PURPOSE: The aim of this study was to investigate the effect of transurethral resection of the prostate (TURP) on erectile function. MATERIALS AND METHODS: A total of 108 patients treated with TURP were retrospectively evaluated. All patients were evaluated 1, 3, and 6 months after TURP by use of the International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF), peak urinary flow rate (Qmax), and post-void residual urine (PVR). RESULTS: One and 3 months after TURP, the erectile function domain score of the IIEF was significantly decreased. However, after 6 months, there was no longer a significant decrease in the erectile function domain score. The change in erectile function was compared with the IPSS score. There was no statistically significant correlation, but patients who had better voiding symptoms after TURP had improved erectile function. CONCLUSIONS: Our study showed that there was a significant decrease in erectile function for 3 months after TURP. However, no significant change in erectile function was observed 6 months after TURP.
Erectile Dysfunction ; Humans ; Male ; Prostate ; Prostatic Hyperplasia ; Retrospective Studies ; Transurethral Resection of Prostate

PURPOSE: We evaluated the safety and efficacy of intrarectal administration of anesthetic agent for transrectal prostate biopsy. MATERIALS AND METHODS: For a double-blind prospective trial, 100 men undergoing transrectal prostate biopsy were randomized into three groups using an established list. In the control group (n=36), 40mL of normal saline was administered transrectally 10 min before the procedure. The lidocaine group (n=31) and the benzocaine group (n=33) were give 40 mL of 1% lidocaine and 0.3% benzocaine, respectively. Patients were asked to score the severity of the pain expected before and after the biopsy procedure using a self-administered verbal rating scale. Pain was assessed using a 10-point linear visual analog scale. RESULTS: The median pain score expected before the transrectal prostate biopsy was 6.7+/-0.3, 7.1+/-0.2, and 6.7+/-0.3 in the control, lidocaine, and benzocaine group, respectively. The median pain score during the biopsy was 6.1+/-0.3, 5.8+/-0.3 (P<0.05), and 5.9+/-0.4 in the control, lidocaine, and benzocaine group, respectively. Ninety seven percent of the control group, 100% of the lidocaine group, and 91% of the benzocaine group complained of severe and bothersome pain, with a score of 5 or greater during the biopsy. No adverse events were noted. CONCLUSIONS: Intrarectal administration of anesthetic agent is a simple, safe, and efficacious method of providing satisfactory anesthesia in patients undergoing transrectal prostate biopsy. We recommend 1% lidocaine solution in the patients to perform transrectal prostatic biopsy.
Anesthesia ; Anesthetics ; Benzocaine ; Biopsy* ; Double-Blind Method* ; Humans ; Lidocaine ; Male ; Prospective Studies ; Prostate ; Visual Analog Scale

PURPOSE: We examined a 24-h urine to evaluate the important biochemical risk factors and relative supersaturation in patients with recurrent nephrolithiasis. METHODS: A total of 17 patients with recurrent nephrolithiasis were analyzed for urinary biochernical stone risk factors and relative supersaturation. They were evaluated using a single 24-h urine specimen with StoneRisk(R) Diagnostic Profile on a random diet. Urinary stone risk factors are calcium, oxalate, citrate, magnesium, uric acid, pH, 24-h urine volume, sodium, phosphorous. Relative supersaturation with respect to stone-forming salts such as calcium oxalate, brushite, monosodium urate and uric acid were calculated. These factors were classified one or more etiologic categories in each patient. RESULTS: Of 17 patients 16 patients (94.2%) had abnormal urinary biochemistry that placed them into one or more of 15 etiologic categories. A single abnormality was documented in only one patient. One patient had no diagnostic abnormality. High urinary sodium encountered in 13 (76.5%) of the patients. Hypercalciuria and hyperuricosuria accounted for 9 (52.9%) and 7(41.1%) of the patients, respectively. The acquired problem of low urine volume (< 2L/d) was found in 8 (47.1%) of the patients and hypoci-traturia affected in 4 (23.5%). But hypomagnesiuria was not detected. The relative supersaturation with respect to monosodium urate was highest and increased in 70.6Yo of patients. CONCLUSION: The StoneRisk(R) Diagnostic Profile using a single 24-h urine specimen is a very useful tool not only in detecting metabolic, environmental and physicochemical abnormalities but also in providing specific therapeutic or preventive guidelines of patients with recurrent nephrolithiasis. In our study the most important biochemical risk factor of recurrent stone former is a high urinary sodium. Furthermore, there is a distinct evidence of high relative supersaturation with respect to monosodium urate. High sodium intake is probably the most important risk factor in patient who develop recurrent stone formation. Therefore, dietary sodium restriction would reduce probability of recurrent nephrolithiasis.
Biochemistry ; Calcium ; Calcium Oxalate ; Citric Acid ; Diet ; Humans ; Hydrogen-Ion Concentration ; Hypercalciuria ; Magnesium ; Nephrolithiasis* ; Risk Factors* ; Salts ; Sodium ; Sodium, Dietary ; Uric Acid ; Urinary Calculi

