PURPOSE: The National Institute of Health (NIH) category III chronic nonbacterial prostatitis/chronic pelvic pain syndromes (CPPS) are commonly seen disorders; however, there has been no consensus on how to manage these patients. The purpose of this trial was to compare the efficacy of antibiotic monotherapy and antibiotic plus alpha-blocker combination therapy for the treatment of CPPS patients. MATERIALS AND METHODS: The study was comprised of 54 patients who were randomly placed into two groups: group I was treated with levofloxacin alone (28 patients), and group II was treated with levofloxacin and alfuzosin (26 patients). The levofloxacin, or the levofloxacin and alfuzosin were given to the respective groups for 8 weeks. The NIH Chronic Prostatitis Symptom Index (NIH-CPSI) was evaluated both before and after the treatment. RESULTS: Before the treatment, the mean CPSI of the group I patients was 23.1+/-8.1, and after the treatment, it was 15.6+/-5.6. For the group II, the mean CPSI before the treatment was 23.9+/-8.3, and after the treatment, it was 11.0+/-4.5. The difference between the pre-and post-treatment CPSI scores of group II was significantly larger than that of group I (p=0.001). The mean differences of the CPSI from the initial scores to the final scores in both groups were followed: 2.2 in group I and 4.3 in group II for the pain domain, 1.5 in group I and 2.8 in group II for the urinary domain, and 3.8 in group I and 5.7 in group II for the quality of life domain. CONCLUSIONS: Combination therapy of levofloxacin with alfuzosin appeared more effective for treating patients with chronic prostatitis/chronic pelvic pain syndrome than just administering antibiotic alone.
Adrenergic alpha-Antagonists ; Anti-Bacterial Agents ; Chronic Disease ; Consensus ; Humans ; Levofloxacin ; Pelvic Pain* ; Prospective Studies* ; Prostatitis ; Quality of Life

PURPOSE: Abnormalities of the relaxation and contraction of the corpus cavernosum can lead to erectile dysfunction. Therefore, we induced a partial bladder outlet obstruction(PBOO) in male rats, and investigated the mechanisms of penile dysfunction with endothelial nitric oxide synthase(eNOS), vascular endothelial growth factor(VEGF), endothelin-1(ET-1), and apoptosis of peri-vascular smooth muscle and connective tissue cells in the corpus cavernosum. MATERIALS AND METHODS: PBOO was induced in 13 Sprague-Dawley rats by placing a 25 gauge needle sheath around the urethra, then ligating the bladder neck with a 3-0 suture. Three week after surgery, distal penile tissues were dissected for immunohistochemical staining, immunoblotting, and TUNEL staining. RESULTS: The expression of eNOS and VEGF were significantly decreased, whereas the expression of ET-1 and apoptosis of perivascular smooth muscle and connective tissue cells were significantly increased in the corpus cavernosum. CONCLUSIONS: The significant increase of ET-1 and apoptosis along with decreased eNOS and VEGF could mediate erectile dysfunction.
Animals ; Apoptosis ; Connective Tissue Cells ; Contracts ; Endothelin-1 ; Erectile Dysfunction ; Humans ; Immunoblotting ; In Situ Nick-End Labeling ; Male ; Muscle, Smooth ; Neck ; Needles ; Nitric Oxide ; Nitric Oxide Synthase Type III ; Rats ; Rats, Sprague-Dawley ; Relaxation ; Sutures ; Urethra ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Vascular Endothelial Growth Factor A

Adrenal myelolipoma is an uncommon, benign, hormonally non-active lesion that is composed of a mix of hemopoietic elements and mature adipose tissue. Most adrenal myelolipomas are incidentally found by ultrasonogram, computed tomography or magnetic resonance imaging. This tumor is commonly asymptomatic, although patients will occasionally present with nonspecific abdominal pain. We report here on a case of myelolipoma that was treated by Hand-assisted transperitoneal laparoscopic adrenalectomy.
Abdominal Pain ; Adipose Tissue ; Adrenal Glands ; Adrenalectomy* ; Humans ; Laparoscopy ; Magnetic Resonance Imaging ; Myelolipoma* ; Ultrasonography

In some patients with prostate cancer and who manifest disease progression during maximal androgen blockade(MAB) therapy, discontinuation of antiandrogen treatment might result in a significant fall in the level of serum prostate-specific antigen(PSA), and this is often correlated with clinical improvement(antiandrogen withdrawal syndrome). However, a decline in the PSA level after the withdrawal of estramustine phosphate is extremely rare. We report here on a case of dramatic decline in the PSA level after withdrawal of estramustine phosphate in a patient with hormone refractory prostate cancer.
Disease Progression ; Drug Therapy ; Estramustine* ; Humans ; Prostate* ; Prostatic Neoplasms*