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: 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

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 aims of this study were to investigate the effects of Korean Red Ginseng(KRG) on vaginal blood flow and histological changes in a hypercholesterolemic female rat model. MATERIALS AND METHODS: Female Sprague-Dawley rats were divided into two groups: the control(n=20) and the hypercholesterolemia(n=40). Hypercholesterolemia group was fed a high fat diet(2% cholesterol, 1% cholic acid, 5% coconut oil) for 12 weeks. The hypercholesterolemia group was further divided into the vehicle only and the KRG treatment(50 mg/kg/day) groups. After 4 and 8 weeks of treatment, vaginal blood flow was measured by a laser Doppler flowmeter. Vaginal tissues were processed for histology and Western blot. RESULTS: After 4 and 8 weeks of treatment, serum cholesterol levels(mg/dl) were significantly increased in the hypercholesterolemia group(1185.0+/-736.1, 934.3+/-212.3) compared with the control group(69.7+/-19.5, 67.1+/-7.2), and partially decreased in KRG treatment group(688.2+/-251.5, 694.2+/-150.4), respectively. Vaginal blood flow(ml/min/100 g tissue) after pelvic nerve stimulation was lower in the hypercholesterolemia group(17.3+/-7.9, 17.9+/-5.5) compared with the control group(27.3+/-17.1, 26.9+/-16.4), however, the KRG treatment group(29.5+/-10.3, 27.4+/-11.1) was as high as the control group, respectively. The expressions of TGF-beta1 tended to increase in the vagina of the hypercholesterolemia animals compared to those of the control and the KRG treatment groups. CONCLUSIONS: KRG treatment in hypercholesterolemic female rats decreased serum cholesterol levels and improved vaginal blood flow. These results suggest that KRG treatment may have a beneficial effect in women's sexual health.
Animals ; Blotting, Western ; Cholesterol ; Cholic Acid ; Cocos ; Female* ; Flowmeters ; Humans ; Hypercholesterolemia ; Models, Animal ; Panax* ; Rats* ; Rats, Sprague-Dawley ; Reproductive Health ; Transforming Growth Factor beta1 ; Vagina

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: Aquaporins (AQPs) are membrane proteins that facilitate water movement across biological membranes. The purposes of this study were to investigate the localization and functional roles of AQP-1 water channels in rat vagina. MATERIALS AND METHODS: Female Sprague-Dawley rats (230~240 g, n=40) were anesthetized. To investigate the expression and localization of AQPs in the vagina, the vaginal branch of the pelvic nerve was stimulated for 60 seconds (10 V, 16 Hz, 0.8 msec), and then the animals were sacrificed immediately or 5 minutes later. The expression and cellular localization of AQP-1 in the vaginal tissue was measured by Western blot and immunohistochemistry. The cytosolic (or intracellular membrane) and plasma membrane fractions of AQP-1 in vaginal tissue were studied by immunoblot analysis. RESULTS: Immunolabeling showed that AQP-1 was mainly expressed in the capillaries and venules of the vagina. The translocation of AQP-1 isoforms from the cytosolic compartment to the plasma membrane compartment was observed right after nerve stimulation and had declined at 5 minutes after nerve stimulation. However, when the nerve stimulation was repeated 3 times, the translocation of AQP-1 from the intracellular membrane compartment to the plasma membrane compartment was still observed at 5 minutes. CONCLUSIONS: This study suggests that sexual arousal induced by pelvic nerve stimulation modulates AQP-1 activity in the rat vagina. This result implies that AQP-1 may play an important role in vaginal lubrication.
Animals ; Aquaporins ; Arousal ; Blotting, Western ; Capillaries ; Cell Membrane ; Cytosol ; Female ; Humans ; Immunohistochemistry ; Intracellular Membranes ; Lubrication ; Membrane Proteins ; Membranes ; Protein Isoforms ; Rats* ; Rats, Sprague-Dawley ; Vagina* ; Venules ; Water Movements

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

PURPOSE: This study was designed to investigate the effect of detrusor overactivity induced by partial bladder outlet obstruction (BOO) on the expression of aquaporin 1 (AQP1) and caveolin 1 (CAV1) in the rat urinary bladder, and to determine the role of these molecules in detrusor overactivity. METHODS: Female Sprague-Dawley rats were divided into control (n=30) and experimental (n=30) groups. The BOO group underwent partial BOO, and the control group underwent a sham operation. After 4 weeks, an urodynamic study was performed to measure the contraction interval and contraction pressure. The expression and cellular localization of AQP1 and CAV1 were determined by western blot and immunofluorescence experiments in the rat urinary bladder. RESULTS: In cystometrograms, the contraction interval was significantly lower in the BOO group (2.9+/-1.5 minutes) than in the control group (6.7+/-1.0 minutes) (P<0.05). Conversely, the average contraction pressure was significantly higher in the BOO group (21.2+/-3.3 mmHg) than in the control group (13.0+/-2.5 mmHg) (P<0.05). AQP1 and CAV1 were coexpressed in the capillaries, arterioles, and venules of the suburothelial layer. AQP1 and CAV1 protein expression was significantly increased in the BOO rats compared to the control rats (P<0.05). CONCLUSIONS: Detrusor overactivity induced by BOO causes a significant increase in the expression of AQP1 and CAV1, which were coexpressed in the suburothelial microvasculature. This finding suggests that AQP1 and CAV1 might be closely related to bladder signal activity and may have a functional role in BOO-associated detrusor overactivity.
Animals ; Aquaporin 1 ; Arterioles ; Blotting, Western ; Capillaries ; Caveolin 1* ; Female ; Fluorescent Antibody Technique ; Humans ; Microvessels ; Rats* ; Rats, Sprague-Dawley ; Urinary Bladder Neck Obstruction* ; Urinary Bladder* ; Urodynamics ; Urothelium* ; Venules