Schwannoma, which may occur in any region of the body, is very rare in the scrotum. Schwannomas are tumors that originate from Schwann cells and, theoretically, could affect any nerve. In spite of the rich innervation of the genital area, these kinds of tumors are not common in the scrotum. A 67-year-old man visited our hospital for investigation of a 2-year episode of multiple slowly growing masses in the scrotum. Testicular tumor markers were within normal range (beta human chorionic gonadotropin <5 mIU, alpha-fetoprotein : 4.86 ng/ml). Scrotal ultrasonography revealed intrascrotal and extratesticular masses in the mid-scrotal region. Complete excision of the scrotal masses was performed. After surgery there was no testicular invasion. Histological examination of the resected specimen showed them to be schwannomas of the scrotum. We report one case of multiple schwannomas of the scrotum with a review of the literature.
Aged ; alpha-Fetoproteins ; Chorionic Gonadotropin ; Humans ; Neurilemmoma ; Schwann Cells ; Scrotum ; Biomarkers, Tumor

The presence of ectopic prostate tissue in the bladder is common, but the involvement of the bladder dome has rarely been reported. This case report describes a 72-year-old man who presented with gross painless hematuria. Cystoscopy revealed a smooth sessile mass at the dome region of the bladder. A complete transurethral resection of the mass was performed. Histopathological examination of the mass revealed the presence of benign ectopic prostatic tissue.
Aged ; Choristoma ; Cystoscopy ; Hematuria ; Humans ; Prostate ; Urinary Bladder ; Urinary Bladder Neoplasms

PURPOSE: To detect the testosterone deficiency syndrome in Mongolian men over 40 years old with erectile dysfunction (ED). MATERIALS AND METHODS: Total of 309 males over 40 years of age who received medical care at the ADAM Urology and Andrology Clinic from 2010 to 2011 were included in this study. An approval from the Ethics Committee of the Ministry of Health of Mongolia was obtained, and each study participant signed a consent form at the beginning of the study. The participants were assigned to either an ED group or a control group, depending on the results of the international index of erectile function (IIEF)-5 questionnaire. The ED group was further divided into three groups (moderate, severe, and very severe) based on the level of ED. The total testosterone (TT) levels were determined in the blood serum using a competitive enzyme-linked immunesorbent assay (ELISA) analytical system UBI Magiwel(TM) Testosterone Quantitative test, and free testosterone (FT) calculated as described by the Vermeulen calculation. Test samples were collected between 8:00 and 11:00 am in the mornings and testosterone deficiency syndrome was diagnosed based on the International Society for the Study of the Aging Male guidelines, particularly, if TT was < or =3.46 ng/ml or free testosterone FT was < or =0.072 ng/ml. RESULTS: ED of moderate, severe, and very severe levels was diagnosed in 199 (64.41%) out of 309 participants. There was an inverse relationship between the main IIEF-5 score and age (r=-0.380, p<0.01). The average TT was 5.75+/-2.316 ng/ml and FT was 0.091+/-0.0084 ng/ml. Compared to the ED group, the control group had a higher TT level: 5.6440+/-1.177 ng/ml and 5.812+/-2.316 ng/ml, respectively. In the control group, the FT level was 0.061+/-0.0084 ng/ml, whereas it was 0.041+/-0.0076 ng/ml in the ED group. CONCLUSIONS: Our study showed that most of the aging males who came to the clinic had moderate to very severe ED (64.55%). The levels of TT (5.644+/-1.177 ng/ml) and FT (0.041+/-0.0036 ng/ml) were significantly lower in ED patients (p<0.05). The testosterone deficiency syndrome was detected in 24.27% of the ED group.
Aging ; Andrology ; Erectile Dysfunction ; Humans ; Male ; Mongolia ; Surveys and Questionnaires ; Testosterone ; Urology

