We describe a case of temporary ischemic change of the glans penis after circumcision. A 36-year-old male exhibited an ischemic change in the color of the glans penis the day after receiving a dorsal penile nerve block for circumcision. After the third day, the color of the glans changed from black to dark brown. After 7 days, the glans returned to near normal skin color without other sequelae.
Adult ; Circumcision, Male ; Female ; Humans ; Ischemia ; Lidocaine ; Male ; Nerve Block ; Penis ; Pudendal Nerve ; Skin

PURPOSE: The purposes of this study were to investigate the effect of Korean Red Ginseng(KRG) extract on the relaxation of the clitoral corpus cavernosal smooth muscle in rabbit. MATERIALS AND METHODS: Rabbit clitoral corpus cavernosal smooth muscle strips were mounted in organ chambers to measure isometric tension. The strips were contracted with phenylephrine(5 x 10(-6) M), and the responses to KRG extract(1~20 mg/ml), nitric oxide inhibitor(N omega-nitro-L-arginine methyl ester, L-NAME), vasoactive intestinal peptide(VIP) receptor antagonist, KCl were examined. The cGMP content of the strips was measured by radioimmunoassay after various dose of KRG extract. RESULTS: The KRG extract(1~20 mg/ml) relaxed the clitoral corpus cavernosal smooth muscle in a dose-dependent manner up to 95%. The relaxation effect of KRG extract was significantly inhibited by L-NAME(10(-4) M) in clitoral corpus cavernosal smooth muscle. The KRG extract also inhibited the contraction induced by depolarization with 10, 20, 40 mM of KCl. The KRG extract(1, 5 mg/ml) increased the accumulation of cGMP in clitoral corpus cavernosal smooth muscle. CONCLUSIONS: These data suggest that KRG extract has a relaxing effect on the clitoral corpus cavernosal smooth muscle in rabbit. These effects are in part mediated by the NO-cGMP pathway and a hyperpolarizing action.
Clitoris ; Female ; Muscle, Smooth ; Nitric Oxide ; Panax* ; Rabbits ; Radioimmunoassay ; Relaxation*

PURPOSE: Alpha adrenergic components do not seem prevalent in the female bladder neck. Nevertheless, some studies using alpha-blockers in women suffering from obstructed urine flow have been reported. We assessed the effectiveness of administering an alpha 1-adrenoceptor antagonist, tamsulosin, in patients with a maximal flow rate less than 12 ml/sec. MATERIALS AND METHODS: From January 2007 to December 2007, 150 patients with a maximal flow rate less than 12 ml/sec were selected for this study. Patients were treated with tamsulosin at a dose of 0.2 mg per day. The effectiveness of tamsulosin was assessed by analyzing the International Prostate Symptom Score (IPSS) and other parameters, including the maximal urinary flow rate (Qmax) and the amount of postvoid residual urine. The data for these parameters were acquired at baseline and after 4 and 12 weeks of treatment. RESULTS: Of the 150 patients, 113 patients (75.3%) completed the study. Except for the storage symptom score, all clinical parameters, including total IPSS, voiding symptom score, Qmax, and the amount of residual urine, showed significant improvement after 4 and 12 weeks of treatment (p<0.05). The incidence of adverse events was only 4.4%, including dizziness in 3 patients, stress incontinence in 1 patient, and lethargy in 1 patient. CONCLUSIONS: The alpha-1 adrenoceptor antagonist tamsulosin significantly improved subjective symptoms and uroflowmetric parameters in female patients with a low maximal flow rate of less than 12 ml/sec. The use of tamsulosin may be an initial treatment option in females with a low maximal urinary flow rate.
Dizziness ; Female ; Humans ; Incidence ; Lethargy ; Lower Urinary Tract Symptoms ; Neck ; Prostate ; Stress, Psychological ; Sulfonamides ; Urinary Bladder ; Urinary Bladder Neck Obstruction