This retrospective study was undertaken to investigate the current clinical trend in the management of ectopic pregnancy. 562 patients of ectopic pregnancy were admitted and managed at the Department of Obstetrics and Gynecology, Chonbuk National University Hospital from Jan. 1. 1985 to Dec. 31. 1996. All cases had a reliable medical record and were divided into two groups, of which group A includes patients admitted from Jan. 1. 1985 to Dec. 31. 1990, group B from the Jan. 1. 1991 to Dec. 31. 1996. The results were obtained as follows. 1. The number of cases of ectopic pregnancy were 248 in group A and 314 in group B. 2. The age group of 20 to 29 years of age was top ranked in group A(49.6%) as well as in group B(46.8%). The age group of 30 to 39 years was 43.2% in group A and 46.6% in group B, respectively. 3. In group A, the case who experienced two deliveries was 31.9%, and nulliparous woman was 30.6%. In group B, the case who experienced two deliveries was 33.1%, nulliparous woman was 33.1%. 4. On reviewing the past medical history, ectopic pregnancy was 11.2% in group A, 10.8% in group B, respectively. Pelvic inflammatory disease was 8.1% in group A and 11.0% in group B, respectively. 5. The interval between the last menstrual period and the onset of symptoms was prevalently in 4 to 8 weeks(64.5% in group A, 61.8% in group B). The terval of 12 weeks or more was 2.0% in group A and 6.0% in group B, respectively. 6. In considering the chief complaints, low abdominal pain was 85.9% and vaginal spotting was 69.0% in group A. On the other hand, low abdominal pain was 91.4% and vaginal spotting was 76.4% in group B, meanwhile nausea and vomitting was 8.6% and dizziness was 3.5% in group A, there were 23.4% of nausea and vomitting and 9.7% of dizziness in group B,7. In relation of the diagnostic methods, the positive rate of culdocentesis in group B was lower than the rate in group A. Diagnostic laparoscopy was done in 5.6% of group A and 14% of group B. The detection rate of adnexal mass and fluid collection in the pelvic cavity was higher in group B than in group A on the ultrasonographic examination. 8. Initial hemoglobin value of 10.1mg/dl or more was 70.9% in group A and 73.2% in group B. The value of 8.0gm/dl or less was 6.4% in group A and 7.0% of group B, respectively. Initial systolic pressure of 110mmHg or more was 74.6% in group A and 66.6% in group B. The systolic pressure of 90mmHg or less was 3.6% in group A and 8.3% in group B.9. The conceptus was almost implantd in the fallopian tube. The ampullary portion was the most common site of ectopic implantation in both groups. 10. Intraabdominal hemorrhage of 500ml or less in amount was 52.4% in group A and 61.1% in group B, individually. However transfusion was not given in 55.6% of group A and in 71.0% of group B. 11. In the therapeutic modalities, laparotomy was performed in 96.8% of group A and in 82.8% of group B, respectively. The pelviscopic operation was done in 2.4% of group A and in 22.3% of group B. In conclusion, ectopic pregnancy was diagnosed increasingly prior to the onset of the hypovolemic symptoms according to developement of high-resolution ultrasonogram, diagnostic laparoscopy and beta-hCG test, therefore the use of minimally invasive techniques in the management of ectopic pregnancy was increasing.
Abdominal Pain ; Blood Pressure ; Diagnosis* ; Dizziness ; Fallopian Tubes ; Female ; Gynecology ; Hand ; Hemorrhage ; Humans ; Hypovolemia ; Jeollabuk-do ; Laparoscopy ; Laparotomy ; Medical Records ; Metrorrhagia ; Nausea ; Obstetrics ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Ectopic* ; Retrospective Studies ; Ultrasonography

