Serous papillary cystadenomas arising in testis have been rarely reported, and they often resemble ovarian serous tumors of borderline malignancy. Herein, we report a case of a serous papillary cystadenoma of the testis in a 59 year old man. Based on a clinical diagnosis of left testicular tumor, a left radical orchiectomy was performed. The pathologic evaluation revealed a serous papillary cystadenoma of borderline malignancy in the testis.
Cystadenoma, Papillary* ; Diagnosis ; Humans ; Middle Aged ; Orchiectomy ; Testis*

PURPOSE: The International Prostate Symptom Score(IPSS) is the most commonly used scoring system to evaluate lower urinary tract symptoms(LUTS) in patients with benign prostatic hyperplasia(BPH). A Korean translation of the IPSS, however, has never been clearly confirmed to assess LUTS accurately. The objective of this study was to measure differences in the Korean-language IPSS when administered by the patient versus the physician, and to evaluate causes of the differences. MATERIALS AND METHODS: One-hundred-thirteen patients with symptomatic BPH completed 3 consecutive IPSS questionnaires, one self-administered at the first visit, the second self-administered at the next visit, and the last by a physician interview just after the second self-administration. We compared differences in the symptom scores between the each of the 3 administrations. In addition, the effect of age and education on the scores was analysed. RESULTS: There was no significant difference in the IPSS between the first and the second self-administration. However, physician-administered scores were significantly lower than the two self-administrations(p <0.01) for all questions except #5 regarding urinary stream. The difference in the score was higher in patients whose LUTS were more severe(p <0.01). Age and education did not affect the scores. CONCLUSIONS: There was a significant difference in the IPSS between patient and physician administration, suggesting a need for revision of the Korean version of IPSS.
Education ; Humans ; Prostate* ; Prostatic Hyperplasia ; Surveys and Questionnaires ; Rivers ; Urinary Tract

PURPOSE: To investigate the frequency of symptoms of late onset hypogonadism(LOH) and the intention for testosterone replacement therapy in Korean males in their 40s and above. MATERIALS AND METHODS: Korean males over age 40 were given a detailed explanation of LOH and the Korean version of Androgen Deficiency in Aging Male(ADAM) questionnaire(Saint Louis University) by e-mail. Positive for ADAM was defined as answering 'yes' to Q3 or Q7 which estimate the decline of sexual desire and erectile dysfunction or answering 'yes' to more than 3 other questions. The men's intention to take testosterone replacement therapy when recommended for symptoms of LOH was also queried. RESULTS: Among 38,502 people who opened the e-mail, 15.1%(5,795) of men responded to the survey. The largest fraction of respondents was males in their 40s(60%). The ADAM questionnaire revealed 64.6% of respondents as positive for LOH. More than 50% of respondents complained of decline in erection, endurance, or sexual desire. When asked about their intention to take testosterone replacement therapy, 96% of those positive for LOH answered that they would accept the treatment. CONCLUSIONS: Although the response ratio was low, 96% of screened LOH men showed high interest in LOH and a positive attitude toward testosterone replacement therapy. Urologists should thoroughly investigate the symptoms of LOH in men in their 40s and above and conduct testosterone replacement therapy as indicated, in order to improve the quality of life for Korean men.
Aging ; Surveys and Questionnaires ; Electronic Mail ; Erectile Dysfunction ; Humans ; Hypogonadism* ; Intention ; Male* ; Quality of Life ; Testosterone

PURPOSE: Premature ejaculation is a common male sexual dysfunction and has an adverse effect on QoL(quality of life). Chronic pelvic pain syndrome(CPPS) is also a common and serious health problem affecting QoL. Although both disorders are common their etiopathogeneses are not well understood. We investigated the prevalence and effect of premature ejaculation on erectile function in CPPS patients and compared these patients with healthy control subjects. MATERIALS AND METHODS: 638 CPPS patients and 102 healthy controls were enrolled in this study. Each patient was given a questionnaire consisting of 3 parts: a demographic data questionnaire, the Korean version of the NIH-CPSI(National Institutes of Health-Chronic Prostatitis Symptom Index), and IIEF(International Index of Erectile Function). Premature ejaculation was defined as intravaginal ejaculation latency of less than 3 minutes with the same partner for at least 6 months. RESULTS: 303 patients with CPPS and 83 healthy controls were eligible for the analysis. The rate of premature ejaculation was much higher in patients with CPPS(71.62%) than healthy controls(22.89%), and this difference was statistically significant(p < 0.01). In the patients with CPPS, the frequency of sexual intercourse per month during the last 3 months was 4.79+/-3.43. In the patients with CPPS, the mean scores for IIEF-EF(erectile function), IIEF-IS(intercourse satisfaction), IIEF-OF(orgasmic function), IIEF-SD(sexual desire) and IIEF-OS(overall satisfaction) were 21.7+/-6.4, 8.5+/-2.9, 7.4+/-2.5, 5.3+/-2.0 and 5.2+/-2.1, respectively. Each mean IIEF domain score was lower than healthy controls, and these differences were statistically significant. But in the patients with CPPS categorized in IIIa and IIIb, the frequency of sexual intercourse and each IIEF domain score showed no difference. CONCLUSIONS: The rate of premature ejaculation was higher in the patients with CPPS than healthy controls.
Academies and Institutes ; Coitus ; Ejaculation ; Humans ; Male ; Pelvic Pain* ; Premature Ejaculation* ; Prevalence* ; Prostatitis

