Journal Detail Information

1

Cite

Share

Corporeal Fibrosis and Erectile Dysfunction as Sequelae of Unrepaired Penile Blunt Trauma.

Korean Journal of Andrology.2010;28(3):226-228.

Penile fracture is an injury caused by the rupture of the tunica albuginea. We report an uncommon case of penile fracture with corporeal fibrosis and erectile dysfunction in a 45-year-old man who sustained a straddle injury to the erect penis. He presented with palpable plaque in the bilateral proximal corpora cavernosa and markedly decreased erectile rigidity at the distal side of the plaque. Exploration and excision of the penile plaque were performed. The patient partially recovered erectile function after surgery and administration of phosphodiesterase-5 inhibitor.
Cyclic Nucleotide Phosphodiesterases, Type 5 ; Erectile Dysfunction ; Fibrosis ; Humans ; Male ; Middle Aged ; Penis ; Rupture

2

Cite

Share

A Case of Fournier Gangrene after Penile Methamphetamine Injection.

Hong Sang MOON ; Jang Hyun LEE ; Hong Yong CHOI ; Hae Young PARK

Korean Journal of Andrology.2010;28(3):223-225.

Fournier gangrene is a fulminant infection of the genitalia, perineum, or abdominal wall. It is a life threatening progressive disease that requires aggressive surgical therapy and broad spectrum antibiotic treatment. We present one case of Fournier gangrene after penile methamphetamine injection.
Abdominal Wall ; Fournier Gangrene ; Genitalia ; Male ; Methamphetamine ; Penis ; Perineum

3

Cite

Share

Penile Augmentation Using Superficial External Pudendal Artery Pedicle and Adipose Tissue.

Myung Cheol GIL ; Doo Hong KIM ; Se Il JUNG ; Kyung Won HWANG ; Jae Il CHUNG

Korean Journal of Andrology.2010;28(3):217-222.

PURPOSE: Many men are to some degree unsatisfied with the size of their penis, whether it is normal in size and appearance or not. We report a novel surgical technique for penile augmentation using a superficial external pudendal artery pedicle. MATERIALS AND METHODS: In total, 8 patients underwent penile augmentation from March 2003 to February 2004. Their mean age was 37.3 years. Five patients were unsatisfied about the size of their penis, and three patients had complications after insertion of foreign material. This penile augmentation technique was developed by using a low abdominal fat-flap where blood is supplied from the external pudendal artery. Spinal or epidural anesthesia was done during the operation, and the fat-flap was elevated and transpositioned to the site of lesion. RESULTS: All cases of patients were performed successfully by autografting using adipose tissue where blood flow was supplied from the external pudendal artery. There were no complications except one case of hematoma after the operation. The mean operative time was 80 min. The mean follow-up period after operation was about 6 months and all patients had a normal sexual life and no voiding dysfunctions. CONCLUSIONS: This novel surgical technique has several advantages. First, reconstruction without skin necrosis was possible even though the defect was large, because the blood supply was favorable. Second, there was no size limitation in augmentation with dermoplasty. Third, there was no evidence of atrophy of the flap.
Adipose Tissue ; Anesthesia, Epidural ; Arteries ; Atrophy ; Follow-Up Studies ; Hematoma ; Humans ; Male ; Necrosis ; Operative Time ; Penile Implantation ; Penis ; Skin ; Transplantation, Autologous

4

Cite

Share

Significance of Laparoscopic Varicocelectomy.

Moung Jin LEE ; Seung Hun CHO ; Jae Young CHOI ; Sung Bin KIM ; Seung Tae LEE ; Seung Ki MIN

Korean Journal of Andrology.2010;28(3):209-216.

PURPOSE: The best option for varicocele treatment is controversial. We evaluate our experience using laparoscopic varicocelectomy & inguinal varicocelectomy, and then compared the two methods. We started this study to find the best treatment for varicocele patients. MATERIALS AND METHODS: Between July 2002 and July 2008, 168 cases (Group I) were treated with laparoscopic varicocelectomy and 157 cases (Group II) were treated with the inguinal approach. We assessed the two methods according to operative time, hospital stay, recurrence rate, complication rate, and cost effectiveness. RESULTS: The mean operative time was 30.2+/-10.9 min for laparoscopic varicocelectomy and 62.6+/-13.3 min for inguinal varicocelectomy (p<0.05). The recurrence rate was 2% for laparoscopic varicocelectomy and 8% for inguinal varicocelectomy (p>0.05). The complication rate was 10.7% for laparoscopic varicocelectomy and 12.7% for inguinal varicocelectomy (p>0.05). The cost of laparoscopic varicocelectomy was 401,870 won, but inguinal varicocelectomy was 256,480 won (p<0.05). CONCLUSIONS: The laparoscopic varicocelectomy required a shorter operative time but no superior outcomes compared to inguinal varicocelectomy. The laparoscopic approach cannot be replaced with the routine open approach but it is thought to be worth consideration in selective cases.
Laparoscopy ; Length of Stay ; Operative Time ; Recurrence ; Varicocele

5

Cite

Share

Effects of Health Insurance Coverage for Vasovasostomy.

