We report a case of testicular tunica albuginea cyst with psammoma body which was treated with excision and testicular preservation. The presumptive diagnosis of a simple intratesticular cyst was made by ultrasound. The intraoperative pathological diagnosis was benign serous cyst and then simple excision of the lesion with testicular masses, and it may permit identification of lesions that can be excised locally with testicular preservation. To our knowledge tunica albuginea cyst with psammoma body, a characteristic histological finding, has not been reported. Its histogenesis was also discussed.
Diagnosis ; Testis ; Ultrasonography

PURPOSE: There is no single method of choice for penoplasty in extensive penile paraffinoma, and surgeons must choose a suitable method according to the condition of each individual patient. Herein, we present 19 cases of extensive penile paraffinoma treated with various scrotal flaps or a new method involving a radial forearm free flap. PATIENTS AND METHODS: We reviewed the 19 cases of penile paraffinoma, which affected the whole penile skin with or without involvement of the scrotal flap 5 cases, an "apron" scrotal flap in 4 cases, and a bipedicle scrotal flap in 3 cases. Because of his underdeveloped scrotum, a new technique, radial forearm free-flap penoplasty, was done in one patient with Klinefelter's syndrome. The postoperative results were satisfactory in all except six cases. One of these was managed by a secondary full-thickness skin graft for partial scrotal flap necrosis, and the others were managed by secondary simple repair for wound disruption and infection. All patients were satisfied with the cosmetic and functional results of the scrotal flap. CONCLUSIONS: Because of their great elasticity, scrotal flaps are extremely advantageous for the repair of an extensively denuded penis. A radial forearm free flap, perhaps including the subcutaneous tissue, a long vascular pedicle, and less hair, is an alternative method when a scrotal flap is not available. Its biggest drawback is the unpleasant appearance of the donor site, which is closed with a split-thickness skin graft.
Elasticity ; Forearm* ; Free Tissue Flaps* ; Hair ; Humans ; Klinefelter Syndrome ; Male ; Necrosis ; Penis* ; Scrotum ; Skin ; Subcutaneous Tissue ; Tissue Donors ; Transplants ; Wounds and Injuries

PURPOSE: To evaluate the long-term efficacy and safety of terazosin, a selective alpha-1 blocker, in the treatment of benign prostatic hyperplasia (BPH) in Korea. PATIENTS AND METHODS: This was a 24-month, open-label, baseline-controlled study with patients evaluated at 1-to 6-month intervals. A total of 228 male patients aged 50 years or older who had clinical evidence of BPH were enrolled. Terazosin was given starting at 1 mg per day and then maintained at a dose of 3-4 mg daily. Efficacy, as judged by the International Prostate Symptom Score (IPSS), and the blood pressure (BP) were assessed according to the schedule. RESULTS: A total of 126 patients completed the study, with the most common reasons for withdrawal being loss to follow-up or adverse events. The mean IPSS was reduced by 35% or greater. In the hypertensive patients, the mean systolic BP was reduced by 11.9%(-18 mmHg) and the mean diastolic BP by 16.8%(-17 mmHg), whereas in normotensive patients, the reductions were 4.0% (-5 mmHg) and 1.2% (-1 mmHg), respectively. There were no significant differences in the IPSS improvement in these two groups. Forty-nine adverse events were reported by 32 patients, the most common being dizziness, postural hypotension, and headache. CONCLUSION: This study suggests that terazosin is effective and well tolerated in long-term treatment of patients with BPH.
Appointments and Schedules ; Blood Pressure ; Dizziness ; Follow-Up Studies ; Headache ; Humans ; Hypotension, Orthostatic ; Korea ; Male ; Prostate ; Prostatic Hyperplasia*

PURPOSE: There diagnostic modalities have been commonly used to detect prostate cancer to date: digital rectal examination (DRE), serum prostate specific antigen (PSA) and transrectal ultrasonography(TRUS). We evaluated the diagnostic values of these three modalities in the early detection of prostate cancer. MATERIALS AND METHODS: We analysed 215 patients with low urinary tract symptoms who had pathologic diagnosis for prostatic cancer was possible by biopsy or transurethral resection. Transectal ultrasonography guided sextant biopsies were performed if the PSA level was greater than 4.0 ng/ml or DRE was suspicious, even if TRUS revealed no ateas suspicious for cancer. TURP were performed without TRUS or biopsies if the PSA level was lesser than 4.0 ng/ml and DRE was negative. RESULTS: Of the 215 patients, 36 (16.7%) revealed prostate cancer. Positive predictive value, sensitivity and specificity was 37.0%. 83.3%. 71.5% for DRE, 30.0%, 91.7%, 58.3% for PSA and 27.6% 58.3%. 43.3% for TRUS respectively. Positive findings on serum PSA or DRE or both tests detected significantly more tumors(97.2%, 35of 36 cancers) than only PSA (91.7%, 33 for 36 cancers), DRE (83.3%, 30 of 36 cancers) and TRUS (60.0%, 21 of 35 cancers) alone. CONCLUSIONS: These result shows that DRE is more valuable and cost effective method for detection of prostate cancer than serum PSA and the use of DRE in conjunction with serum PSA enhances prostate cancer detection.
Biopsy ; Diagnosis ; Digital Rectal Examination* ; Humans ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Sensitivity and Specificity ; Transurethral Resection of Prostate ; Ultrasonography* ; Urinary Tract

