Since the elderly population has been increasing recently in our country, old male patients with testosterone deficiency syndrome (TDS) with a significantly decreasing quality of life are becoming increasingly common. TDS in males is defined as a biochemical syndrome associated with advancing age and characterized by clinical manifestation and a deficiency in the serum testosterone level. These patients should be treated with extrinsic testosterone to improve quality of life. TDS in males should be diagnosed in the case of clinical manifestation with serum total testosterone <8 nmol/L (230 ng/dL) or calculated free testosterone <225 pmol/L (65 pg/mL) but not diagnosed in the case of serum total testosterone >12 nmol/L (350 ng/dL). Products for testosterone replacement therapy (TRT) are administrated orally, transdermally, and through injectable preparations. Daily testosterone undecanoate is widely used for oral administration with good results and no hepatotoxicity. Short-acting intramuscular preparations are very effective but show wide swings in the resulting supra-physiological level of serum testosterone. Long-acting intramuscular preparations is also very effective and lasting for 3 months with normal physiologic levels. Many products for TRT on the market are effective and generally safe. However, those have a few significant adverse events each other. The ideal product should have notable effectsand few side effects, (such as selective androgen receptor modulators), be easy to administrate, maintain physiologic serum concentration, and be inexpensive. TDS in males can easily be correct by TRT. However, the advantages and disadvantages of the individual products and follow-up management of complicated adverse events should be understood before starting and maintaining TRT.
Administration, Oral ; Aged ; Follow-Up Studies ; Humans ; Male ; Quality of Life ; Receptors, Androgen ; Sorbitol ; Testosterone ; Tyramine

Recently transurethral incision of prostate (TUIP) is suggested to be a useful method in treating BPH weighting less 35gm, short prostatic urethra. mild bladder outlet obstruction by cystoscopy, and subjective obstructive symptoms with no concomitant prostate cancer. The therapeutic effects of TUIP is compared with those of transurethral resection of prostate (TURP) in small BPH (less than 35gm in weight). 1. The mean prostatic weight of TUIP group (14 cases) and TURP group (15 cases) was 23.9+/-7.2 gm and 25.3+/-7.1gm, each respectively. 2. Pre-and postoperative average flow rates were 4.1 and 10.3 ml/sec in TUIP group and 2.9 and 13.2 ml/set in TURP group. Pre- and postoperative maximum flow rates (MFR) were 7.4 and 13.0 ml/sec in the former and 5.6 and 19.4 ml/sec in the latter (p<0.01). 3. Voiding time (sec/100 ml) improved from 32.2 to 12.8 sec/100 ml in TUIP group and from 41.2 to 6.5 sec/100 ml in TURP group. The initiation time (sec) was shortened From 8.3 to 2.0 sec in the former and from 6.3 to 4.O sec in the latter. 4. In operative time, TUIP group necessitated 25+/-14 minutes, and TURP group. 52+/-10 minutes (p<0.001). 5. Mean duration of catheterization and hospitalization were 3.9 and 5.3 days in TUIP group, an 5.5 and 7.6 days in TURP group (p>0.05). 6. Improvements in the subjective symptoms were noted in 13 (92.2%) of 14 cases in TUIP group and 12 (80%) of 15 cases in TURP group. 7. In complications, l of hematuria requiring transfusion and 1 of incomplete incision in TUIP group and l of hematuria, 1 of retrograde ejaculation and 1 of urinary incontinence in TUIP group were experienced. In comparison to TURP. TUIP is easier in technique, less invasive with fewer complications and shows improvements in the subjective symptoms. Therefore. TUIP is a useful method in treating small BPH. especially in sexually active patients.
Catheterization ; Catheters ; Cystoscopy ; Ejaculation ; Hematuria ; Hospitalization ; Humans ; Male ; Operative Time ; Prostate* ; Prostatic Hyperplasia* ; Prostatic Neoplasms ; Transurethral Resection of Prostate ; Urethra ; Urinary Bladder Neck Obstruction ; Urinary Incontinence

In this paper, the title was described incorrectly.

