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Book Review: Androgen Deficiency and Testosterone Replacement: Current Controversies and Strategies.

Du Geon MOON

The World Journal of Men's Health.2015;33(2):121-121. doi:10.5534/wjmh.2015.33.2.121

No abstract available.
Testosterone*

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The Testis Completely Replaced by a Huge Epidermal Cyst in an Older Man.

Kyung Kgi PARK ; Chang Lim HYUN ; Sung Dae KIM ; Young Joo KIM ; Jung Sik HUH

The World Journal of Men's Health.2015;33(2):117-120. doi:10.5534/wjmh.2015.33.2.117

Epidermal cysts are commonly encountered, slow-growing superficial cysts in the hair-bearing areas of the body, and are usually discovered in the second and fourth decades of life. These cysts tend to be superficial, meaning that they can be easily found by ultrasound and digital palpation at a moderate degree of growth. However, we found a huge testicular cyst that went undetected until old age. In this report, we describe the interesting case of a patient in whom the right testis was totally replaced with an epidermal cyst. The cyst was found by ultrasonography and further evaluated with magnetic resonance imaging. We performed orchiectomy under the impression of an epidermal cyst. The pathologic report confirmed this clinical impression. Over 24 months of follow-up, we did not find any recurrence of a growing mass on the testis.
Aged, 80 and over ; Epidermal Cyst* ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Orchiectomy ; Palpation ; Recurrence ; Testicular Neoplasms ; Testis* ; Ultrasonography

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The Effect of Vitis vinifera L. Juice on Serum Levels of Inhibin B, Sperm Count in Adult Male Rats.

Mohammad Reza AFZALZADEH ; Akram AHANGARPOUR ; Ashraf AMIRZARGAR ; Mohammad Kazemi VARNAMKHASTI ; Hadi GANJALIDARANI

The World Journal of Men's Health.2015;33(2):109-116. doi:10.5534/wjmh.2015.33.2.109

PURPOSE: Vitis vinifera is a species of Vitis that is native to the Mediterranean region, central Europe, and southwestern Asia, and has been used as a drug in traditional medicine. Traditional medicinal plants have been used for medical purposes with increasing effectiveness. It is important to identify drugs that inhibit spermatogenesis. Therefore, the present study aimed to investigate the effect of grape juice (GJ) on serum levels of inhibin B and sperm count in normal male rats. MATERIALS AND METHODS: Thirty-five adult male rats were randomly divided into five groups, each containing seven rats. Rats in the control group received 1 mL of normal saline over the course of the study. The experimental groups received GJ (100, 200, 400, and 1,600 mg/kg, orally, for 35 days consecutively). At the end of the treatment period, fertility indices were measured, including body weight difference, sex organ weight, sperm motility and count, epididymal sperm reserve, daily sperm production (DSP), and serum inhibin B levels. RESULTS: We found that GJ reduces body weight difference, was associated with decreased sperm motility and count in all treatment groups (p< or =0.05 and p< or =0.001, respectively). Moreover, DSP was significantly decreased in all treatment groups compared to the control group (p< or =0.05), except in the group receiving 100 mg/kg of GJ. Inhibin B levels were significantly decreased in all treatment groups (p< or =0.05). CONCLUSIONS: The results of our study suggest that GJ in all doses, but especially in higher doses, may decrease fertility in male rats.
Adult* ; Animals ; Asia ; Body Weight ; Europe ; Fertility ; Humans ; Inhibins* ; Male* ; Medicine, Traditional ; Mediterranean Region ; Organ Size ; Plants, Medicinal ; Rats* ; Sex Characteristics ; Sperm Count* ; Sperm Motility ; Spermatogenesis ; Spermatozoa* ; Vitis*

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Chronic Prostatitis: A Possible Cause of Hematospermia.

