In this paper, acknowledgments section was omitted unintentionally.

In this paper, acknowledgments section was omitted unintentionally.

PURPOSE: Accurately measuring urinary urgency is important for diagnosing overactive bladder (OAB) and quantifying improvements in treatment outcome. Various methods have been recommended for evaluating urinary urgency, but these methods assess individual perceptions and preferences. To overcome the subjectivity in measuring urinary urgency, we evaluated the relationship between uroflowmetric parameters and urinary urgency in women with OAB. METHODS: Consecutive female patients with lower urinary tract symptoms (n=110) were prospectively enrolled in this study between April 2011 and September 2012. Individuals with a history of using medications that are known to affect bladder function were excluded. All enrolled patients completed uroflowmetry with a delayed time to voiding (T2V). After urination was completed, patients were asked whether they experienced any urinary hesitancy or urgency at that time. RESULTS: The mean patient age was 56.1 years; 70 out of 110 patients reported some degree of urinary urgency. T2V decreased with increased urgency. Several uroflowmetric parameters were observed to have a significant correlation with urinary urgency. T2V had a meaningful correlation coefficient for individuals with urgency, regardless of the voided volume. There was no significant correlation between the presence of urinary hesitancy and T2V. CONCLUSIONS: We believe that T2V would be a complementary tool for diagnosing and determining the degree of urinary urgency in women with OAB.
Female ; Humans ; Lower Urinary Tract Symptoms ; Prospective Studies ; Treatment Outcome ; Urinary Bladder ; Urinary Bladder, Overactive* ; Urination* ; Urodynamics

PURPOSE: Compared with radical retropubic prostatectomy (RRP), laparoscopic surgery significantly reduces postoperative discomfort, the length of the hospital stay and the length of the convalescent period. However, the procedure of laparoscopic radical prostatectomy (LRP) is difficult to master. Therefore, we considered the surgical technique that is minimally invasive like LRP and it does not require a considerable learning curve and brings good results, like conventional RRP. MATERIALS AND METHODS: From January to May 2006 at our institution, we performed LaMRRP on 7 patients who were diagnosed with clinically localized prostate cancer. Under general anesthesia, a 5cm midline incision was made suprapubically and a 10mm trocar is introduced extraperitoneally at the umbilicus for the camera. The assistant port consisted of a 5mm trocar that was placed for blood suction and for vesicourethral anastomosis. We performed the operation under direct vision through the small window and using a video monitor. The surgical procedures followed the steps employed in conventional RRP. RESULTS: We successfully performed the operation in all cases without any extension of the incision. The mean patient age is 68.4 years old (range: 59-75). The mean operating time was 320 min (range: 290-360). The mean blood loss was 1,380ml (range: 1,150-1,800). There were no major complications. The postoperative pain was noticeably reduced compared with conventional RRP. The urethral catheter was left in place for 18 days (range: 14-25) in all the patients and postoperative cystography showed no leakage. CONCLUSIONS: We could perform LaMRRP with using enhanced surgical views, and there was no long learning curve and no additional expense. The results of LaMRRP were not significantly different from that of conventional RRP. Therefore, LaMRRP could be a useful method for the treatment of localized prostate cancer.
Anesthesia, General ; Humans ; Laparoscopy* ; Laparotomy* ; Learning Curve ; Length of Stay ; Pain, Postoperative ; Prostate* ; Prostatectomy* ; Prostatic Neoplasms* ; Suction ; Surgical Instruments ; Umbilicus ; Urinary Catheters

