PURPOSE: To evaluate the usefulness and effectiveness of endoscopic management for recurrent hematospermia, we performed transurethral endoscopy of the seminal vesicles in patients with recurrent hematospermia, despite the administration of oral medication. MATERIALS AND METHODS: Sixteen patients were enrolled this study. Initially, all patients were treated with oral antibiotics for 6-8 weeks. Transrectal ultrasound (TRUS) and/or MRI were performed to find the anatomic abnormality and its relation with pelvic organs. The mean patient age and duration of symptoms were 43.9 years (range 24-64 years) and 21.3 months (range 1-108), respectively. We used a 6.5Fr. rigid ureteroscope and/or 14Fr. endoureterotomy instruments for the seminal vesiculoscopic examination. Patients were followed for more than 12 months after the procedures. RESULTS: An endoscopic seminal vesicle examination was able to be successfully performed in all patients. A midline cyst was found at 10 cases, which were fulgurated. Endoscopic incisions or dilation of the ejaculatory duct were performed in all patients. An ejaculatory duct stone was found at 5 cases, and removed endoscopically. All patients reported improvement of hematospermia after the procedure, and 3 with perineal discomfort became symptom free. Postoperative complications, such as epididymitis, orchitis and ejaculatory abnormalities, were not observed in any patient. CONCLUSIONS: Transurethral endoscopic interventions of the seminal vesicles can be performed easily with a conventional 6.5Fr. rigid ureteroscope and/or 14Fr. endoureterotomy instruments. Transurethral endoscopic managements were effective and safe treatment options in recurrent hematospermia patients.
Anti-Bacterial Agents ; Ejaculatory Ducts ; Endoscopy ; Epididymitis ; Hemorrhage ; Hemospermia* ; Humans ; Magnetic Resonance Imaging ; Male ; Orchitis ; Postoperative Complications ; Semen ; Seminal Vesicles ; Ultrasonography ; Ureteroscopes

Purpose: A laparoscopic radical nephrectomy is known to cause less morbidity than a traditional open radical nephrectomy. In our institution, the laparoscopic approach, with intact specimen removal, has become the standard technique for radical nephrectomies. Herein, we report the results and oncological outcome of the experience of a single center. Materials and Methods: We reviewed 68 transperitoneal laparoscopic radical nephrectomies, performed for suspected renal cell carcinoma between December 1999 and June 2006. All data were collected from the patient's medical records. Results: The mean tumor size, surgical time and estimated blood loss were 4.82cm (1.7-14), 228.5 min (120-480) and 409.1cc (32-1,312), respectively. Conversion to open surgery was required in one case due to Endo-GIA malfunction, and conversion to hand-assisted surgery was performed in one case. The histological findings were pT1, pT2 and pT3 in 40 (59.7%), 9 (13.4%) and 18 patients (26.9%), respectively. In one case, the histology confirmed a non-malignant disease. The follow-up period was from 3 to 80 months (median 18). Distant metastasis was observed in 2 cases, but there was no local recurrence or port metastasis. Conclusions: A laparoscopic radical nephrectomy is a safe and feasible treatment for localized renal cell carcinomas. Longer follow-up and large scale studies are necessary to evaluate the long-term survival and disease- free rates, and confirm the effectiveness of performing a radical laparoscopic nephrectomy.
Carcinoma, Renal Cell ; Conversion to Open Surgery ; Follow-Up Studies ; Humans ; Laparoscopy ; Medical Records ; Neoplasm Metastasis ; Nephrectomy* ; Operative Time ; Recurrence

Metastatic tumors involving the spermatic cord are very rare, and the prognosis for such patients is poor. The primary tumors that are frequently metastatic to the spermatic cord are gastric and colon carcinomas. We report a case of a 35-year-old male with a metastatic spermatic cord tumor following a palliative anterior resection for sigmoid colon cancer with peritoneal seeding. The patient complained of a tender mass in a right inguinal lesion. A right orchiectomy was performed, and the pathologic finding was a poorly differentiated adenocarcinoma similar to that of the sigmoid colon cancer.
Male ; Humans ; Adenocarcinoma ; Neoplasm Metastasis

Background: and Purpose The rate of donepezil discontinuation and the underlying reasons for discontinuation in Asian patients with Alzheimer’s disease (AD) are currently unknown. We aimed to determine the treatment discontinuation rates in AD patients who had newly been prescribed donepezil in routine clinical practice in Asia. Methods: This 1-year observational study involved 38 institutions in seven Asian countries, and it evaluated 398 participants aged 50–90 years with a diagnosis of probable AD and on newly prescribed donepezil monotherapy. The primary endpoint was the rate of donepezil discontinuation over 1 year. Secondary endpoints included the reason for discontinuation,treatment duration, changes in cognitive function over the 1-year study period, and compliance as assessed using a clinician rating scale (CRS) and visual analog scale (VAS). Results: Donepezil was discontinued in 83 (20.9%) patients, most commonly due to an adverse event (43.4%). The mean treatment duration was 103.67 days in patients who discontinued. Among patients whose cognitive function was assessed at baseline and 1 year, there were no significant changes in scores on the Mini-Mental State Examination, Montreal Cognitive Assessment, and Trail-Making Test–Black and White scores, whereas the Clinical Dementia Rating score increased significantly (p<0.001). Treatment compliance at 1 year was 96.8% (306/316) on the CRS and 92.6±14.1% (mean±standard deviation) on the VAS. Conclusions In patients on newly prescribed donepezil, the primary reason for discontinuation was an adverse event. Cognitive assessments revealed no significant worsening at 1 year, indicating that continuous donepezil treatment contributes to the maintenance of cognitive function.

Background: and Purpose The rate of donepezil discontinuation and the underlying reasons for discontinuation in Asian patients with Alzheimer’s disease (AD) are currently unknown. We aimed to determine the treatment discontinuation rates in AD patients who had newly been prescribed donepezil in routine clinical practice in Asia. Methods: This 1-year observational study involved 38 institutions in seven Asian countries, and it evaluated 398 participants aged 50–90 years with a diagnosis of probable AD and on newly prescribed donepezil monotherapy. The primary endpoint was the rate of donepezil discontinuation over 1 year. Secondary endpoints included the reason for discontinuation,treatment duration, changes in cognitive function over the 1-year study period, and compliance as assessed using a clinician rating scale (CRS) and visual analog scale (VAS). Results: Donepezil was discontinued in 83 (20.9%) patients, most commonly due to an adverse event (43.4%). The mean treatment duration was 103.67 days in patients who discontinued. Among patients whose cognitive function was assessed at baseline and 1 year, there were no significant changes in scores on the Mini-Mental State Examination, Montreal Cognitive Assessment, and Trail-Making Test–Black and White scores, whereas the Clinical Dementia Rating score increased significantly (p<0.001). Treatment compliance at 1 year was 96.8% (306/316) on the CRS and 92.6±14.1% (mean±standard deviation) on the VAS. Conclusions In patients on newly prescribed donepezil, the primary reason for discontinuation was an adverse event. Cognitive assessments revealed no significant worsening at 1 year, indicating that continuous donepezil treatment contributes to the maintenance of cognitive function.