PURPOSE: Several reports have showed that female lower urinary tract symptoms affect health related quality of life and sexual function. However, there is lack of data proving the overactive bladder (OAB) on sexual function. We evaluated the impact of OAB on sexual function. MATERIALS AND METHODS: We included 82 women from 18 to 65 years old with overactive bladder symptoms including urinary frequency and urgency. A control group was recruited at the Health Care Center for health medical examination of our hospital. All patients were asked to complete the Koran version of Female Sexual Function Index (FSFI) to assess sexual function. RESULTS: The Mean age was 47.37+/-8.73 and 49.90+/-5.36 in OAB and Control group. Each of the dimension scores in FSFI represents worse sexual function in patients with OAB than the control group. The total scores of the FSFI were significantly decreased in the OAB group 20.10+/-4.10 than 24.64+/-3.91 (p<0.05). Among the six subdomains of FSFI, four domains of desire (4.92+/-1.59 vs 6.80+/-2.19), arousal (9.87+/-2.87 vs 11.50+/-2.44), orgasm (7.22+/-2.09 vs 9.52+/-2.96), satisfaction (6.95+/-2.09 vs 8.45+/-2.28) scores were significantly decreased in the OAB group (P<0.05) than control group. But, there was no statistically significant differences in domain of lubrication (11.12+/-2.80 vs 11.72+/-2.56) and pain (6.85+/-1.91vs 6.92+/-1.92) between the OAB group and control group. CONCLUSION: In this study, OAB syndrome was found to cause greater deterioration in sexual function. These results suggest that OAB symptoms have a significant impact on women's sexual function.
Arousal ; Delivery of Health Care ; Female ; Humans ; Lower Urinary Tract Symptoms ; Lubrication ; Orgasm ; Prospective Studies* ; Quality of Life ; Sexuality ; Urinary Bladder, Overactive*

PURPOSE: The primary objective of this study was to evaluate the impact of radical retropubic prostatectomy(RRP) on lower urinary tract symptoms(LUTS) in patients with clinically localized prostate cancer. MATERIALS AND METHODS: Between 2000 and 2006, 82 men with clinically localized prostate cancer underwent RRP. The International Prostate Symptom Score(IPSS) and the IPSS quality of life(QoL) score, and uroflowmetry were administered both prior to and 1 year after RRP. RESULTS: The overall mean total IPSS, maximal flow rate, and postvoid residual volume did not change over time after RRP. Prior to and after RRP, the mean maximal flow rate and residual urine changed from 17.6ml/sec to 17.9ml/sec(p=0.566) and 16.9ml to 15.8ml(p=0.777), respectively. Total IPSS also changed after RRP, from 12.8 to 12.5(p=0.731). The reduction of the IPSS was more prominent in patients with severe symptoms(IPSS> or =20), whereas in those with moderate symptoms(8< or =IPSS<20), the score did not change significantly after RRP. Furthermore, in those patients with no or mild symptoms(IPSS<8), the score increased after RRP. CONCLUSIONS: RRP was not shown to improve uroflowmetric parameters, including maximal flow rate, postvoid residual urine, and IPSS, in cases of moderate LUTS. However, RRP may exert a beneficial effect in those patients with severe LUTS, and may also have adverse effects on some individuals with no or mild symptoms. We believe that these results might be utilized when counseling patients about treatment options for localized prostate cancer.
Counseling ; Humans ; Lower Urinary Tract Symptoms ; Male ; Prostate ; Prostatic Neoplasms ; Residual Volume ; Urinary Tract

Endometrial stromal sarcoma (ESS) is a mesenchymal neoplasm that usually occurs as a primary tumor of the uterine corpus, but rarely arises in other sites, such as the ovary, pelvic cavity, mesentery, omentum and intestine. Herein, we present a rare case of low-grade ESS presented as prevesical mass. A 60-yr-old woman who had undergone total hysterectomy for endometriosis eleven years ago was presented with incidentally detected prevesical pelvic mass. Since malignant transformation of urachal remnants was possible, the mass was suspected to be a urachal tumor. Extraction of the mass was performed, and the histopathologic diagnosis was low-grade ESS. In summary, prevesical tumor is rare but in patients with endometriosis, we suggest endometriosis and its possible malignant changes should be taken into account in the differential diagnosis of prevesical mass.
Diagnosis, Differential ; Endometrial Neoplasms/*diagnosis/pathology/ultrasonography ; Endometriosis/diagnosis ; Female ; Humans ; Hysterectomy ; Middle Aged ; Sarcoma, Endometrial Stromal/*diagnosis/pathology/ultrasonography ; Urachus/abnormalities ; Urinary Bladder Neoplasms/diagnosis