Intramural implantation is among the rarest forms of ectopic pregnancy.Since the first description by Perli, 21 cases were reported in worldwide literatures.The pathologic criteria required for intramural pregnancy is that the product of conception is completely surrounded by uterine musculature and is separated from the uterine cavity and the fallopian tube or round ligament.The previous history of uterine injury or adenomyosis is known as possible etiology of intramural implantation. Because the early diagnosis is very difficult, most cases is found after onset of complication such as a uterine rupture or hemoperitoneum. We have recently experienced a case of intramural pregnancy diagnosed and treated by laparoscopy in a 9 weeks gestation nulliparous woman without previous history of uterine injury or disease, and report with a brief review of literatures.
Adenomyosis ; Early Diagnosis ; Fallopian Tubes ; Female ; Fertilization ; Hemoperitoneum ; Humans ; Laparoscopy ; Pregnancy ; Pregnancy, Ectopic ; Uterine Rupture ; Round Ligaments

Testicular biopsy to have been utilized as a diagnostic tool in male infertility were underwent experimentally to observe the effects on the morphology and the physiology of post-biopsied testis of 17 male rabbits. Bilateral orchiectomy was done at third day, 1st week, 2nd week and 4th week after open testicular biopsy, and biopsied testes were compared with contralateral control in histopathological views. The results were summarized as follows : 1. In seminiferous tubules of sham-operated tests, there was no significant pathologic changes. 2. The inflammatory reaction was most severe at third day after biopsy and completely disappeared at 4th week. 3. Increased thickness of tunica albuginea and fibrotic reaction were observed near the biopsy site. 4. Spermatogenesis did not only decrease near the biopsy site with atrophy of the seminiferous tubules but also mildly decreased on the far area, that all began to recover at 4th week. 5. No evidence of immunologic reaction and hyperplasia of Leydig cell were demonstrated. It was suggested that testicular injury after biopsy was developed by interference of local blood flow, obstruction of seminiferous tubules and inflammatory reaction, so that could be minimized by application of open testicular biopsy only to definitively indicated cases.
Atrophy ; Biopsy* ; Humans ; Hyperplasia ; Infertility, Male ; Male ; Orchiectomy ; Physiology ; Rabbits ; Seminiferous Tubules ; Spermatogenesis ; Testis*

To assess the presence and the severity of renal scarring in primary vesicoureteral reflux (VUR), 11 children (3 girls and 8 boys, 19 kidneys) underwent intravenous pyelography (IVP) and 99m Tc-dimercaptosuccinic acid (DMSA) renoscintigraphy and the following results were obtained : 1. Of 19 kidneys, renal margin was shown in 5(26.3% ) and renal scar was revealed only in 3 (15.8%) on IVP. 2. Renal margin in all ( 100.0% ) and renal scar in 12 (63.1%) of the kidney were revealed on 99m Tc-DMSA renoscintigraphy. 3. On the follow-up ranging from 6 months to 13 years after surgical reconstruction, 8 kidneys showed no reversible improvements in renal scar except one, in which progression of renal scar was noted. We concluded that 99m Tc-DMSA renoscintigraphy is more valuable than IVP in evaluating the degree of renal scar and the renal margin.
Child* ; Cicatrix* ; Female ; Follow-Up Studies ; Humans ; Kidney ; Urography ; Vesico-Ureteral Reflux*

We reviewed the result of one-stage hypospadias repair of 32 cases, from Jan. 1989 to Dec. 1994, according to the site of urethral opening after release of chordee. The following results were obtained. 1. The posterior hypospadias (posterior penile, penoscrotal) was 18 cases and the anterior & middle hypospadias was 16 cases. 2. Success rate of posterior hypospadias repair was 9/18(50%) and that of anterior & middle hypospadias was 9/16(56.3%), it was not different statistically (P<0.05). 3. Complication rate of posterior hypospadias repair was 9/18 (50%) and of anterior & middle hypospadias was 7/16(43,5%), it was not different statistically (P<0.05) and complications were managed by simple procedure and require no further treatment. In condition, one stage repair of hypospadias could be applicable in most cases of hypospadias. The complication and morbidity were minimal.
Female ; Hypospadias* ; Male

