No abstract available.
Female* ; Humans ; Prevalence*

Studies of urinary incontinence have so far paid little attention with female urinary incontinence (FUI). The aims of this study are to define the nature and extent of psychological stress in women with FUI in the absence of other abnormality. Thirty women aged 24 to 51 were diagnosed as FUI and 30 women as control group without FUI. Diagnostic procedure included a history taking, physical examination, and urodynamic evaluation. Personality traits were assessed by means of the state-trait anxiety inventory (STAI) and the Beck depression inventory (BDI) in 30 FUI women. The results were compared with a control group of c,0ntinent women. The mean patient age were 39.6 years in FUI and 40.5 years in control group. Among the FUI patients, 23 (77%) were genuine stress incontinence (GSI), and 7 (23%) were GSI with urge incontinence (UI). State anxiety inventory was 44.78 +/-10.27 in FUI group and 39.97 +/- 4.49 in control group, there was a significant difference (p=0.025). Depression inventory were 8.67 +/- 7.91 in FUI and 4.47 + 2.09 in control group, with a significant difference also (p=0.007). However, trait-anxiety inventory was 44.70 +/-9.54, and 40.80 +/- 5.31, respectively without no significant difference (p>0.05). The results of this study were that FUI was `associated with state-anxiety and depression. Although FUI is not a severe physical disability, many psychological problems are associated with it.
Anxiety* ; Depression* ; Female* ; Humans ; Physical Examination ; Stress, Psychological ; Urinary Incontinence* ; Urinary Incontinence, Urge ; Urodynamics

In 1948, Kegel first described biofeedback therapy with perineometer for the treatment of genuine stress incontinence and reported a 90% improvement in 455 patients treated. After then, most urologists and gynecologist favored the anti-incontinence surgery in spite of the effectiveness of pelvic floor exercise. However, pelvic floor muscle exercise is regarded as ""something good to do"" before considering surgery, nowadays. This study evaluated the efficacy of the pelvic floor muscle exercise for the treatment of genuine stress incontinence patients with mild symptoms and pelvic relaxation. We treated 31 patients with pelvic floor muscle exercise with perineometer and followed up all of the patients for 3 months. Twenty seven out of thirty one cases improved incontinence symptom. Sixty five percent of cases showed less than 2 gm urine leak after one hour pad test and 48% of cases showed the increase of vaginal tone (mean 13.2mmHg) with perineometer. This study shows the improvement of genuine stress incontinence symptom is mainly due to perineal blockage just before the increase of intraabdominal pressure.
Biofeedback, Psychology ; Humans ; Pelvic Floor* ; Relaxation

No abstract available.

The sling operation is especially indicated in patients with intrinsic sphincter dysfunction (ISD). We evaluated of the effectiveness of the sling operation for the treatment of genuine stress incontinence patients with ISD. We operated 7 patients and followed up all of the patients for 214 (mean 8) months. Preoperative maximal urethral closure pressure was ranged from 23 to 74 (mean 38.4) cmH2O and valsalva leak point pressure (VLPP) was ranged from 41 to 78 (mean 59.5) cmH2O. We applied rectus fascia or GoreTex mesh as sling material. As a results, genuine stress incontinence (GSI) had completely cured in all of 7 cases. However, postoperative urinary retention was developed in two cases. In one of these, we released suspension suture, and in another case, urethrolysis and Raz operation was underwent in other hospital. All of these two cases showed improvement of voiding and any recurrence of incontinence was not noted. In conclusion, GSI due to ISD can be cured by the technique of the sling operation, so we suggest that the sling operation is one of the treatment for GSI patient with ISD.
Fascia ; Humans ; Polytetrafluoroethylene ; Recurrence ; Sutures ; Urinary Retention

