PURPOSE: Some women choose to undergo posterior colporrhaphy (PC) concurrently with procedures for SUI to regain sexual confidence and improve sexual function. We determine the effect of PC on sexual function in women requiring a midurethral sling for SUI. MATERIALS AND METHODS: A total of 119 women were retrospectively reviewed 81 women had the midurethral sling alone (Group A), and 38 women voluntarily had PC concurrently with the midurethral sling (Group B). Sexual function was evaluated using the FSFI before and after surgery. RESULTS: The postoperative composite scores were significantly increased in both groups (Group A: p=0.02; Group B: p=0.04), and significant increases were observed in 'desire,' 'arousal' and 'satisfaction'. However, there were no significant differences in the composite score or six domainscores between the two groups. CONCLUSION: PC performed concurrently with midurethral sling for treatment of SUI does not provide any additional benefits towards improving the sexual function.
Female ; Humans ; Retrospective Studies ; Suburethral Slings ; Urinary Incontinence

PURPOSE: To compare the success rates, complications and cost effectiveness of extracorporeal shock wave lithotripsy (ESWL) and ureteroscopic lithotripsy (URS) using a Holmium: YAG laser to establish the more effective treatment for upper and mid ureter stones. MATERIALS AND METHODS: This retrospective study included 83 and 286 patients treated with URS and ESWL, respectively, for upper and mid ureter stones. URS was performed with a 7.5Fr semi-rigid ureterorenoscope and Holmium: YAG laser. ESWL was performed with Stonelith V.5 (PCK, Turkey). The stone sizes, success rates, postoperative complications and cost effectiveness were analyzed for each group. RESULTS: The overall success rates of the URS and ESWL were 97.6 and 82.5%, respectively. Success rates of URS were 98.4 and 95.2% when the stones were smaller and larger than 10mm, respectively. In the ESWL group, the success rates after the third session were 86.3 and 65.4% with stones smaller and larger than 10mm, respectively. The complication rates associated with URS and ESWL were 6 and 4.2%, respectively. The average cost of URS was lower than that of ESWL. CONCLISIONS: In our study, URS with Holmium: YAG laser was more efficacious than ESWL. Considering both the success rate and cost effectiveness, URS should remain the recommended first-line treatment for upper and mid ureter stones.
Cost-Benefit Analysis ; Holmium* ; Humans ; Lasers, Solid-State* ; Lithotripsy* ; Postoperative Complications ; Retrospective Studies ; Shock* ; Ureter* ; Ureteroscopy

PURPOSE: We evaluated the usefulness of the nuclear matrix protein 22 BladderChek (NMP22BC) test for the screening and follow-up of bladder cancer. MATERIALS AND METHODS: From February 2006 to September 2009, we enrolled 1,070 patients who had hematuria or who were being followed up for bladder cancer. We compared the sensitivity and specificity of the NMP22BC test with those of urine cytology. RESULTS: The sensitivity of the NMP22BC test (77.5%) was significantly higher than that of urine cytology (46.3%). The specificity of the NMP22BC test was 88.8%, compared with 97.9% for urine cytology. The sensitivity of the NMP22BC test (81.8%) in non-muscle-invasive bladder cancer was higher than that of cytology (36.4%). However, the sensitivity of the NMP22BC test and of urine cytology in invasive bladder cancer were 57.1% and 92.9%, respectively. The sensitivity of the NMP22BC test was higher for low-grade bladder cancer (83.9%) than for high-grade (62.5%), and the sensitivity of cytology was higher for high-grade bladder cancer (66.7%) than for low-grade (37.5%). Follow-up bladder cancer was detected in 262 patients. The sensitivity of the NMP22BC test in that group (72.7%) was decreased and the specificity (91.7%) was increased. The sensitivity of cytology (54.5%) in the follow-up group was increased and the specificity (95.6%) was decreased. The presence of pyuria was significantly associated with the lower specificity of the NMP22BC test. CONCLUSIONS: The greater sensitivity of the NMP22BC test may be more useful for the diagnosis of non-muscle-invasive bladder cancer and low-grade bladder cancer than for the diagnosis of invasive or high-grade bladder cancer. If the NMP22BC test is performed in the absence of pyuria, it may play a compensatory role for urine cytology.
Follow-Up Studies ; Hematuria ; Humans ; Mass Screening ; Nuclear Matrix ; Nuclear Proteins ; Pyuria ; Sensitivity and Specificity ; Urinary Bladder ; Urinary Bladder Neoplasms