We reviewed the result of one-stage hypospadias repair of 32 cases, from Jan. 1989 to Dec. 1994, according to the site of urethral opening after release of chordee. The following results were obtained. 1. The posterior hypospadias (posterior penile, penoscrotal) was 18 cases and the anterior & middle hypospadias was 16 cases. 2. Success rate of posterior hypospadias repair was 9/18(50%) and that of anterior & middle hypospadias was 9/16(56.3%), it was not different statistically (P<0.05). 3. Complication rate of posterior hypospadias repair was 9/18 (50%) and of anterior & middle hypospadias was 7/16(43,5%), it was not different statistically (P<0.05) and complications were managed by simple procedure and require no further treatment. In condition, one stage repair of hypospadias could be applicable in most cases of hypospadias. The complication and morbidity were minimal.
Female ; Hypospadias* ; Male

ESWL monotherapy has been considered a valid initial treatment for staghorn calculi. In an effort to reduce post-ESWL obstruction, many urologists place ureteral stents before ESWL. The use of ureteral stents has proved to contribute to successful stone passage and to reduce post- ESWL morbidity but there also have been reports of complications that might have been caused by indwelling ureteral stents. From January 1989 to December 1995, we reviewed 29 patients with ureteral obstruction after ESWL (EDAP LT-01 & 02) monotherapy without ureteral stenting in 47 patients with staghorn calculi. Ureteral obstruction was occurred in 29 patients (61.7%); 16 (55.2%) in the upper ureter, 11 (37.9%) in the lower ureter, and 2 (6.9%) in the mid-ureter. Steinstrasse was occurred in 13 patients (13/29, 44.8%); 8 (61.5%) in the lower ureter, 4 (30.7%) in the upper ureter, and 1 (7.7%) in the mid-ureter. Ureteral obstruction was occurred regardless of the size of the staghorn calculi(length, breadth, volume). The method of resolving ureteral obstruction was additional ESWL (21 patients, 72.4%), and auxillary procedures including PCN (4 patients, 13.8%), push up procedure (1 patient, 3.4%), push up & double J stenting (1 patient, 3.4%), and ureterolithotomy (2 patient, 6.9%). Mean number of session of ESWL resolving ureteral obstruction was 3.27. Overall complete stone-free rate of staghorn calculi was 55.3%(26 patients). Our results indicate that postoperative ureteral obstruction is easily relieved without major complication by additional ESWL or auxillary procedures. Therefore, ie believe that ESWL monotherapy without ureteral stenting may be adequate treatment modality of staghorn calculi.
Calculi* ; Humans ; Pregnenolone Carbonitrile ; Stents* ; Ureter* ; Ureteral Obstruction*

PURPOSE: To assess whether the prostate volume and two types of lower urinary tract symptoms independently affect erectile function. MATERIALS AND MATHODS: One hundred and fifty two men, who visited outpatient department of Urology and health examination center, were investigated using validated symptom scales, including International Prostatic Symptom Score (IPSS) and International Index of Erectile Function-5 (IIEF-5). The Prostate volume was measured by one examiner using transrectal ultrasonography (TRUS). The correlations between the IIEF-5, emptying and storage symptoms of IPSS, prostate volume and age were subjected to univariate and multivariate analyses. RESULTS: The mean age, prostate volume, and IPSS and IIEF-5 scores were 54.0+/-10.6 years (31-77), 29.1+/-20.4cm(3) (7.9-170.0), and 15.1+/-9.4 (1-35) and 14.6+/-7.1 (1-25), respectively. From the univariate analysis, significant correlations were found between the IPSS and IIEF-5 scores, and the prostate volume and IIEF-5 score, and the age and IIEF-5. When the data were subjected to a multivariate analysis, statistically significant correlations were still observed between the IPSS and IIEF-5 scores and the age and IIEF-5 score, but not between the prostate volume and IIEF-5 score. Furthermore, the storage symptoms of IPSS affected erectile function, with statistical significance, whereas the emptying symptoms did not. CONCLUSIONS: In patients with benign prostatic hyperplasia, lower urinary tract symptoms, especially storage symptoms and age, caused decreases in erectile function. However, the prostate volume itself did not reduce erectile function.
Humans ; Lower Urinary Tract Symptoms* ; Male ; Multivariate Analysis ; Outpatients ; Prostate* ; Prostatic Hyperplasia ; Ultrasonography ; Urinary Tract ; Urology ; Weights and Measures