AIMTo evaluate the effects of metabolic profiles on lower urinary tract symptoms (LUTS) in men with erectile dysfunction (ED).

METHODSA total of 75 impotent men aged 25-75 years old (mean 58.1 years) were included in the study on a prospective basis. Patients were evaluated with a complete history, physical examination, anthropometry and metabolic profiles. LUTS were assessed using the International Prostate Symptom Score (IPSS).

RESULTSOverall, there was no correlation between the IPSS and continuous parameters. However, when continuous variables were categorized, some parameters were significantly associated with LUTS. Patients with triglyceride level of 150 mg/dL or higher had more severe symptoms than those with triglyceride levels less than 150 mg/dL (19.4 +/- 2.4 vs. 14.3 +/- 1.1, P = 0.033). When 40 mg/dL was chosen as the high-density lipoprotein (HDL)-cholesterol cut-off level, the IPSS was significantly different between the two groups divided by 40 mg/dL (19.4 +/- 2.6 for HDL-cholesterol < 40 mg/dL vs. 14.4 +/- 1.0 for HDL-cholesterol = or > 40 mg/dL, P = 0.042). The area under the receiver operating characteristic curve (AUROCC) of triglyceride was 65.7% (95% confidence interval [CI], 52.6%-82.3%; P = 0.034) for severe LUTS. However, the AUROCC for 'HDL-cholesterol' was not significant (area, 65.4%; 95% CI, 48.2%-82.7%; P = 0.062). No other factors were determined to be significant in this regard.

CONCLUSIONThe results of the present study indicate that some metabolic profiles might influence LUTS in men with ED.

Adult ; Aged ; Aging ; Body Mass Index ; Erectile Dysfunction ; etiology ; pathology ; physiopathology ; Humans ; Male ; Metabolic Syndrome ; etiology ; Middle Aged ; Prostate ; pathology ; Risk Factors ; Triglycerides ; blood ; Urologic Diseases ; etiology ; pathology ; physiopathology

Recurrent disc herniation and postoperative fibrosis are the main disease entities causing failed back surgery syndrome (FBSS) and magnetic resonance (MR) imaging has become a major diagnostic modality in differentiating the two. To observe the variable entities of FBSS and their MR findings, we retrospectively analyzed 15 MR images in 12 patients. The causes of FBSS were as follows; normal (no organic cause), fibrosis, new or recurrent disc herniation, discitis, osteomyelitis, inflammation at operation site, epidural abscess, arachnoiditis, and hematoma. Except a case of hematoma, gadolinium enhancement scan was necessary and informative in the diagnosis of FBSS and MR imaging only was not enough in the diagnosis of arachnoiditis.
Arachnoid ; Arachnoiditis ; Diagnosis ; Discitis ; Epidural Abscess ; Failed Back Surgery Syndrome* ; Fibrosis ; Gadolinium ; Hematoma ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Osteomyelitis ; Retrospective Studies

PURPOSE: This study was initiated to establish the hazard ratios for risk of urinary stone formation in chronic spinal cord injury (SCI) patients. MATERIALS AND METHODS: A total of 140 male patients who were injured before 1987 were eligible for this investigation and they were followed up on a yearly basis from January 1987 and December 2003. RESULTS: Over the 17 years, 39 patients (27.9%) and 21 patients (15.0%) were diagnosed with bladder and renal stones for a total of 59 and 25 episodes, respectively. On multivariate analysis, bladder stone was more common for the patients who were injured at 24 years old or older than is was for those patients who were injured at less than 24 years old (odds ratio [OR]: 2.490; 95% confidence interval [CI]: 1.092-5.677; p=0.030). In another model, the patients with complete injury had a greater risk of renal stone formation than those with incomplete injury (OR: 4.095; 95% CI: 1.295-12.944; p=0.016). We also found that renal stone was more common for the patients with urethral catheterization (UC) than for the patients who could spontaneous void (OR: 5.668; 95% CI: 1.306-24.604; p=0.021), and for patients with bladder stone than for those without bladder stone (OR: 4.678; 95% CI: 1.447-15.126; p=0.010). CONCLUSIONS: Injury characteristics are important for the development of urinary stone in chronic traumatic SCI patients. In addition, our findings suggest that for the cases who cannot undergo intermittent catheterization or when the bladder cannot empty spontaneously, suprapubic cystostomy is better than UC is regards to renal stone formation in this population.
Catheterization ; Catheters ; Cystostomy ; Follow-Up Studies* ; Humans ; Male* ; Multivariate Analysis ; Risk Factors* ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder ; Urinary Bladder Calculi ; Urinary Calculi* ; Urinary Catheterization ; Urinary Catheters ; Young Adult

