PURPOSE: The penile augmentation operation is getting popular in Korea, but we don`t have enough data about normal penile length distribution of Korean male and their self-esteem about their penile size. So I investigated the flaccid and erect penile sizes of young Korean males and their penile size complex or pride if any. This study data could be a step stone to establish better operation indication and patient consultation. MATERIALS AND METHODS: After explanation and agreement to the purpose and methods of this study, 171 Korean male in early 20`s who visit our institution were take part in. I measured their pre-pubic bone fat pad depth, flaccid penile length, flaccid mid-shaft circumferences and stretched length under warm and comfortable private environment. Then erect penile lengths and mid-shaft circumferences were measured after self-stimulation which was tried two times if needed. I used rigid ruler except the measuring of penile circumference to avoid measurement bias originated from penile skin curvature. Then they were asked to answer several questions including, `How do you think about your penile size?`, `Why do you think so?'. I used the correlation analysis and the student t-test to analyze our data statistically. RESULTS: Total number of study subject who can get sufficient erection is 156 among 171 subjects. In 156 subjects, mean flaccid length, flaccid circumference, erect length and erect circumference were 6.1+/-1.3cm, 8.9+/-0.8cm, 10.8+/-1.3cm and 11.3+/-1.2cm(Table 1). Mean stretched length was 9.6+/-1.2cm and the stretched length most closely correlated with the erect length(r=0.81)(Table 2). Mean fat pad depth was 1.1+/-0.4cm and mean functional penile length, the sum of erect length and fat pad depth, was 11.9+/-1.3cm. In 156 subjects, the answer about penile size were 7(4.5%) `very small`, 32(20.5%) `small`, 110(70.5%) `normal`, 7(4.5%) `large`, and no `very large`(Table 3). And most of them compared their penile size with others at rest room or rocker room. CONCLUSIONS: This study demonstrated that more Korean young males think their penile size is small rather than large. And their penile self-esteem is based on their flaccid length mostly. To define the length guideline of penile augmentation, I used flaccid length 3.5cm and erect length 8.2cm as reference values which are 2 standard deviation below from the average among normal distribution. In consultation of the patient who want penile augmentation, urologist should consider the tendency of low self-esteem about penile size and the distribution of flaccid and erect penile size of young Korean male.
Adipose Tissue ; Bias (Epidemiology) ; Humans ; Korea* ; Male ; Reference Values ; Self Concept* ; Skin

Percutaneous nephrostomy (PCN) is an established technique in urology but there have been few reports in pediatric urology. We reviewed retrospectively 48 cases for evaluation of the indication, results, complications, and the methods of follow-up after PCN. From October '85 to December '95, on 50 kidneys of 48 patients, 64 PCN were performed. Male patients were predominant (39:9). The indication of PCN were the functional evaluation of huge hydronephrotic kidneys (23 PCN), the relieve of urinary obstruction (10), the urinary diversion (9), the urinary tract infection (11), the differential diagnosis of hydronephrosis (1) and re-PCN after catheter displacement or obstruction (10). 23 patients for the functional evaluation of huge hydronephrotic kidneys that had poor function in the intravenous pyelography or the radioisotope renal scan, and/or the thin parenchyme in ultrasound, had got the regular follow-up with check of the daily urine output, the creatinine clearance after 2-14 days. 19 who showed good urine output (200-1000ml/day) and good creatinine clearance (average 22.4% of total creatinine clearance) after 2-14 days, were managed by reconstructive surgery and nephrectomy was performed in 4 patients who showed poor urine output (less than 10 ml/ day) or poor creatinine clearance( 1.1 and 3.5 % of total creatinine clearance). After PCN, there were mild infection in 3 cases and no serious complication. But there were catheter displacement in 13 cases and catheter obstruction in 3 cases, and in 13 cases of catheter displacement, 8 (53.3%, 8/15) were under 1 year-old, 4 (25%, 4/16) were between 1 and 5 year-old, and 1 (5.9%, 1/17) was over 6 year-old. In 2 cases of UPJ obstruction, the thickening of renal pelvis had made pyeloplasty difficult. Our data shows that a brief period (within 2 weeks) of nephrostomy drainage allows the kidney to display its potential for recovery of function, as measured by differential creatinine clearance and daily urine output. In pediatrics, PCN should be performed carefully in the selected cases and the duration of nephrostomy should be shortened as possible.
Catheter Obstruction ; Catheters ; Child* ; Child, Preschool ; Creatinine ; Diagnosis, Differential ; Drainage ; Follow-Up Studies ; Humans ; Hydronephrosis ; Infant* ; Kidney ; Kidney Pelvis ; Male ; Nephrectomy ; Nephrostomy, Percutaneous* ; Pediatrics ; Pregnenolone Carbonitrile ; Recovery of Function ; Retrospective Studies ; Ultrasonography ; Urinary Diversion ; Urinary Tract Infections ; Urography ; Urology

