PURPOSE: Detrusor instability (DI) is a main cause of persistent voiding difficulty after TURP in patients with benign prostatic hyperplasia (BPH). So we retrospectively estimated the effect of TURP in BPH patients with DI. MATERIALS AND METHODS: Of the 81 patients who had undergone TURP due to prostatism, 35 patients with BPH were followed at 3 weeks and 6 months postoperatively (21 without DI cases vs. 14 with DI; 6 persistent DI, 7 resolved DI, 1 missing case at 3 weeks and 4 persistent DI, 7 resolved DI, 2 missing cases at 6 months). We compared each group using symptom score (IPSS) and urodynamic parameters. RESULTS: Each irritative and obstructive symptoms were significantly improved in both group (p<0.05). The maximal flow rate (from 12.2 to 25.4ml/sec), average flow rate (from 8.9 to 15.2ml/ sec), residual urine volume (from 135.9 to 39.1ml) in patients without DI and maximal bladder volume (from 150.0 to 203.7ml), maximal flow rate (from 12.5 to 18.6ml/sec), residual urine volume (from 65.7 to 26.0ml) in patients with DI were improved significantly (p<0.05) after TURP, but other parameters were not improved (p>0.05). There were no significant differences in all parameters between 3 weeks and 6 months postoperative period (p>0.05). The amplitude of improvement had no significant difference between two group. There were no significant differences in IPSS and urodynamic parameters between persistent and resolved DI group. CONCLUSION: We suggest that TURP is good therapeutic option even in BPH patients with DI at short term postoperative period, but attempt to predict which patients would have persistent DI following TURP was failed.
Humans ; Postoperative Period ; Prostatic Hyperplasia ; Prostatism ; Retrospective Studies ; Transurethral Resection of Prostate* ; Urinary Bladder ; Urodynamics*

No abstract available.
Orthopedic Procedures* ; Orthopedics*

Although fungal infections involving the genitourinary system are increasing in case, those involving the prostate are uncommon and fungal prostatic abscesses are especially rare. There are a few sporadic reports in the literature of fungal prostatic abscess. We thought that a high index of suspicion for fungal prostatic infection must be maintained especially in high risk patients. We report a case of candidal prostatic abscess in a 37-year old man with diabetes. The diagnosis and management are discussed, and the literature is reviewed.
Abscess* ; Adult ; Candida albicans ; Diagnosis ; Humans ; Prostate ; Urogenital System

Leiomyoma is a benign tumor, which usually occur at the smooth muscle of the gastrointestinal tract and uterus but rarely occurs on the corpus cavernosum of the penis. We experienced a patient with leiomyomas on the bilateral corpus cavernosa of the penis accompanied with impotence in a 60-year-old man. The patient was treated with complete local excision and has remained well without recurrence for l year, So we report this case with review of literatures.
Erectile Dysfunction ; Gastrointestinal Tract ; Humans ; Leiomyoma* ; Male ; Middle Aged ; Muscle, Smooth ; Penis* ; Recurrence ; Uterus

Sixty diabetic cystopathy patients (symptomatic DCP, 4.9%) among 1236 patients of diabetes mellitus (DM) from May, 1995 to June, 1996 were analyzed to ascertain the usefulness of urodynamic study in the diagnosis of DCP. The mean age was 58 (24--80) years and mean duration of DM was 9 (1~30) years. 36 (60%) patients had diabetic neuropathy, 31 (52%) had diabetic retinopathy and 4 (7%) had diabetic nephropathy. DM was managed by insulin pump (DIABECARETM, 52%) and subcutaneous insulin injection (42%). In residual urine and voiding diaries, residual urine volume more than 40ml was 83%, voiding interval less than 2 or more than 5 hours was 67% and voiding amount less than 200ml or more than 400ml was 48%. According to urodynamic findings, patients were classified as detrusor areflexia (63%), impaired detrusor contractility (18%), detrusor instability (15%) and normal detrusor contraction (3%). There were no significant differences of age, semm-HbA1C, treatment method and duration of diabetes mellitus among above groups. Mean duration of DM in irritative symptom group (32%), combined symptom group (23%) and obstructive symptom group (45%) were 2 years, 8 years and 15 years respectively (p<0.001). The shape of the cystometrographic curve was not influenced by the rate of bladder filling (40ml/min versus 100ml/min). In conclusion, because DCP is marked by insidious onset and progression with minimal symptoms, DCP can be early diagnosed using urodynamic study especially in patients with voiding symptoms and 1ong.DM duration.
Diabetes Mellitus ; Diabetic Nephropathies ; Diabetic Neuropathies ; Diabetic Retinopathy ; Diagnosis ; Humans ; Insulin ; Urinary Bladder ; Urodynamics*

