The overactive bladder, according to the original definition by International Continence Society refers to the storage phase of the bladder and is diagnosed by urodynamics. The overactive bladder is a medical condition referring to the symptoms of frequency and urgency, with or without urge incontinence, in the absence of local pathology or metabolic factors that would account for these symptoms. The definition of overactive bladder needs clarification, which would help to overcome the current confusion. Possible neurological, muscular, and metabolic causes have been proposed but in many cases the exact causes remain unclear. The diagnosis depends greatly on a detailed history, clinical examination, and urinalysis. Urodynamic evaluation is indicated when neuropathy is suspected, and the treatment may be unsuccessful without exact knowledge of patients' state. It can be treated conservatively by bladder training, physiotherapy, and drugs alone or with combination. For refractory cases neuromodulation, denervation techniques, and bladder augmentation or substitution can be used with good results.
Behavior Therapy ; Denervation ; Diagnosis ; Pathology ; Urinalysis ; Urinary Bladder ; Urinary Bladder, Overactive* ; Urinary Incontinence, Urge ; Urodynamics

No abstract available.
Apoptosis* ; Hyperplasia*

Foreign bodies in genitourinary tract are not rare and most of them are present in the bladder. Various kinds of object are introduced into bladder through urethra by both male and female patients. Traditionally, they were introduced mainly for the purpose of sexual behavior. But recently like in our cases, many of them are inserted iatrogenically with development of endourologic procedure. We report 14 cases of bladder foreign bodies. Some of them are surprising and beyond common sense in kind of object and aim of insertion. Six cases were inserted by iatrogenic, 5 cases for masturbation, 2 cases by independently of patient`s intention by other person(s). One patient who had history of mental retardation did not remember when, how, why and by whom the foreign body had been introduced. All the foreign bodies could be diagnosed by history, symptom, X-ray and cystoscopy and removed by cystoscopic manipulation or cystostomy with ease and without complication.
Cystoscopy ; Cystostomy ; Female ; Foreign Bodies* ; Humans ; Intellectual Disability ; Intention ; Male ; Masturbation ; Sexual Behavior ; Urethra ; Urinary Bladder*

Foreign bodies in genitourinary tract are not rare and most of them are present in the bladder. Various kinds of object are introduced into bladder through urethra by both male and female patients. Traditionally, they were introduced mainly for the purpose of sexual behavior. But recently like in our cases, many of them are inserted iatrogenically with development of endourologic procedure. We report 14 cases of bladder foreign bodies. Some of them are surprising and beyond common sense in kind of object and aim of insertion. Six cases were inserted by iatrogenic, 5 cases for masturbation, 2 cases by independently of patient`s intention by other person(s). One patient who had history of mental retardation did not remember when, how, why and by whom the foreign body had been introduced. All the foreign bodies could be diagnosed by history, symptom, X-ray and cystoscopy and removed by cystoscopic manipulation or cystostomy with ease and without complication.
Cystoscopy ; Cystostomy ; Female ; Foreign Bodies* ; Humans ; Intellectual Disability ; Intention ; Male ; Masturbation ; Sexual Behavior ; Urethra ; Urinary Bladder*

From August 1991 to July 1992, 262 patients of benign prostatic hyperplasia (BPH) were treated with transurethral microwave thermotherapy (TUMT). Among those, 64 patients were followed up more than I year and 26 patients were followed up more than 4 years without other treatment. The patient`s age ranged from 49 to 80 years with a mean of 64.3 years. Prostate volume determined by transrectal ultrasonography ranged from 27.0cm3 to 73.6cm3, the mean 40.8cm3. After I year, maximum flow rate increased from 8.1+/-2.3ml/sec to 11.5+/-3.6ml/sec, Madsen symptom score decreased from 12.6 +/-3.8 to 6.6+/-4.7, and residual urine volume decreased from 75.6+/-33.5ml to 43.4+/-35.3ml. Complete response of maximum flow rate and Madsen symptom score observed in 17.2% in each group, partial response in 50.0% and 40.6%, and non-response in 32.8% and 42.2%. Improvement of subjective symptoms were evaluated by patients themselves and divided into 3 groups: ""satisfactory"" was 28.1%, ""acceptable"" 34.4%, and ""not effective"" 37.5%. Complications were i case of erectile dysfunction and 4 cases of dry ejaculation. Among the 64 patients who were followed up more than 1 year, 26 patients (40.6%) were remained without other treatment, 20 (31.3%) patients were medicated additionally, 11 (17.2%) patients required TUR-P during the follow-up period due to persistent symptoms, and 7 (10.9%) patients were performed re-TUMT. In conclusion, TUMT could be useful, safe and inexpensive treatment for BPH when it is applied selectively and should be advanced in mechanism to be more effective in treatment of BPH.
Ejaculation ; Erectile Dysfunction ; Follow-Up Studies* ; Humans ; Male ; Prostate ; Prostatic Hyperplasia ; Transurethral Resection of Prostate* ; Ultrasonography