A few previous reports have described cases wherein electrical wire cables were inserted into the male urethra and bladder. Electrical wire cables are available at home and are easy to insert. However, after they coil in the patient's bladder, they are difficult to remove. In February 2013, a 30-year-old man presented to the emergency room of SMG-SNU Boramae Medical Center with a urethral foreign body. He had inserted an electrical wire cable into his urethra for the purpose of masturbation, despite having a regular sex partner and no underlying disease. A kidney-ureter-bladder radiography showed a tangled wire in his bladder and urethra. On the next day, we tried to remove the wire cystoscopically, but this proved to be impossible because of complex coiling and the slippery surface of the wire. A Pfannenstiel incision was made to remove the foreign body. No postoperative complications were noted.
Adult ; Emergency Service, Hospital ; Foreign Bodies ; Humans ; Male ; Masturbation ; Postoperative Complications ; Radiography ; Urethra ; Urinary Bladder

A few previous reports have described cases wherein electrical wire cables were inserted into the male urethra and bladder. Electrical wire cables are available at home and are easy to insert. However, after they coil in the patient's bladder, they are difficult to remove. In February 2013, a 30-year-old man presented to the emergency room of SMG-SNU Boramae Medical Center with a urethral foreign body. He had inserted an electrical wire cable into his urethra for the purpose of masturbation, despite having a regular sex partner and no underlying disease. A kidney-ureter-bladder radiography showed a tangled wire in his bladder and urethra. On the next day, we tried to remove the wire cystoscopically, but this proved to be impossible because of complex coiling and the slippery surface of the wire. A Pfannenstiel incision was made to remove the foreign body. No postoperative complications were noted.
Adult ; Emergency Service, Hospital ; Foreign Bodies ; Humans ; Male ; Masturbation ; Postoperative Complications ; Radiography ; Urethra ; Urinary Bladder

The prevalence of benign prostatic hyperplasia (BPH) is rising with Korea becoming an aging society. As patients age, their comorbidities and the risks associated with anesthesia increase. Recently, there has been an increasing concern regarding sexual function after surgery. As a result, interest in minimally invasive surgery for BPH that does not require anesthesia or affect sexual function has grown. This review article introduces newly developed minimally invasive surgeries for BPH divided into four categories based on the strategy—mechanical, anatomical, atrophic, and laparoscopic. Here, the mechanisms for each surgical method have been introduced. Furthermore, recent representative studies of these procedures with a focus on randomized controlled trials and meta-analyses have also been reviewed. Side effects related to sexual function have also been mentioned briefly along with the efficacy and indication for robotic BPH surgery, which has recently been attracting attention. However, these newer, minimally invasive procedures require additional comparative randomized controlled trials and long-term results to produce more robust evidence for their use.

The prevalence of benign prostatic hyperplasia (BPH) is rising with Korea becoming an aging society. As patients age, their comorbidities and the risks associated with anesthesia increase. Recently, there has been an increasing concern regarding sexual function after surgery. As a result, interest in minimally invasive surgery for BPH that does not require anesthesia or affect sexual function has grown. This review article introduces newly developed minimally invasive surgeries for BPH divided into four categories based on the strategy—mechanical, anatomical, atrophic, and laparoscopic. Here, the mechanisms for each surgical method have been introduced. Furthermore, recent representative studies of these procedures with a focus on randomized controlled trials and meta-analyses have also been reviewed. Side effects related to sexual function have also been mentioned briefly along with the efficacy and indication for robotic BPH surgery, which has recently been attracting attention. However, these newer, minimally invasive procedures require additional comparative randomized controlled trials and long-term results to produce more robust evidence for their use.
Aging ; Anesthesia ; Comorbidity ; Humans ; Korea ; Lower Urinary Tract Symptoms ; Methods ; Minimally Invasive Surgical Procedures ; Prevalence ; Prostatic Hyperplasia ; Sexual Dysfunction, Physiological ; Transurethral Resection of Prostate

The prevalence of benign prostatic hyperplasia (BPH) is rising with Korea becoming an aging society. As patients age, their comorbidities and the risks associated with anesthesia increase. Recently, there has been an increasing concern regarding sexual function after surgery. As a result, interest in minimally invasive surgery for BPH that does not require anesthesia or affect sexual function has grown. This review article introduces newly developed minimally invasive surgeries for BPH divided into four categories based on the strategy—mechanical, anatomical, atrophic, and laparoscopic. Here, the mechanisms for each surgical method have been introduced. Furthermore, recent representative studies of these procedures with a focus on randomized controlled trials and meta-analyses have also been reviewed. Side effects related to sexual function have also been mentioned briefly along with the efficacy and indication for robotic BPH surgery, which has recently been attracting attention. However, these newer, minimally invasive procedures require additional comparative randomized controlled trials and long-term results to produce more robust evidence for their use.

