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

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*

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

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

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: 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

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: 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

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