No abstract available.
Ankle Fractures* ; Ankle*

A 25 year old patient who had low back pain and sciatica was diagnosed as having a lumbar intraspinal extradural synovial cyst adjacent to a facet joint between the third and fourth lumbar vertebrae. The extradural defects defined with positive contrast myelography and postmyelographic computed tomographic scanning were posterolateral to the dural sac. Biopsy revealed the findings compatible with synovial cyst. Treatment consisted of laminectomy and surgical excision of the cyst.
Biopsy ; Humans ; Laminectomy ; Low Back Pain ; Lumbar Vertebrae ; Myelography ; Sciatica ; Synovial Cyst ; Zygapophyseal Joint

The formation of cysts in the parameatal area has been reported as rare. A parameatal urethral cyst is a congenital anomaly and has been reported even more rarely in adults. In this study, we present two cases of parameatal urethral cyst and aim to investigate their causes and treatment methods. The extent of cyst spread was assessed using a urethroscope prior to cyst excision, and the excision range was determined accordingly. Complete excision of the cyst was performed as the treatment for parameatal urethral cyst. Both patients were adults who presented with urinary symptoms related to the cyst, necessitating the excision of the congenital parameatal urethral cyst.

PURPOSE: A 5-alpha-reductase inhibitor(5 alpha RI) can induce apoptosis and decrease the prostatic volume in patients with benign prostatic hyperplasia (BPH). In this study we assessed the expression of survivin and bcl-2 in the epithelium of BPH patients treated with finasteride. MATERIALS AND METHODS: Group 1 consisted of 39 patients who underwent transurethral resection of the prostate(TURP) without medication and Group 2 consisted of 31 patients who underwent TURP and were treated with finasteride for more than three months. The mean age of both groups of patients was 73.03+/-7.02 years and 74.71+/-5.99 years, respectively. Immunohistochemical staining for survivin, bcl-2 and ki-67 was performed in prostatic tissues. The percentage of cells that expressed survivin and bcl-2 were classified into four categories based on the staining intensity. The expression of ki-67 in nuclei using 10 random cells per specimen was obtained. The relationship between 5alphaRI and the expression of survivin, bcl-2 and ki-67 was analyzed. RESULTS: The total mean prostate volume of group 1 patients and group 2 patients was 45.51ml and 37.23ml, respectively (p<0.001) and the mean serum total prostate-specific antigen(PSA) level of group 1 patients and group 2 patients was 5.09ng/ml and 3.75ng/ml, respectively(p=0.105). Decreased expression of survivin and bcl-2 in specimens from group 2 patients was observed as compared to the level of expression in group 1 patients(p<0.001, p=0.001). Expression of ki-67 determined in samples from both groups was not significantly different(p=0.345). CONCLUSIONS: We suggest that finasteride may induce apoptosis of prostatic epithelial cells in BPH patients by reducing the expression of survivin and bcl-2. These findings may indicate a reduction of prostatic volume.

PURPOSE: The aim of this study was to evaluate the effect of periurethral prostatic calculi on lower urinary tract symptoms(LUTS) at the initial visit and after treatment with an alpha-blocker in benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: A total of 223 male patients with LUTS were studied. Group 1 consisted of 81 patients with periurethral prostatic calculi within 5 mm from the prostatic urethra of the transitional zone, as determined by transrectal ultrasound. Group 2 consisted of 142 patients without periurethral prostatic calculi within 5 mm from the prostatic urethra. The International Prostate Symptom Score(IPSS), maximal urinary flow rate (Qmax) and post voided residual urine(PVR) were measured in patients of both groups at the beginning of the study and at eight weeks after the treatment with 4 mg doxazosin gastrointestinal therapeutic system (GITS). RESULTS: Voiding, storage and the total IPSS for Group 1 patients were higher than for Group 2 patients(p>0.05). Quality of life(QoL), Qmax, and PVR were not significantly different at the initial visit. After treatment with 4 mg doxazosin GITS, an improvement of voiding, storage and the total IPSS for Group 2 patients was seen as compared to Group 1 patients (p<0.05). The mean improvement of QoL was 0.44+/-0.73 for group 1 patients and 1.13+/-0.82 for group 2 patients(p<0.001). The mean change of Qmax was 1.02+/-1.40 ml/sec for Group 1 patients and 1.52+/-1.84ml/sec for Group 2 patients(p=0.035). Changes of PVR were not significant between the two groups. CONCLUSIONS:This study suggests that the periurethral prostatic calculi may aggravate lower urinary tract symptoms and decrease the effect of alpha- blockers.
Male ; Humans