Dae Hyeon KWON ; Jang Ho BAE ; Phil Hyun SONG ; Hyun Tae KIM ; Ki Hak MOON

Korean Journal of Andrology.2010;28(3):203-208.

PURPOSE: In early 1980s, vasectomy was performed in more than 10 thousand men of reproductive age annually without cost as a South Korean government policy of birth control, but because the policy has been converted to encouraging childbirth since July 2004, vasovasostomy is now covered by national health insurance. We investigated the effect of national health insurance coverage of vasovasostomy. MATERIALS AND METHODS: From August 1997 to June 2009, a total of 117 patients who underwent vasovasostomy were enrolled in this study. We divided the patients into two groups. The 63 patients undergoing the procedure before national health insurance coverage were included in group A, and the other 54 patients, who underwent the procedure after insurance coverage began, were classified into group B. The two groups were compared according to age, spouse's age, time since vasectomy, number of children at the time of vasectomy, occupation, educational attainment, religion, and the reason for vasovasostomy. RESULTS: The average number of cases of vasovasostomy was almost 3 times higher after insurance coverage was introduced, at 2.3 cases per month. The average spouse's age was significantly higher in group B than group A (35.2+/-4.8 vs. 32.2+/-3.5, p=0.012). Time since vasectomy was shorter in group B than group A (5.7+/-4.7 years vs. 8.9+/-5.0 years, p=0.001). Number of children at the time of vasectomy showed no significant difference between group A and group B, at 1.7+/-0.7 and 1.6+/-0.8 respectively. Cross tabulation analysis of occupation, educational status, religion, and the reason for vasovasostomy showed no significant difference. The patency rate was significantly higher in group A than group B (87.3% vs. 90.7%, p=0.012), but there was no significant difference in pregnancy rate. CONCLUSIONS: A significant increase was seen in patency rate, but not in pregnancy rate, after insurance coverage. However, further follow up will show us that a rise in the patency rate promises positive effects on the rise of pregnancy rate. We suggest that insurance coverage for vasovasostomy has encouraged an increase in births.
Child ; Contraception ; Educational Status ; Humans ; Insurance Coverage ; Insurance, Health ; Male ; National Health Programs ; Occupations ; Parturition ; Pregnancy ; Pregnancy Rate ; Vasectomy ; Vasovasostomy

6

Cite

Share

Oral Testosterone Undecanoate Versus Transdermal Testosterone Gel for the Treatment of Testosterone Deficiency Syndrome: A Retrospective Comparative Study.

Min Gu PARK ; Seung Min JEONG ; Sun Tae AHN ; Jea Il KANG ; Su Hwan SHIN ; Tae Yong PARK ; Jae Hyun BAE ; Je Jong KIM ; Du Geon MOON

Korean Journal of Andrology.2010;28(3):197-202.

PURPOSE: Oral testosterone undecanoate and transdermal testosterone gel are the testosterone formulas widely prescribed as hormonal replacement for tesosterone deficiency syndrome (TDS) in male patients. We evaluated the changes in serum testosterone level and the effects of these medicines. MATERIALS AND METHODS: The medical records of 162 patients who were diagnosed with TDS based on serum testosterone (<2.55 ng/ml) and prescribed testosterone formula were analyzed retrospectively. In the 111 patients of group I, tablets of oral testosterone undecanoate were initially given. If the follow up serum testosterone level had not increased enough, the dosages were increased up to 6 tablets. In the 51 patients of group II, one pack of transdermal testosterone gel (5 gm) daily without dosage adjustment was prescribed. Statistical analysis was done to identify any correlations among age, initial and final aging male's symptoms scale (AMS) score, initial, peak and final testosterone level, and duration of therapy. RESULTS: The mean ages of group I and II were 53.4+/-14.5 and 55.2+/-11.9, respectively (p>0.05). The initial and final testosterone levels of the two groups were not significantly different. However, the peak level during treatment was significantly higher in group II (p<0.05). The maximal increment of testosterone level was also significantly higher in group II. Initially, group II reached its peak testosterone level earlier than group I. The final serum levels were not significantly different after adjustment of dosages in group I. Testosterone replacement significantly decreased the AMS scales in both groups. CONCLUSIONS: Both oral testosterone undecanoate and transdermal testosterone gel improved the serum testosterone level and symptom score for those with TDS. Transdermal testosterone gel may reach the peak serum testosterone level faster than oral testosterone undecanoate. Large prospective studies are required to assess the precise role of testosterone replacement therapy.
Aging ; Follow-Up Studies ; Humans ; Hypogonadism ; Male ; Medical Records ; Retrospective Studies ; Sorbitol ; Tablets ; Testosterone ; Tyramine ; Weights and Measures

7

Cite

Share

Testosterone Replacement in Men with Late-onset Hypogonadism Symptoms and Loss of Diurnal Rhythm of Total Testosterone.

