Median raphe cyst is a relatively uncommon disease and is caused by a defect in the embryonic development of male genitalia. Here, we report a case of median raphe cyst on the glans penis in a 20-year-old male, which was successfully treated by surgical excision.
Embryonic Development ; Female ; Genitalia, Male ; Humans ; Male ; Penis ; Pregnancy ; Young Adult

Polyorchidism is a very rare congenital anomaly and about 100 cases have been documented in the literature until today. Polyorchidism or supernumenary testis is defined as the presence of more than 2 histologically proven testes. In most case, polyorchidism have characteristics of unilateral involvement and three testis and mainly finding in left-side testis. And although patient age was various, average age was about 18-year-old in previous review of article. We report a rare case of polyorchidism that an old age patient had an incidentally found right accessory testis in operating a testicular injury.
Adolescent ; Humans ; Testis

PURPOSE: The aim of this study was to assess the efficacy and safety of tamsulosin, 0.2mg/day on sexual function in Korean BPH patients. Patients and Methods: 116 patients (mean age: 60 yrs) with BPH were enrolled in this study and 0.2mg of tamsulosin was administrated every night for 3 months. Primary efficacy was evaluated with changes of IIEF and GEQ. Secondary efficacy parameters were changes of IPSS and QoL, uroflowmetry, changes of total IIEF and IIEF domain score according to the severity of IPSS, and retrograde ejaculation. RESULTS: Before treatment, patients of moderate IPSS (8-19) and severe IPSS (20-35) were 56% and 44% and QoL<3 and QoL>3 were 33.6% and 66.4%. In primary efficacy evaluation, total IIEF score was significantly increased from 37.0+/- 18.2 to 40.5+/- 18.9 (p<0.01). All domains of IIEF except orgasmic function were significantly improved. GEQ showed improvement of erection in 34.4% and intercourse ability in 30.1%. In secondary efficacy evaluation, IPSS was significantly decreased from 18.4+/- 6.9 to 12.9+/- 6.7 (p<0.01) and QoL was significantly improved from 3.8+/- 1.1 to 2.7+/- 1.4 (p<0.01). Qmax significantly increased from 14.2+/- 8.3 to 16.5+/- 11.3 ml/sec (p<0.01). Total IIEF score and EF domain score were significantly improved from 36.8+/- 18.5 to 41.8+/- 19.1 (p<0.01) and from 13.0+/- 7.1 to 14.7+/- 7.9 (p<0.01) in patients of moderate IPSS but no improvement in severe patients. Retrograde ejaculation occurred in 2 patients (2%). No serious adverse reactions were observed. CONCLUSIONS: Tamsulosin, 0.2mg/day was effective and safe dose for the improvement of LUTS and sexual function for Korean BPH/LUTS patients.
Ejaculation ; Humans ; Male ; Orgasm ; Prospective Studies ; Sulfonamides

PURPOSE: Intravesical prostatic protrusion (IPP) is a morphological change of prostate protruded into bladder and might be related to bladder outlet obstruction (BOO) depending on the extent of protrusion. There is a high possibility that lower urinary tract symptoms (LUTS) tends to get worse as IPP grows. Therefore, it is necessary to examine the effect of IPP on LUTS after revision of prostate volume in order to identify the direct effect of IPP on BOO and LUTS. MATERIALS AND METHODS: A retrospective study of 296 male patients diagnosed with benign prostate hyperplasia (BPH) between August 2006 and December 2008 were performed. The patients were evaluated with international prostate symptoms score (IPSS) and quality of life (QoL), uroflowmetry (UFR), post-void residual urine volume (PVR), prostate volume and IPP as measured by transurectal ultrasound (TRUS). The changes of IPSS after 8 weeks of medication treatment and the occurrence rates of transurethral resection of prostate (TURP) and acute urinary retention (AUR) were compared. By checking IPSS and UFR, the improvement of voiding symptom was evaluated. RESULTS: The population of patients with moderate enlargement (30-50gm) of prostate extent was 147 (49.6%) out of 296, the whole examined population. There were correlation between IPP and IPSS (p=0.002) and the storage symptoms score was significantly increased (p=0.014). After 8 weeks of medication treatment, both moderate BPH patients with IPP showed similar improvement in storage symptom compared to non-IPP groups. But, the TURP was significantly performed more with IPP (p=0.040) than non-IPP groups and more AUR has occurred (p=0.013). After TURP, IPP group resulted in improvement of IPSS, storage symptoms score and voiding symptoms score statistically compared to non-IPP group. As the change of UFR and IPSS after TURP had shown, the improvements of voiding volume, maximal flow rate (Qmax), and average flow rate (Qavg) in IPP groups were smaller however, it is no correlation in statistical view. CONCLUSIONS: Moderate BPH group with IPP has a higher possibility of having AUR and surgical treatment while showing significant correlation with storage symptoms. A further prospective study is necessary for identification of improvement of IPSS and UFR after TURP and IPP should be checked carefully during TRUS.
Humans ; Hyperplasia ; Indoles ; Lower Urinary Tract Symptoms ; Male ; Prostate ; Prostatic Hyperplasia ; Quality of Life ; Retrospective Studies ; Transurethral Resection of Prostate ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Retention