PURPOSE: We analyzed factors associated with early recovery of continence after laparoscopic radical prostatectomy. MATERIALS AND METHODS: Among 467 patients treated with laparoscopic radical prostatectomy for localized prostate cancer between 2007 and 2012, 249 patients who underwent a preoperative urodynamic study were enrolled. The patients' age, prostate volume, preoperative serum prostate-specific antigen (PSA), Gleason score, pathologic stage, and preoperative urodynamic parameters were recorded. The preoperative membranous and prostatic urethral length on magnetic resonance image, nerve sparing technique, and type of surgical procedure (extrafascial and intrafascial) were analyzed. Patients were considered to have early recovery of continence when they needed no pad in 3 months or less after surgery. RESULTS: Ninety-two patients were in the early recovery group and 157 were in the late recovery group. The membranous urethral lengths were 12.06+/-2.56 and 11.81+/-2.87 mm, and prostatic urethral lengths were 36.39+/-6.15 and 37.45+/-7.55 mm in each group, respectively. The membranous-posterior urethral length ratios were 0.25+/-0.06 and 0.24+/-0.06, and prostatic-posterior urethral length ratios were 0.75+/-0.06 and 0.76+/-0.06, respectively. In and of themselves, the membranous and prostatic urethral lengths were not associated with recovery duration however, the membranous-total and prostatic-total urethral length ratios were related (p=0.024 and 0.024, respectively). None of the urodynamic parameters correlated with continence recovery time. In the multivariate analysis, the type of surgical procedure (odds ratio [OR], 7.032; 95% confidence interval [CI], 2.660 to 18.590; p<0.001) and membranous urethral length (OR, 0.845; 95% CI, 0.766 to 0.931; p=0.001) were significantly related to early recovery of continence. CONCLUSIONS: The current intrafascial surgical procedure is the most important factor affecting early recovery of continence after laparoscopic radical prostatectomy.
Humans ; Laparoscopy ; Magnetic Resonance Imaging ; Multivariate Analysis ; Neoplasm Grading ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms ; Urinary Incontinence ; Urodynamics

PURPOSE: A low quality clinical trial could produce errors, and these errors could, in turn, distort the results of the clinical trial. To avoid applying distorted results of trials clinically, a quality analysis of clinical trials is needed. MATERIALS AND METHODS: We selected randomized controlled trials (RCTs) about erectile dysfunction (ED) conducted in Korea using Medline and KoreaMed. Quality assessment of selected RCTs was performed using three assessment tools (Jadad scales, van Tulder scale, Cochrane Collaboration Risk of Bias Tool [CCRBT]). RESULTS: The first RCT about ED conducted in Korea was published in 2002. Since 2002, a total of 20 RCTs have been published in medical journals. Among the 20 articles, only 1 article was found to have a low risk of bias according to the CCRBT. On the Jadad scale, there were 17 high quality articles, while 19 articles were assessed as high quality by the VTS. Only 2 RCTs described the randomization method adequately. Only 1 RCT presented allocation concealment. CONCLUSIONS: A low quality clinical trial could produce errors, and these errors could, in turn, distort the results of the clinical trial. To avoid applying distorted results of trials clinically, a quality analysis of clinical trials is needed. The quality of RCTs was found to be high because almost all of the selected RCTs were double blinded studies. However, the quality of RCTs was inadequate with regard to the lack of randomization and absence of allocation concealment. Therefore, performing adequate randomization and adding a description of the appropriate concealment of allocation may improve the quality of RCTs.
Bias (Epidemiology) ; Erectile Dysfunction ; Korea ; Male ; Random Allocation