PURPOSE: To explore the effect of bi-parametric MRI-ultrasound (MR/US) fusion prostate biopsy on the detection of overall cancer and significant prostate cancer (sPCa). MATERIALS AND METHODS: We examined 140 patients with suspected prostate cancer lesions on MRI from August 2016 to March 2018. All patients had undergone 3T pre-biopsy bi-parametric (T2 weighted and diffusion-weighted) prostate MRI (bpMRI), and their MRI images were evaluated with Prostate Imaging Reporting and Data System (PI-RADS) version 2.0. MR/US fusion targeted prostate biopsy was performed for lesions with a PI-RADS score ≥3 before systemic biopsy. The results of targeted and systemic biopsy were evaluated in regards to detection rate according to PI-RADS score. RESULTS: Of the patients (mean age=67.2 years, mean prostate-specific antigen level=8.1 ng/mL), 66 (47.1%) and 37 (26.4%) patients were diagnosed with cancer and significant prostate cancer, respectively. The rate of positive targeted biopsy increased with higher PI-RADS score (3: 40.4%, 4: 56.7%, 5: 90.0%). The proportion of significant prostate cancer among positive target lesions was 65.3% (32/49). CONCLUSION: bpMRI is a feasible tool with which to identify sPCa. MR/US fusion biopsy, rather than systemic biopsy, can help identify sPCa. We recommend using supplemental tools to increase prostate cancer detection in patients with PI-RADS 3 lesions.
Biopsy ; Diffusion ; Humans ; Image-Guided Biopsy ; Information Systems ; Magnetic Resonance Imaging ; Male ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Ultrasonography

PURPOSE: We aimed to determine whether 12 core-extended biopsies of the prostate could predict insignificant prostate cancer (IPCa) in Koreans reliably enough to recommend active surveillance. MATERIALS AND METHODS: Two hundred and ninety-seven patients who underwent radical prostatectomy after 12 core-extended prostate biopsies were retrospectively reviewed. 38 cases (12.8%) were shown to be IPCa. RESULTS: The average age was 65.2 years, serum PSA was 5.49 ng/dL, and the PSA density was 0.11. The Gleason scores (GS) were 6 (3+3) in 31, 5 (3+2) in 4, and 4 (2+2) in 3. After radical prostatectomy, higher GS was given in 16 (42.1%), whereas lower GS was given in 1 case (2.6%), as compared with the GS obtained from biopsy. 11 (28.9%) had GS of 7 (3+4) and 5 (13.2%) had GS of 7 (4+3). 6 in GS 7 (4+3) and 1 in GS 7 (3+4) showed prostate capsule invasion and 1 in GS 7 (4+3) had seminal vesicle invasion. Prostate capsule invasion was observed in 1 with GS 6 (3+3). The rate of inaccuracy of the contemporary Epstein criteria was 42.1%. Only PSA density was a reliable indicator of clinically IPCa (odds ratio=1.384, 95% CI, 1.103 to 2.091). CONCLUSION: Diagnosis of IPCa from a prostate biopsy underestimated the true nature of prostate cancer in as many as 42.1% of Koreans.
Aged ; Humans ; Male ; Middle Aged ; Prostate-Specific Antigen/blood ; Prostatectomy ; Prostatic Neoplasms/blood/*diagnosis/surgery ; Retrospective Studies

The present study evaluated optimal baseline prostate-specific antigen (PSA) level at different ages in order to determine the risk of developing prostate cancer (CaP). We analyzed 6,651 Korean men, aged 40-69 yr. The serum PSA levels for these men were measured at one institute from 2000 to 2004 and were determined to be between 0-4 ng/mL. Patients were divided into 4 groups of 25th-percentile intervals, based on initial PSA level. Of these, the group with an increased risk was selected, and the optimal value was determined by the maximal area under a receiver-operating characteristic curve within the selected group. The risk of CaP diagnosis was evaluated by Cox regression. The mean follow-up period was 8.3 yr. CaP was detected in 27 of the 6,651 subjects. CaP detection rate was increased according to age. The optimal PSA value to distinguish the risk of CaP was 2.0 ng/mL for 50- to 69-yr-olds. Patients with a baseline PSA level greater than the optimal value had a 27.78 fold increase in the prostate cancer risk. Baseline PSA values are useful for determining the risk of developing CaP in Korean men for 50- and 69-yr-old. We suggest that PSA testing intervals be modified based on their baseline PSA levels.
Adult ; Age Factors ; Aged ; Area Under Curve ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prostate-Specific Antigen/*blood ; Prostatic Neoplasms/*diagnosis ; Risk Factors