PURPOSE: Catheter-associated urinary tract infections are inevitable in patients with a long-term indwelling catheter. The antibacterial activity of nitrofurazone-impregnating compounds has recently been employed in urinary catheter, and may be effective in blocking infections. The aims of this study were to evaluate the bacterial isolation, antibiotic sensitivity test and the efficacy of a nitrofurazone-coated urinary catheter. MATERIALS AND METHODS: A total of 41 patients that required an indwelling urinary catheter for longer than 4 weeks were assigned to receive either a silicone (n=24), or nitrofurazone, coated catheter (n=17). Urine and catheter tip samples were cultured for bacteriological assessment. The results of the bacterial culture and antibiotic sensitivity test, rate of infection from urine and proximal tip were compared between the two groups. RESULTS: The bacterial cultures from the tips of the silicone and nitrofurazone catheters were in 95.8 and 82.4%, respectively, but were statistically insignificant (p=0.064). Bacteriuria developed in 79.2 and 64.7% of the silicone-coated and nitrofurazone-coated catheter groups (p=0.476). Gram negative bacteria were found in 65 (69.8%), with the most three frequent species being Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumonia in 23 (24.7%), 20 (21.5%) and 16 (17.2%), respectively. All the organisms were more susceptible to amikacin, aztreonam and ceftriaxone, but were relatively resistant to ampicillin, gentamycin and ciprofloxacin. CONCLUSIONS: Many of the patients with a long-term indwelling catheter had bacterial infections or colonization in the urine and proximal catheter-tip samples, despite the preventive administration of antibiotics. This study failed to demonstrate any efficacy of a nitrofurazone-coated catheter.
Amikacin ; Ampicillin ; Anti-Bacterial Agents ; Aztreonam ; Bacterial Infections ; Bacteriuria ; Catheterization ; Catheters* ; Catheters, Indwelling ; Ceftriaxone ; Ciprofloxacin ; Colon ; Escherichia coli ; Gentamicins ; Gram-Negative Bacteria ; Humans ; Klebsiella ; Nitrofurazone ; Pneumonia ; Pseudomonas aeruginosa ; Silicones* ; Urinary Catheters ; Urinary Tract Infections

PURPOSE: Apoptosis is mediated by apoptosis-specific genes, certain oncogenes and tumor suppressor genes. Caspase-3, a group of cysteine proteases, ier in cases with intermediate (Gleason score 5-7) and high-grade (Gleason score 8-10) PCA than cases with BPH and low-grade PCA (Gleason score 2-4).
Adenocarcinoma* ; Apoptosis ; Caspase 3 ; Cysteine Proteases ; Genes, Tumor Suppressor ; Neoplasm Grading ; Oncogenes ; Passive Cutaneous Anaphylaxis ; Prostate* ; Prostatic Hyperplasia*

We noticed the treatment results of each of them after having treated the seventy-nine cases of benign prostatic hyperplasia with TUMT (N=32, Term ; 92.6-93.3), TUR-P (N=31, Term; 91.4-93.3), open prostatectomy (N=16, Term; 91.4-93.3). However, there was a difficulty to get to statistical reliability, for there was a little gap between the term of survey and the period of treatment of three groups. The results are following. In the TUMT, the maximal flow rate was improved from 8.2ml/s to 13.3ml/s and Madsen score dropped from 13.6 to 5.3, in the TUR-P they were 8.4ml/s to 16.5ml /s and 14.5 to 5.3 respectively, and in the open prostatectomy 6.8ml/s to 20.0ml/s and 15.8 to 5. 3 respectively. The degree of satisfaction of the patients themselves with each prescription was 46.9% in the TUMT. 67.7% in the TUR-P and 81.2% in the open prostatectomy. But 18.8% and l6.l% of the patients thought TUMT and TUR-P respectively ineffective. The conclusion is that open prostatectomy presented the better results than TUMT or TUR-P in the degree of satisfaction of patients and uroflowmetry during the survey period. And even though TUMT have presented lesser degree of satisfaction then TUR-P up to now, if the exact indications for the use of TUMT are found and the mechanical improvements undergo, then a number of benign prostatic hyperplasia cases seem to be treated in more safety and with lesser cost and time by TUMT instead of TUR-P.
Humans ; Hyperthermia, Induced ; Microwaves* ; Prescriptions ; Prostatectomy* ; Prostatic Hyperplasia*

No abstract available.
Urinary Tract Infections* ; Urinary Tract*

Prostatic calculosis is a physiological feature of the aging process, but it plays an important role in prostatic diseases. Recently we have evaluated the size and location of prostatic calculi in 314 patients with prostatic disease during the period from Aug. 1991 to Feb. 1992 using transrectal ultrasonogram. Prostatic calculi over 3 mm in diameter (with strone echo and posterior acoustic shadow) were observed 12% (3/26) in normal control group, 26% (47/170) in BPH and 20% (17/85) in chronic prostatitis. The incidence or size of prostatic calculi were increased with age. We classifed the calculi "central", when calculus located around the verumontanum or prostatic urethra and "peripheral", when calculus located peripherally. 76% of calculi with prostatitis were located centrally but 59% of calculi with BPH were located peripherally. 69% of calculi with symptom group (patients who complain of voiding dysfunction in 60 years or elder age group without BPH or other urologic diseases) were located centally. Prostatic calculi were also observed in four patients with hematospermia (4/6) and in five patients with-ejaculatory duct cyst (5/6). These results indicate that all prostatic calculi were not asymptomatic and transrectal ultrasonogram should be done to evaluate prostatism. The treatment modality can be chosen and the prognosis estimated by knowing the location and size of prostatic calculi.
Acoustics ; Aging ; Calculi* ; Hemospermia ; Humans ; Incidence ; Lithiasis ; Prognosis ; Prostatic Diseases ; Prostatism* ; Prostatitis ; Ultrasonography ; Urethra