No abstract available.
Prospective Studies* ; Prostate*

No abstract available.
Muscle, Smooth* ; Relaxation*

Androgen deficiency in aging male has become a topic of increasing interest and debate throughout the world. The past decade has brought evidence that androgen treatment of hypogonadal men has benefits for multiple target organs. It is recognized that significant alterations in many endocrine systems occur in association with aging, but the significance of these changes is not well understood. In addition to its role in specific organ systems, testosterone has been found to play a role in the pathogenesis of metabolic syndrome and endothelial dysfunction. Based on data from the last 20 years, the syndrome previously called PADAM(partial androgen deficiency in aging male) is now referred to as LOH(late-onset hypogonadism), as recommended by the ISA(International Society of Andrology) at the 4th ISSAM Congress in 2004. LOH is a clinical and biochemical syndrome associated with advancing age and characterized by a set of typical symptoms accompanied by a deficiency in serum testosterone. Diagnostic tools for LOH, long-term data on the effects of testosterone replacement in aging men, and specific risk data for the prostate and cardiovascular systems are still limited. However, we have seen the recent development of a more effective and safe formulation of testosterone, e.g., Testogel 1% and a long-acting testosterone undecanoate injectable. Until better methods for caring LOH are refined, the urologists should be alert and stay current with the updates from the academic societies.
Aging ; Cardiovascular System ; Endocrine System ; Hormone Replacement Therapy ; Humans ; Hypogonadism* ; Male* ; Prostate ; Testosterone

Erectile dysfunction (ED) can negatively impact the quality of life among men, and increasingly affects all age strata. This has led to an explosion of health information on ED both for patients and doctors, which may cause potentially harmful effects when misused or abused. Therefore, the necessity of developing a standardized, appropriate guideline for the diagnosis and management of ED is increasing. In this review, the author describes risk factors, diagnosis and treatment guidelines for ED, which can be usefully applied in clinical practice.
Diagnosis* ; Erectile Dysfunction* ; Explosions ; Humans ; Male ; Phosphodiesterase 5 Inhibitors ; Quality of Life ; Risk Factors*

Despite the low incidence of adrenal involvement from renal cell carcinoma, ipsilateral adrenalectomy continues to be a standard part of radical nephrectomy at most medical centers. We reviewed retrospectively 51 patients treated with standard radical nephrectomy and 36 patients treated with modified radical nephrectomy sparing the ipsilateral adrenal gland. Histopathology confirmed malignant involvement of the adrenal in one patient who had evidence of adrenal involvement on the preoperative CT scan, and 50 patients who were normal on the preoperative CT scan didn`t have malignancy on their adrenal specimens. There were no malignant involvement of the adrenal on follow-up CT scan in 36 patients treated with sparing their adrenal and didn`t affected their prognosis and survival. These findings suggest that the ipsilateral adrenal gland need not be removed routinely as part of perifascial nephrectomy for renal cell carcinoma. For patients with middle and lower pole localized renal cell carcinoma who have normal findings on preoperative CT scans, modified radical nephrectomy sparing the adrenal gland may be a surgical alternative to radical nephrectomy.
Adrenal Glands ; Adrenalectomy* ; Carcinoma, Renal Cell ; Follow-Up Studies ; Humans ; Incidence ; Nephrectomy* ; Prognosis ; Retrospective Studies ; Tomography, X-Ray Computed

The understanding of nocturia has been much changed in last decade. Recently, nocturia has been recognized as a separate clinical entity within the lower urinary tract symptom complex. The pathophysiology of nocturia is multifactorial and can be complex and its cause remains unclear in a significant number of patients. Although the successful introduction of DDAVP to decrease nocturnal urine output in severe nocturia resistant to conventional treatment demonstrated new perspectives in management of nocturia, the primary treatment modality must be based on the disease. We reviewed the definition and etiologies of nocturia, offering the current diagnostic procedures and standards of care and we suggest practical tip for the management of nocturia.
Deamino Arginine Vasopressin ; Humans ; Nocturia ; Standard of Care ; Urinary Tract ; Urology

