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*

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

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

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

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

PURPOSE: It is suggested that caveolin and aquaporin might be closely associated with bladder signal activity. We investigated the effect of the deletion of caveolin 1, using caveolin 1 knockout mice, on the expression of aquaporin 1 in order to identify their relation in the urothelium of the urinary bladder. METHODS: The cellular localization and expressions of aquaporin 1 and caveolin 1, in the wild type and caveolin 1 knockout mice urinary bladder, were examined by Western blot and immunofluorescence techniques. RESULTS: Aquaporin 1 and caveolin 1 were coexpressed in the arterioles, venules, and capillaries of the suburothelial layer in the wild type controls. Aquaporin 1 protein expression was significantly higher in the caveolin 1 knockout mice than in the wild type controls (P <0.05). CONCLUSIONS: The results imply that aquaporin 1 and caveolin 1 may share a distinct relation with the bladder signal activity. This might play a specific role in bladder dysfunction.
Animals ; Aquaporin 1* ; Arterioles ; Blotting, Western ; Capillaries ; Caveolin 1* ; Fluorescent Antibody Technique ; Mice* ; Mice, Knockout ; Urinary Bladder* ; Urothelium ; Venules

PURPOSE: Aquaporins (AQPs) are membrane proteins that facilitate water movement across biological membranes. AQPs are also called water channels, and they have recently been reported to be expressed in rat and human urothelium. The purposes of this study were to investigate the effect of bladder outlet obstruction (BOO) on the rat urothelium and AQP1 expression in rat urothelium. MATERIALS AND METHODS: Female Sprague-Dawley rats (230-240 g each, n=20) were divided into 2 groups: the sham group (the Con group, n=10) and the partial BOO group (the BOO group, n=10). The BOO group underwent a partial BOO. The expression and cellular localization of AQP1 were determined by performing Western blotting and immunohistochemistry on the rat urinary bladder. RESULTS: AQP1 immunoreactivity in both the control and the BOO groups was localized in the capillaries, arterioles, and venules of the lamina propria of the urinary bladder. The protein expression of AQP1 was significantly increased in the BOO group. CONCLUSIONS: This study showed that BOO causes a significant increase in the expression of AQP1. This may imply that AQP1 has a functional role in the detrusor instability that occurs in association with BOO.
Animals ; Aquaporin 1 ; Aquaporins ; Arterioles ; Blotting, Western ; Capillaries ; Female ; Humans ; Immunohistochemistry ; Membrane Proteins ; Membranes ; Mucous Membrane ; Rats ; Rats, Sprague-Dawley ; Salicylamides ; Urethral Obstruction ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urothelium ; Venules ; Water Movements

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: We investigated whether the Valsalva leak point pressure (VLPP) is valuable for predicting postoperative outcome measurement after transobturator suburethral tape (TVT-O) implantation for treating stress urinary incontinence (SUI) in women. MATERIALS AND METHODS: A total of 204 female patients who underwent TVT-O placement for treatment of SUI from March 2008 to February 2012 were enrolled in this retrospective study. All patients completed the incontinence quality of Life questionnaire (I-QoL), a self-reported quality of life measure specific to urinary incontinence, and the cure rate of incontinence was measured before and 6 months after surgery. Cure was defined as no leakage of urine postoperatively both subjectively and objectively. We compared pre- and postoperative I-QoL scores according to preoperative VLPP and Stamey grade. RESULTS: The numbers of patients with Stamey grades I, II, and III were 99 (48.5%), 84 (41.2%), and 21 (10.3%), respectively. A total of 30 (14.7%), 87 (42.6%), and 87 patients (42.6%) showed VLPP< or =60, 6090 cm H2O, respectively. Preoperative VLPP was not significantly different according to preoperative I-QoL or change in I-QoL after surgery. However, I-QoL after surgery improved in patients with a high preoperative Stamey grade (p=0.001). CONCLUSIONS: VLPP was not a factor related to surgical outcome from the midurethral sling procedure. Stamey grade rather than VLPP was important for predicting subjective quality of life and improved incontinence-related quality of life after surgery.
Female* ; Humans ; Quality of Life* ; Questionnaires ; Retrospective Studies ; Suburethral Slings* ; Treatment Outcome ; Urinary Incontinence* ; Urodynamics