Various laparoscopic nephroureterectomy techniques for urothelial carcinoma of the upper urinary tract have been developed to minimize postoperative discomfort and the necessity for a lengthy convalescence. We performed hand-assisted retroperitoneoscopic nephroureterectomy without hand-assisted device in 3 male patients with urothelial carcinoma of the distal ureter. Average operative time and estimated blood loss were 251 min (range 235 to 280) and 250 mL (range 200 to 300), respectively. Complication did not occur and conversion to open surgery was not necessary in all cases. Postoperative analgesic requirements were moderate and the time to regular diet intake averaged 3 days (range 2 to 4). None of the patients had a positive margin on the final pathologic specimen. At the average follow-up of 8.1 months, no regional recurrence, port-site metastasis, bladder recurrence, or distant metastasis were noted in any patient. We described our initial experience with the described technique, which obviates the need for midprocedural patient repositioning.
Aged ; Humans ; Laparoscopes ; Laparoscopy/*methods ; Male ; Middle Aged ; Nephrectomy/instrumentation/*methods ; Retroperitoneal Space/pathology/*surgery ; Treatment Outcome ; Ureter/pathology/*surgery ; Ureteral Neoplasms/pathology/*surgery

Acute airway obstruction after anterior cervical surgery is rare, but does occur. Airway obstruction due to prevertebral soft tissue swelling is unpredictable, but potentially lethal. We managed a 67-year-old male who developed acute airway obstruction caused by marked prevertebral soft tissue swelling on the first day after anterior cervical discectomy and fusion at the C4-C5 level.
Aged ; Airway Obstruction ; Diskectomy ; Humans ; Male

PURPOSE: To identify the predictors of death from other causes in patients with localized renal cell carcinoma (RCC). MATERIALS AND METHODS: We identified 1,101 patients with pathologically confirmed T1 or T2 RCC with a follow-up duration of over 6 months. Survival according to the cause of death was evaluated by using the Kaplan-Meier analysis with log-rank test. Prognostic factors for death from other causes were assessed by multivariate analysis using the Cox proportional hazard regression model. Once the prognostic factors were identified, a risk-group variable was created by counting the number of unfavorable features present for each patient. RESULTS: The median follow-up was 62 months, and RCC-related death occurred in 50 patients (4.5%), whereas death from other causes occurred in 47 (4.3%). Patients who died from other causes had a higher American Society of Anesthesiologist (ASA) score (26.1% vs. 10.2%; p=0.044), older age (63.4 years vs. 55.0 years; p<0.001), smaller mass size (5.1 cm vs. 7.9 cm; p<0.001), and lower nuclear grade (p=0.003). In the multivariate Cox regression analysis, older age, higher ASA score, and lower body mass index were independent factors predicting death from other causes in patients with localized RCC. On the basis of the number of risk factors for death from other causes, the 5-year other-cause-specific survival was 98.3% (0 risk factors), 84.7% (1 risk factor), and 67.6% (2 or 3 risk factors), respectively (p<0.001). CONCLUSIONS: Older age, higher ASA score, and lower body mass index were independent predictors of death from other causes in patients with localized RCC.
Body Mass Index ; Carcinoma, Renal Cell ; Cause of Death ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Multivariate Analysis ; Risk Factors ; Watchful Waiting

For the patients suffering from extensive deep vein thrombosis (DVT), the placement of an inferior vena cava (IVC) filter in conjunction with anticoagulant therapy has been used to prevent pulmonary embolisms. However, for the patients who anticoagulant is contraindicated or if this is complicated, the use of an IVC filter without concurrent anticoagulation may become the sole treatment for pulmonary embolisms. In this situation, the thrombi trapped in the IVC filter may cause significant clinical problems. We report here on a case of IVC filter thrombosis that was successfully treated by aspiration thrombectomy after placing another filter proximal to the previous filter.
Humans ; Pulmonary Embolism ; Thrombectomy* ; Thrombosis* ; Vena Cava Filters* ; Vena Cava, Inferior* ; Venous Thrombosis

PURPOSE: This study evaluated the demographics and semen parameters of males with cancer who banked their sperm prior to chemotherapy. MATERIALS AND METHODS: This is a retrospective study of 66 cases referred for sperm banking prior to initiation of chemotherapy over a 15-year period (1999~2014). Patients who had previously received cancer treatment including chemotherapy or radiotherapy were not included in this study. RESULTS: We studied a total of 66 cancer patients referred for cryopreservation of sperm prior to chemotherapy. The mean age of the patients at the time of banking was 32.0+/-7.9 years (range, 19~58 years). The types of cancer were testicular cancer (31 cases, 47.0%), non-Hodgkin's disease (10 cases, 15.1%), Hodgkin's disease (5 cases, 7.6%), leukemia (8 cases, 12.1%), gastrointestinal malignancy (5 cases, 7.6%), and musculoskeletal malignancy (5 cases, 7.6%). There were significant differences in sperm concentration and viability among the various types of cancer, but no significant difference in semen volume or sperm motility and morphology. CONCLUSIONS: In this study we found that sperm quality could decrease even before chemotherapy. Because chemotherapy can also negatively affect spermatogenesis, sperm cryopreservation prior to treatment should be strongly recommended for cancer patients of reproductive age.
Cryopreservation* ; Demography ; Drug Therapy* ; Hodgkin Disease ; Humans ; Infertility, Male ; Korea ; Leukemia ; Male ; Radiotherapy ; Retrospective Studies ; Semen ; Semen Analysis* ; Sperm Banks ; Sperm Motility ; Spermatogenesis ; Spermatozoa* ; Testicular Neoplasms