PURPOSE: Prostatic abscess is a very rare disease whose incidence has been reported to be approximately 0.2% in patients with urologic symptoms. Besides, it cannot be diagnosed by interview and physical examination, for which imaging studies must also be performed. In the current study, we examined the clinical usefulness of imaging studies in making a diagnosis of prostatic abscess and the effect of a fine needle aspiration based on trans-rectal ultrasonography on the treatment outcomes. MATERIALS AND METHODS: In ten patients who were diagnosed with prostatic abscess and then treated during a period ranging from January of 1995 to June of 2008 (mean age: 61.8 years, range: 40-89 years), a past history, clinical symptoms, physical examination findings, laboratory findings, trans-rectal ultrasonography findings, computed tomography findings, treatment modalities and complications were retrospectively analyzed. RESULTS: All patients complained fever and voiding dysfunction as chief complaint. On trans-rectal ultrasonography and computed tomography scans, all the ten patients had abnormal findings. In five patients, there were nonhomogenous hypo-echoic lesions on trans-rectal ultrasonography. All the patients had cystic abscess lesions detected on computed tomography scans. In four patients, in whom the diameter of lesions was greater than 1cm on computed tomography scans, a fine needle aspiration was performed on trans-rectal ultrasonography and antibiotic treatment was performed. In six patients, in whom the diameter of lesions was smaller than 1 cm on computed tomography scans, antibiotic treatment was performed. There were statistically significant differences in the length of hospital stay and the size of prostate gland between the group where a fine needle aspiration was performed using trans-rectal ultrasonography and the group where antibiotic treatment was performed (p<0.05). However, there was no significant difference in the period of antibiotic treatment (P>0.05). Length of antibiotic therapy was shorter in antibiotic therapy only group, but there was no statistically significant difference (P>0.05). CONCLUSIONS: A computed tomography is a useful diagnostic modality for prostatic abscess. Besides, a fine needle aspiration based on trans-rectal ultrasonography is one of the minimally invasive treatment regimens for prostatic abscess, whose good treatment outcomes have been well documented. Furthermore, there were no severe complications in our series.
Abscess ; Biopsy, Fine-Needle ; Fever ; Humans ; Incidence ; Length of Stay ; Physical Examination ; Prostate ; Rare Diseases ; Retrospective Studies

PURPOSE: Sildenafil citrate(Viagra(R)), a PDE-5 inhibitor in the corpus carvenosum to facilitate penile erection has improved impaired erectile responses in men and has been accepted as a primary treatment of erectile dysfunction. However, complications occurred by Viagra have increased due to its overuse and misuse. Therefore, we have performed a survey to compare physicians and general population in Busan, Korea to assess their understanding of Viagra. Methods and Materials: In 2007, printed surveys were mailed to randomly sampled candidates of 197 primary physicians and 696 individuals from general population, 327 medical students in Busan were surveyed by door-to-door visits. We assessed opinions associated with Viagra eliciting their understanding about its safety, direction, and complications. Data were analyzed using SPSS and were identified by crosstabulation analysis using Ki-square test. RESULTS: Of 1,265 eligible responses, several differences were found between the 3 groups. Compared to general population, the others were more likely to understand the efficacy, directions, and complications of Viagra. Physicians and medical students(43.1% and 39.0%) gave more preference than general population(26.1%) to using Viagra. There were differences in understanding of Viagra with changes of education level. However, it showed no significant differences about idea of illegal Viagra and combination usage with nitrates. Conclusion: The number of patients using Viagra is increasing but their understanding about Viagra is still poor. Moreover, general populations understand Viagra as 'assistant' for erection poorly. Even some medical students understand more than physicians. The ideas of complications would likely affect to negative thinking about usage for Viagra. Therefore more active and continuous educations for proper use of Viagra are suggested for medical efficacy and less complications.
Erectile Dysfunction ; Humans ; Korea ; Male ; Nitrates ; Penile Erection ; Piperazines ; Postal Service ; Purines ; Students, Medical ; Sulfones ; Thinking ; Sildenafil Citrate