PURPOSE: Prostatic manipulation and surgery have been shown to increase serum prostate-specific antigen (PSA). We studied the effect of ejaculation on the serum PSA levels. MATERIALS AND METHODS: We evaluated 131 men(16 to 64 years old) who had no history of surgery or inflammatory disease of the urogenital tract. The total serum PSA, free PSA, serum total testosterone, free testosterone, luteinizing hormone(LH), and follicular stimulating hormone(FSH) were evaluated 1 hour after ejaculation. RESULTS: A PSA level was detected in all the men. There were statistically significant changes of the serum PSA level before and after ejaculation. We compared the parameters between increased PSA group and the decreased PSA group. There were significant differences between the two groups on comparison of the total prostate volume(25.4+/-3.6g vs 15.1+/-4.2g, respectively) and the transition zone volume(7.1+/-2.7g vs 5.3+/-1.1g, respectively). CONCLUSIONS: Based on our data, ejaculation affects the serum PSA concentration in young men, and there seems to be a physiological relationship between ejaculation and the PSA level. The larger the prostate volume, the more ejaculation has an effect on the serum PSA level.
Ejaculation* ; Humans ; Lutein ; Male ; Prostate ; Prostate-Specific Antigen* ; Testosterone

PURPOSE: To evaluate possible factors affecting urethral stricture development after TURP in patients with BPH. MATERIALS AND METHODS: We reviewed retrospectively medical records of patients who underwent TURP for 6 years. All operations were performed by 2 experienced doctors who have minimum 200 practices. Patients were classified into 2 groups. Group A included patients with urethral stricture required periodic urethral dilation or urethrotomy. Group B included those without urethral stricture development after TURP. We analyzed all possible factors such as resection time, prostate volume, resection volume, resectoscope size, preoperative catheterization duration due to AUR, postoperative catheterization duration, preoperative pyuria, prostate needle biopsy performed preoperatively and PSA level, age and co-morbid systemic diseases. RESULTS: 595 patients underwent TURP between 2000 and 2005. 76 of them were excluded because of preexisting urethral stricture or secondary TURP. 110 were categorized into group A and 409 into group B. There was no statistical difference between group A and B with respect to age, preoperative catheterization duration in patients with AUR, postoperative catheterization duration, prostate volume, resection volume, preoperative PSA level, preoperative pyuria, preoperative biopsy history, resectoscope size(22F vs 24F) and anesthesia method (general vs spinal), respectively. However, there is significant difference between group A and B in comparison of resection time(58.5+/-21.6 min vs 48.5+/-23.2 min, p=0.02). CONCLUSION: Our data demonstrate that the shortening of resection time is the most important single factor to decrease urethral stricture formation after TURP in patients with BPH.
Anesthesia ; Biopsy ; Biopsy, Needle ; Catheterization ; Catheters ; Humans ; Medical Records ; Prostate* ; Prostatic Hyperplasia* ; Pyuria ; Retrospective Studies ; Transurethral Resection of Prostate ; Urethral Stricture*

