients (9%) had a Grade II erection, 2 (6%) a Grade III, 16 (50%) a Grade IV, and 11 (34%) a Grade V. During duplex ultrasonography, 4 patients (13%) had a Grade II erection, 7 (22%) a Grade III, 16 (50%) a Grade IV, and 5 (16%) an arade V. During real-time AVSS, 22 patients (69%) showed better drectile quality. Initial Doppler ultrasonographic scanning showed arteriogenic impotence in 9 patients (28%), veno-occlusive disease in 5 (16%), and mixed arteriogenic and venogenic impotence in 18 (25%), veno-occlusive in 9 (28%), and mixed type in 2 (6%). Therefore, the initial diagnosis turned to be different after AVSS in 26 patients (81%). The sexual drive was rated grade I in 9 (28%), grade II in 11(34%), and grade III in 12 (38%). CONCLUSION: Real-time AVSS with an eyeglasses-type monitor remarkably enhances the quality of pharmacologically induced erections. Such stimulation may be useful during penile color Doppler ultrasonography to help in making the ccorrect diagnosis of the cause of erectile dysfunction.
Alprostadil ; Arteries ; Blood Flow Velocity ; Diagnosis ; Erectile Dysfunction ; Female ; Humans ; Impotence, Vasculogenic ; Male ; Palpation ; Ultrasonography ; Ultrasonography, Doppler ; Ultrasonography, Doppler, Color ; Ultrasonography, Doppler, Duplex*

PUROPOSE: To evaluate the effects of nocturia on health-related quality of life (HRQoL) and sleep. MATERIAL AND METHODS: From January 2007 to December 2007, 180 patients with lower urinary tract symptoms were prospectively selected for this study. Study was conducted among respondents with nocturia (void/night> or =1) (n=119) and age matched controls (no nocturia) (n=61), with participants completing a series of questionnaires on HRQoL (OAB-q short form) and Medical Outcomes Study (MOS) sleep scale and frequency voiding chart. RESULTS: The patients population had a mean age of 57.2 years. In the patients, the mean number of void per night was measured, 58 patients reported 2>void/night> or =1, 32 patients reported 3> voids/night> or =2 and 29 patients reported void/night> or =3. The number of nocturia episodes/night was significantly associated with the overactive bladder (OAB) symptom score (p=0.001), symptom bother (p=0.001) and the MOS sleep index (p=0.016). CONCLUSIONS: Increases in the number of voids/night have further negative effects on sleep, symptom bother and HRQoL.
Surveys and Questionnaires ; Female ; Humans ; Lower Urinary Tract Symptoms ; Nocturia* ; Prospective Studies ; Quality of Life* ; Surveys and Questionnaires ; Urinary Bladder, Overactive

No abstract available.
Adosterol/diagnostic use ; Adrenal Cortex/radiography/*radionuclide imaging ; Adrenal Cortex Neoplasms/pathology/radiography/*radionuclide imaging/surgery ; Adrenalectomy/methods ; Adrenocortical Adenoma/pathology/radiography/*radionuclide imaging/surgery ; Aged ; Aldosterone/blood ; Blood Specimen Collection/methods ; Humans ; Hyperaldosteronism/radiography/*radionuclide imaging ; Male ; Radiopharmaceuticals/diagnostic use ; Tomography, X-Ray Computed