PURPOSE: We investigated prostate size and its correlation with final pathologic outcomes and prognosis. MATERIALS AND METHODS: From 1993 to 2009, 830 consecutive patients who underwent radical prostatectomy with follow-up duration of 12 months or more were included in this study. Patients were categorized according to prostate size as follows: group 1, prostate size < or =40 g (n=458), and group 2, prostate size >40 g (n=472). Preoperative parameters and postoperative pathologic outcomes were compared between groups. Multivariate analysis with Cox proportional hazards regression model was used to identify the pathologic and clinical factors affecting biochemical recurrence. RESULTS: Patients in group 1 had higher pathologic T stage (pT2a=17.7% vs. 23.9%, pT2b=1.1% vs. 0%, pT2c=40.4% vs. 39.8%, pT3a=29.5% vs. 21.0%, pT3b=10.7% vs. 13.2%, p=0.003) and higher positive surgical margin (40.3% vs. 33.1%, p=0.033) than did patients in group 2. Pathologic Gleason score was not significantly different between the two groups. The 5-year biochemical-recurrence-free survival was 62.3% for patients in group 1 and 73.2% for patients in group 2 (p=0.005). Multivariate Cox regression analysis showed that prostate size of 40 g or less (hazard ratio [HR], 1.378; 95% confidence interval [CI], 1.027 to 1.848; p=0.032), extracapsular extension (HR, 1.592; 95% CI, 1.147 to 2.209; p=0.005), positive surgical margin (HR, 2.348; 95% CI, 1.701 to 3.242; p<0.001), and pathologic Gleason sum (HR, 1.507; 95% CI, 1.292 to 1.758; p<0.001) were independent predictors of biochemical recurrence. CONCLUSIONS: Smaller prostate size was associated with increased risk of higher pT stage and positive surgical margin after radical prostatectomy. Also, prostate size less than 40 g was an independent prognostic factor for biochemical recurrence.
Follow-Up Studies ; Humans ; Multivariate Analysis ; Neoplasm Grading ; Prognosis ; Prostate ; Prostatectomy ; Recurrence

PURPOSE: We investigated prostate size and its correlation with final pathologic outcomes and prognosis. MATERIALS AND METHODS: From 1993 to 2009, 830 consecutive patients who underwent radical prostatectomy with follow-up duration of 12 months or more were included in this study. Patients were categorized according to prostate size as follows: group 1, prostate size < or =40 g (n=458), and group 2, prostate size >40 g (n=472). Preoperative parameters and postoperative pathologic outcomes were compared between groups. Multivariate analysis with Cox proportional hazards regression model was used to identify the pathologic and clinical factors affecting biochemical recurrence. RESULTS: Patients in group 1 had higher pathologic T stage (pT2a=17.7% vs. 23.9%, pT2b=1.1% vs. 0%, pT2c=40.4% vs. 39.8%, pT3a=29.5% vs. 21.0%, pT3b=10.7% vs. 13.2%, p=0.003) and higher positive surgical margin (40.3% vs. 33.1%, p=0.033) than did patients in group 2. Pathologic Gleason score was not significantly different between the two groups. The 5-year biochemical-recurrence-free survival was 62.3% for patients in group 1 and 73.2% for patients in group 2 (p=0.005). Multivariate Cox regression analysis showed that prostate size of 40 g or less (hazard ratio [HR], 1.378; 95% confidence interval [CI], 1.027 to 1.848; p=0.032), extracapsular extension (HR, 1.592; 95% CI, 1.147 to 2.209; p=0.005), positive surgical margin (HR, 2.348; 95% CI, 1.701 to 3.242; p<0.001), and pathologic Gleason sum (HR, 1.507; 95% CI, 1.292 to 1.758; p<0.001) were independent predictors of biochemical recurrence. CONCLUSIONS: Smaller prostate size was associated with increased risk of higher pT stage and positive surgical margin after radical prostatectomy. Also, prostate size less than 40 g was an independent prognostic factor for biochemical recurrence.
Follow-Up Studies ; Humans ; Multivariate Analysis ; Neoplasm Grading ; Prognosis ; Prostate ; Prostatectomy ; Recurrence