Gilho LEE

The World Journal of Men's Health.2015;33(2):103-108. doi:10.5534/wjmh.2015.33.2.103

PURPOSE: While hematospermia is mainly caused by genitourinary inflammatory disorders, very few studies have been published on prostatitis-associated hematospermia (PAH) diagnosed using robust prostatitis evaluation methods. Therefore, we have evaluated the incidence of PAH by using systematic methods for evaluating prostatitis. MATERIALS AND METHODS: We evaluated 37 hematospermia patients from a single hospital over the last five years. We classified the patients into PAH versus hematospermia without any evidence of prostatitis (HWP) by using a NIH-Chronic Prostatitis Symptom Index questionnaire and expressed prostatic secretion studies. RESULTS: The mean age was 55.89+/-14.87 years, and the patients were grouped into two groups: one group had 12 HWP patients and the other 25 PAH patients. PAH patients were further sub-classified: chronic bacterial prostatitis (3 patients), chronic nonbacterial prostatitis (10 patients), prostadynia (7 patients), and asymptomatic prostatitis (5 patients). We found Enterococcus faecalis in the three chronic bacterial prostatitis patients. We could not find any statistically significant difference between the PAH and the HWP groups in terms of the age interval, serum prostate-specific antigen level, and prostate volume. Even though there was no statistically significant difference in the items about urination between the two groups, we found a statistically significant difference in the quality of life (QoL) impact for the patients in this study. CONCLUSIONS: Two-thirds of the hematospermia patients were associated with some evidence of prostatitis. Further, the patients with PAH revealed poor QoL compared with the patients with HWP. Therefore, we must evaluate the presence of prostatitis in hematospermia patients and alleviate the prostatitis-associated symptoms to improve their QoL.
Enterococcus faecalis ; Hemospermia* ; Humans ; Incidence ; Prostate ; Prostate-Specific Antigen ; Prostatitis* ; Quality of Life ; Urination

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Penile Fracture: Our Experience in a Tertiary Care Hospital.

Rajkumar Singha MAHAPATRA ; Anup Kumar KUNDU ; Dilip Kumar PAL

The World Journal of Men's Health.2015;33(2):95-102. doi:10.5534/wjmh.2015.33.2.95

PURPOSE: Penile fracture is rare, but it is a urological emergency that always requires immediate attention. Moreover, penile fracture has been reported more frequently in recent years. It may have devastating physical, functional, and psychological consequences if not properly managed in time. MATERIALS AND METHODS: The objective of this study was to highlight the causes, clinical presentation, and outcomes of cases of penile fracture. This was a prospective observational study extending from November 2012 to November 2014. Each patient underwent a thorough clinical evaluation and received proper treatment. RESULTS: Twenty patients with penile fracture, aged 19 to 56 years (mean, 28 years) were evaluated in this study. Vaginal intercourse was the most common mechanism of injury. Most of the patients (95%) were diagnosed clinically with a proper history and clinical examination. Nineteen patients were treated surgically. The patients underwent six months of follow-up, and were evaluated with local examinations, questionnaires, and colour Doppler ultrasonography as necessary. CONCLUSIONS: Although penile fracture is an under-reported urological emergency, its incidence is increasing. It is usually diagnosed based on a clinical examination, but ultrasonography can be very helpful in diagnosis. Especially in cases where treatment is delayed, surgery is preferable to conservative management, because it is associated with better outcomes and fewer long-term complications.
Diagnosis ; Emergencies ; Follow-Up Studies ; Humans ; Incidence ; Male ; Observational Study ; Penile Diseases ; Penile Prosthesis ; Prospective Studies ; Tertiary Healthcare* ; Ultrasonography ; Ultrasonography, Doppler ; Urogenital System

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Controlling Legal Risk for Effective Hospital Management.

Hyun Jun PARK ; Duk Young CHO ; Yong Sug PARK ; Sun Wook KIM ; Jae Hong PARK ; Nam Cheol PARK

The World Journal of Men's Health.2016;34(1):56-63. doi:10.5534/wjmh.2016.34.1.56