PURPOSE: To assess the utility of spin-echo magnetic resonance(MR) imaging in the evaluation of thoracic and abdominal aortic aneurysm. MATERIALS AND METHODS: The spin-echo MR images of 27 aortic aneurysms in 22 patients were analyzed and correlated with angiography and/or operative findings retrospectively. Evaluations included location, type, and maximum diameter of the aneuyusm, mural thrombus, major branch involvement, and relationship with adjacent organ. RESULTS: The location of aneurysms was ascending thoracic aorta in seven cases, ascending thoracic aorta and aortic arch in one, descending thoracic aorta in six, thoracoabdominal aorta in three, and abdominal aorta in eight. Nineteen were fusiform, and eight were saccular. The mean of maximum diameters of the aneurysms was 7.9cm (4-10cm) on MR and 7.3cm (3-10cm) on angiography. Mural thrombus were noted in 13 cases on MR imaging and seven cases on angiograhpy. Angiography also underestimated the amount of mural thrombus. Eight cases involved major aortic branches. Although MR imaging and angiography were equal in the assessment of major abdominal aortic branches, MR imaging could not clearly demonstrate arch vessels, especially left subclavian artery, in aortic arch aneurysms. Among seven ascending thoracic aneurysms, six had aortic regurgitation. MR imaging showed left ventricular enlargement in all six cases. There was pericardial effusion in four cases which were noted only on MR imaging. MR imaging demonstrated hydronephrosis and renal atrophy in two cases of abdominal aortic aneurysms respectively. CONCLUSION: In the assessment of size of the aneurysm, mural thrombus, and relation with adjacent organs, MR imaging was better than angiography. MR and anglographic findings were equal in the assessment of the location and type of the aneurysm. Angiography was better than MR imaging in the assessment of major branch involvement, especially left subclavian artery.
Aneurysm ; Angiography ; Aorta ; Aorta, Abdominal ; Aorta, Thoracic ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Aortic Valve Insufficiency ; Atrophy ; Humans ; Hydronephrosis ; Magnetic Resonance Imaging ; Pericardial Effusion ; Retrospective Studies ; Subclavian Artery ; Thrombosis

PURPOSE: We evaluated the factors that affect the improvement of the initial peak flow rate after transurethral resection of the prostate (TURP) or photoselective vaporization of the prostate (PVP) for benign prostatic hyperplasia (BPH) patients by using noninvasive tools. METHODS: One hundred and twenty seven BPH patients who had undergone TURP or PVP between January 2005 and May 2009 were evaluated. They were divided into 2 groups: the postoperative initial peak urinary flow rate (Qmax) was less than 10 mL/sec (Group 1; n=37, TURP=11, PVP=26) and more than 10 mL/sec (Group 2; n=90, TURP=41, PVP=49). We confirmed the patients' preoperative check lists. The check list were the international prostate symptom score (IPSS), the quality of life score, a past history of acute urinary retention (AUR), body mass index and/or pyuria, the serum prostate-specific antigen (PSA) level and the prostate volume, the prostate transitional zone volume and prostatic calcification. The initial Qmax was measured at the outpatient clinic one week after discharge. RESULTS: The improvement rate was not significant difference between the TURP group (78.8%) and the PVP group (65.3%). The efficacy parameters were the IPSS-storage symptom score, the prostate volume, the PSA level and a past history of AUR. The IPSS-storage symptom scores of Group 1 (12.3+/-3.3) was higher than those of Group 2 (10.5+/-1.7). The prostate volume of Group 2 (42.3+/-16.6 g) was bigger than that of Group 1 (36.6+/-7.8 g). The PSA level of Group 2 (3.8+/-2.6 ng/mL) was higher than that of Group 1 (2.6+/-2.6 ng/mL). A past history of AUR in Group 1 (35.1%) was more prevalent than that of Group 2 (15.6%). CONCLUSIONS: The non-invasive factors affecting the initial Qmax after TURP or PVP were the IPSS-storage symptom score, the prostate volume and a past history of AUR. Accordingly, in patients who have a higher IPSS-storage symptom score, a smaller prostate volume and a history of AUR, there might be a detrimental effect on the initial Qmax after TURP or PVP. These factors might also be used as long-term prognostic factors.
Ambulatory Care Facilities ; Body Mass Index ; Humans ; Laser Therapy ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Pyuria ; Quality of Life ; Transurethral Resection of Prostate ; Urinary Retention ; Volatilization