PURPOSE: It is generally believed that chronic prostatitis is initiated by urethritis. However in actual clinical situations, many male patients without histories of urethritis present with prostatitis. To evaluate the possible relationship, we reviewed of patients with chronic prostatitis. MATERIALS AND METHODS: 326 consecutive patients with prostatitis were reviewed retrospectively on: duration of prostatitis, any history of urethritis, and history of intercourse including incidents with a high risk partner (eg. prostitutes). Prostatic ultrasonographic findings and voiding symptoms were compared with history of urethritis. RESULTS: A history of urethritis was found in 228 (70%) of patients, but 36 (11%) denied both sexual intercourse and urethritis. In 62 (19%) patients, there was no history of urethritis but there existed a sexual encounter with a high risk partner. There is no statistically difference between the history of urethritis and the duration of prostatitis, the prostatic ultrasonographic findings, and voiding symptoms. Therefore no significant relationship between urethritis and chronic prostatitis was found. CONCLUSIONS: These data suggest that having urethritis is not an important risk factor in chronic prostatitis. These studies may be comforting to those who are inflicted with chronic prostatitis and concerned with the nature of the disease. Thus chronic prostatitis can be explained as an inflammation of the prostate, not a dreadful end result of sexually transmitted disease.
Coitus ; Humans ; Inflammation ; Male ; Prostate ; Prostatitis* ; Retrospective Studies ; Risk Factors ; Sexually Transmitted Diseases ; Urethritis*

PURPOSE: Penile size has been a focus of interest in the life and the culture throughout human history. It has been a longstanding question whether there is any relation between penile size and the dimensions of body extremities. We measured the standard length of the penis and investigate whether any body extremity is a predictive index of penile size in Korea men. PATIENTS AND METHODS: A series of 655 males above 17 years of age were examined during a 4-month period. Stretched penile length, penile circumference, and length and characteristics of various body parts and features (1st finger, 2nd finger, 3rd finger, 1st toe, 2nd toe, 3rd toe, ear, mouth, nose, height, weight, and baldness) were investigated by one examiner. To see the relation among the penile length and circumference and various body dimensions, univariate and multivariate statistical methods such as correlation analysis and multiple linear regression were applied. RESULTS: The mean values standard deviations were 46.6 +/- 18.4 for age, 10.0 +/- 2.0 cm for the length of the penis, and 8.5 +/- 1.0 cm for the circumference of the penis. In a correlation coefficient analysis, the length of the penis was slightly correlated with penile circumference. Additionally, the circumference of the penis was slightly correlated with penile length, patient height, weight, and 3rd toe and 1st toe length, in decreasing order. In a multivariate analysis, the coefficients of determination from multiple linear regression were 13% and 15% for the length and the circumferences of the penis, respectively. CONCLUSIONS: Human body index including the size or characteristics of body extremities is not enough to predict the penile size.
Ear ; Extremities ; Fingers ; Human Body ; Humans ; Korea ; Linear Models ; Male ; Mouth ; Multivariate Analysis ; Nose ; Penis ; Toes

PURPOSE: To investigate the clinical efficacy of Korea red ginseng for relief of mild vasculogenic impotence. PATIENTS AND METHODS: Twenty-six patients having mild vasculogenic impotence (absence of full rigidity on the pharmacologic erection test and peak systolic velocity in the cavernous arteries of 20-35 cm/sec) were enrolled in this randomized, double-blinded, placebo-controlled study. Duplex sonography of the cavernous artery, Rigiscan noctunal penile tumescence monitoring, and a modified Watts sexual function questionnaire were carried out before and after 3 months of treatment. RESULTS: The total and sexual satisfaction score on the questionnaire were significantly increased after treatment with Korean red ginseng. Most of the other variables were also improved, although without statistical significance. Even though the difference was insignificant, possibly because of the small number of patients enrolled, the end-diastolic velocity in the cavernous artery was decreased in patients receiving ginseng. This finding might reflect a relaxation effect of ginseng on corpus cavernosal smooth muscle, which has been demonstrated in vitro. CONCLUSION: Korea red ginseng might improve subjective sexual function in men with mild vasculogenic impotence. However, efficacy was not proved objectively.
Arteries ; Female ; Humans ; Impotence, Vasculogenic ; Korea* ; Male ; Muscle, Smooth ; Panax* ; Penile Erection ; Surveys and Questionnaires ; Relaxation

