PURPOSE: The object was to study prospectively the results of a modified intravaginal sling operation for the surgical treatment of female stress urinary incontinence using tension-free vaginal tape (TVT) as a new continence procedure. MATERIALS AND METHODS: 55 women with demonstrable stress urinary incontinence underwent a nonrandomized, prospective study using the TVT sling operation. Preoperatively the patients were evaluated with Stamey grade and urodynamic testing. After having TVT sling operation, we observed the postoperative results throughout the 1-year follow-up. RESULTS: The mean age of the patients was 52.8 years and mean operation time was 26.6 minutes. Mean duration of postoperative catheterization was 1.1 days. 35 patients (63.6%) were completely cured throughout the 1-year follow-up period, and 18 patients (32.7%) were significantly improved. They did not loose urine apart from an occasional leakage during severe cold. CONCLUSIONS: TVT sling operation is a safe, simple and effective procedure for the treatment of stress incontinence.
Catheterization ; Catheters ; Female ; Follow-Up Studies ; Humans ; Prospective Studies ; Suburethral Slings* ; Urinary Incontinence* ; Urodynamics

To evaluate the characteristics of MR findings in osteomyelitis, retrospective MR image interpretations were made in 18 patients with osteomyelitis proved either either by surgery(n=17) or clinical course(n=1). Osteomyelitis was acute in five patients, subacute in five, chronic in seven, and healed in one. Area of active inflammation had low marrow marrow signal intensity on T1-weighted images, high signal intensity on T2-weighted images inhomogeneously. It has been said that morrphologic characteristics of osteomyelitis in MR improved the accuracy in diagnosis of osteomyelitis and that gadolinium enhanced MR image further assisted in the planning of surgery. Out study was performed to observe the signal intensity change or morphologic change of bone marrow, cortex, periosteal reaction, and soft tissue which are specific for osteomyelitis. Multiple inhomogensous round marrow lesions were noted with central high signal intensity and peripheral low signal intensity on T1-weighted images, and central low signal intensity and peripheral high signal intensity on T2 weighted images in two patients. Intra and extraosseous abscesses showed rim enhancement after gadopentetate dimeglumine injectron. The signal intensity of the relatively higher than the internal area of the abscess on T1-weighted images. Cortical bone destruction showed high signal intensities T2-weighted images with destruction patterns of fine radial, circumferential, vertical or wedge shaped. MR imaging, by displaying specific signal intensities and morphological changes of bone marrow, cortex, periosteal reaction and soft tissue, would be an aid in early diagnosis and in planning for appropriate conservative and operative therapeutic procedures for osteomyelitis.
Abscess ; Bone Marrow ; Diagnosis ; Early Diagnosis ; Extremities* ; Gadolinium ; Gadolinium DTPA ; Humans ; Inflammation ; Magnetic Resonance Imaging* ; Osteomyelitis* ; Retrospective Studies

PURPOSE: Specific microorganisms, such as Chlamydia and Mycoplasma, are rarely detected in chronic pelvic pain syndrome, but fastidious and non-culturable microorganisms may be important in its etiology. The objective of this study was to evaluate the usefulness and significance of polymerase chain reaction (PCR) in the diagnosis of the etiologies of chronic pelvic pain syndrome, especially using semen as a specimen. MATERIALS AND METHODS: Between August 2005 and July 2006, 237 patients, with a mean age of 39 years (range 25-67 years), were evaluated for chronic pelvic pain syndrome. PCR testing of the semen was performed in all cases to establish the persistence of C. trachomatis, T. vaginalis, M. hominis, M. genitalium and U. urealyticum. RESULTS: Of the 237 patients, 79 (33.3%) and 158 (66.7%) were categories IIIa and IIIb, respectively. On PCR, using semen, 18 (22.8%) of the 79 category IIIa and 26 (16.5%) of the 158 category IIIb cases were found to have positive PCRs for the causative microorganisms of CPPS. In a total of 53 isolates presenting positive PCR, the common causative microorganisms were U. urealyticum, C. trachomatis, M. genitalium, T. vaginalis and M. hominis in 23 (43.4%), 16 (30.1%), 11 (20.8%), 2 (3.8%) and 1 case (1.9%), respectively. CONCLISIONS: PCR is revolutionizing the diagnosis of many infectious diseases, particularly those caused by microorganisms that are difficult to cultivate. Moreover, PCR shows nearly 100% accuracy in terms of sensitivity and specificity. PCR using semen, which can detect various microorganisms suggestive of the etiologies of chronic pelvic pain syndrome, is expected to play an important role in the diagnosis, treatment and follow up of chronic pelvic pain syndrome in urology.
Chlamydia ; Communicable Diseases ; Diagnosis ; Humans ; Mycoplasma ; Pelvic Pain* ; Polymerase Chain Reaction* ; Prostatitis ; Semen* ; Sensitivity and Specificity ; Urology