PURPOSE: We evaluated the effect of tamsulosin and hydrochlorothiazide (Dichlozid) on the expulsion of ureteral stones. MATERIALS AND METHODS: A total of 132 patients with a single ureteral calculi less than 10 mm in diameter were enrolled and divided into 3 groups: group 1 (n=40) received tamsulosin (0.2 mg/day), group 2 (n=35) received Dichlozid (25 mg/day) and tamsulosin (0.2 mg/day), and group 3 (n=57) was the control. Proximal and distal ureteral stones were evaluated separately. Efficacy was evaluated in terms of the rate and duration of expulsion according to stone size (<5 mm, > or =5 mm) for a maximum period of 4 weeks. RESULTS: The mean stone diameters were 4.9+/-1.7 mm (group 1), 4.8+/-1.6 mm (group 2), and 5.3+/-1.8 mm (group 3). The overall expulsion rates were 70%, 74.3%, and 52.6%, respectively, and showed statistical significance. The mean durations of expulsion were 14.7+/-1.6, 12.8+/-1.5, and 18.0+/-2.0 days, respectively, and group 2 showed a significant decrease in the duration. There were no significant differences in the expulsion rate of proximal and distal ureteral stones in any group. Distal ureteral stones in groups 1 and 2 showed a significant reduction in the mean expulsion time (<5 mm: 13.6+/-0.5, 11.8+/-0.7, and 16.7+/-0.8 days in groups 1, 2, and 3, respectively; > or =5 mm: 15.0+/-1.4, 13.0+/-0.6, and 17.8+/-0.4 days in groups 1, 2, and 3, respectively). The mean expulsion time for smaller proximal stones (<5 mm) in groups 1 and 2 was reduced significantly (17+/-0.6, 15.2+/-0.8, and 19.3+/-0.6 days in groups 1, 2, and 3, respectively). CONCLUSIONS: Medical therapy with tamsulosin is time-saving and effective for treating ureteral calculi. In addition, adjunctive treatment with Dichlozid may reduce the duration of expulsion.
Diuretics ; Humans ; Hydrochlorothiazide ; Sulfonamides ; Ureter ; Ureteral Calculi

The incidence of prostate cancer (PCa) is increasing concomitantly with population aging. Accordingly, interest in radiation therapy (RT) and the frequency of RT are also increasing. The types of RT can be broadly divided into external beam RT (EBRT), brachytherapy (BT), and combination therapy (EBRT+BT). Lower urinary tract symptoms (LUTS) after RT for the treatment of PCa are common; however, there are few reviews on the relationship between RT and LUTS. Herein, we review the causes and incidence of LUTS, as well as the evaluation and treatment options. Because of the reported risks of RT, patients undergoing RT should be counseled regarding the challenges of treatment and informed that they may have higher failure rates than nonirradiated patients. Moreover, thorough evaluation and treatment strategies are needed to support treatment recommendations. With a review of the existing literature, this narrative article provides an overview to aid urologists in treating patients presenting with complications associated with RT for the treatment of PCa. Further research is required to provide evidence of the effectiveness and feasibility of the management approach to the care of patients with LUTS after RT for the treatment of PCa.