No abstract available.
Testosterone*

PURPOSE: Although prostate specific antigen(PSA) is an excellent tumor marker, it is not prostate cancer-specific but organ-specific. The objectives of this study is to identify the correlation between the nonmalignant elevation of PSA and the characteristics of DRE, TRUS, and histologic features. MATERIALS AND METHOD: Ninety nine patients with elevated PSA were divided into 3 groups of prostatic cancer(46), benign prostatic hyperplasia(46), and infectious prostatic disease(10) according to their clinical history and histology of prostate. RESULTS: There was significant elevation of PSA in order of prostate cancer, infectious disease, prostatic intraepithelial neoplasia(PIN), and benign prostatic hyperplasia(p > 0.01). Episodes of acute urinary retention and pyuria more frequently induced nonmalignant elevation of PSA(p > 0.05). There was no specific correlation between the findings of TRUS and elevation of PSA except intraprostatic calculi and cyst. Irregularity of margin and seminal vesicle on TRUS highly suggested prostatic cancer. On microscopic examination, high grade PIN, enlarged nucleus, prominent nucleoli and perineural invasion were highly correlated with prostatic cancer. CONCLUSIONS: These results suggest that nonmalignant elevation of PSA has following clinical characteristics: episodes of urinary retention, bladder calculi, urinary tract infection, prostatic calculi or cyst, and histologically benign. And the values of PSA in nonmalignant condition is not so elevated as malignancy.
Calculi ; Communicable Diseases ; Humans ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Pyuria ; Seminal Vesicles ; Urinary Bladder Calculi ; Urinary Retention

PURPOSE: Intracavernous injection of prostaglandin (PG) E1 or papaverine (PA) is widely used in the diagnosis and treatment of erectile dysfunction. Because these drugs are sometimes associated with insufficient erection in and side effects such as priapism, corporal fibrosis, and pain, there has been increasing interest in finding effective and safe alternatives. Recent studies demonstrated that pinacidil (PI) relaxes the smooth muscle. This study was performed to examine the efficacy of PI as an alternative or supplement to drugs such as PG, PA, or phentolamine (PT). MATERIALS AND METHODS: In 28 adult male cats, the maximal intracavernous pressure (ICPmax), time to ICPmax (T1/2) and duration of increased ICP (time) in response to intracavernous injection of PG, PA, or mixture of vasoactive drugs (PA + PT, PA + PG + PT) were compared with the responses to mixtures containing PI (PI + PA, PI + PA + PT,
Adult ; Animals ; Cats ; Diagnosis ; Erectile Dysfunction ; Fibrosis ; Humans ; Male ; Muscle, Smooth ; Papaverine ; Penile Erection ; Penis ; Phentolamine ; Pinacidil* ; Potassium Channels ; Priapism

It is accepted by urologists that transurethral resection of the prostate(TURP) is a golden standard in the treatment of benign prostatic hyperplasia( BPH). TURP is a safe procedure with low mortality rate but the rare, severe morbidity made the need for nonoperative treatment for BPH. Recently, non-invasive transurethral microwave hyperthermia has been applied as an alternative treatment of TURP. As a part of ongoing effort to evaluate the effect of transurethral microwave hyperthermia for BPH, we compared the outcomes of TURP with transurethral thermal therapy(TUTT). In 34 patients treated with TURP, the preoperative peak urine flow rate was 6.61ml/sec, but has changed to 14.33 and 14.64ml/sec at postoperative 4weeks and 6months respectively. The Boyarsky symptom score was 13.7 preoperatively, but has changed to 4.43 and 4.66 at postoperative 4weeks and 6months respectively Amount of residual urine was 91.35cc preoperatively. but has decreased to 40.7 and 40.32cc at postoperative 4weeks and 6months respectively. In 35 patients treated with TUTT. the preoperative peak urine flow rate was 9.24ml/sec, but has increased to 11.83 and 12.39ml/sec at postoperative 4weeks and 6months respectively. The preoperative Boyarsky symptom score of 12.9 has decreased to 8.58 and 8.97 at postoperative 4weeks and 6months respectively. The preoperative amount of residual urine was 52.45cc, but has changed to 44.74 and 35.2cc at postoperative 4weeks and 6months respectively. When comparing the parameters between two groups, the improvement of peak urine flow rate was greater in TURP than in TUTT group at postoperative 6months(p<0.01). The decreases of symptom score and amount of residual urine also were greater in TURP than in TUTT group, but not significantly different. In both group, no noticeable complications were encountered. These findings suggest that TURP is more effective than TUTT in the treatment of symptomatic BPH. But our data also raise the possibility that TUTT represents a safe outpatient approach to treatment of BPH, particularly for patients not considered to be candidates for conventional surgical treatments of BPH.
Fever ; Humans ; Microwaves ; Mortality ; Outpatients ; Prostate* ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate