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Penile Abscess Caused by Intracavernous Injection of Sildenafil Citrate Oral Pill.

Un Gi BAEK ; Ji Yoon KIM ; Sang Taek KWON ; Ki Hak MOON ; Tong Choon PARK ; Jae Ho CHO

Korean Journal of Andrology.2004;22(1):41-43.

We report the successful treatment by percutaneous aspiration and antibiotics of a penile abscess in an elderly man attributed to misapplication of sildenafil citrate. The etiology, diagnosis, and management of penile abscess are discussed.
Abscess* ; Aged ; Anti-Bacterial Agents ; Citric Acid* ; Diagnosis ; Humans ; Sildenafil Citrate

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Combination Therapy of Intraurethral Condyloma Acuminatum with Holmium: YAG Laser and 5-Fluorouracil Instillation.

Il Whan KIM ; In Rae CHO ; Kun Chul LEE ; Joon Seong JEON

Korean Journal of Andrology.2004;22(1):36-40.

PURPOSE: Condyloma acuminatum is a common sexually transmitted disease of the external genitalia and anus. Approximately 5% of patients demonstrate urethral involvement. Electrical fulguration or excision using a pediatric resectoscope has been used in the management of such lesions. Holmium(Ho):YAG laser, 5-FU(fluorouracil), or interferon may be helpful in eradicating them. We reviewed the results of intraurethral condyloma acuminatum treatment with Ho:YAG laser and 5-FU solution. MATERIALS AND METHODS: From January 2001 to July 2002, seven patients with intraurethral condylomata acuminata were enrolled in the study. The mean age of the subjects was 19.5(range 25~43) years. Under local anesthesia with 10% lidocaine spray and jelly, all of the intraurethral lesions were removed with the Ho:YAG laser followed by coverage with 10mL of 5% 5-FU solution. Intraurethral injection of 5-FU was performed weekly up to six times. Urethroscopy for detection of recurrence was done 3 months after initial laser therapy. RESULTS: Most patients had multiple intraurethral lesions. Six patients (86%) responded to initial therapy without local recurrence with a mean follow-up of 15.8 (range 9.1-23.2) months. One patient had a recurrence at 2 months. CONCLUSIONS: We believe that the Ho:YAG laser plus 5% 5-FU solution is a useful option for the treatment of intraurethral condyloma acuminatum.
Anal Canal ; Anesthesia, Local ; Condylomata Acuminata ; Fluorouracil* ; Follow-Up Studies ; Genitalia ; Holmium* ; Humans ; Interferons ; Laser Therapy ; Lasers, Solid-State* ; Lidocaine ; Recurrence ; Sexually Transmitted Diseases

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Appropriate Testosterone-to-Estradiol Ratios for Aromatase Inhibitor Usage in Oligoasthenospermic Men.

Jae Seok LEE ; Yong Seog PARK ; Joong Sik LEE ; Ju Tae SEO

Korean Journal of Andrology.2004;22(1):31-35.

PURPOSE: We investigated whether oligospermic or asthenospermic men have decreased testosterone-to-estradiol (TE) ratios and whether this condition can be corrected with an oral aromatase inhibitor. We also determined the predictive value of pretreatment TE ratios for aromatase inhibitor efficacy in infertile men. MATERIALS AND METHODS: From June 2002 to December 2003, a total of 68 subfertile men with abnormal TE ratios were treated with 1 mg of anastrozole daily for 3 months. Changes in serum testosterone, serum estradiol, TE ratios, and semen parameters were evaluated 3 months after this therapy. RESULTS: Men treated with anastrozole had an increase in TE ratios (mean 0.2+/-0.7 [SE] versus 0.38+/-0.15; p<0.001). Semen analysis before and during anastrozole treatment showed an increase in sperm concentration (48.96 versus 70.42 million/mL; p<0.001) and motility (26.3 versus 33.2%; p<0.005). CONCLUSIONS: Men who are subfertile with lower TE ratios can be treated with an aromatase inhibitor with an increase in TE ratios that correlates with improved semen characteristics. We advise that an aromatase inhibitor be used in oligospermic or asthenospermic men if the TE ratio is below 0.2.
Aromatase* ; Estradiol ; Humans ; Male ; Semen ; Semen Analysis ; Spermatozoa ; Testosterone

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Effect of Menopause on the Expression of Androgen Receptors in Human Vagina.

Jong Hyeon JUN ; Hana YOON

Korean Journal of Andrology.2004;22(1):24-30.

PURPOSE: Many women complain of various pattern of sexual dysfunction after surgical or natural menopause. This study aimed to investigate the effect of menopause on the expression of androgen receptors in the human vagina and sexual functions. MATERIALS AND METHODS: The subjects were women aged from their 30's to 70's who required transvaginal surgery. Subjects were divided into three groups: premenopausal, postmenopausal without hormone replacement therapy, and postmenopausal with hormone replacement therapy. Tissues from the proximal and distal thirds of the vagina were collected during the operation. The expression of androgen receptors was examined using RT-PCR and immunohistochemical techniques. RESULTS: In tissue from the distal third of the vagina, androgen receptor expression decreased after menopause compared with the premenopausal group. In the hormone replacement group, androgen receptor expression was decreased compared with non-hormone replacement group. Androgen receptor expression correlated with sexual function independent of hormonal status. CONCLUSIONS: Clinically, significant numbers of postmenopausal women show changes of sexual function. Androgen is thought to be one of the major factors controlling female sexual function. This study supports that the androgen receptor expression could be changed by the hormonal status and we should consider this change when managing sexual dysfunction in female.
Female ; Hormone Replacement Therapy ; Humans* ; Menopause* ; Receptors, Androgen* ; Vagina*

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Prevalence and Knowledge of Premature Ejaculation in the Area of Busan.

Sung Woo PARK ; Hyun Jun PARK ; Nam Cheol PARK

Korean Journal of Andrology.2004;22(1):19-23.

PURPOSE: We investigated the prevalence of premature ejaculation and knowledge of the disease in young and middle-aged men in Busan. MATERIALS AND METHODS: The subjects were 500 men aged from 21 to 49 years(average 37.7 years) who had no history of erectile dysfunction and had a stable sexual partner. The numbers of responders in their third, fourth, and fifth decades were 36, 299, and 165, respectively. All interviews were performed by the same urologic resident. The questionnaire consisted of 10 questions in three domains covering the prevalence and severity of premature ejaculation, its influence on sexual life, and therapy. RESULTS: The overall prevalence of premature ejaculation was 41.0% (205/500), being highest in younger men (50.0% in the third decade [18/36], 45.8% in the fourth decade [137/299], and 30.3% in the fifth decade [50/165]). Men saying they "always or almost always" or "usually" had the condition accounted for 2.0% (10 men) of the total study population, being 0 in the third decade, 2.0% (6 men) in fourth decade and 2.4% (4 men) in fifth decade. The man himself and his sexual partner complained of more than moderate discomfort in 29 cases (14.1%) and 22 cases (10.7%), respectively. Only three men (1.4%) had received treatment for premature ejaculation, but the numbers of men who wished to try medical or surgical treatment were 32 (66.7%) and 16 (33.3%), respectively. CONCLUSIONS: Although the prevalence of premature ejaculation is high in young and middle aged men in Busan, it has not been regarded as sexual dysfunction for the most part, and the treatment rate is low. We suggest that public education about the pathophysiology and management of premature ejaculation is required.
Busan* ; Education ; Erectile Dysfunction ; Humans ; Male ; Middle Aged ; Premature Ejaculation* ; Prevalence* ; Surveys and Questionnaires ; Sexual Partners

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Risk Factors for Development of Long-term Complications after Surgical Repair of Penile Fracture.

Dalsan YOU ; Bumsik HONG ; Jong Yeon PARK ; Tai Young AHN

Korean Journal of Andrology.2004;22(1):14-18.