PURPOSE: In recent year, erectile dysfunction patients are increasing, and some of them want to increase their erectile function without using medication or surgical methods, In this study we attempted to find the value of electrical stimulation with electrical stimulation machine Hi-DREAM 328(TM) made in Korea as a treatment method of no definite underling disease caused erectile dysfunction patients. MATERIALS AND METHODS: In 22 cases erectile dysfunction patients we treated them two times per week for 4 weeks totally 8 times above mentioned machine, each session was spent for 1 hour 48 minutes. We checked IIEF-5 (International Index of Erectile Function-5) score repeatedly for comparing the change of IIEF-5 score pretreatment, 1 month after treatment and 3 month after treatment. And we compared the effect of treatment as comparing the IIEF-5 score changing each time. RESULTS: Total IIEF-5 score of pretreatment was 9.6+/-5.5, 1 month and 3 month after electrical stimulation were 17.9+/-2.9, 16.2+/-2.9, respectively. In the patients with venous leakage, IIEF-5 score was no increase definitely following electrical stimulation. But in the case of abnormal SPACE, pretreatment of IIEF-5 score was 12.1+/-5.2, 1 month and 3 month after electrical stimulation were 18.1+/-7.6, 16.5+/-7.4, respectively. We found that IIEF-5 score were increased in no definite organic caused erectile dysfunction patients, and there was significant correlation statistically (p<0.05) in erectile function, maintenance of erection, intercourse satisfaction, overall satisfaction. The remaining effect after treatment was decreased in time follow up. But the erectile function was preserved at comparing before treatment. CONCLUSIONS: We suggest that electrical stimulation is one of the treatment modalities in the treatment of no definite underling disease caused erectile dysfunction patients rather than vascular abnormalities as like venous leakage.
Electric Stimulation* ; Erectile Dysfunction* ; Follow-Up Studies ; Humans ; Korea ; Male

Priapism is a rare disease, but needs early intervention and appropriate management. We present 2 cases of ischemic low-flow priapism after intracavernosal injection of vasoactive drug. 43-year-old man and 61-year-old man visited our clinic complaining of continuous plan and erection persisting for several days after self cavernosal injection for increasing their erectile function. We performed blood gas analysis of cavernosal blood and color doppler ultrasound. And so we confirmed the diagnosis of low-flow priapism. Detumescence was finally achieved after the proximal shunt operation. Their erectile function was not recovered and they became permanent impotence.
Adult ; Blood Gas Analysis ; Diagnosis ; Early Intervention (Education) ; Erectile Dysfunction ; Humans ; Male ; Middle Aged ; Priapism* ; Rare Diseases ; Ultrasonography

PURPOSE: Many men are to some degree unsatisfied with the size of their penis, whether it is normal in size and appearance or not. We report a novel surgical technique for penile augmentation using a superficial external pudendal artery pedicle. MATERIALS AND METHODS: In total, 8 patients underwent penile augmentation from March 2003 to February 2004. Their mean age was 37.3 years. Five patients were unsatisfied about the size of their penis, and three patients had complications after insertion of foreign material. This penile augmentation technique was developed by using a low abdominal fat-flap where blood is supplied from the external pudendal artery. Spinal or epidural anesthesia was done during the operation, and the fat-flap was elevated and transpositioned to the site of lesion. RESULTS: All cases of patients were performed successfully by autografting using adipose tissue where blood flow was supplied from the external pudendal artery. There were no complications except one case of hematoma after the operation. The mean operative time was 80 min. The mean follow-up period after operation was about 6 months and all patients had a normal sexual life and no voiding dysfunctions. CONCLUSIONS: This novel surgical technique has several advantages. First, reconstruction without skin necrosis was possible even though the defect was large, because the blood supply was favorable. Second, there was no size limitation in augmentation with dermoplasty. Third, there was no evidence of atrophy of the flap.
Adipose Tissue ; Anesthesia, Epidural ; Arteries ; Atrophy ; Follow-Up Studies ; Hematoma ; Humans ; Male ; Necrosis ; Operative Time ; Penile Implantation ; Penis ; Skin ; Transplantation, Autologous

BACKGROUND AND OBJECTIVES : Ageotrophic nystagmus in the horizontal canal BPPV has been explained as a result of cupulolithiasis theory, and has been reported to have the less therapeutic response to conservative rehabilitations than the other type BPPV . Though methods to detach the debris with vibrator have been introduced, the effect has been questioned and it's not physiologic. MATERIALS AND METHOD : We introduce a new head shaking-forced prolonged position method as a more convenient method, and report typical 2 cases of ageotrophic horizontal canal BPPV managed with it and analyzed results of 25 cases all told. RESULTS AND CONCLUSION : The average number of rehabilitation was less than two, and loss of direction changing positional nystagmus could be observed immediately after rehabilitation.
Head ; Nystagmus, Physiologic ; Rehabilitation ; Vertigo*

PURPOSE: The radiobiology of prostate cancer favors a hypofractionated dose regimen. We report here our experience with the CyberKnife(TM), demonstrating its efficacy, safety, and feasibility as a treatment modality for non-metastatic prostate cancer. MATERIALS AND METHODS: Between October 2002 and April 2006, 20 patients with biopsy-proven prostate cancer were treated with the CyberKnife(TM). The distribution of clinical risks, as assessed by using D'Amico's definition for risk grouping, was as follows: low (4), intermediate (5), and high (11). Three patients received 32 Gy, 7 patients received 34 Gy, and 10 patients received 36 Gy. All patients received the radiation doses in 4 fractions. The rectal and bladder toxicities were graded by using the criteria set forth by the Radiation Therapy Oncology Group (RTOG). RESULTS: The mean patient age was 71.4 years (range, 52-79 years), and the mean follow-up period was 35.5 months (range, 8-74 months). There were 2 acute and 1 late grade 2 gastrointestinal toxicities, and 1 acute and 2 late grade 2 urinary toxicities. The 5-year overall survival rate was 100%, respectively. The 5-year biochemical failure-free rate of the low-risk, intermediate-risk, and high-risk patients was 100%, 100%, and 90.9%, respectively. CONCLUSIONS: CyberKnife(TM) is a safe, well-tolerated, and rather effective treatment for non-metastatic prostate cancer. We obtained a 100% 5-year biochemical failure-free rate in low-risk and intermediate-risk patients. CyberKnife(TM) is a viable option for the treatment of non-metastatic prostate cancer.
Follow-Up Studies ; Humans ; Prostate ; Prostatic Neoplasms ; Radiobiology ; Radiosurgery ; Survival Rate ; Urinary Bladder

PURPOSE: The aim of this study was to evaluate the effectiveness and indication of radiofrequency ablation(RFA) using renal VX2 tumors by implantation of VX2 tumor cells under the renal capsule in rabbits. MATERIALS AND METHODS: Ten rabbits were injected with 30-40microliter VX2 tumor cells(1.2x10(7) viable cells/ml) under the renal capsule of the right kidney by right subcostal incision. On the 14th day after the tumor cells were implanted, we checked for the development of renal tumors, and the sizes and shapes(exophytic or central) of the tumors by the use of computed tomography. We performed RFA in the renal VX2 tumors with a 17G StarBurst electrode through kidney exposure. After the first and third day following RFA, renal function was checked. On the third day, we performed CT and harvested the kidneys for gross and microscopic evaluation. RESULTS: We confirmed the development of renal VX2 tumors in nine cases. Tumor shapes were exophytic in seven cases and central in two cases; the mean size of the tumors was 2.1 cm(range, 1.1-3.8cm). In all tumors, RFA was performed. From the use of enhanced CT after RFA on the third day, all of the lesions treated with RFA showed no enhancement. From the pathological findings, coagulative necroses were seen on all of the lesions treated with RFA. The necrotized tumor size after RFA was not different statistically as measured by CT and a pathological examination (p=0.833) CONCLUSIONS:: In centrally located renal tumors, we experienced thermal injury in pelvocalyceal systems. RFA is an effective method for nephron sparing surgery as the tumor cells completely disappear and there is preserved renal function and the procedure is easy to apply. We suggest that the RFA method for exophytic renal tumors is more effective than other procedures.
Rabbits ; Animals

PURPOSE: The widespread use of serum prostate specific antigen and extended needle biopsy of the prostate as screening procedures for prostate cancer has not only led to an increase of detecting prostate cancer as a whole, but also to an increase of detecting small low grade tumors. Still, the clinical significance of small, low grade, single-core positivity on prostate biopsy hasn't yet been determined. So, we tried to investigate the clinicopathological features of prostate cancers that showed only single- core positivity on extended prostate needle biopsy. MATERIALS AND METHODS: 144 patients were managed with radical prostatectomy during 2003-2005 at our institution. Insignificant prostate cancer on biopsy specimens was defined as a single-core positive biopsy containing a focus of 3mm or less of moderately differentiated prostate cancer (Gleason score< or=6) and clinical insignificant cancer in the radical specimens was defined as a low volume (<0.5cc) of moderately differentiated organ- confined prostate cancer. We analyzed the clinicopathological features and the clinical significance in regards to the number of positive cores and the biopsy significance. RESULTS: Of 144 patients, 46 (31.9%) patients were diagnosed on the basis on single-core positive prostate cancer. Of these 114 patients, 32 (69.6%) patients had insignificance prostate cancer on biopsy. Although the single core positive group had more favorable pathologic features than the multiple core positive group, only 5 (10.9%) were found to have clinically insignificant cancer at radical prostatectomy. Also, in the biopsy insignificant group, only 5 patients (15.6%) were found to have clinically insignificant cancer. However, there were no features that could accurately predict insignificant prostate cancer preoperatively. CONCLUSIONS: Although the clinicopathological features of the prostate cancers that were detected in only a single-core on prostate needle biopsy were observed to be suggestive of less advanced disease, most of such single-core positive cancers may be clinically significant disease.
Biopsy ; Biopsy, Needle* ; Humans ; Mass Screening ; Needles* ; Prostate* ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms*