No abstract available.
Abdominal Wall* ; Fascia* ; Ligaments*

No abstract available.
Erectile Dysfunction* ; Humans ; Male

PURPOSE: When combined with transurethral resection, intravesical Bacillus Calmette-Guerin(BCG) is effective in delaying recurrence and progression of superficial bladder cancer including carcinoma in situ. Dose schedules vary and the optimum regimen has not been defined. And criteria for selection of patients who may benefit from an additional course of BCG have not yet been established. In an attempt to identify patients who are likely to respond, we analyzed our experience in patients with superficial bladder cancer treated with a subsequent course of BCG therapy MATERIALS AND METHODS: From June 1989 until June 1996, 74 patients with superficial bladder tumor were treated under protocol at our institution with intravesical BCG. Of 74 patients who received an initial once a week for 6 week and once a month for 3-month of intravesical BCG(course 1) for superficial transitional cell carcinoma of the bladder, 21 were treated another course(course 2). RESULTS: First course of BCG was successful in 43(64.1%) of 67 patients treated for prophylaxis and 3(42.8%) of treated for carcinoma in situ. Of 28 patients who failed the initial treatment course, 21 were given an additional BCG therapy. Subsequent progression of disease(muscle infiltration, metastasis or local progression) occurred in 3 patients(14.2%). Of 18 patients(85.7%) without progression 11(52.3%) had a complete response and 7(33.3%) had new tumors, and they were rendered free of disease after transurethral resection. The median duration of response to course 1 of intravesical BCG was shorter for patients with disease progression or recurrence after course 2 than for those with no progression or recurrence(13.8 and 21.3 months, p<0.05). The median intenal between course 1 and 2 of intravesical BCG was 18 months. The internal from course 2 of intravesical BCG to progression or recurrence correlated with the duration of response to course 1 of treatment(p<0.05). CONCLUSIONS: Our analysis indicate that the usefulness of a subsequent course of intravesical BCG for the treatment of new tumors is related to the duration of response to course 1. Patients with a long-lasting response to the initial course of BCG(18 months or more) are likely to benefit from another course.
Appointments and Schedules ; Bacillus* ; Carcinoma in Situ ; Carcinoma, Transitional Cell ; Disease Progression ; Humans ; Mycobacterium bovis ; Neoplasm Metastasis ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: Chronic prostatitis is characterized by various symptoms. To elucidate the prevalence of such symptoms, we developed a questionnaire composed of six pain-related, seven sex-related, and 11 voiding-related questions and evaluated chronic prostatitis patients under 50 years of age. MATERIALS AND METHODS: From March 1995 to July 1996, a total of 500 patients (prostatitis 303, prostatodynia with history of prostatitis 153, prostatodynia only 44) underwent study. The mean age was 35 years and the average duration of infliction was 3.5 months. RESULTS: Perineal, testicular, and penile pains were the most often complained types of perceived pains. The most frequently complained voiding symptoms were frequency, weak stream, residual urine sensation and dribbling which were seen in over 40% of the patients. More than 50% of the patients responded as having some type of voiding difficulty. For sexual symptoms, premature ejaculation , decreased libido and orgasm, decreased potency, and pain associated with ejaculation were seen in 64%, 55%, 54%, and 47% of the patients. When the prostatitis and prostatodynia patients were compared to one another to find out any characteristic symptoms of prostatitis, there was no difference in pain but statistically significantly higher response was observed in ejaculation associated pain and a decrease in orgasm in the prostatitis group. CONCLUSIONS: Our data have helped to elucidate the characteristics of symptoms in prostatitis patients, and the questionaire can be used as a tool to standardize prostatitis symptoms, and to evaluate treatment responses.
Ejaculation ; Humans ; Libido ; Male ; Orgasm ; Premature Ejaculation ; Prevalence* ; Prostate* ; Prostatitis ; Surveys and Questionnaires ; Rivers ; Sensation

OBJECTIVE: The objective of this study was to compare results of the macroscopic one-layer vasovasostomy with those of microscopic one-layer vasovasostomy and to analyze the change of semen parameters according to the interval of vasal obstruction. METHOD AND MATERIALS: Between March 1987 and December 1997, we performed 121 vasovasostomies using modified one-layer technique with loupe magnification (macroscopic vasovasostomy) or microscope. Among the 68 could be followed post-operatively, 37 patients were treated by macroscopic technique with loupe, and 31 patients by microscopic technique. We compared rates of anatomical patency (sperm count above than 10x106/ml) and pregnancy of macroscopic vasovasotomy with those of microscopic vasovasostomy. Patency and pregnancy fates according to vasal obstructive interval were also examined. RESULTS: The patency rates of macroscopic and microscopic technique were 86.5% and 87.1%, and pregnancy rates of macroscopic and microscopic technique were 64.9% and 67.7%. There was no statistical significance between these two methods (p>0.05). The pregnancy rates and sperm motility were decreased if more than 10 years had elapsed following vasectomy(p<0.05). CONCLUSION: We found little difference in success rates resulting from macroscopic and microscopic vasovasostomy and the former had the advantage of reduced cost and a lower operator skill level. in post-operative semen analysis, the sperm motility was the most probable factor associated with vasal obstructive interval.
Humans ; Pregnancy ; Pregnancy Rate ; Semen ; Semen Analysis ; Sperm Motility ; Vasovasostomy*

