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

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

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

PURPOSE: To evaluate the impact of lower urinary tract symptom (LUTS) on restlessness and quality of life (QoL) in young men. MATERIALS AND METHODS: The National Institutes of Health (NIH) - Chronic Prostatitis Symptom Index (CPSI) was used to identify men with LUTS in a community. The questionnaire also asked about sociodemographic characteristics. A total of 15,264 men, with LUTS without pain, were included in this study. RESULTS: Of the subjects, 521 (3.4%) felt their bladder did not empty fully after urinating more than 20% of the time, while 1,495 (9.7%) had to urinate again within 2 hours more than 20% of the time. Men dwelling in major towns were more likely to report they experienced incomplete emptying (p<0.001) and frequency (p<0.001). As educational level increased, the likelihood of frequency decreased (p=0.033), but that of incomplete emptying did not. In the multivariate model used, men experienced mild incomplete emptying had a 5.2-fold greater risk for restlessness (odds ratio [OR], 5.21; p<0.001) and those experiencing moderate to severe incomplete emptying had a 14.8-fold greater risk (OR, 14.84; p<0.001) than men that did not experience incomplete emptying. Mild frequency was associated with a 6.9-fold greater risk of restlessness (OR, 6.91; p<0.001) and moderate to severe frequency was associated with a 52.7-fold greater risk (OR, 52.67; p<0.001) than no frequency. CONCLUSIONS: The community-based prevalence of LUTS was found to be high in the population studied. The study indicated that demographic variables might influence the prevalence of LUTS in young men. In addition, our findings suggest that young men with LUTS experience a negative impact on their QoL.
Humans ; Male ; National Institutes of Health (U.S.) ; Prevalence ; Prostatitis ; Psychomotor Agitation ; Quality of Life* ; Surveys and Questionnaires ; Urinary Bladder ; Urinary Tract*

PURPOSE: We investigated the incidence and risk factors of contralateral inguinal hernia or hydrocele in men dwelling in community with initially unilateral disease. MATERIALS AND METHODS: A total of 2,700 men aged 20 years dwelling in the community were randomly selected at a 10.0% sampling fraction after a sampling process by census district and 2,080 of these men agreed to participate in the study. All volunteers underwent a standard evaluation, including a detailed medical history and physical examination. They completed a self-administered questionnaire providing detailed information on any previous history. To evaluate risk factors for contralateral occurrence of inguinal hernia or hydrocele, we compared 3 possible variables (initial side, type and history of repair) between total patients with and those without contralateral inguinal hernia or hydrocele. For patients who underwent repair, 4 variables were compared (initial side, type, ipsilateral recurrence and age at repair) between the 2 groups. RESULTS: Of the participants, 48 men (2.3%) were observed to either have inguinal hernia or hydrocele on physical examination (n=14) or had a history of inguinal hernia or hydrocele repair (n=34). Six (12.5%) patients experienced contralateral inguinal hernia or hydrocele. Contralateral diseases occurred in 2 of 28 (7.1%) patients with initial right inguinal hernia or hydrocele, and 4 of 20 (20.0%) patients with initial left inguinal hernia or hydrocele. There were no significant differences between the 2 groups in any of the variables. CONCLUSIONS: We did not identify subgroups at sufficiently increased risk to warrant contralateral exploration. Our findings suggest that routine contralateral exploration cannot be justified in these patients since the incidence of contralateral clinical inguinal hernia or hydrocele is low.
Censuses ; Epidemiologic Studies* ; Hernia, Inguinal* ; Humans ; Incidence ; Male ; Physical Examination ; Surveys and Questionnaires ; Recurrence ; Risk Factors ; 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

PURPOSE: We investigated whether psychological factors could influence on the symptoms of chronic prostatitis based on general population that have not previously been examined or treated. MATERIALS AND METHODS: Between August and November 2000, we randomly selected 100 male residents in the area of Chung-nam including Daejoen city. The participants completed self- administered questionnaires. Based on our inclusion criteria, 87 participants were included in this study. RESULTS: Scores of Beck Depression Inventory of participants with higher pain and urinary symptoms domain scores were significantly higher than those with lower pain and urinary symptoms domain scores of the National Institutes of Health-chronic prostatitis symptom index (p=0.001 and p=0.028, respectively). However, anxiety did not influence on the symptoms of chronic prostatitis based on the results of State-Trait Anxiety Inventory. Based on the results of Bem Sex Role Inventory, masculinity score of participants with higher urinary symptoms domain scores were significantly lower than those with lower urinary symptoms domain scores (p=0.042). CONCLUSIONS: Our results suggest that psychological problems may involve in an early stage of chronic prostatitis and have a causative role in chronic prostatitis.
Academies and Institutes ; Anxiety ; Depression ; Gender Identity ; Humans ; Male ; Masculinity ; Prostatitis* ; Psychology ; Surveys and Questionnaires

PURPOSE: This study aimed to evaluate the cancer detection rate in a Korean population with prostate-specific antigen (PSA) levels greater than or equal to 20.0ng/mL. MATERIALS AND METHODS: A total of 174 men 50 to 79 years old (median 69) included in the study. The median prostate volume of the patients was 44.8mL (range 14.1 to 210.0) and their serum PSA ranged from 20.0 to 9725.0ng/mL (median 44.8). RESULTS: Of 174 men 141 (81.0%) were diagnosed with prostate cancer on initial biopsy. In the total number of patients, the positive predictive value (PPV) was 62.9% for PSA 20 to 29.9, 72.7% for PSA 30 to 39.9 and 100% for PSA 40 to 49.9 ng/mL. In patients with an abnormal digital rectal examination (DRE), the values for these PSA ranges increased to 89.5%, 91.7% and 100%, respectively. The PPV was 81.0% for PSA cutoff of 20, 89.2% for a cutoff of 30, 95.4% for a cutoff of 40, and 94.7% for a cutoff of 50 ng/mL. In conjunction with an abnormal DRE, the values for these PSA cutoffs increased to 95.9%, 98.1%, 100%, and 100%, respectively. CONCLUSION: Our data suggest the ability to predict the presence of prostate cancer reliably on initial biopsy when PSA threshold is greater than or equal to 50ng/mL. This PSA threshold may be lowered to 40ng/mL in the presence of an abnormal DRE. In Korean men with high PSA, the detection rate of prostate cancer on biopsy appears to be comparable to that for American men.
Aged ; Biopsy ; Cohort Studies ; Digital Rectal Examination ; Humans ; Korea ; Male ; Middle Aged ; Predictive Value of Tests ; Prostate/pathology ; Prostate-Specific Antigen/*blood ; Prostatic Neoplasms/*diagnosis/metabolism/pathology

No abstract available.
Stroke*