Eun Tak KIM ; Jong Hyun LEE ; Ji Hoon JUNG ; Hyun Wook JO ; Hyun Taek JU ; Jin Sung PARK ; Seung Hyo WOO ; Dae Kyung KIM

Korean Journal of Andrology.2010;28(3):190-196.

PURPOSE: It is known that the loss of diurnal rhythm of testosterone by age is related to late-onset hypogonadism (LOH). Currently testosterone replacement therapy (TRT) has been recommended only in men with hypogonadism. We evaluated the effectiveness and safety of TRT for men with LOH symptoms and the loss of diurnal rhythm of total testosterone but normal values of total testosterone. MATERIALS AND METHODS: We enrolled 62 patients in whom the difference in testosterone between morning and evening was lower than 108 ng/dl, whose morning values were higher than 300 ng/dl, and who were diagnosed with LOH using the Androgen Deficiency in Aging Male (ADAM) questionnaire. Among the 62 patients enrolled, 44 completed the daily application of 1% testosterone gel or the intramuscular injection of long-acting testosterone undecanoate for the full 20-week period. We compared the data at baseline, and the 8th and 20th week using the Aging Males' Symptoms (AMS) scale, the International Index of Erectile Function (IIEF)-15, the International Prostate Symptoms Score (IPSS), and the serum levels of total testosterone, prostate specific antigen (PSA), complete blood cell count (CBC), and lipid profile. RESULTS: The mean age was 54.9+/-7.2 years. Subjects main symptoms were sexual dysfunction and decrease of ejaculate volume. AMS scales before and after TRT were 41.3+/-18.5 and 35.8+/-19.7 (p<0.05). IIEF total scores before and after TRT were 29.7+/-13.7 and 38.9+/-17.4 (p<0.001). However, 18 patients (40.9%) were not satisfied with TRT and only 11% were fully satisfied. Total testosterone and estradiol were higher after TRT but the other values had not changed. The most common adverse event (27.3%) was erythrocystosis (18.2%). CONCLUSIONS: TRT could induce total testosterone to reach the mid-normal level and was relatively effective for aging male symptoms and sexual function. It is essential for physician to inform patients about potential adverse events and the low satisfaction rate associated with TRT even though TRT has generally been effective.
Aging ; Blood Cell Count ; Circadian Rhythm ; Estradiol ; Hormone Replacement Therapy ; Humans ; Hypogonadism ; Injections, Intramuscular ; Male ; Prostate ; Prostate-Specific Antigen ; Surveys and Questionnaires ; Reference Values ; Testosterone ; Weights and Measures

8

Cite

Share

Comparision of Prostate-specific Antigen Reduction after Performing Transurethral Resection of the Prostate according to a Preoperative Prostate-specific Antigen Value of 4 ng/ml.

An Gu LEE ; Sung Yong CHO ; In Rae CHO

Korean Journal of Andrology.2010;28(3):184-189.

PURPOSE: We compared prostate-specific antigen (PSA) reduction after performing transurethral resection of the prostate (TURP) according to a preoperative PSA value of 4 ng/ml and analyzed the meaning of elevation of the preoperative PSA value over 4 ng/ml. MATERIALS AND METHODS: We investigated the PSA level and prostate volume by transrectal ultrasonography (TRUS), urine flow rate, residual urine volume, and international prostate symptom score (IPSS) preoperatively and at 1 year after performing TURP in 61 clinically diagnosed BPH patients who had lower urinary tract symptoms (LUTS). We enrolled the 61 patients into 2 groups according to their preoperative PSA level relative to 4 ng/ml and compared the PSA reduction ratio (postoperative PSA level/preoperative PSA level), prostate volume reduction ratio, preoperative prostate volume, resected prostate volume, preoperative residual urine volume, preoperative maximal flow rate, and IPSS in each group. RESULTS: In the preoperative PSA group > or =4 ng/ml, the PSA reduction ratio was significantly lower than the PSA group <4 ng/ml and there were significant differences between the two groups in total IPSS, obstructive score, and preoperative maximal urine flow rate but no significant differences in preoperative prostate volume, prostate volume reduction ratio, or resected prostate volume. CONCLUSIONS: Marked PSA reduction after performing TURP was achieved in members of the preoperative PSA group > or =4 ng/ml, who are expected to have more severe bladder outlet obstruction (BOO).
Humans ; Lower Urinary Tract Symptoms ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Transurethral Resection of Prostate ; Urinary Bladder Neck Obstruction

9

Cite

Share

Biocompatibility of Parylene-C as a Coating Material of Implantable Bladder Volume Sensor.

