PURPOSE: Chronic prostatitis is a common diagnosis, and the morbidity of this disease results from a constellation of genitourinary symptoms. We surveyed a population of 19 year old Korean men using National I nstitutes of Health Chronic Protatitis symptom Index, evaluated symptomatology associated with chronic prostatitis and gathered epidemiologic data about this disease. MATERIALS AND METHODS: During May 2000, a total of 4339 male residents in the area of Chung-nam including Taejeon city visited the Military Manpower Administered questionnaire. and the impact of symptoms on quality of life. the results were analyzed statistically by PC-SPSS version 7.5. RESULTS: There were statistically significant correlations among every item and domain, respectively by Pearson's correlation analysis (p=0.00). Pain domain significantly contributed to predicting quality of life domain and explained 42% of the variance on quality of life domain (r=0.65,p=0.00). The change in the amount of explained variance was significant when entering urinary symptoms domain (r(2)change=0.19,p=0.00). Overall pain and urinary symptoms domain predicted 61% of the variance in quality of life domain (r=0.78,p=0.00). If a score of 6 in quality of life domain was determined to the cut-off score of the chronic prostatitis, the prevalence of the chronic prostatitis was 3.8%. CONCLUSIONS: the National Institutes of Health chronic prostatitis and pain and urinary symptoms significantly contribute towards explaining variances in quality of life. although there data show much less common prevalence than most nonpopulation studies suggest, we suggest that chronic prostatitis is a common disease in Korean men if one consider that our data were surveyed in only 19 year old men.
Daejeon* ; Diagnosis ; Humans ; Male ; Military Personnel ; National Institutes of Health (U.S.) ; Prevalence ; Prostatitis* ; Quality of Life ; Surveys and Questionnaires ; Young Adult

Although radical cystectomy with pelvic lymph node dissection (PLND) is the standard treatment for muscle-invasive bladder cancer, the optimal extent of PLND and the minimum number of nodes that should be examined for pathology remain unclear. However, evidence is growing that extended PLND has additional diagnostic and therapeutic benefits relative to standard PLND. In particular, a more meticulous and extended PLND may improve the disease-free survival of node-negative patients because it removes undetected micrometastases. Indeed, some patients with positive nodes can be cured by surgery alone, even those with gross adenopathy. Increasing lines of evidence also suggest that the extent of the primary bladder tumor, the number of lymph nodes that are removed, and the lymph node tumor burden are important prognostic variables in patients undergoing cystectomy. Therefore, extended PLND may not only provide improved prognostic information, it may also have a clinically significant therapeutic benefit for both lymph node-positive and node-negative patients undergoing radical cystectomy. Although the absolute limits of PLND remain to be determined, evidence supports the notion that a more extended PLND should include the common iliac vessels and presacral lymph nodes at cystectomy. Such PLND should only be performed in patients who are appropriate surgical candidates. Prospective, randomized trials are needed to properly establish the extent of PLND that is required to generate these benefits.
Cystectomy ; Disease-Free Survival ; Humans ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Micrometastasis ; Tumor Burden ; Urinary Bladder ; Urinary Bladder Neoplasms

PURPOSE: To evaluate whether radial rigidity measured using RigiScan(R) represents the intracorporeal pressure effectively. MATERIALS AND METHODS: From January 1998 to May 1999, total of 23 patients with erectile dysfunction were evaluated by RigiScan(R) and duplex ultrasonography after the intracorporeal injection of prostaglandin E1. Peak systolic velocity and end diastolic velocity were measured by duplex ultrasonography and then the resistance index was calculated as (peak systolic velocity-end diastolic velocity)/(peak systolic velocity). Radial rigidity of penile tip and base was measured by RigiScanR . The results were analyzed statistically by PC-SPSS version 7.5. RESULTS: There were statistically significant correlations between radial rigidity of penile tip and base and the resistance index by Spearman's correlation analysis, respectively (r=0.680, p<0.001)(r=0.703, p<0.001). When radial rigidity of penile tip and base exceeded 60% of maximum, radial rigidity of penile tip and base again correlated well with the resistance index, respectively (r=0.659, p=0.020)(r=0.759, p=0.011). Based on clinically determined degree of erection, radial rigidity of penile tip and base represented the intracorporeal pressure effectively. CONCLUSIONS: Radial rigidity measured by RigiScan(R) represents the intracorporeal pressure effectively.
Alprostadil* ; Erectile Dysfunction ; Humans ; Male ; Ultrasonography

No abstract available.
Neuroendocrine Cells* ; Prostate* ; Prostatic Hyperplasia*