PURPOSE: Smoking is a known risk factor for lung cancer, cardiovascular diseases, and atherosclerosis. The link between smoking and erectile dysfunction(ED) has been supported from in vitro studies, animal studies, and epidemiological evidence. We evaluated the effect of smoking on penile hemodynamics in ED. MATERIALS AND METHODS: Patients aged 40~80 years who visited our urological institute for ED were enrolled. We performed a standard ED evaluation that included medical history, physical examination, and measurements of serum glucose, testosterone, and prolactin. We excluded ED patients with abnormal androgen profiles and patients with ED risk factors other than smoking. A total of 108 ED patients entered the study, including 51 current smokers, 24 non-smokers, and 33 ex-smokers. All patients then underwent extensive evaluation, including nocturnal penile tumescence and rigidity(NPTR) monitoring with Rigiscan(R), and pharmacopenile Doppler ultrasonography for peak systolic velocity(PSV), and end diastolic velocity(EDV). RESULTS: The average ages of the current smokers, non-smokers, and ex-smokers were 55.7+/-4.6, 53.7+/-3.9, and 56.5+/-4.3 years, respectively(p=0.07). Of current smokers, 78% had abnormal NPTR testing, compared with 64% of non-smokers and 67% of ex-smokers(p=0.04; current vs non-smokers, p=0.04; current vs ex-smokers). The average PSV for current smokers, non-smokers, and ex-smokers was 26.8+/-3.2, 31.2+/-4.5, and 29.7+/-4.4 cm/s, respectively(p=0.06; current vs non-smokers, p=0.07; current vs ex-smokers). The average EDV for current smokers, non-smokers, and ex-smokers was 5.9+/-2.7, 4.4+/-1.6, and 4.2+/-1.5 cm/s, respectively(p=0.04; current vs non-smokers, p=0.03; current vs ex-smokers). In the currently-smoking patients, there was no significant correlation between NPTR, PSV, or EDV and the amount or duration of smoking. CONCLUSIONS: We concluded that dysfunction of penile veno-occlusive mechanism plays a substantial role in the development of ED in smokers.
Animals ; Atherosclerosis ; Blood Glucose ; Cardiovascular Diseases ; Erectile Dysfunction* ; Hemodynamics* ; Humans ; Lung Neoplasms ; Male ; Penile Erection ; Physical Examination ; Prolactin ; Risk Factors ; Smoke* ; Smoking* ; Testosterone ; Ultrasonography, Doppler

PURPOSE: The purpose of this study was to correlate erectile function with polysomnographic indexes of obstructive sleep apnea(OSA) and other associated factors. MATERIALS AND METHODS: Among the 42 patients who visited our sleep clinic, we enrolled 32 patients who scored lower than 22 on the IIEF-5(International Index of Erectile Function-5). Polysomnography(PSG) was performed for OSA evaluation. Apnea-hypopnea index(AHI), AHI during REM sleep, AHI during non-REM sleep, arousal index(AI), and sleep efficacy(SE) were used as PSG indexes. Obesity was quantified by body mass index(BMI). The patients were divided into 2 groups according to AHI: group A< or =10(n=13); group B> 10(n=19). BMI and erectile function scores were compared between the 2 groups. The correlations among erectile function scores, PSG indexes, and BMI were analyzed. RESULTS: IIEF-5 score was negatively correlated with AHI(r=-0.372, p <0.05) and AI(r=-0.472, p <0.05), and there was a positive correlation with SE(r=0.372, p <0.05) of PSG. Between the 2 AIH groups, the low AHI group had a statistically higher mean erectile function score, especially in the EF domain and in the total IIEF score compared to the high AHI group. CONCLUSIONS: Indexes for penile rigidity were negatively correlated with AHI and AI. These findings suggest that AHI, AI, and SE of PSG are meaningful indexes of erectile function and support the hypothesis that hypoxia induced by sleep apnea plays a role in poor rigidity. Further studies in larger groups, including analysis of PSG indexes and erectile function changes before and after the treatment of sleep apnea, would be necessary to confirm this hypothesis.
Anoxia ; Arousal ; Erectile Dysfunction* ; Humans ; Male ; Obesity ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Sleep, REM