PURPOSE: There are several reports about relationships between cardiovascular risk factors and lower urinary tract symptoms (LUTS). We investigated the effects of risk factors for vascular disease on LUTS and erectile function (ED). MATERIALS AND METHODS: We prospectively analyzed 273 patients who had LUTS or ED. A self administered questionnaire of International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF) were given to patients. Cardiovascular risk factors including hypertension, smoking status, diabetes and dyslipidemia were determined in each patients. RESULTS: Mean age was 60.5+/-9.4 years. Mean IPSS, IIEF and IIEF-EF score were 15.9+/-5.9, 30.1+/-15.4 and 17.35+/-9.0, respectively. There are statistically significant differences in the IPSS (p=0.047), IIEF (p=0.024) and IIEF-EF domain score (p=0.044) between men with no risk factors and men with one or more risk factors. IPSS, IIEF and IIEF-EF score were 11.5+/-6.4, 39.8+/-11.9 and 19.6+/-8.7 in men with no risk factor (n=94), 16.6+/-5.6, 28.4+/-15.0 and 15.1+/-9.3 in men with at least one risk factor (n=179). In men with one to four risk factors, the mean IPSS was 14.5+/-5.1 (n=63), 16.3+/-4.4 (n=45), 21.2+/-5.5 (n=43) and 26.5+/-3.5 (n=28)(p=0.001); the mean IIEF score was 31.4+/-14.2, 27.8+/-16.8, 22.5+/-14.1 and 19.0+/-9.9 (p=0.037); the mean IIEF-EF score was 17.1+/-8.9, 14.7+/-9.0, 10.9+/-9.7 and 8.8+/-4.5 (p=0.023), respectively. CONCLUSIONS: Men with risk factors for vascular disease are more likely to have a higher IPSS and a lower IIEF and IIEF-EF score than men without risk factors. These results suggests that vascular disease of men is significantly related with the progression of LUTS and ED.
Dyslipidemias ; Erectile Dysfunction ; Humans ; Hypertension ; Lower Urinary Tract Symptoms ; Male ; Multiple Endocrine Neoplasia Type 1 ; Prospective Studies ; Prostate ; Surveys and Questionnaires ; Risk Factors ; Smoke ; Smoking ; Vascular Diseases

PURPOSE: We investigated the results of voiding parameters according to the subtypes of audiovisual stimulation (AVS)- and sexual stimulation (SS)-penogram in patients with both erectile dysfunction (ED) and lower urinary tract symptoms (LUTS). MATERIALS AND METHODS: Sixty seven patients with ED and LUTS were included in this study. Erectile function was evaluated by international index of erectile function (IIEF)-5, AVS-penogram, and SS-penogram. After AVS-penogram, SS-penogram was performed 30 minutes after taking mirodenafil (100mg) orally. We also evaluated voiding function with international prostatic symptom score (IPSS), quality of life score (QoL), urinary flow rate (UFR), residual urine volume (RV), and transrectal ultrasonograpy (TRUS). Voiding functionparameters were analyzed according to the subtypes of AVS- and SS-penogram. RESULTS: Although there was tendency that the IIEF-5 scores were lower in patients who showed decreased erectile responses on AVS-penogram, but it did not reach the statistical significance (p= 0.09). The RV was significantly increased as the erectile function worsens based on AVS-penogram (p= 0.003). However, no significant relationship was found betweenresults of SS-penogram and voiding function parameters. CONCLUSIONS: Our results revealed some relationship between voiding function and erectile function evaluated by AVS-penogram, but not by SS-penogram, in patients with both ED and LUTS. AVS-penogram, as well as IIEF questionnaire, may play an important role in predicting voiding function in patient with both conditions .
Erectile Dysfunction ; Humans ; Lower Urinary Tract Symptoms ; Male ; Pyrimidinones ; Quality of Life ; Surveys and Questionnaires ; Sulfonamides