Epidermal cysts are commonly encountered, slow-growing superficial cysts in the hair-bearing areas of the body, and are usually discovered in the second and fourth decades of life. These cysts tend to be superficial, meaning that they can be easily found by ultrasound and digital palpation at a moderate degree of growth. However, we found a huge testicular cyst that went undetected until old age. In this report, we describe the interesting case of a patient in whom the right testis was totally replaced with an epidermal cyst. The cyst was found by ultrasonography and further evaluated with magnetic resonance imaging. We performed orchiectomy under the impression of an epidermal cyst. The pathologic report confirmed this clinical impression. Over 24 months of follow-up, we did not find any recurrence of a growing mass on the testis.
Aged, 80 and over ; Epidermal Cyst* ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Orchiectomy ; Palpation ; Recurrence ; Testicular Neoplasms ; Testis* ; Ultrasonography

PURPOSE: Incidence of cancer has been increasing each years. The incidence of genitourinary cancer are also being increased. We aim to describe the time trends in genitourinary cancer incidence in Jeju province. MATERIALS AND METHODS: Age-standardized rates for incidence of genitourinary tract cancer in Korea and world standard population were calculated using the databases from the Jeju Cancer Rigistry from 1999 to 2012. RESULTS: Cancer incidence in Jeju was increased approximately 2-fold from 1217 cases 1999 to 2376 cases in 1999. Prostate cancer occurred most frequently followed by bladder tumor, and kidney cancer in 2012. In the prostate cancer, incidence was increasing every year from 18 cases in 1999 to 110 cases in 2012. Age-standardized incidence rate (ASR) was approximately four time increased, from 3.0 cases in 1999 and 11.2 cases in 2012. Incidence of bladder cancer were 43 cases in 1999 and 27 cases in 2012, ASR of bladder cancer was increased from 5.0 cases in 1999 to 7.5 cases in 2012. Kidney cancer showed constantly reducing the incidence. Peak is 60 cases in 2009 and recent incidence was 37 cases in 2012. There was no significant change in the incidence of testicular cancer, ureter cancer, renal pelvis cancer from 1999 to 2012. CONCLUSIONS: Incidence of cancer has been increasing in Jeju, similar to other area In Korea. Prostate cancer is the most common urological cancer in Jeju province, and kidney cancer incidence is recently decreasing. We should try to prevent genitourinary tract cancer caused obesity and smoking.
Incidence* ; Kidney Neoplasms ; Kidney Pelvis ; Korea ; Obesity ; Prostatic Neoplasms ; Smoke ; Smoking ; Testicular Neoplasms ; Ureteral Neoplasms ; Urinary Bladder Neoplasms ; Urogenital Neoplasms* ; Urologic Neoplasms

Gastrointestinal stromal tumors (GISTs) are an unusual and heterogeneous group of spindle cell tumors that can also appear on the exterior of the gastrointestinal tract (extra-GISTs). Despite the fact that extra-GISTs or large rectal GISTs can lead to the clinical impression of a prostatic mass, these tumors are, in general, excluded in the differential diagnosis of spindle cell tumors observed on prostate needle biopsy. Here, we present, in detail, a case of an extra-GIST identified on prostatic biopsy; the tumor was previously believed to be a primary prostatic stromal sarcoma in the differential diagnosis. Every investigator should check for KIT (CD117) in immunohistochemical staining to rule out an extra-GIST prior to diagnosing a solitary prostatic tumor, specialized prostatic stromal tumor, or leiomyosarcoma on prostate needle biopsy.
Biopsy ; Biopsy, Needle ; Diagnosis* ; Diagnosis, Differential ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Humans ; Leiomyosarcoma ; Prostate ; Research Personnel ; Sarcoma