PURPOSE: The valsalva leak point pressure (VLPP), a quantitative measure of sphincteric function, is used widely to diagnose intrinsic sphincter deficiency (ISD). This study was to evaluate the correlation between VLPP and maximum urethra closure pressure (MUCP) in patients with stress urinary incontinence. MATERIALS AND METHODS: We divided the patients into two categories: 60 patients affected by ISD as they had stress incontinence; 80 patients suffering from stress incontinence without ISD. The presence/absence of ISD was considered the dependent variable and was correlated against the following independent variables: age, vaginal deliveries, menopause, previous urogynecological surgery, VLPP, MUCP, and functional urethral length (FUL). This two groups were compared VLPP with MUCP to evlauate their correlation. RESULTS: The statistical analysis showed close correlation between ISD and age (p=0.045), urogynecological surgery (p=0.013), VLPP (p=0.000), MUCP (p=0.000), FUL (p=0.000). There was statistically significant relationship between VLPP and MUCP (p=0.01), however a correlation coefficient of 0.303 demonstrated poor clinical relationship. When the cut-off value of MUCP were 20, 30, 40 cmH2O, there was no the diagnostic value of ISD. CONCLUSION: The MUCP has statistically significant relationship with VLPP but, low correlation coefficient demonstrated poor clinical relationship. Therefore, it is not clinically useful to evaluate urethral sphincter function.
Female ; Humans ; Menopause ; Urethra* ; Urinary Incontinence*

Sarcomatoid carcinomas of the urinary bladder are very rare and highly malignant tumors containing both malignant mesenchymal and epithelial elements. These exhibit a prominent spindle cell component as a malignant mesenchymal elements and are tumors with a poor prognosis despite aggressive treatment. Recently we experienced a case of sarcomatoid carcinoma of the bladder in a 69 year-old male. He complained of painless gross hematuria and diagnosis was made by immunohistochemical stain. Partial cystectomy was performed. After 5 months, he was readmitted due to gross hematuria, voiding difficulty and generalized weakness. Pelvic CT showed a recurrent mass in the bladder. He received only conservative treatment and died 1 month later.
Aged ; Cellular Structures ; Cystectomy ; Diagnosis ; Hematuria ; Humans ; Male ; Prognosis ; Urinary Bladder*

PURPOSE: Penile prosthesis implantation to correct the irreversible erectile dysfunction is a common. We investigated complications and causes of revision after implantation of the penile prosthesis. MATERIALS AND METHODS: We followed 72 patients who underwent penile prosthesis implantation performed by the same surgeon from January 1993 to July 2006. The medical records of all patients were retrospectively reviewed. The mean follow up duration was 30.3 months, and average age at operation was 56.7+/-11.0 years. RESULTS: The malleable penile prosthesis was implanted on 8 patients. The inflatable penile prosthesis was implanted on 63 patients and Dynaflex was implanted in the one patient. Of the patients implanted inflatable penile prosthesis, complications were developed in the 14 patients and 17 cases of complications were developed. Of the complications, mechanical complications were broken of connecting tubing(7), mulfunction of Dynaflex(1) and difficulty of deflation(1). Of 17 complications, non-mechanical complications were urethral stricture(5), erosion of urethra(1), migration of reservoir into the bladder(1) and SST deformity(1). CONCLUSIONS: Penile prosthesis has high complications rates, and revision rate also is high. Mechanical failure was the most common cause of surgical revision. Although urethral stricture is rare complication, it was developed in the 5 patients due to mal-rotation of the cylinder.
Erectile Dysfunction ; Follow-Up Studies ; Humans ; Male ; Medical Records ; Penile Implantation ; Penile Prosthesis* ; Reoperation ; Retrospective Studies ; Urethral Stricture

Post-traumatic arteriovenous fistula (AVF) and pseudoaneurysm are rare, and mostly occur in stab wound patients. Suspected AVF and pseudoaneurysm requires angiography, with planned simultaneous embolization. Superselective embolization is generally a safe and effective treatment modality for AVF and pseudoaneurysm with minimal associated morbidity. Rare complications of the embolization do occur, including renal abscess, postembolization syndrome, impaired renal function, pulmonary embolism caused by migration of coils, and allergic reaction. We present here the case of a man who presented with a newly discovered pseudoaneurysm after embolization of a renal AVF with pseudoaneurysm after a renal stab wound.
Abscess ; Aneurysm, False ; Angiography ; Arteriovenous Fistula ; Embolization, Therapeutic ; Humans ; Hypersensitivity ; Pulmonary Embolism ; Wounds, Stab