PURPOSE: To analyze the types of medical malpractice, medical errors, and medical disputes in a university hospital for the proposal of countermeasures that maximize the efficiency of hospital management, medical departments, and healthcare providers. MATERIALS AND METHODS: This study retrospectively reviewed and analyzed 55 closed civil lawsuits among 64 medical lawsuit cases carried out in Pusan National University Hospital from January 2000 to April 2013 using medical records, petitions, briefs, and data from the Medical Dispute Mediation Committee. RESULTS: Of 55 civil lawsuits, men were the main plaintiffs in 31 cases (56.4%). The average period from medical malpractice to malpractice proceeding was 16.5 months (range, 1 month to 6.4 years), and the average period from malpractice proceeding to the disposition of a lawsuit was 21.7 months (range, 1 month to 4 years and 11 months). CONCLUSIONS: Hospitals can effectively manage their legal risks by implementing a systematic medical system, eliminating risk factors in administrative service, educating all hospital employees on preventative strategies, and improving customer service. Furthermore, efforts should be made to establish standard coping strategies to manage medical disputes and malpractice lawsuits, operate alternative dispute resolution methods including the Medical Dispute Mediation Committee, create a compliance support center, deploy a specialized workforce including improved legal services for employees, and specialize the management-level tasks of the hospital.
Busan ; Compliance ; Dissent and Disputes ; Financial Management, Hospital ; Health Personnel ; Humans ; Male ; Malpractice ; Medical Errors ; Medical Records ; Negotiating ; Retrospective Studies ; Risk Factors

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Prospective Randomized Controlled Study on the Efficacy of Multimedia Informed Consent for Patients Scheduled to Undergo Green-Light High-Performance System Photoselective Vaporization of the Prostate.

Dong Yeub HAM ; Woo Suk CHOI ; Sang Hoon SONG ; Young Joon AHN ; Hyoung Keun PARK ; Hyeong Gon KIM ; Hwancheol SON

The World Journal of Men's Health.2016;34(1):47-55. doi:10.5534/wjmh.2016.34.1.47

PURPOSE: The aim of this study was to evaluate the efficacy of a multimedia informed consent (IC) presentation on the understanding and satisfaction of patients who were scheduled to receive 120-W green-light high-performance system photoselective vaporization of the prostate (HPS-PVP). MATERIALS AND METHODS: A multimedia IC (M-IC) presentation for HPS-PVP was developed. Forty men with benign prostatic hyperplasia who were scheduled to undergo HPS-PVP were prospectively randomized to a conventional written IC group (W-IC group, n=20) or the M-IC group (n=20). The allocated IC was obtained by one certified urologist, followed by a 15-question test (maximum score, 15) to evaluate objective understanding, and questionnaires on subjective understanding (range, 0~10) and satisfaction (range, 0~10) using a visual analogue scale. RESULTS: Demographic characteristics, including age and the highest level of education, did not significantly differ between the two groups. No significant differences were found in scores reflecting the objective understanding of HPS-PVP (9.9±2.3 vs. 10.6±2.8, p=0.332) or in subjective understanding scores (7.5±2.1 vs. 8.6±1.7, p=0.122); however, the M-IC group showed higher satisfaction scores than the W-IC group (7.4±1.7 vs. 8.4±1.5, p=0.033). After adjusting for age and educational level, the M-IC group still had significantly higher satisfaction scores. CONCLUSIONS: M-IC did not enhance the objective knowledge of patients regarding this surgical procedure. However, it improved the satisfaction of patients with the IC process itself.
Education ; Humans ; Informed Consent* ; Male ; Multimedia* ; Prospective Studies* ; Prostate* ; Prostatic Hyperplasia ; Surgical Procedures, Operative ; Volatilization*

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The Efficacy of Medical Treatment of Peyronie's Disease: Potassium Para-Aminobenzoate Monotherapy vs. Combination Therapy with Tamoxifen, L-Carnitine, and Phosphodiesterase Type 5 Inhibitor.