PURPOSE: Diabetes mellitus is one of the most common causes of erectile dysfunction (ED). The pathogenesis of ED in diabetic patients is not clear, although vasculogenic and neurogenic factors are involved. This study was designed to further characterize the pathophysiologic manifestations of ED in diabetic patients. MATERIALS AND METHODS: Fifty-seven important patients aged 20 to 71 (mean 45) years participated in this study. On the basis of their medical history, physical examination, and multidisciplinary impotence work-ups, patients were divided into diabetic (n=25) and non-diabetic (psychogenic; n=32) groups. To evaluate vasculogenic manifestations, a pharmacological erection test and penile duplex ultrasonography were performed. To evaluate neurologic manifestations, nicotinamide adenine dinucleotide phosphate (NADPH) diaphorase staining was performed on cavernous tissue samples obtained by percutaneous biopsy. Staining was assessed by counting the number of nitric oxide synthase (NOS)-containing nerve fibers present in four random fields (power 400x). In the diabetic group, we additionally assessed the duration of diabetes, the duration of treatment, and the latency between the onst of ED and the time diabetes was diagnosed. RESULTS: The pathophysiologic causes for ED in the diabetics proved to be neurogenic in 44%, vasculogenic in 20%, and mixed (combined neurogenic and vasculogenic) in 36%. Vascular assessment in the diabetics showed that penile rigidity was decreased and end-diastolic velocity was increased compared with the nondiabetics. Latency to the onset of ED from the diagnosis of diabetes was 0 to 15 (average 5.3) years, and it was closely correlated with the status of NOS-containing nerves (p<0.05). The status of NOS-containing nerves also correlated well with the degree of diabetic control but not with the control method. CONCLUSIONS: Diabetes causes ED by a variety pathophysiologic mechanisms, including neurogenic, vasculogenic, or both. Early and appropriate control of diabetes is required to prevent ED.
Biopsy ; Diabetes Mellitus ; Diagnosis ; Erectile Dysfunction* ; Humans ; Male ; NADP ; Nerve Fibers ; Neurologic Manifestations ; Nitric Oxide Synthase ; Penile Erection ; Physical Examination ; Ultrasonography

BACKGROUND AND PURPOSE: Catecholamines have an effect on sexual drive. When the sympathetic nervous system is excited, norepinephrine is released from nerve terminals, epinephrine from the adrenal glands, and dopamine in the central nervous system. Serotonin has a central inhibitory effect on sexual drive. Major adrenergic and serotoninergic innervation is found in the hippocampus. This study was performed to investigate the differences in serotonin release from rat hippocampal slices in the central nervous system in response to various catecholamines. MATERIALS AND METHODS: The hippocampus from the rat brain was sliced. After 30 minutes' incubation in normal buffer, the slices were incubated for 20 minutes in a buffer containing 0.1 micro M [3H]5-HT and then washed. After administration of norepinephrine (10-5M), dopamine (10-5M), or epinephrine (10-5M), the release of [3H]5-HT into the buffer was measured. The radioactivity in each buffer and tissue was counted, and the results were expressed as a percentage of the total activity. The value of released [3H]5-HT was expressed as percent of the value at 50 minutes when a steady state of [3H]5-HT release had been obtained. RESULTS: After administration of norepinephrine, dopamine, and epinephrine, the values (mean +/- SE, %) were 115.7 +/- 2.3, 136.8 +/- 10.5, 107.4 +/- 7.7 at 60 minutes and 105.8 +/- 5.5, 140.7 +/- 7.7, 94.2 +/- 6.2 at 70 minutes vs. 96.6 +/- 1.9 at 60 minutes and 89.2 +/- 2.3 at 70 minutes for the control group. The release thus was increased significantly after administration of norepinephrine and dopamine, and the effect of dopamine was more significant than that of epinephrine. CONCLUSIONS: Release of serotonin is increased by norepinephrine and dopamine. The effect of dopamine was more significant than that of epinephrine. Reciprocal increase in serotonin release after administration of catecholamines may be involved in their effect on sexual function.
Adrenal Glands ; Animals ; Brain ; Catecholamines* ; Central Nervous System ; Dopamine ; Epinephrine ; Hippocampus ; Norepinephrine ; Radioactivity ; Rats* ; Serotonin* ; Sympathetic Nervous System