PURPOSE: The National Institutes of Health chronic prostatitis symptom index (NIH-CPSI) provides a valid outcome measure for men with chronic prostatitis. We surveyed a population of 20 year old Korean men using NIH-CPSI, and evaluated whether differences of dwelling regions and educational levels impacted on symptom index. MATERIALS AND METHODS: Between May and July 2000, a total of 12,659 male residents in the area of Chungnam including city of Taejoen visited the Military Manpower Administration. The 10,205 participants (response rate 80.6%) completed a self-administered questionnaire. The collected data were then used to estimate the impact of dwelling regions and educational levels on symptom index. RESULTS: Urinary symptoms and quality of life domain scores of participants dwelling in urban community regions were significantly higher than those in rural community (p<0.001, p=0.004, respectively). Pain and quality of life domain scores of participants with higher educational levels were significantly higher than those of lower educational levels (p<0.001, p<0.001, respectively). Pain domain was influenced by educational levels rather than dwelling regions and urinary symptom domain was influenced by dwelling regions rather than educational levels. CONCLUSIONS: Our findings show that the prevalence of chronic prostatitis may be influenced by dwelling regions and educational levels. We suggest that the differences of prevalence based on dwelling regions and educational levels should be considered as the characteristics of chronic prostatitis.
Chungcheongnam-do ; Humans ; Male ; Military Personnel ; National Institutes of Health (U.S.) ; Outcome Assessment (Health Care) ; Prevalence ; Prostatitis* ; Quality of Life ; Surveys and Questionnaires ; Rural Population ; Young Adult*

PURPOSE: To determine whether the preoperative residual urine fraction(RF) correlates with the change in the maximal flow rate(Qmax) in patients treated for benign prostatic hyperplasia(BPH). MATERIALS AND METHODS: From February 1995 to June 1999, 81 men aged 54 to 82 years (mean: 65.4 +/- 6.7 years) with BPH were examined with Qmax and residual volume using uroflometry and ultrasonography, respectively, before and after transurethral resection of the prostate. The RF was defined as the postvoiding residual/premicturition volume x100. Statistical analysis was performed by simple linear regression using SPSS. RESULTS: The magnitude of improvement in Qmax postoperatively was greatest in patients who had preoperative Qmax < 12mL/sec and RF > 25, followed by Qmax < 12mL/sec and RF < 25, Qmax > 12mL/sec and RF > 25, and Qmax > 12mL/sec and RF < 25. The extent of improvement in Qmax in patients had a value < 12mL/sec was significantly better than that in patients who had a value > 12mL/sec. Among patients who had a Qmax > 12mL/sec preoperatively, the improvement in those who had an RF > 25 was significant better than that in patients who had an RF < 25. CONCLUSION: We suggest that RF and Qmax may have the value as indicator for surgery of benign prostatic hyperplasia preoperatively. The higher RF and Qmax, the poorer postoperative Qmax are anticipates in the patients with benign prostatic hyperplasia.
Humans ; Linear Models ; Male ; Prostate ; Prostatic Hyperplasia* ; Residual Volume ; Transurethral Resection of Prostate* ; Ultrasonography

PURPOSE: We intended to compare with the effectiveness of conservative and immediate surgical management of iatrogenic ureteral injuries according to the types of injury. MATERIALS AND METHODS: We reviewed the medical records of 32 cases with iatrogenic ureteral injuries resulting from obstetric and gynecologic procedures from June 1986 to October 1997. The age of these patients ranged from 24 to 76 years(mean age 50.7). RESULTS: The types of procedure resulting in iatrogenic ureteral injuries were radical hysterectomy in 16 cases(50.0%), abdominal hysterectomy in 8 cases(25.0%), cesarean section in 5 cases(15.6%), salpingoophorectomy in 1 case(3.1%) and radiation therapy in 2 cases(6.3%). The types of urethral injury were urethral obstruction in 18 cases(56.3%), ureterovaginal fistula in 9 cases(28.1%) and ureterocutaneous fistula in 5 cases(15.6%). As the initial treatment, conservative treatments were in 17 cases(56.7%) and surgical treatments were in 13 cases(43.3%). The result of surgical treatment as the initial treatment was good in all cases, but the failure rate of conservative treatment was 35.2%. CONCLUSIONS: Generally conservative treatment is the first recommendable method in iatrogenic urethral injuries with delayed diagnosis, but early definitive operative repair may be more feasible and preferable method in selected cases regardless of types of urethral injury.
Cesarean Section ; Delayed Diagnosis* ; Female ; Fistula ; Humans ; Hysterectomy ; Medical Records ; Pregnancy ; Ureter* ; Urethral Obstruction