Tae Yong PARK ; Hyeong Guk JEONG ; Jong Jin PARK ; Ji Yun CHAE ; Jong Wook KIM ; Mi Mi OH ; Hong Seok PARK ; Je Jong KIM ; Du Geon MOON

The World Journal of Men's Health.2016;34(1):40-46. doi:10.5534/wjmh.2016.34.1.40

PURPOSE: This study was designed to evaluate the efficacy of medical treatment of Peyronie's disease. MATERIALS AND METHODS: A total of 109 patients with Peyronie's disease who had been treated from January 2011 to December 2014 were retrospectively reviewed in this study. Forty-four patients (Group 1) were treated with 12 mg of potassium para-aminobenzoate daily. Sixty-five patients (Group 2) were treated with combination therapy: tamoxifen (20 mg) and acetyl-L-carnitine (300 mg) twice daily in addition to a phosphodiesterase type 5 inhibitor. Ability to perform sexual intercourse, pain during erection, size of plaque, and penile curvature angle were assessed. RESULTS: In Group 1, 30 of 44 patients (68.2%) discontinued treatment within 12 weeks, while 5 patients (7.7%) in Group 2 discontinued treatment. Pain during erection and plaque size were improved in both groups but showed no statistical difference due to the high dropout rate in Group 1. In both groups, penile curvature was improved, but demonstrated no statistical difference between the treatment groups. However, combination therapy demonstrated a better response rate in patients whose penile curvature angle was less than 30° (44.4% vs. 79.1%, p=0.048). The rate of successful sexual intercourse was significantly higher in Group 2 (42.8% vs. 78.3%, p=0.034). The number of patients who underwent surgical correction despite medical treatment was significantly higher in Group 1 (35.7% vs. 13.3%, p=0.048). CONCLUSIONS: Early medical combination therapy in Peyronie's disease may present better results in patients whose curvature angle is less than 30°.
4-Aminobenzoic Acid ; Acetylcarnitine ; Carnitine* ; Coitus ; Drug Therapy, Combination ; Humans ; Male ; Patient Dropouts ; Penile Induration* ; Potassium* ; Retrospective Studies ; Tamoxifen*

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Necrosis of the Penis with Multiple Vessel Atherosclerosis.

Sung Dae KIM ; Jung Sik HUH ; Young Joo KIM

The World Journal of Men's Health.2014;32(1):66-68. doi:10.5534/wjmh.2014.32.1.66

Penile necrosis is a very rare complication because of its rich collateral supply. Conservative management is apt to be ineffective; thus penectomy is usually performed. We present a case of penile necrosis and claudication of both legs with multiple atherosclerosis in a type II diabetes mellitus patient who was successfully treated with angioplasty, penoplasty, and additional intracavernous injections of prostaglandin E1. The treatment resulted in relief of the leg pain and healing of the penile ischemic lesions.
Alprostadil ; Angioplasty ; Atherosclerosis* ; Diabetes Mellitus ; Humans ; Leg ; Male ; Necrosis* ; Penis*

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The Role of Imaging in the Diagnosis of Recurrence of Primary Seminal Vesicle Adenocarcinoma.

Martina SOLLINI ; Monica SILVOTTI ; Massimiliano CASALI ; Franco GIOVANARDI ; Alvise ZADRO ; Armando FROIO ; Paola Anna ERBA ; Annibale VERSARI

The World Journal of Men's Health.2014;32(1):61-65. doi:10.5534/wjmh.2014.32.1.61

Primary seminal vesicle (SV) adenocarcinoma is a rare tumor. A small amount of data about the role of imaging to detect tumor recurrence is available. We report the case of a 58-year-old patient with primary SV clear-cell well-differentiated adenocarcinoma. Clinical and instrumental examinations were negative for the 32 months after treatments when computed tomography scan, [18F]fluoro-D-glucose positron emission tomography/computed tomography and pelvic magnetic resonance imaging showed the appearance of a lesion in the left perineal muscle suspected for recurrence. Patient was symptomless. Cytology of the suspected lesion confirmed SV adenocarcinoma recurrence. The combined approach, using radiological and nuclear medicine techniques, seems to be effective in the follow-up of SV adenocarcinoma. Technological advances, together with awareness of this rare tumor, have the potential of improving patients outcomes not only by providing earlier detection and accurate staging, but also by detecting recurrence and thereby avoiding delays and therapeutic dilemmas.
Adenocarcinoma* ; Diagnosis* ; Electrons ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Multidetector Computed Tomography ; Nuclear Medicine ; Positron-Emission Tomography ; Recurrence* ; Seminal Vesicles* ; Urogenital Neoplasms

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