A total of 47 women with stress urinary incontinence underwent periurethral injection of autologous fat. Of the 47 women, 13 were related to intrinsic sphincter dysfunction and the others were anatomic incontinence. Patients' age ranged from 20 to 69 years (mean 55.8. The fat was harvested from the low abdominal wall by micro-liposuction unit. The fat was injected at 4 and 8 o'clock position and the mean quantity was 15.7ml. Mean follow up was 16.2 months. Of the patients, 14 (29.8%) are cured, 5 (10.6%) are improved, and 28 (59.6%) are failed. Of the intrinsic sphincter dysfunction group, 6 (46.2%) are cured, 2 (15.4%) are improved, and 5 (38.5%) are failed. In contrast to the anatomic incontinence group 8 (23.5%) are cured, 3 (8.8%) are improved, and 23 (67.6%) are failed We conclude that the periurethral autologous fat injection is a safe, and low-cost, high benefit procedure in intrinsic sphincter dysfunction patients.
Abdominal Wall ; Female ; Follow-Up Studies ; Humans ; Urinary Incontinence*

PURPOSE: We investigated the effect of anticholinergic drug treatment before midurethral sling surgery in patients with mixed urinary incontinence(MUI). MATERIALS AND METHODS: Between January 2004 and December 2006, 112 female patients with MUI were evaluated. Forty-seven patients were not medicated with anticholinergic drugs(Group A) and 65 patients were medicated with anticholinergic drugs(Group B) for 2 weeks or more(2-8 weeks, mean 2.34+/-1.02) before the midurethral sling operation. After the midurethral sling operation, the patients were followed up for 4 weeks or more(4-48 weeks, Group A is 7.83+/-8.70, Group B is 6.77+/-7.58). Cure of the incontinence after the procedure was defined as the absence of subjective symptoms such as frequency, urgency, urge incontinence and the absence of objective leakage on stress testing. All other cases were considered failures. RESULTS: There were no significant differences between the group that was not medicated preoperatively (Group A) and the group that was preoperatively medicated(Group B)(cure rate of Group A was 87.2% and Group B was 89.2%, p=0.745) in the cure rate for pure stress urinary incontinence. However, comparison of the postoperative results for the MUI showed significant differences (cure rate of Group A was 63.8% and Group B was 81.6%, p=0.035). The cure rate was significantly higher in the preoperatively medicated patients than in the patients who were not preoperatively medicated with regard to the MUI. CONCLUSIONS: Our findings suggest that treatment with anticholinergic medications before a midurethral sling operation improves the cure rate in patients with MUI.
Exercise Test ; Female ; Humans ; Suburethral Slings* ; Urinary Incontinence* ; Urinary Incontinence, Urge

Hemospermia is a common urologic problem that can be caused by diverse pathologic entities, including inflammatory and neoplastic disorders of the seminal tract. Transrectal ultrasonography provides excellent anatomic detail of pathologic changes in the seminal vesicle and ejaculatory duct. Morphological change of the seminal tract of patient with hemospermia was determined by means or transrectal sonography on 16 patients. The 14 patients (88%) had positive sonographic findings, Abnormalities detected included 5 cases of seminal vesicle stones, 2 cases of dilatated seminal vesicles, 3 cases of ejaculatory duct stones. 2 cases of ejaculatory duct cysts, 1 case of seminal vesicle stone and ejaculatory duct stone, 1 case of Mullerian duct cyst. Our result indicate that transrectal ultrasound is effective in studing in patient with organic hemospermia.
Ejaculatory Ducts ; Hemospermia* ; Humans ; Male ; Seminal Vesicles ; Ultrasonography*

We investigated the detection rate of Chlamydia trachomatis by enzyme immunoassay technique in cases of 89 patients with nongonococcal urethritis, 20 patients with chronic nonbacterial prostatitis. 17 males with previously treated urethritis, and 38 female patients who visited due to husband with urethritis, profuse vaginal discharge, vulvar itching. urinary symptoms and postcoital bleeding. The results were summarized as follows : The detection rates of Chlamydia trachomatis were 24.7% (22/89) in nongonococcal urethritis patients. 20% (4/20) in chronic nonbacterial prostatitis patients, 5.9% (1/17) in previously treated urethritis males. In the female patients. the detection rate were 28.6% (2/7) in patients with urethritis husband. 43.5% (10/23) with profuse vaginal discharge, 28.6% (2/7) with vulvar itching. 22.2% (2/9) with urinary symptoms and 12.5% (1/8) with postcoital bleeding.
Chlamydia trachomatis ; Chlamydia* ; Female ; Hemorrhage ; Humans ; Immunoenzyme Techniques* ; Male ; Prostatitis ; Pruritus ; Sexually Transmitted Diseases* ; Spouses ; Urethritis ; Vaginal Discharge

PURPOSE: To determine the correlation between the maximal urethral closure pressure and the stress leak-point pressure in the patients with genuine stress incontinence, and to define the benefit of maximal urethral closure pressure for detecting type III stress urinary incontinence. MATERIALS AND METHODS: 115 patients with genuine stress incontinence were evaluated with multichannel urodynamics. Maximal urethral closure pressures and stress leak-point pressures were determined and correlated. RESULTS: There was a statistically significant relationship (p=0.0001) between the stress leak-point pressure and the maximal urethral closure pressure. However, a correlation coefficient of 0.50 demonstrated poor clinical relationship. A stress leak-point pressure less than 60 centimeter H2O had 91.7% sensitivity, 78.8% specificity and 28.9% positive predictive value in detecting low-pressure urethra. CONCLUSION: The stress leak-point pressure has poor clinical correlation to the maximal urethral closure pressure. And maximal urethral closure pressure has no additional benefit for detecting type III stress urinary incontinence.
Humans ; Sensitivity and Specificity ; Urethra ; Urinary Incontinence ; Urodynamics