Polyorchidism is a very rare anomaly of the genitourinary tract and about 100 cases have been reported in the literature. Although polyorchidism is associated with undescended testis, inguinal hernia, testicular torsion, hydrocele, epididymitis, varicocele and cancer, the majority of the patients are asymptomatic and present with painless groin or testicular masses. We describe a case of polyorchidism in a 19-year-old man with varicocele and review the literature and current management of polyorchidism.
Cryptorchidism ; Epididymitis ; Groin ; Hernia, Inguinal ; Humans ; Male ; Spermatic Cord Torsion ; Varicocele* ; Young Adult

PURPOSE: Stem cell-based cell therapy has recently been tried as a way to restore cavernosal function in an animal model. The aims of this study were to elucidate the effect of intracavernosally injected embryonic stem cells(ESCs) in aged rat. MATERIALS AND METHODS: Male Sprague Dawley rats were divided into 3 groups: young control(12 weeks old; n=10), old with vehicle injection(24 months old; n=7), and old with ESC injection(24 months old; n=8). ESCs were transfected with firefly luciferase attached to adenovirus and then injected intracavernously 2 times with a 1-week interval. Cell survival was assessed by optical molecular imaging 2 days after the last ESC injection. At 4 weeks after the last injection, intracavernosal pressure and systemic arterial pressure were recorded after pelvic nerve stimulation. Serum testosterone levels were measured by radioimmunoassay. RESULTS: We observed fluorescent signals around the external genitalia of animals injected with ESCs. The serum testosterone level of the old group(1.39+/-0.07 ng/ml) was significantly lower compared to the young control group(2.98+/-0.31 ng/ml)(p=0.03). The percentage of intracavernosal pressure/systolic blood pressure was significantly lower in the old group(58.5+/-8.6%) compared to the young control group(69.5+/-6.6%)(p=0.034). However, the old group with ESC injection(61.6+/-9.9%) did not show any significant differences from the old group(p>0.05). The old group with ESC injection showed histomorphometry similar to the old group. CONCLUSIONS: The presence of intracavernosal ESCs can be noninvasively monitored with optical molecular imaging. However, the intracavernosal injection of ESCs did not improve erectile function in the aging rat. Further studies are needed to elucidate the regulatory factors of stem cell differentiation in the corpus cavernosum.
Adenoviridae ; Aging ; Animals ; Arterial Pressure ; Blood Pressure ; Cell Survival ; Cell- and Tissue-Based Therapy ; Embryonic Stem Cells* ; Erectile Dysfunction ; Fireflies ; Genitalia ; Humans ; Luciferases ; Male ; Models, Animal ; Molecular Imaging ; Radioimmunoassay ; Rats* ; Rats, Sprague-Dawley ; Stem Cells ; Testosterone

PURPOSE: This study was performed to determine the effects of phytoestrogen on seminal vesicle excitability. MATERIALS AND METHODS: Single smooth muscle cells of seminal vesicle were obtained from rabbits using proteolytic enzymes(collagenase). Using single cell and channel recording methods of patch clamp, the various currents of potassium channels in smooth muscle cells were recorded. Potassium currents were divided into calcium dependent and independent. RESULTS: Most of the calcium dependent K currents were maxi-K currents and most of calcium independent ones were delayed rectifier K currents. Inside-out patch clamp technique was used to characterize the maxi-K channel. The channel showed outward rectification and calcium dependency. The single-channel conductance of this channel estimated from slope conductance was 119.4+/-11.7 pS under physiological conditions. These characteristics were typical properties of maxi-K channels. Application of genistein(10micronM) rarely affected the delayed rectifier K channel activities, but it evoked significant increase of maxi-K channel activities at both single cell and channel levels. CONCLUSIONS: From these results it is strongly suggested that the excitability and contractility of seminal vesicle might be modulated by genistein through a mechanism of maxi-K channel activation.
Calcium ; Genistein ; Large-Conductance Calcium-Activated Potassium Channels ; Muscle, Smooth* ; Myocytes, Smooth Muscle* ; Phytoestrogens* ; Potassium Channels* ; Potassium* ; Rabbits ; Seminal Vesicles*