A few cases of laparoscopic surgery for urachal remnant in children has been reported in English literature. With recent developments in minimal invasive surgery, laparoscopic approach for urachal remnant in adulthood is recommended by some laparoscopic surgeons because of its technical feasibility and safety as well as cosmesis. Recently we experienced a case of complicated urachal remnant in a 14-month-old girl, who was managed by laparoscopic approach. At presentation, she complained of high fever and lower urinary tract symptoms. After 6 weeks of antibiotics therapy, laparoscopic surgery was performed transperitoneally via 3 ports. Our experience suggests that laparoscopic excision of urachal remnant can be performed easily and safely in children.
Urachus/*abnormalities/pathology/*surgery ; Staphylococcus aureus ; Staphylococcal Infections/complications ; Laparoscopy/*methods ; Infant ; Humans ; Female

Growth factor stimulation induces Y783 phosphorylation of phosphoinositide-specific PLC-gamma1, and the subsequent activation of this enzyme in a cellular signaling cascade. Previously, we showed that a double point mutation, Y509A/F510A, of PLC-gamma1, abolished interactions with translational elongation factor 1-alpha. Here, we report that the Y509A/F510A mutant PLC-gamma1 displayed extremely high levels of Y783 phosphorylation and enhanced catalytic activity, compared to wild-type PLC-gamma1, upon treatment of COS7 cells with EGF. In quiescent COS7 cells, the Y509A/F510A mutant PLC-gamma1 exhibited a constitutive hydrolytic activity, whereas the wild-type counterpart displayed a basal level of activity. Upon treatment of COS7 cells with EGF, the Y783F mutation in Y509A/F510A PLC-gamma1 (Y509A/F510A/Y783F triple mutant) cells also led to an enhanced catalytic activity, whereas Y783F mutation alone displayed a basal level of activity. Our results collectively suggest that the Y509A/F510A mutant is more susceptible to receptor tyrosine kinase-induced Y783 phosphorylation than is wild-type PLC-gamma1, but no longer requires Y783 phosphorylation step for the Y509A/F510A mutant PLC-gamma1 activation in vivo.
Amino Acid Substitution/drug effects/*genetics ; Animals ; COS Cells ; Cercopithecus aethiops ; Enzyme Activation/drug effects ; Epidermal Growth Factor/*pharmacology ; Hydrolysis/drug effects ; Mutant Proteins/metabolism ; Phosphatidylinositols/*metabolism ; Phospholipase C gamma/*genetics/metabolism ; Phosphorylation/drug effects ; Phosphotyrosine/*metabolism ; Point Mutation/*genetics ; Rats

The urinary bladder is seldom injured by external forces, as it is located in the pelvic cavity, behind the symphysis pubis, and protected by the bony pelvis. Gynecological procedures are a major cause of bladder injury. Herein, a case of extraperitoneal bladder rupture, identified 6 days after vaginal delivery in a 27-year-old woman, with no history of cesarean section or pelvic surgery, and who was cured of the bladder rupture using conservative treatment with the indwelling of a urethral Foley catheter, is reported.
Adult ; Catheters ; Cesarean Section ; Female ; Humans ; Pelvis ; Postpartum Period ; Pregnancy ; Rupture* ; Urinary Bladder*