PURPOSE: Recent studies have showed that interstitial cells of Cajal (ICCs) are widely distributed in the genitourinary tract and have suggested their involvement in spontaneous electrical activity and muscle contraction. The purposes of this study were to investigate the effect of estrogen on ICCs in rat urinary bladder from the detrusor overactivity induced by ovariectomy. MATERIALS AND METHODS: Female Sprague-Dawley rats (230-240 g, N=60) were divided into three groups: control (N=20), bilateral ovariectomy (Ovx, N=20), and bilateral ovariectomy followed by subcutaneous injections of 17 beta-estradiol (50 mg/kg/day, Ovx + Est, N=20). After 4 weeks, urodynamic studies measuring contraction interval and contraction pressure were done. The cellular localization of ICCs was determined by immunohistochemistry in the rat urinary bladder. RESULTS: Filling cystometry studies demonstrated a reduced interval between voiding contractions and an increased voiding pressure in Ovx group. The approximate the contraction interval (min) was (3.9+/-0.25) significantly decreased in the Ovx group compared to the control group (6.7+/-0.15), which was increased after estrogen treatment (9.7+/-0.22) (p<0.05). Conversely, the average contraction pressures (mmHg) were increased in the Ovx group (28.9+/-2.1) compared to the control group (21.2+/-1.45), and decreased after estrogen treatment (24.8+/-2.21) (p<0.05). The population of c-Kit immunoreactive ICCs was decreased in both the urothelial and muscle layers in Ovx bladders, which increased to the control value after estrogen treatment. CONCLUSIONS: These results demonstrated an decreased immunoreactivity of ICCs in the menopausal rat model and suggest that thedecreased population of ICCs expression may contribute to the modulation of bladder overactivity induced by menopause.
Animals ; Contracts ; Estradiol ; Estrogens ; Female ; Humans ; Immunohistochemistry ; Injections, Subcutaneous ; Interstitial Cells of Cajal ; Menopause ; Muscle Contraction ; Muscles ; Ovariectomy ; Rats ; Rats, Sprague-Dawley ; Urinary Bladder ; Urodynamics

Cartilage oligomeric matrix protein-angiopoietin-1 (COMP-Ang1) is an angiogenic factor for vascular angiogenesis. The aim was to investigate the effect of an intracavernosal injection of COMP-Ang1 on cavernosal angiogenesis in a diabetic rat model. Male Otsuka Long-Evans Tokushima Fatty (OLETF) rats made up the experimental group (1 yr old) and Long-Evans Tokushima Otsuka (LETO) rats made up the control group. The experimental group was divided into vehicle only, 10 microg COMP-Ang1, and 20 microg COMP-Ang1. COMP-Ang1 was injected into the corpus cavernosum of the penis. After 4 weeks, the penile tissues of the rats were obtained for immunohistochemistry and Western blot analysis. The immunoreactivity of PECAM-1 and VEGF was increased in the COMP-Ang1 group compared with the vehicle only group. Moreover, the expression of PECAM-1 and VEGF was notably augmented in the 20 microg Comp Ang-1 group. In the immunoblotting study, the expression of PECAM-1 and VEGF protein was significantly less in the OLEFT rats than in the control LETO rats. However, this expression was restored to control level after intracavernosal injection of COMP-Ang1. These results show that an intracavernosal injection of COMP-Ang1 enhances cavernous angiogenesis by structurally reinforcing the cavernosal endothelium.
Angiopoietin-1/genetics/*metabolism ; Animals ; Antigens, CD31/metabolism ; Blood Glucose/analysis ; Blotting, Western ; Body Weight ; Cartilage Oligomeric Matrix Protein/genetics/*metabolism ; Diabetes Mellitus, Experimental/*pathology ; Immunohistochemistry ; Male ; Neovascularization, Physiologic/*drug effects ; Penis/metabolism/pathology ; Rats ; Rats, Long-Evans ; Recombinant Fusion Proteins/biosynthesis/genetics/*pharmacology ; Vascular Endothelial Growth Factor A/metabolism

PUROPOSE: To evaluate the effects of nocturia on health-related quality of life (HRQoL) and sleep. MATERIAL AND METHODS: From January 2007 to December 2007, 180 patients with lower urinary tract symptoms were prospectively selected for this study. Study was conducted among respondents with nocturia (void/night> or =1) (n=119) and age matched controls (no nocturia) (n=61), with participants completing a series of questionnaires on HRQoL (OAB-q short form) and Medical Outcomes Study (MOS) sleep scale and frequency voiding chart. RESULTS: The patients population had a mean age of 57.2 years. In the patients, the mean number of void per night was measured, 58 patients reported 2>void/night> or =1, 32 patients reported 3> voids/night> or =2 and 29 patients reported void/night> or =3. The number of nocturia episodes/night was significantly associated with the overactive bladder (OAB) symptom score (p=0.001), symptom bother (p=0.001) and the MOS sleep index (p=0.016). CONCLUSIONS: Increases in the number of voids/night have further negative effects on sleep, symptom bother and HRQoL.
Surveys and Questionnaires ; Female ; Humans ; Lower Urinary Tract Symptoms ; Nocturia* ; Prospective Studies ; Quality of Life* ; Surveys and Questionnaires ; Urinary Bladder, Overactive

We report a case of genital swelling in a patient receiving continuous ambulatory peritoneal dialysis. A physical examination did not identify any defect. Ultrasonography revealed a large hydrocele, and surgical repair brought resolution of the genital swelling. Two months later, however, the genital swelling had recurred and was not improved until peritoneal dialysis was replaced by hemodialysis 3 months later.
Genitalia ; Humans ; Ligation ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Physical Examination ; Renal Dialysis ; Testicular Hydrocele