PURPOSE: This study was conducted to perform a comparative analysis of the efficacy and safety of photoselective vaporization of the prostate (PVP) for treatment of benign prostatic hyperplasia (BPH) in men with a prostate volume greater than 60 cc. MATERIALS AND METHODS: The clinical data of 249 men with symptomatic BPH who underwent PVP between January 2006 and June 2008 were retrospectively analyzed. All patients were classified into two groups according to their prostate volume (group A, <60 cc; group B, > or =60 cc). The preoperative evaluation included a digital rectal exam, urinalysis, prostate-specific antigen levels, International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximal flow rate (Qmax), postvoid residual urine volume (PVR), and transrectal ultrasonography. The total operative time, used energy (kJ), urethral Foley catheter indwelling period, and the number of hospital days were recorded afterward. The IPSS, QoL score, Qmax, and PVR were evaluated at 1, 3, 6, and 12 months postoperatively. RESULTS: In both groups, significant improvements in the subjective and objective voiding parameters were achieved and these improvements were sustainable for at least 1 year with minimal complications. During the follow-up period, the PVR in group B significantly increased. Retrograde ejaculation and urethral stricture were the common complications in both groups. There was no significant difference in the incidence rate. CONCLUSIONS: PVP is safe and efficacious, with durable results for men with symptomatic BPH and large prostate volumes.
Catheters ; Ejaculation ; Follow-Up Studies ; Humans ; Incidence ; Laser Therapy ; Male ; Operative Time ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Quality of Life ; Retrospective Studies ; Urethral Stricture ; Urinalysis ; Volatilization

PURPOSE: The aim of this study was to evaluate the influence of 8 weeks of 0.2mg tamsulosin medication on the erectile and ejaculatory functions of patients with benign prostatic hyperplasia(BPH). MATERIALS AND METHODS: 108 patients with BPH and they were without prostate cancer and neurogenic bladder were included in this study. Initial evaluations included a thorough history, digital rectal exam, urinalysis, serum prostate-specific antigen, uroflowmetry(UFM), post void residual urine measurement, transrectal ultrasound, International Prostatic Symptom Score(IPSS) and an International Index of Erectile Function(IIEF) and ejaculatory function questionnaire. After 4 and 8 weeks of medication, we analyzed the differences of these parameters at each week. RESULTS: The mean age of the patients was 61.3+/-9.0 years old and their prostate volume was 35.7+/-21.3ml. The IIEF erectile function(EF) domain score showed no statistically significant difference after medication. However, the orgasmic function domain score showed a significant decrease from 16.3+/-9.3 to 15.7+/-9.6 at the 4th and 8th week. Regarding the ejaculatory function, when the patients were divided into two groups according to the EF domain score(<10, > or =11), the score of the ejaculatory volume showed a tendency to decrease from 2.5+/-1.0 to 2.2+/-1.2(p=0.07), and the score for satisfaction about ejaculation was decreased from 3.0+/-1.2 to 2.5+/-1.5(p=0.01) in the larger EF domain group after 8 weeks of treatment. The IPSS score and UFM parameters improved significantly after medication(p<0.05). CONCLUSIONS: For the patients with BPH, 8 weeks of 0.2mg tamsulosin medication caused significant improvement in their voiding function. In addition, our findings suggest that 0.2mg tamsulosin medication may the influence erectile and ejaculatory function.
Ejaculation ; Humans ; Male ; Orgasm ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia* ; Prostatic Neoplasms ; Questionnaires ; Ultrasonography ; Urinalysis ; Urinary Bladder, Neurogenic

PURPOSE: Previous infravesical outflow obstruction study of rat bladder has demonstrated the increased expression of collagen genes after partial obstruction. But there are few reports about the electromicroscopic findings of rat urinary bladder after partial outlet obstruction. This investigation was carried out to study the ultrastructural changes in smooth muscle cells and collagen fibers after partial obstruction of rat bladder. MATERIALS AND METHODS: Infravesical outflow obstruction was induced in Sprague-Dawley female rats. After 1, 2 and 4 weeks, the hypertrophied bladders were removed, fixated, embedded for electron microscopy and examined the ultrastructure of the bladder musculature. RESULTS: Clumping of nuclear chromatin, dilated sarcoplasmic reticulum and mitochondrias, depletion of ribosomes, disarrangement of the myofilaments and dense bodies, collagen deposition, and thickening and multiplying of basal lamina were observed. CONCLUSIONS: These results demonstrate that partial bladder outlet obstruction in the rat results in numerous changes of the organelles of smooth muscle cells and collagen deposition in the detrusor, which will be able to explain the resultant alteration in detrusor contractility and compliance.
Animals ; Basement Membrane ; Chromatin ; Collagen ; Compliance ; Female ; Humans ; Microscopy, Electron ; Mitochondria ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Myofibrils ; Organelles ; Rats* ; Rats, Sprague-Dawley ; Ribosomes ; Sarcoplasmic Reticulum ; Urinary Bladder Neck Obstruction ; Urinary Bladder*