During the past 10 years, there have been many studies in the field of female sexual function and dysfunction. Studies of genital hemodynamic-related sexual arousal, contractility of the genital tissue, and the effects of sex steroid hormones on sexual function are increasing our understanding of female sexual function and dysfunction, and also are fundamental to the pharmacotherapy of female sexual dysfunction. On the basis of the clinical studies, testosterone is a strongly recommended treatment for women with sexual desire disorder with androgen deficiency. Female sexual arousal disorder with defects in genital hemodynamics is considered as a candidate for drugs that increase genital blood flow, including phentolamine, phosphodiesterase type 5 inhibitors, apomorphine, prostaglandine E1, and VIP derivates. Although many drugs have bee tested in the clinical treatment of sexual symptoms the results of clinical trials with these drugs have not been consistent. Women are largely affected in the initiation of sexual desire and in the process of sexual arousal by psychodynamics like mood or intimacy. However, some of the drugs which have shown inconsistent effects may still offer the promise of significantly improving sexual symptoms, and certainly offer treatment options that go beyond psychological treatment, which has been the only treatment available for many decades. In this review, I will summarize several drugs that have been tried clinically or could be applied theoretically.
Apomorphine ; Arousal ; Bees ; Drug Therapy ; Female* ; Gonadal Steroid Hormones ; Hemodynamics ; Humans ; Phentolamine ; Phosphodiesterase 5 Inhibitors ; Sexual Dysfunctions, Psychological ; Testosterone

Currently intracavernous pharmacotherapy is the second common therapeutic modality for erectile dysfunction after the introduction of Viagra. Nevertheless, intracavernous pharmacotherapy has increased in popularity for the past 15 years. While having an overwhelming safety after complete training in injection method, this treatment option can reveal unexpected complications related to self-injection. We report two cases of intracavernous needle breakage associated with alprostadil (Caverject , Pharmacia-Upjohn) and trimix self-injection therapy with a brief review of the literature.
Alprostadil ; Drug Therapy ; Erectile Dysfunction ; Male ; Needles* ; Sildenafil Citrate

A study was conducted in three large populations to determine whether sperm quality has changed in Korea between January 1995 to November 1999. We reviewed sperm concentration, motility and semen volume on two tertiary general hospitals in Korea, data of which collected since 1995 till 1999 according to the WHO guidelines(1987). The data were collected in healthy young Korean men in one center and those who visited urologic clinic in another center, There was no statistically significant difference at each year(p>0.05). Also semen volume and motility were not changed during that times. The data was collected in 1999 in both centers and monthly trends were also compared. No significant change was observed. No changes were observed in the semen parameters analysed in this two distinct populations, showing no evidence of deteriorating sperm quality in Korea over recent years. Furthermore, more data is required to draw any conclusion about the trend of semen qualities in Korea.
Hospitals, General ; Humans ; Korea ; Male ; Semen Analysis ; Semen* ; Spermatozoa

PURPOSE: While apoptosis of the rat prostate cells has been the focus of many studies on androgen action and prostatic carcinogenesis, little is known for morphometric measurement about rat prostatic glands. Apoptosis was described as a morphologically distinct form of cell death. However, the approach of morphological assessment in one cell to define apoptosis has some disadvantages. We studied androgen ablation induced reduction of glandular epithelial cells with counting apoptotic cells and measuring glandular cell mass with image analyzer. MATERIALS AND METHODS: Male Sprague-Dawley rats were used. The morphologic changes were evaluated at 4, 7, 14 days after castration. The ventral lobe was microdissected. The distal part of it was harvested under guide of dissecting microscope. The number of apoptotic cells were quantified in Masson & trichrome stained specimens. Using image analyzer, area densities in glandular lesion of prostatic epithelium were calculated. RESULTS: After castration. the distal duct may seem to be melted down into the proximal ducts and tall columnar epithelial cells of distal duct seem to be changed into cubodial cells. The apoptotic counts were 1.00+/-0.28, 5.06+/-0.98, 6.01+/-0.97, and 2.04+/-0.70 in control, 4th, 7th and 14th day group, respectively (p<0.05), The areas of epithelial cell mass were 13874+/-3106 micrometer2. 5530+/-3244 micrometer2, 2345+/-1226micrometer2, and 1339+/-652 micrometer2. in control, 4th. 7th and 14th day group, respectively(p<0.05). CONCLUSIONS: We conclude that castration induces a more profound involution of the rat ventral prostate. After castration, the apoptotic count and reduction of the area of epithelial cell mass rapidly processed by 7th day and after that time, this process is continuously but slowly decreased until 14th day after castration. The apoptotic counts among the epithelial cells are well matched with the morphometric measurements about epithelial glands.
Animals ; Apoptosis* ; Carcinogenesis ; Castration* ; Cell Death ; Epithelial Cells* ; Epithelium ; Humans ; Male ; Prostate* ; Rats* ; Rats, Sprague-Dawley