PURPOSE: The aim of this study was to review clinical features of penile fracture and to characterize risk factors for the development of long-term complications after its surgical correction. MATERIALS AND METHODS: We retrospectively reviewed the cases of 10 patients who underwent surgical therapy for penile fracture between June 1995 and September 2003. Patient age at presentation ranged from 17 to 54 years (mean 32 years). All patients underwent surgical therapy in an emergency setting. The time between the injury and surgery ranged from 7 to 240 hours (mean 44.5 hours). Radiologic work-up included penile ultrasonography for 9 patients and retrograde urethrography for patients suspected of having concomitant urethral injury. We investigated multiple clinical features to characterize risk factors relevant to the development of long-term complications. The mean follow-up was 36.5 month. RESULTS: Penile ultrasonography revealed defects in the tunica albuginea in seven patients, including six in whom the defect was identical to the injury site. At surgery, the size of the injury was between 3 mm and 50 mm. Two patients with concomitant urethral injury showed larger defects than those with an intact urethra. Long-term complications such as penile curvature and erectile dysfunction were found in two men with large defects involving the urethra and three with long lapses from injury to surgical correction. CONCLUSIONS: Long-term complications after surgical therapy for penile fracture are likely to occur in patients with a large defect in the tunica albuginea involving the urethra or with delayed surgical correction.
Emergencies ; Erectile Dysfunction ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Risk Factors* ; Ultrasonography ; Urethra

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Sildenafil Compliance after Restoration of Erectile Function.

Hwan cheol SON ; Jae wook SHIN ; Dae Jung LIM ; Kwan jin PARK ; Soo Woong KIM ; Jae Seung PAICK

Korean Journal of Andrology.2004;22(1):11-13.

PURPOSE: Regarding for erectile dysfunction(ED), Sildenafil has produced satisfactory clinical results. However, Some patient discontinue sildenafil treatment for a variety of reasons after successful restoration of erectile function. We investigated the reasons for such discontinuations of sildenafil after restoration of erectile function by sildenafil medication. MATERIALS AND METHODS: After sildenafil medication, one hundred fifty six patients whose score of erectile function domain of the 15-item International Index of Erectile Function(IIEF) increased to 26 or more, were included in this study. Six-months after the first sildenafil prescription, compliance to medication and the reason for discontinuity were reviewed by chart or surveyed by telephone. RESULTS: In 156 successfully treated patients, 54(34.6%) discontinued sildenafil medication. The 2 most common reasons for discontinuation were trouble in the partners' or patients' emotional readiness for restoration of sexual activity after long-term abstinence and fear of possible side effects. CONCLUSIONS: After restoration of erectile function, many patients discontinued the use of sildenafil medication. The reasons for discontinuing the medication were primarily emotional or relationship-oriented issues. The counseling of both partners and education about the effects and side effects of the drugs are recommended to promote the successful recovery of sexual activity.
Compliance* ; Counseling ; Education ; Erectile Dysfunction ; Humans ; Male ; Prescriptions ; Sexual Behavior ; Telephone ; Sildenafil Citrate

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Diagnosis and Treatment of Surgically Uncorrectable Azoospermia.

Ju Tae SEO

Korean Journal of Andrology.2004;22(1):1-10.

Accurate diagnosis and evaluation of surgically uncorrectable azoospermia are essential for appropriate treatment and intervention. This article summarized the latest ideas and issues in male infertility. The state of art is reviewed, including diagnostic tools for azoospermic men, sperm retrieval techniques, as well as assisted reproductive technique currently issued. Coupled with sperm retrieval, intracytoplasmic sperm injection(ICSI) has dramatically changed the treatment of surgically uncorrectable azoospermia. Despite severely impaired spermatogenesis, men with the finding of focal spermatogenesis in the testis biopsy specimens have become candidates for treatment. These couples should not only be counseled regarding the possibility of passing infertility to the offspring but also informed that genetic abnormalities may exist. Microsurgical reconstruction remains the treatment of choice for men with reconstructable obstructive azoospermia. Sperm retrieval techniques performed with ICSI are highly effective for men in whom reconstruction is not feasible and with impaired spermatogenesis.
Azoospermia* ; Biopsy ; Diagnosis* ; Family Characteristics ; Humans ; Infertility ; Infertility, Male ; Male ; Reproductive Techniques, Assisted ; Sperm Injections, Intracytoplasmic ; Sperm Retrieval ; Spermatogenesis ; Spermatozoa ; Testis

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The Clinical Characteristics of Peyronie's Disease Patients with Diabetes Mellitus.