This study evaluated the Comparison of the Effectiveness of Pelvic Floor Muscle exercise and Biofeedback treatment for Genuine Stress Incontinence I assigned 60 participants to 2 groups : 30 to the pelvic floor muscle exercise group and 30 to the biofeedback group. Treatment protocol lasted for 6 weeks. Peak pressure, and duration time of pelvic muscle contraction were evaluated by a perineometer. Lower urinary symptoms, sexual matter and life style scores were achieved by using Jackson's scale. The treatment efficacy of the pelvic floor muscle exercise is compared with the biofeedback group and the main results of the comparison are as follows: 1. Pelvic muscle contraction 1) The peak pressure in the biofeedback group was significantly increased(P=0.000). 2. The frequency and quantity of incontinence 1) The frequency of incontinence in the biofeedback group was significantly decreased(P=0.000). 2) The quantity of incontinence in the biofeedback group was significantly decreased(P=0.000). 3. The lower urinary symptoms Daily frequency(P=0.000), nocturia(P=0.000), urgency(P=0.000), bladder pain(P=0.000), unexplained incontinence(P=0.048), wearing protection(P=0.022), changing outer clothing(P=0.005), hesitancy(P=0.008), intermittent stream(P=0.000), abnormal strength of stream(P=0.004), retention(P=0.000), incomplete emptying(P=0.000), and inability to stop mid steam(P=0.006) of the lower urinary symptoms in the biofeedback group were significantly decreased. 4. The sexual matters The dry vagina(P=0.004) and pain during sexual intercourse(P=0.002) in the biofeedback group was significantly decreased. 5. The life style. The fluid intake restriction(P=0.007), affected daily task(P=0.003), avoidance of places & situation(P=0.003), interference in Physical activity(P=0.002), interference in relationship with other people(P=0.01), and feeling about the rest of life with urinary symptom(P=0.000) in the biofeedback group were significantly decreased. In conclusion, the biofeedback treatment was more effective than the pelvic floor muscle exercise in genuine stress incontinence.
Biofeedback, Psychology* ; Clinical Protocols ; Female ; Humans ; Life Style ; Muscle Contraction ; Pelvic Floor* ; Treatment Outcome ; Urinary Bladder

This study evaluated the Comparison of the Effectiveness of Pelvic Floor Muscle exercise and Biofeedback treatment for Genuine Stress Incontinence I assigned 60 participants to 2 groups : 30 to the pelvic floor muscle exercise group and 30 to the biofeedback group. Treatment protocol lasted for 6 weeks. Peak pressure, and duration time of pelvic muscle contraction were evaluated by a perineometer. Lower urinary symptoms, sexual matter and life style scores were achieved by using Jackson's scale. The treatment efficacy of the pelvic floor muscle exercise is compared with the biofeedback group and the main results of the comparison are as follows: 1. Pelvic muscle contraction 1) The peak pressure in the biofeedback group was significantly increased(P=0.000). 2. The frequency and quantity of incontinence 1) The frequency of incontinence in the biofeedback group was significantly decreased(P=0.000). 2) The quantity of incontinence in the biofeedback group was significantly decreased(P=0.000). 3. The lower urinary symptoms Daily frequency(P=0.000), nocturia(P=0.000), urgency(P=0.000), bladder pain(P=0.000), unexplained incontinence(P=0.048), wearing protection(P=0.022), changing outer clothing(P=0.005), hesitancy(P=0.008), intermittent stream(P=0.000), abnormal strength of stream(P=0.004), retention(P=0.000), incomplete emptying(P=0.000), and inability to stop mid steam(P=0.006) of the lower urinary symptoms in the biofeedback group were significantly decreased. 4. The sexual matters The dry vagina(P=0.004) and pain during sexual intercourse(P=0.002) in the biofeedback group was significantly decreased. 5. The life style. The fluid intake restriction(P=0.007), affected daily task(P=0.003), avoidance of places & situation(P=0.003), interference in Physical activity(P=0.002), interference in relationship with other people(P=0.01), and feeling about the rest of life with urinary symptom(P=0.000) in the biofeedback group were significantly decreased. In conclusion, the biofeedback treatment was more effective than the pelvic floor muscle exercise in genuine stress incontinence.
Biofeedback, Psychology* ; Clinical Protocols ; Female ; Humans ; Life Style ; Muscle Contraction ; Pelvic Floor* ; Treatment Outcome ; Urinary Bladder

Reports of osteomyelitis in the proximal humerus with pyogenic glenohumeral arthritis of adjacent joints mostly involve pediatric patients. Nowadays, osteomyelitis that is secondary to adjacent pyogenic glenohumeral arthritis is extremely rare, even more so in adults than in pediatrics. We report a rare case of the pyogenic glenohumeral arthritis followed by osteomyelitis of the proximal humerus in an elderly patient. Initially, we diagnosed a case of pyogenic glenohumeral arthritis only, which, despite arthroscopic synovectomy, did not resolve and severe pain continued. Subsequent radiological imaging, performed after our suspicion of a secondary involvement, allowed us to diagnose osteomyelitis combined with the pyogenic glenohumeral arthritis, which we had overlooked because of the extreme rarity of the condition in adults since the antibiotic era began.
Adult ; Aged* ; Arthritis* ; Arthritis, Infectious ; Humans ; Humerus* ; Joints ; Osteomyelitis* ; Pediatrics ; Shoulder