PURPOSE: The aim of this study was to investigate the anti-inflammatory effects of a new herbal formula (WSY-1075) in a nonbacterial prostatitis rat model. MATERIALS AND METHODS: Prostatitis was induced in male Wistar rats (n=32) by treatment with 17 beta-estradiol and dihydrotestosterone for 4 weeks. After the induction of prostatitis, the rats were randomly divided into one of four treatment groups: control (n=8), ciprofloxacin (n=8), WSY-1075 (100 mg/kg) (n=8), and WSY-1075 (400 mg/kg) (n=8). After 4 weeks of treatment, the prostatic proinflammatory cytokine (tumor necrosis factor-alpha, interleukin [IL]-6, and IL-8) levels and histological findings were noted. RESULTS: The ciprofloxacin and WSY-1075 treatment groups showed significantly decreased proinflammatory cytokine levels compared with the control group. Histologically, treatment with ciprofloxacin and WSY-1075 significantly suppressed the severity of prostatitis lesions compared with those in the control group. No differences in the proinflammatory cytokine levels or histologic findings were observed with the dose dependent treatment of WSY-1075. CONCLUSIONS: The new herbal formula, WSY-1075, showed effective anti-inflammatory activities in the prostate and may be useful for the clinical treatment of nonbacterial prostatitis. Our findings suggest that WSY-1075 has a beneficial effect on the prevention and treatment of nonbacterial prostatitis.
Animals ; Ciprofloxacin ; Dihydrotestosterone ; Estradiol ; Humans ; Inflammation ; Interleukins ; Male ; Prostate ; Prostatitis ; Rats ; Rats, Wistar

PURPOSE: The purpose of the present study was to investigate the effect of sesame oil on the reproductive parameters of diabetic male Wistar rats. MATERIALS AND METHODS: The adult male rats in a split plot design were divided into normal (n=10), normal 5% (n=5; 5% sesame oil enriched diet), diabetic (Streptozocin induced diabetes; n=9), diabetic 5% (n=9; 5% sesame oil enriched diet), and diabetic 10% (n=9; 10% sesame oil enriched diet) groups. Diet supplementation continued for 56 days. RESULTS: Sesame oil supplementation did not reduce the plasma glucose concentration of rats in the diabetic groups (p>0.05). The total spermatogonia, spermatocytes, Leydig cells/tubule, and the germ cell to Sertoli cell ratio were lower in the diabetic rats than the normal ones (p<0.05), and with the exception of spermatogonia counts, these values improved by the addition of sesame oil to the diet (p<0.05). The sperm progressive motility and viability were lower in the diabetic rats (p<0.05) and sesame oil supplementation did not improve them. Incorporation of sesame oil into the diet improved the plasma testosterone concentration of the diabetic rats in a dose-dependent manner (p<0.05). CONCLUSIONS: In summary, sesame oil supplementation improved the reproductive parameters of diabetic rats at the levels of the testicular microstructure and function, but was not effective in protecting the epididymal sperm.
Adult ; Animals ; Diabetes Mellitus ; Diet ; Germ Cells ; Male ; Rats ; Sesame Oil ; Sesamum ; Spermatocytes ; Spermatogonia ; Spermatozoa ; Testis ; Testosterone

Adipose tissue, where various metabolic hormones are secreted, plays a role in metabolizing different substances including androgen. Within fat tissue, enzymes such as aromatase and aldo-keto reductase 1C are responsible for metabolizing testosterone into estrogen and 5-dihydrotestosterone into inactive metabolites. Adipose tissue can also affect the secretion of gonadotropin, which influences the formation of androgen in the testes. At the same time, androgen has an impact on the distribution and proliferation of adipose tissue. The adrenoreceptors for catecholamines, which have been proven to play an essential role in controlling lipolysis, function by being up-regulated by androgens. Furthermore, androgens regulate the activity of lipoprotein lipase, a key enzyme involved in intracellular esterification of adipose tissue.
Adipose Tissue ; Alcohol Oxidoreductases ; Androgens ; Aromatase ; Catecholamines ; Esterification ; Estrogens ; Gonadotropins ; Humans ; Lipolysis ; Lipoprotein Lipase ; Male ; Oxidoreductases ; Testis ; Testosterone