Hyun Jun PARK ; Chang Yell LEE ; Nam Cheol PARK

Korean Journal of Andrology.2008;26(2):74-79.

PURPOSE: Although several studies have attempted to identify a relationship between Peyronie's disease (PD) and associated comorbidites including diabetes mellitus (DM), little is known about the effect of DM on the natural history of PD. We investigated the clinical characteristics of PD patients with DM for understanding of this association. MATERIAL & METHODS: Patients with PD and DM (Group 1) and those with no DM (Group 2) were compared by age, duration of PD, size and location of the plaque, severity of the penile curvature, presence of pain on erection, and the severity of erectile dysfunction by IIEF-5 scores. RESULTS: There was no significant difference in mean age of patients, duration of PD and location of the plaque between Group 1 and Group 2, respectively. The rate of severe penile curvature (>60degrees) was more frequent in Group 1 (22.7% vs. 8.6%). Plaque size was significantly bigger in Group 1 than that of Group 2 (2.2+/-1.6 vs. 1.7+/-1.3 cm, p<0.05) and mean degree of penile curvature was significantly greater in Group 1 than Group 2 (31.4+/-8.7degrees vs. 24.9+/-6.6degrees, p<0.05). The rate of severe ED (IIEF-5 < or =11 score) was significantly greater in Group 1 (18.2% vs. 4.2%, p<0.05) but pain on erection was significantly greater in Group 2 (31.8% vs. 49.2%, p<0.05). CONCLUSIONS: These results suggest that the presence of DM in patients with PD exaggerates the severity of PD by affecting the size of the plaque, penile curvature and consequent erectile dysfunction.
Diabetes Mellitus ; Erectile Dysfunction ; Humans ; Male ; Natural History ; Penile Induration

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Therapy with Human Chorionic Gonadotropin and Human Menopausal Gonadotropin in Men with Hypogonadotropic Hypogonadism.

Sang Deuk KIM ; Myung Ki KIM ; Jong Kwan PARK

Korean Journal of Andrology.2008;26(2):69-73.

PURPOSE: Hypogonadotropic hypogonadism (HH) is an uncommon cause of virilization and male infertility. We evaluated the effect of the combination therapy with human chorionic gonadotropin (hCG) and human menopausal gonadotropin (hMG) in patients with HH. MATERIALS AND METHODS: Between May 2000 and April 2007, we evaluated 15patients with HH. Testicular volume, serum luteinizing hormone (LH), follicle stimulating hormone (FSH), total testosterone, and semen analysis were consecutively monitored at 6, 12, 24, 36 and 48 months after hCG/hMG combination therapy. Statistical analysis was performed by Paired Student's t-test. RESULTS: Testicular volume showed a time-dependent increase in all patients who received hCG/hMG combination therapy (p<0.01). At 12 months, 12 patients showed and were significant improvement in FSH (1.6+/-0.97mIU/ml, p<0.033) and in serum total testosterone (71+/-2.73ng/ml, p=0.003), respectively. During hCG/hMG combination therapy, semen volume, sperm number, sperm motility, and sperm morphology were improved. However, there was no significant change in LH levels. CONCLUSIONS: Our experience in the management of the patients with HH suggests that hCG/hMG combination therapy might be effective in improving the sperm volume, sperm number, sperm motility, sperm morphology, plasma FSH, total testosterone level, and testicular volume. Thus hCG/hMG therapy seems a better choice in the patients with HH who want pregnancy.
Chorionic Gonadotropin ; Follicle Stimulating Hormone ; Gonadotropins ; Humans ; Hypogonadism ; Infertility, Male ; Luteinizing Hormone ; Male ; Plasma ; Semen ; Semen Analysis ; Sperm Count ; Sperm Motility ; Spermatozoa ; Testosterone ; Virilism

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