The incidence of prostate cancer (PCa) is increasing concomitantly with population aging. Accordingly, interest in radiation therapy (RT) and the frequency of RT are also increasing. The types of RT can be broadly divided into external beam RT (EBRT), brachytherapy (BT), and combination therapy (EBRT+BT). Lower urinary tract symptoms (LUTS) after RT for the treatment of PCa are common; however, there are few reviews on the relationship between RT and LUTS. Herein, we review the causes and incidence of LUTS, as well as the evaluation and treatment options. Because of the reported risks of RT, patients undergoing RT should be counseled regarding the challenges of treatment and informed that they may have higher failure rates than nonirradiated patients. Moreover, thorough evaluation and treatment strategies are needed to support treatment recommendations. With a review of the existing literature, this narrative article provides an overview to aid urologists in treating patients presenting with complications associated with RT for the treatment of PCa. Further research is required to provide evidence of the effectiveness and feasibility of the management approach to the care of patients with LUTS after RT for the treatment of PCa.

Objectives: Body protective compound-157 (BPC-157) is a stable gastric pentadecapeptide that has been effective in trials aiming to increase wound healing capabilities and decrease inflammatory cell influx, including studies on the healing of muscles and tendons. There are no studies about the effect of BPC-157 on pain transmission via nociception. This study examined the antinociceptive effects of BPC-157 using formalin tests and immunohistochemistry. Methods: Rats were randomly divided into the control, morphine and BPC-157 groups. Pain behavior was quantified periodically at 5- and 35- min intervals (representative values of phases 1 and 2) by counting the number of flinches exhibited by the injected paw after injection. The dorsal root ganglia (DRG) and spinal cords (SC) were collected, and then, the number of cytokine-positive cells was determined via immunostaining. Results: BPC-157 dose-dependently decreased the number of flinches during phase 1 but did not decrease the number of flinches during phase 2. During phase 1, interleukin-1β (IL-1β) in the DRG tissue was significantly different in the morphine, 10 μg/kg BPC-157, and 20 μg/kg BPC-157 groups. During phase 2, statistical significance was achieved in the DRG tissue in the morphine, 20 μg/kg BPC-157, and 40 μg/kg BPC-157 groups. During phase 1, interleukin-6 was significantly different in the DRG tissue in the morphine group and the SC tissue in the 10 μg/kg BPC-157 group. During phase 2, statistical significance was achieved in the morphine group and the BPC-157 20 μg/kg group in both the DRG and SC tissues. There were no significant differences in tumor necrosis factor-α between the DRG and SC tissues. Conclusions BPC-157 was effective during phase 1 but not during phase 2, as determined by the formalin test. BPC-157 decreased the expression of IL-1β in the DRG tissue in phases 1 and 2.

Objectives: Body protective compound-157 (BPC-157) is a stable gastric pentadecapeptide that has been effective in trials aiming to increase wound healing capabilities and decrease inflammatory cell influx, including studies on the healing of muscles and tendons. There are no studies about the effect of BPC-157 on pain transmission via nociception. This study examined the antinociceptive effects of BPC-157 using formalin tests and immunohistochemistry. Methods: Rats were randomly divided into the control, morphine and BPC-157 groups. Pain behavior was quantified periodically at 5- and 35- min intervals (representative values of phases 1 and 2) by counting the number of flinches exhibited by the injected paw after injection. The dorsal root ganglia (DRG) and spinal cords (SC) were collected, and then, the number of cytokine-positive cells was determined via immunostaining. Results: BPC-157 dose-dependently decreased the number of flinches during phase 1 but did not decrease the number of flinches during phase 2. During phase 1, interleukin-1β (IL-1β) in the DRG tissue was significantly different in the morphine, 10 μg/kg BPC-157, and 20 μg/kg BPC-157 groups. During phase 2, statistical significance was achieved in the DRG tissue in the morphine, 20 μg/kg BPC-157, and 40 μg/kg BPC-157 groups. During phase 1, interleukin-6 was significantly different in the DRG tissue in the morphine group and the SC tissue in the 10 μg/kg BPC-157 group. During phase 2, statistical significance was achieved in the morphine group and the BPC-157 20 μg/kg group in both the DRG and SC tissues. There were no significant differences in tumor necrosis factor-α between the DRG and SC tissues. Conclusions BPC-157 was effective during phase 1 but not during phase 2, as determined by the formalin test. BPC-157 decreased the expression of IL-1β in the DRG tissue in phases 1 and 2.