PURPOSE: We have evaluated the patterns of diagnostic and treatment practices for benign prostatic hyperplasia (BPH) in a country that does not have country-specific clinical practice guidelines. MATERIALS AND METHODS: Probability samples were taken from the Korean Urological Association Registry of Physicians, and randomly sampled Korean urologists were asked to complete a questionnaire. The survey explored practice characteristics and attitudes, as well as diagnostic and treatment strategies, for the management of BPH. RESULTS: Of the 850 questionnaires sent, 302 were returned, and 277 of those were included in the final analysis (response rate 32.6%). For the initial evaluation, most urologists routinely used digital rectal examinations (DRE) and urinalysis. Uroflowmetry was used 34.7% of the time. Pressure-flow studies were rarely done. Symptom assessment was used in only 46.9% of cases. In addition, a significant number (58.8%) reported that treatment decisions were not based on the symptom questionnaire. Before surgery, almost all urologists routinely used DRE, urinalysis, and prostate-specific antigen tests. Of the respondents, 55.6% and 41.9% had prescribed alpha- blockers and alpha-blockers with 5-alpha reductase inhibitors, respectively. 81.2% of urologists perceived that selective alpha-blockers are different in terms of efficacy, and 82.7% felt that they differed in safety. Most respondents prescribed 5-alpha reductase inhibitors based on the prostate size. CONCLUSION: These data provide a picture of current practices regarding the management of BPH in Korea. The diagnostic and treatment practices for BPH do not follow published guidelines. Our findings ask the question "How influential are international guidelines, and do they really affect patient management in countries that do not have country-specific guidelines?"
Urology/standards ; Societies, Medical ; Questionnaires ; Prostatic Hyperplasia/diagnosis/*therapy ; Practice Guidelines ; Middle Aged ; Male ; Korea ; Humans ; Diagnosis, Differential ; Developing Countries ; Aged ; Adult

PURPOSE: To investigate the influence of cryptorchidism on the testicular volume and gender identity of young men within a community. MATERIALS AND METHODS: Of 27,202 men, aged 20 years, within the community, a 10% sampling fraction was randomly selected, of which 2,080 (a response rate 77.0%) agreed to participate in the study. All volunteers underwent a standard evaluation, including a detailed medical history and physical examination. To evaluate the influence of cryptorchidism on gender identity, we used the Bem Sex Role Inventory (BSRI) in the men without testicular disease, but who were observed to have cryptorchidism on physical examination, or had a history of operation for cryptorchidism. RESULTS: Of the participants, 38 (1.8%) were observed to have cryptorchidism, or had a history of operation for cryptorchidism (right; 15, left; 21, bilateral; 2). Of these patients, 29 had a history of operation, with a mean age at the time of operation of 8.9+/-3.9 years, ranging from 2 to 19 years. Of the 36 patients with unilateral cryptorchidism, the contralateral testicular volume of the men that underwent an orchiopexy was no different to that of those that underwent an orchiectomy or that had no operation at all. Comparing the masculinity and femininity scores, using the BSRI between the orchiopexy and normal groups, the masculinity score of the orchiopexy group was lower than that of the normal group. CONCLUSIONS: Our results demonstrate that a delayed orchiopexy does not improve the growth of the testicular volume on the affected side, or the masculine identity, in men with unilateral cryptorchidism. In addition, these findings suggest that there is a need to increase the awareness related to cryptorchidism amongst all parties involved in the health care of children.
Adolescent* ; Child ; Cryptorchidism* ; Delivery of Health Care ; Femininity ; Gender Identity* ; Humans ; Male ; Masculinity ; Orchiectomy ; Orchiopexy ; Physical Examination ; Prevalence ; Testicular Diseases ; Testis ; Volunteers

PURPOSE: We determined the impact of prostate volume on the efficacy of the high-power (80 W) potassium-titanyl-phosphate (KTP) photoselective laser vaporization of the prostate in men with lower urinary tract symptoms (LUTS). MATERIALS AND METHODS: Patients were stratified into 3 groups according to prostate volume: '< 40 g' (n = 49) and '40-59 g' (n = 49) and '> or = 60 g' (n = 22). Median follow-up was 9 months (range 6 to 21). RESULTS: No differences in age and follow-up duration were observed in the three groups. At baseline, no significant differences were noted in the three groups in terms of the International Prostate Symptom Score (IPSS) (21.4, 19.4 and 19.1; p = 0.412) as well as the maximum flow rate (Qmax) (10.2, 9.2, and 8.6 mL/s; p = 0.291) and post-void residual (PVR) (66.2, 80.4, and 71.5 mL; p = 0.856). The mean operative times were 30.9, 46.9, and 58.6 minutes (p < 0.001) and total median energy deliveries for each group were 62.3, 97.6, and 135.9 kJ, respectively (p < 0.001). No severe intraoperative complication was observed. At the last follow-up, these parameters improved significantly regardless of prostate volume, and the IPSS (11.1, 9.4, and 12.3; p = 0.286) as well as Qmax (15.9, 15.9, and 14.2 mL/s; p = 0.690) and PVR (33.7, 28.4, and 14.2 mL; p = 0.395) were not significantly different among the groups. CONCLUSION: Although a larger prostate requires more time and energy delivery, photoselective laser vaporization of the prostate is safe and efficacious for patients with LUTS regardless of prostate volume.
Aged ; Aged, 80 and over ; Feasibility Studies ; Humans ; Laser Therapy ; Male ; Middle Aged ; Phosphates/*chemistry ; Prostate/*physiology/surgery ; Prostate-Specific Antigen/blood ; Prostatic Hyperplasia/complications/*surgery ; Retrospective Studies ; Titanium/*chemistry ; Treatment Outcome ; Urinary Tract/pathology ; Volatilization