PURPOSE: This study was designed to investigate the effect of detrusor overactivity induced by partial bladder outlet obstruction (BOO) on the expression of aquaporin 1 (AQP1) and caveolin 1 (CAV1) in the rat urinary bladder, and to determine the role of these molecules in detrusor overactivity. METHODS: Female Sprague-Dawley rats were divided into control (n=30) and experimental (n=30) groups. The BOO group underwent partial BOO, and the control group underwent a sham operation. After 4 weeks, an urodynamic study was performed to measure the contraction interval and contraction pressure. The expression and cellular localization of AQP1 and CAV1 were determined by western blot and immunofluorescence experiments in the rat urinary bladder. RESULTS: In cystometrograms, the contraction interval was significantly lower in the BOO group (2.9+/-1.5 minutes) than in the control group (6.7+/-1.0 minutes) (P<0.05). Conversely, the average contraction pressure was significantly higher in the BOO group (21.2+/-3.3 mmHg) than in the control group (13.0+/-2.5 mmHg) (P<0.05). AQP1 and CAV1 were coexpressed in the capillaries, arterioles, and venules of the suburothelial layer. AQP1 and CAV1 protein expression was significantly increased in the BOO rats compared to the control rats (P<0.05). CONCLUSIONS: Detrusor overactivity induced by BOO causes a significant increase in the expression of AQP1 and CAV1, which were coexpressed in the suburothelial microvasculature. This finding suggests that AQP1 and CAV1 might be closely related to bladder signal activity and may have a functional role in BOO-associated detrusor overactivity.
Animals ; Aquaporin 1 ; Arterioles ; Blotting, Western ; Capillaries ; Caveolin 1* ; Female ; Fluorescent Antibody Technique ; Humans ; Microvessels ; Rats* ; Rats, Sprague-Dawley ; Urinary Bladder Neck Obstruction* ; Urinary Bladder* ; Urodynamics ; Urothelium* ; Venules

The inflammatory myofibroblastic tumor (IMT), also knowns as inflammatory pseuduotumor, is a soft tissue lesion of unknown etiology. In the urogenital tract, IMT mainly affects the urinary bladder or prostate, but rarely the kidney. It has been considered as a nonneoplastic reactive inflammatory lesion, but nowadays, it is regarded as a neoplasm due to its high recurrence rate and metastasis. We describe a case of a 61-yr-old woman that had originally been misdiagnosed as renal cell carcinoma, which was pathologically revealed to be an IMT.
Actins/metabolism ; Carcinoma, Renal Cell/diagnosis/pathology ; Diagnosis, Differential ; *Diagnostic Errors ; Female ; Granuloma, Plasma Cell/*diagnosis/pathology/surgery ; Humans ; Kidney Neoplasms/*diagnosis/pathology ; Magnetic Resonance Imaging ; Middle Aged ; Tomography, X-Ray Computed ; Vimentin/metabolism

We report a case of primary fibroepithelial polyps (FEPs) in the middle of both ureters in a patient with advanced gastric cancer and acute renal failure. Ureteral FEPs are rare benign lesions, and multiple, bilateral lesions are extremely rare. To our knowledge, this report is the seventh case of bilateral FEPs in the literature. Our case has clinical implications because FEPs should be considered as a cause of ureteral obstruction inducing acute renal failure in advanced gastric cancer.
Acute Kidney Injury/*etiology ; Aged ; Humans ; Male ; Neoplasms, Fibroepithelial/*pathology ; *Polyps/complications/pathology ; Stomach Neoplasms/*pathology ; Ureteral Neoplasms/*pathology ; Ureteral Obstruction/*pathology

PURPOSE: We tried to discover the voiding patterns, which was diurnal & nocturnal urinary volume and voiding frequencies in women with overactive bladder (OAB). MATERIALS AND METHODS: All voided volumes, times and frequencies were recorded in 249 women with overactive bladder. The subjects age related changes in bladder capacity, urinary volume and frequency were evaluated. The causes of nocturnal urinary frequency and its increase with age in older women with OAB were evaluated using 3 days of voiding diaries. Nocturia was devided into three types: nocturnal polyuria, decreased nocturnal bladder capacity and mixed type. RESULTS: Total voided volume, daytime urine volume, functional bladder capacity were decreased with the age. Nocturnal urine volume and nocturnal urinary frequency were increased with age. Nocturnal polyuria was the major cause for nocturia, and mixed type was increased with age. CONCLUSIONS: Voiding symptoms as well as storage symptoms were increased with age in OAB female. In most cases, nocturia was caused by nocturnal polyuria.
Aging ; Female ; Humans ; Nocturia ; Polyuria ; Urinary Bladder ; Urinary Bladder, Overactive*