Testosterone is important in the physiology of various organs and tissues. The serum testosterone concentration gradually declines as one of the processes of aging. Thus, the concept of late-onset hypogonadism has gained increasing attention in the last few years. Reported symptoms of late-onset hypogonadism are easily recognized and include diminished sexual desire and erectile quality, particularly in nocturnal erections, changes in mood with concomitant decreases in intellectual activity and spatial orientation, fatigue, depression and anger, a decrease in lean body mass with associated decreases in muscle volume and strength, a decrease in body hair and skin alterations, and decreased bone mineral density resulting in osteoporosis. Among these various symptoms, sexual dysfunction has been the most common and necessary to treat in the field of urology. It is well known that a low serum testosterone level is associated with erectile dysfunction and hypoactive sexual libido and that testosterone replacement treatment can improve these symptoms in patients with hypogonadism. Recently, in addition to sexual dysfunction, a close relationship between metabolic syndrome, characterized by central obesity, insulin resistance, dyslipidemia, and hypertension, and late-onset hypogonadism has been highlighted by several epidemiologic studies. Several randomized control trials have shown that testosterone replacement treatment significantly decreases insulin resistance in addition to its advantage for obesity. Furthermore, metabolic syndrome is one of the major risk factors for cardiovascular disease, and a low serum testosterone level is closely related to the development of atherosclerosis. Presently, it is speculated that a low serum testosterone level may increase the risk for cardiovascular disease. Thus, testosterone is a key molecule in men's health, especially that of elderly men.
Aged ; Aging ; Anger ; Atherosclerosis ; Bone Density ; Cardiovascular Diseases ; Depression ; Dyslipidemias ; Erectile Dysfunction ; Fatigue ; Hair ; Humans ; Hypertension ; Hypogonadism ; Insulin Resistance ; Libido ; Male ; Men's Health ; Muscles ; Obesity ; Obesity, Abdominal ; Orientation ; Osteoporosis ; Risk Factors ; Skin ; Testosterone ; Urology

Late-onset hypogonadism (LOH) is a syndromic condition that has a well-recognized association with sexual and reproductive failure. LOH is frequently associated with chronic conditions including cardiovascular diseases (CVD), obesity, osteoporosis, HIV infection, renal failure, and obstructive pulmonary diseases. Despite this evidence, in patients with these conditions, LOH is still only rarely investigated and testosterone replacement therapy (TRT) rarely considered. In this paper, we critically reviewed the available evidence on LOH treatment focusing on possible risks and benefits. Medical therapy of LOH should be individualized depending on the etiology of the disease and the patient's expectations. The fear of prostate cancer and the risk of erythrocytosis probably represent the main limitations of TRT in aging men. However, TRT in healthy older men in near physiological doses does not appear to incur serious adverse events, although regular monitoring of prostate-specific antigen and hematocrit levels is required. Available evidence also suggests that TRT might ameliorate central obesity and glycometabolic control in patients with metabolic syndrome and type 2 diabetes. In addition, TRT has been associated with an increase in bone mineral density in men with osteoporosis, with an improvement in lean body mass in subjects with human immunodeficiency virus infection or chronic obstructive pulmonary disease, as well as with peripheral oxygenation in patients with chronic kidney diseases. Despite this evidence, however, it should be recognized that the results of these trials were heterogeneous and limited by small sample sizes. Hence, further research is required regarding the long-term benefits and adverse effects of TRT in LOH.
Aging ; Bone Density ; Cardiovascular Diseases ; Diabetes Mellitus ; Erectile Dysfunction ; Hematocrit ; HIV ; HIV Infections ; Humans ; Hypogonadism ; Lung Diseases, Obstructive ; Male ; Obesity ; Obesity, Abdominal ; Osteoporosis ; Polycythemia ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Pulmonary Disease, Chronic Obstructive ; Renal Insufficiency ; Renal Insufficiency, Chronic ; Testosterone