Dong Sup LEE ; Su Jin KIM ; Dong Wan SOHN ; Bum Kyu CHOI ; Moon Kyu LEE ; Seung Joon LEE ; Sae Woong KIM

Korean Journal of Andrology.2010;28(3):175-183.

PURPOSE: Development of an implantable bladder volume sensor that could reduce complications and improve the quality of life for neurogenic bladder patients is assignment task that falls in the field of urology. Nevertheless, there is lack of research on whether biomaterials are biocompatible to the urinary bladder or not. Polyethylene glycol (PEG), polydimethylsiloxane (PDMS) and parylene-C are well known biocompatible materials in other fields of medicine. Because PEG is biodegradable and PDMS has a relatively low affinity to substrate with less durability than parylene-C, we evaluated the biocompatibility of parylene-C to the urinary bladde,r comparing of it to PEG and PDMS. MATERIALS AND METHODS: Nine rabbits were classified into three groups. Coin shaped aluminum substrates were affixed onto the external wall of the urinary bladder in each rabbit. At this point, the three rabbits which had substrates coated with PEG were assigned to group 1, those with PDMS were assigned to group 2 and those with parylene-C were assigned to group 3. In each group, one rabbit was sacrificed at one week, another rabbit was sacrificed at two weeks and the other rabbit was sacrificed at four weeks. At each time microscopic evaluation was done. To detect macrophages, we used fluorescence microscopy and applied MAC 387 staining. RESULTS: At one week, macrophage accumulation was observed on the external surface of the urinary bladder adjacent to the device no matter which material was used as a coating, but it had almost disappeared by four weeks. In addition, the inflammatory reaction was limited at the external surface of the urinary bladder, and did not expand into the muscular layer. CONCLUSIONS: With respect to biocompatibility, there was no difference among the three biomaterials. With its characteristics of durability and easy affinity regardless of the type of substrate, parylene-C would make an excellent coating material for a bio-device implantable into the urinary bladder.
Aluminum ; Biocompatible Materials ; Dimethylpolysiloxanes ; Humans ; Macrophages ; Microscopy, Fluorescence ; Numismatics ; Polyethylene Glycols ; Polymers ; Quality of Life ; Rabbits ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urology ; Xylenes

10

Cite

Share

Measurement of Bladder Volume Using an Implantable Volume Sensor in Rats.

Dong Sup LEE ; Su Jin KIM ; Dong Wan SOHN ; Je Mo YOO ; Bum Kyu CHOI ; Moon Kyu LEE ; Seung Joon LEE ; Sae Woong KIM

Korean Journal of Andrology.2010;28(3):169-174.

PURPOSE: Real-time monitoring of urinary bladder volume can not only provide information on urinary bladder function more precisely in laboratories and in the setting of intravesical pressure monitoring, but can also help areflexic neurogenic bladder patients have notice of the timing for optimal urination to prevent secondary complications. Thus we introduce a new implantable bladder volume monitoring device and its usefulness. MATERIALS AND METHODS: Ten male Sprague-Dawley rats were used under intraperitoneal anesthesia. Two microelectrodes produced by a micro-electrical-mechanical systems (MEMS) process were stitched onto each side wall of the urinary bladder and 25 G needles were inserted through the bladder dome. The distances between two microelectrodes converted from capacitances recorded by LCR meter were monitored in real-time during cystometry. Urinary bladder volume was estimated with its shape approximated as a sphere. RESULTS: Estimated bladder volume correlated well statistically with infused volume in (p<0.05 regression analysis). Since the urinary bladder was filled with over 0.6 cc normal saline in each rat, estimated urinary volume was not different than infused saline volume (p>0.05, repeated measures ANOVA). CONCLUSIONS: In our animal model, an implantable volume-monitoring device produced reliable data. Therefore, we expect that it should be an excellent tool for detecting urinary bladder volume and producing more accurate and useful information during urodynamic laboratory studies with small animals. Furthermore, we expect that this study will be the foundation of research for the clinical application of bladder volume monitoring devices to areflexic neurogenic bladder patients.
Anesthesia ; Animals ; Humans ; Male ; Micro-Electrical-Mechanical Systems ; Microelectrodes ; Models, Animal ; Needles ; Rats ; Rats, Sprague-Dawley ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urination ; Urodynamics

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share