PURPOSE: The aim of this study was to evaluate the efficacy of a terpene mixture compared with alpha-blocker in patients with chronic pelvic pain syndrome (CPPS). MATERIALS AND METHODS: Patients diagnosed with CPPS were included in this study. The patients were randomly placed into three groups. Group 1 was treated with levofloxacin alone (36 patients), group 2 was treated with levofloxacin and alfuzosin (33 patients), and group 3 was treated with levofloxacin and terpene mixture (34 patients) for 8 weeks. The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) was evaluated in patients in each group at the beginning of the study and after 8 weeks of treatment. RESULTS: Pain domain, urinary domain, quality of life domain, and total score on the NIH-CPSI were not significantly different at the initial visit. After treatment with each medication, improvements on the pain domain and total score of the NIH-CPSI were better in group 3 than in group 1 or group 2 (p<0.05). Improvement on the urinary domain of the NIH-CPSI was better in group 2 than in group 1 or group 3 (p=0.014). Changes in the quality of life domain of the NIH-CPSI were not significant among the three groups. CONCLUSIONS: This study suggests that the terpene mixture and alpha-blockers may have significant benefit for symptomatic relief, especially in the pain and urinary domains, respectively.
Adrenergic alpha-Antagonists ; Humans ; National Institutes of Health (U.S.) ; Ofloxacin ; Pelvic Pain ; Prospective Studies ; Prostatitis ; Quality of Life ; Quinazolines ; Terpenes

No abstract available.
Catheters*

We report a case of pseudotumor cerebri associated with hematologic disorder, polycythemia vera. The patient was 35 years old woman and experienced headache and nausea for three months. She presented bilateral papilledema with visual field defect. On MRI investigation no intracranial abnomality were observed except empty sella syndrome. Lumbar puncture showed increased intracranial pressure and normal biology. Hematologic study showed elevated hemoglobin and hematocrit level. The patient was treated with therapeutic lumbar puncture and acetazolamide. Repeated phlebotomy was done for treatment of polycythemia vera, and symptoms resolved gradually.
Acetazolamide ; Adult ; Biology ; Empty Sella Syndrome ; Female ; Headache ; Hematocrit ; Humans ; Intracranial Pressure ; Magnetic Resonance Imaging ; Nausea ; Papilledema ; Phlebotomy ; Polycythemia Vera* ; Polycythemia* ; Pseudotumor Cerebri* ; Spinal Puncture ; Visual Fields

PURPOSE: The aim of this study was to evaluate the effect of chronic prostatic inflammation on acute urinary retention(AUR) in the setting of benign prostatic hyperplasia(BPH). MATERIALS AND METHODS: A total of 132 male patients admitted to our clinic with BPH-related AUR or BPH-related lower urinary tract symptoms (LUTS) were included in this study. These patients were divided into two groups. Group 1 consisted of 58 patients with AUR who underwent transurethral resection of the prostate(TURP), and group 2 consisted of 74 patients with LUTS who underwent TURP. Prostatic infarction, morphology, inflammation were examined. Prostatic infarction was evaluated according to the presence or absence of infarction. Prostatic morphology was assessed according to three categories: mainly glandular hyperplasia, stromal hyperplasia, or a mixture of glandular and stromal hyperplasia. Prostatic inflammation was assessed according to three categories: mild, moderate, and severe. RESULTS: Prostatic infarction was observed in 8.6% of the patients in group 1 and in 8.1% of the patients in group 2(p=1.000). Glandular, stromal, and mixed hyperplasia were detected in 36.2%, 5.2%, and 58.6% of the patients in group 1 and in 35.1%, 6.8%, and 58.1% of the patients in group 2, respectively(p=0.222). Mild, moderate, and severe chronic prostatic inflammation were observed in 39.7%, 31.0%, and 29.3% of the patients in group 1 and in 73.0%, 20.3%, and 6.7% of the patients in group 2, respectively(p<0.001). CONCLULSIONS: Chronic prostatic inflammation may play an important role on AUR developing secondary to BPH.
Male ; Humans

PURPOSE: We investigated the effect of the level of spinal cord injury and urinary catheterization on sexual function and activity in male patients with upper motor neuron (UMN) injury. MATERIALS AND METHODS: We reviewed patient's chart, radiologic and urodynamic study. We interviewed patient's sexual activity according to educational status, economic and marriage state, occupation, duration of spinal cord injury and pattern of voiding. A total of 114 male patients with neurogenic bladder due to UMN injury were included in the study. Group 1 consisted of 33 patients who underwent a clean intermittent catheterization (CIC) regimen and group 2 consisted of 81 patients with a suprapubic catheter, condom catheter, or Foley catheter. A detailed sexual behavior was taken for all patients to complete a questionnaire including the 5-item version of the International Index of Erectile Function (IIEF-5). RESULTS: Satisfaction with intercourse (p=0.037) and total score (p=0.032) on the IIEF-5 were significantly higher in group 1 than in group 2. The other items on the IIEF-5 did not differ significantly between the groups. When the subjects were stratified according to level of spinal cord injury, 8 patients (18.6%) with cervical cord injury had no sexual activity, whereas 24 patients (33.8%) with non-cervical-cord injury did (p=0.048). Patients with no sexual activity were 12.1% (4/33) of the patients in the CIC group and 34.6% (28/81) of the patients who underwent other regimens (p=0.016). CONCLUSIONS: Our results demonstrate that level of spinal cord injury and urinary catheterization may influence the sexual activity of male patients with UMN injury. Our results suggest that the CIC regimen had a positive effect on the sexual activity of these patients.
Catheters ; Condoms ; Educational Status ; Erectile Dysfunction ; Humans ; Intermittent Urethral Catheterization ; Male ; Marriage ; Motor Neurons ; Occupations ; Sexual Behavior ; Spinal Cord ; Spinal Cord Injuries ; Urinary Bladder, Neurogenic ; Urinary Catheterization ; Urinary Catheters ; Urodynamics