Male hypogonadism refers to decrease in Leydig cell function, diminished or absent spermatogenesis, or both in tandem. The results of clinical investigation on 29 patients with male hypogonadism seen in urology department of Severance hospital from May, 1980 to August, 1982 are reported. The results were as follows; 1. Physical findings varied according to whether onset occurred before or after puberty. 2. The major physical finding was delay in sexual maturation. In addition, gynecomastia was found in 7 cases, hyposmia or anosmia in 4 cases, secondary bilateral anorchia in 4 cases, cryptorchidism in 3 cases and mental retardation in 1 case. 3. In patients with hypergonadotrophic hypogonadism (eunuch group), testicular volume was 2.5 +/- 0.8 ml. In patients with hypogonadotrophic hypogonadism (eunuchoid group), testicular volume was 2.4 +/- 1.8ml. 4. In patients with hypergonadotrophic hypogonadism, penile length was 4.4 +/- 1.2cm. In patients with hypogonadotrophic hypogonadism, penile length was 2.8 +/- 1.4cm. 5. In patients with hypergonadotrophic hypogonadism, serum FSH was 62.4 +/- 20.5mlU/ml, serum LH 65.0 +/- 23.6mlU/ml, serum testosterone 1.6 +/- 1.4ng/ml and serum prolactin 10.2 +/- 4.2ng/ml. In patients with hypogonadotrophic hypogonadism, serum FSH was 3.5 +/- l.9mlU/ml, serum LH 5.3 +/- 2.8mlU/ml and serum testosterone 0.9 +/- 0.6ng/ml. 6. The cause of hypergonadotrophic hypogonadism was Klinefelter's syndrome in 5 cases, prepubertal traumatic bilateral anorchisms in 2 cases, postpubertal bilateral anorchisms for seminoma or torsion in 2 cases. Testicular atrophy was found in 3 cases, 2 cases having past history of mumps orchitis and 1 case having past history of trauma. In 3 cases, no etiology could be identified. 7. The causes of hypogonadotrophic hypogonadism was a kallmann's syndrome in 4 cases. In two other cases, a pituitary lesion was suspected but could not be confirmed due to absence of pituitary hormone reserve function test. Two cases were identified as gonadotropin deficiency with growth hormone deficiency. 8. In patients with hypergonadotrophic hypogonadism, androgen replacement therapy with a testosterone preparation was performed. After the treatment, improvement of male secondary sex characteristics such as hair growth, voice change, enlargement of penis size and scrotum size was noted. Promotion and maintenance of sexual potency was also noted. 9. The patients with hypogonadotrophic hypogonadism were treated with androgen, HCG or HCG and HMG. However, due to the short period of therapy and follow-up, no firm conclusions about treatment efficacy in this group can be drawn. However, the best therapy to promote fertility should have been human chorionic gonadotropin combined with human menopausal gonadotropin. In conclusion, it appears that long-term treatment with androgen preparation promotes sexual potency and improves male secondary sex characteristics in hypergonadotrophic hypogonadism. In addition, long-term treatment with human chorionic gonadotropin combined with human menopausal gonadotropin may provide an efficient means of treating patients with hypogonadotrophic hypogonadism to obtain potency and fertility.
Adolescent ; Atrophy ; Chorionic Gonadotropin ; Cryptorchidism ; Fertility ; Follow-Up Studies ; Gonadotropins ; Growth Hormone ; Gynecomastia ; Hair ; Humans ; Hypogonadism* ; Intellectual Disability ; Kallmann Syndrome ; Klinefelter Syndrome ; Male* ; Mumps ; Olfaction Disorders ; Orchitis ; Penis ; Prolactin ; Puberty ; Scrotum ; Seminoma ; Sex Characteristics ; Sexual Maturation ; Spermatogenesis ; Testosterone ; Treatment Outcome ; Urology ; Voice

From October 1990 through July 1991, 187 women who complained of urinary incontinence underwent investigation in the department of urology, especially urodynamically, compared with 42 women with female urethral syndrome as control group. The following results were obtained ; mean functional urethral length was 3.1+/-0.9cm and mean maximal urethral closure pressure was 80.2+/-2.4cmH2O in genuine stress incontinence patients. But each results of female urethral syndrome were 3.6+/-0.7cm and 121.1+/-3.8cmH2O, respectively, and were higher than those of genuine stress incontinence (p <0.05 ). The incidence of positive pressure equalization of genuine stress incontinence was higher than that of control group, as 85.6% and 14.3% (p<0.05). The findings of uroflowmetry and cystometry showed within normal limits in genuine stress incontinence and poor voiding pattern in female urethral syndrome. Conclusively. urodynamic study was important for diagnosis and follow up of genuine stress incontinence.
Diagnosis ; Female ; Humans ; Incidence ; Urinary Incontinence ; Urodynamics* ; Urology