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: 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: 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 determined the efficacy and safety of a relatively high dose of terazosin (5mg) in Korean patients with lower urinary tract symptoms (LUTS), with or without concomitant hypertension. MATERIALS AND METHODS: From July to December 2006, 200 men who consecutively presented with LUTS were prospectively studied. Eight weeks after treatment, blood pressure (BP), uroflowmetry, and International Prostate Symptom Score (I-PSS) were assessed. For analysis purposes, patients were stratified according to concomitant hypertension. Of the 200 patients, 173 completed the scheduled eight-week treatment period. RESULTS: At baseline, no differences were evident in the two groups in terms of I-PSS, Qmax, PVR and BP. After eight weeks of treatment-although I-PSS and uroflowmetry parameters were not significantly different in the two groups-systolic and diastolic BP in the non-hypertensive control group were higher than in the hypertensive group (p= 0.001 and p=0.0100, respectively). Changes in I-PSS, uroflowmetry parameters, and BPs measured at week eight post- treatment commencement did not significantly differ between the two groups. Moreover, the addition of 5mg of terazosin to antihypertensives did not cause a significant reduction in either systolic or diastolic BP in either group. CONCLUSION: Adding terazosin to existing antihypertensive regimens did not seem to increase the incidence of adverse events. Our findings suggest that 5mg terazosin is effective and that it has an acceptable safety profile as an add-on therapy for patients with LUTS and concomitant hypertension.
Adrenergic alpha-Antagonists/adverse effects/therapeutic use ; Aged ; Asian Continental Ancestry Group ; Blood Pressure/drug effects ; Humans ; Hypertension/complications/*drug therapy/physiopathology ; Korea ; Male ; Middle Aged ; Prazosin/adverse effects/*analogs & derivatives/therapeutic use ; Prospective Studies ; Prostate/drug effects/pathology ; Treatment Outcome ; Urodynamics/drug effects ; Urologic Diseases/complications/*drug therapy/ethnology

We assessed several emotional variables in patients experiencing conventional urodynamic and ambulatory urodynamic monitoring (AUM) to verify the hypothesis that AUM is tolerated as well as conventional urodynamics. A total of 33 women and 7 men from 23 to 72 years of age who were undergoing both procedures were prospectively included in this study. Prior to and immediately after the procedures, each patient completed a self-administered questionnaire. Answers were given on a visual analogue scale. The degree of anxiety was higher for conventional urodynamics than for AUM (p = 0.045), while the degree of boredom experienced during AUM was higher than that during conventional urodynamics (p= 0.013). There was no significant difference in the degree of shame or bother experienced by the patients during the two procedures. In general, patients tolerated both examinations extremely well. The examiner-rated degree of intolerance during conventional urodynamics was influenced by the subjective pain score (p=0.001), while all other emotional variables except bother were not significantly related with the degree of intolerance during AUM (p=0.007). A total of 74.4% and 84.6% responded that they were willing to repeat conventional urodynamics and AUM, respectively, which were not significantly different. Although AUM produced a significantly higher level of boredom than conventional urodynamics, our data demonstrates that patients are as tolerant of AUM as they are of conventional urodynamic procedures.
*Urodynamics ; Urination Disorders/*diagnosis/*urine ; Urinary Incontinence/diagnosis ; Questionnaires ; Pain Measurement ; Pain ; Monitoring, Ambulatory/*methods ; Middle Aged ; Male ; Humans ; Fluoroscopy/*methods ; Female ; Anxiety ; Aged ; 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

PURPOSE: It has been recognized that silicone gel filled prosthesis has a possible hazard of immunological disease. We intended to analyze immunological alterations in recipients of silicone gel filled penile and testicular prosthesis. MATERIALS AND METHODS: Medical records of 14 patients who underwent penile prosthesis insertion and 24 patients who underwent testicular prosthesis insertion were reviewed. Of 38 recipients, 8 patients with penile prosthesis and 15 patients with testicular prosthsis were examined by symptom, physical examination and serologic tests. Serologic tests included erythrocyte sedimentation rate, rheumatoid factor, antinuclear antibody, complement 3, complement 4, immunoglobulin A, immunoglbulin E, immunoglobulin G, and immunoglobulin M. RESULTS: Of 38 patients who underwent prosthesis, there were postoperative complications in 6 patients. Of 23 patients who were examined by symptom, physical examination and serologic tests, 1 patients have intermittent testicular pain and all the patient were normal on physical examination. Of 8 patients who underwent penile prosthesis insertion, the abnormality rates of serologic tests were 25.0% in erythrocyte sedimentation rate, 12.5% in rheumatoid factor, 25.0% in increased complement 3, 12.5% in complement 4, 50.0% in immunoglobulin E, and 12.5% in immunoglobulin G. Antineuclear antibody was weakly reactive at 1:40 titer in 2 patients(25.0%), but these results were within normal range, and immunoglobulin G and immunoglobulin M were normal in all the patients. Of 15 patients who underwent testicular prosthesis insertion, the abnormality rates of serologic tests were 13.3% in erythrocyte sedimentation rate, 60..0% in complememt 3, 20.0% in complement 4, 13.3% in immunoglobulin A, 100.0% in immunoglobulin E, and 66.7% in immunoglobulin G. And rheumatoid factor, antineuclear antibody, and immunoglobulin M were normal in all the patients. There were no patients with the diagnostic criteria of immunological disease. CONCLUSIONS: There were no patients that were included in diagnostic criteria of immunological diseases in our results and it is suggested that silicone gel filled prosthesis have no hazard of immunological disease. However, because serologic tests were abnormal in some patients, we suggest that careful followup of recipients of silicone gel filled prosthesis is needed.
Antibodies, Antinuclear ; Blood Sedimentation ; Complement C3 ; Complement C4 ; Follow-Up Studies ; Humans* ; Immune System Diseases ; Immunoglobulin A ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Medical Records ; Penile Prosthesis ; Physical Examination ; Postoperative Complications ; Prostheses and Implants* ; Reference Values ; Rheumatoid Factor ; Serologic Tests ; Silicone Gels