PURPOSE: Primary culture of the cavernous smooth muscle cells from corpus cavernous tissues is known to be difficult, mainly because of contamination with fibroblasts. We applied a new method for better isolation of rat penile smooth muscle cells (RPSMCs) from rat corpus cavernosum tissue for reliable ex vivo research on erectile dysfunction. MATERIALS AND METHODS: With the use of 8-week-old adult male Sprague-Dawley rats, ex vivo migrations of rat cavernous tissue were measured by penis and aortic ring assay by use of a Matrigel-based D-valine-modified culture method. The expression of alpha-smooth muscle actin (alpha-SMA) and platelet/endothelial cell adhesion molecule (PECAM)-1 in the RPSMCs was determined by standard immunofluorescent staining and immunoblotting. The expression patterns of phosphodiesterase (PDE) family mRNA in RPSMCs were compared with patterns in rat aortic smooth muscle cells (RASMCs) by use of quantitative real-time reverse transcription polymerase chain reaction. RESULTS: Immunocytochemical staining showed greater alpha-SMA-positive and PCAM-1-negative fluorescence. Moreover, whereas the expression of alpha-SMA was detected in the RPSMCs, that of PECAM-1 was not. The levels of PDE1A, PDE1B, PDE1C, PDE2A, PDE3A, PDE4A, PDE4B, PDE4C, PDE4D, and PDE5A mRNA in the RPSMCs were about 3.2-, 4.4-, 3.4-, 29.0-, 3.5-, 2.8-, 2.9-, 6.1-, 45.0-, and 6.0-fold the corresponding expression in RASMCs. CONCLUSIONS: We developed a two-stage tissue culture method utilizing a Matrigel-based sprouting culture system to facilitate stromal cell sprouting and an adherent culture system using D-valine to eliminate the contamination of fibroblasts into the smooth muscle cells.
Actins ; Adult ; Animals ; Antigens, CD31 ; Caves ; Cell Adhesion ; Collagen ; Drug Combinations ; Erectile Dysfunction ; Fibroblasts ; Fluorescence ; Humans ; Immunoblotting ; Laminin ; Male ; Muscle, Smooth ; Muscles ; Myocytes, Smooth Muscle ; Penile Erection ; Penis ; Primary Cell Culture ; Proteoglycans ; Rats ; Rats, Sprague-Dawley ; Reverse Transcription ; RNA, Messenger ; Stromal Cells

PURPOSE: Chronic pelvic pain syndrome(CPPS) is a debilitating condition characterized by pelvic pain and voiding symptoms. Pelvic floor tension myalgia is hypothesized to be a contributing factor in CPPS. The therapeutic effect of biofeedback and electrical stimulation for CPPS was evaluated prospectively. MATERIALS AND METHODS: Thirteen patients with CPPS intractable to conventional medication were enrolled. The patients were treated by domestic KontinenceTM equipment 2 times a week for 6 weeks. Patients completed the National Institute of Health Chronic Prostatitis Symptom Index(NIH-CPSI) before and after treatment. RESULTS: The average score for all 3 domains in NIH-CPSI significantly decreased. Pain domain decreased from 12.9+/-3.4 to 9.8+/-1.7(p=0.002), voiding symptoms from 4.5+/-1.6 to 3.2+/-0.9(p=0.006), and impact plus quality of life from 7.3+/-2.2 to 4.7+/-1.5(p=0.003). CONCLUSIONS: Biofeedback with electrical stimulation therapy can provide significant improvement in CPPS intractable to medication. Large, randomized trials are needed to confirm its efficacy.
Biofeedback, Psychology* ; Electric Stimulation Therapy* ; Electric Stimulation* ; Humans ; Myalgia ; Pelvic Floor ; Pelvic Pain* ; Prospective Studies ; Prostatitis ; Quality of Life