PURPOSE: The precise etiology and classification of nocturia in women is not enough. We evaluated age related changes and classified the type of nocturia by age in women. METHODS: We included 118 women 20 years or older with nocturia at least one time during night time. Subjects were divided into three groups by the age: group 1, under 40 years; group 2, 40 through 59 years; group 3, 60 years and above. The causes of nocturia and its pattern changed by age in women were evaluated using 3 days frequency volume chart. Nocturia was devided into three types: nocturnal polyuria, decreased nocturnal bladder capacity and mixed type. RESULTS: The mean age was 57.2+/-11.8 and the mean nocturnal frequency was 2.7+/-1.8. In all age group, noctural polyuria was the major cause for noturia (40.8%), followed by low nocturnal bladder capacity (23.7%). As a major cause of nocturia, there was a significant increase of the incidence of nocturnal polyuria in aged people: group 1, 32.4%; group 2, 41.0%; group 3: 47.6% (P<0.04). CONCLUSIONS: Nocturnal polyuria and decreased nocturnal bladder capacity are the major causes of nocturia in women. Nocturnal polyuria was the major cause of nocturia with age over 60 years old. In aged women, nocturnal polyuria should be considered as a main cuase of nocturia and treated based on these result.
Aged ; Female ; Humans ; Incidence ; Nocturia ; Polyuria ; Urinary Bladder

We present the case of an 81-year-old patient with testicular metastasis from prostate carcinoma. After the initial diagnosis of prostate cancer, he had an 8-year course of hormonal therapy and showed no clinical evidence of metastasis to other organs. Asymptomatic metastasis of prostate carcinoma to the testis is a rare clinical condition. We diagnosed his condition, based on histopathology following a subcapsular orchiectomy and transurethral resection of the prostate.
Adenocarcinoma/*pathology/surgery ; Aged, 80 and over ; Humans ; Male ; Neoplasm Metastasis ; Orchiectomy ; Prostatic Neoplasms/*pathology/surgery ; Testicular Neoplasms/*secondary/surgery ; Transurethral Resection of Prostate

PURPOSE: The purpose of this study is to determine the predictive factors that are associated with stress urinary incontinence (SUI) due to intrinsic sphincter deficiency (ISD) in women. METHODS: Between January 2008 and December 2009, 185 women with urodynamically proven SUI were included in this study and retrospectively reviewed the medical record. Preoperative SUI symptoms were classified by Stamey grade. Valsalva leak point pressure (VLPP) determination series was repeated two times in each subject after finishing one series of VLPP measurement. The patients were classified into three groups according to VLPP; 1) ISD: VLPP< or =60 cm H2O, 2) equivocal: 6090 cm H2O. Chi-square test and multivariate (logistic regression test) analyses were performed to determine the factors associated with ISD. RESULTS: The mean patient age was 54.2 years (range, 44.5 to 68.4 years). Seventy-one women (38.3%) were in the ISD group and 70 (37.8%) in the AI group. The results of univariate and multivariate analyses found that women with ISD had a higher symptom grade than women with AI (P=0.001 and 0.0001, respectively). The number of patients in the ISD and AI group in accordance with the symptom grade were 7 (10%) and 44 (62%) in grade I, 50 (54%) and 23 (25%) in grade II, and 14 (63%) and 3 (14%) in grade III respectively. There was no correlation between VLPP and other clinical factors. CONCLUSIONS: High symptom grade was the only independent clinical factor that predicted the presence of ISD. This should be considered when counseling the patients with SUI.
Counseling ; Female ; Humans ; Medical Records ; Multivariate Analysis ; Retrospective Studies ; Urinary Incontinence