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Metastatic Squamous Cell Carcinoma of the Kidney from Cholangiocarcinoma.

Hoon CHOI ; Tae Il NOH ; Byeong Kuk HAM ; Jae Young PARK ; Kang Soo SHIM ; Jae Hyun BAE

The World Journal of Men's Health.2012;30(3):198-201. doi:10.5534/wjmh.2012.30.3.198

We present a rare case of a metastatic renal tumor originating from adenosquamous carcinoma of the intrahepatic bile duct. A 64-year-old man treated with bisegmentectomy and extended cholecystectomy for cholangiocarcinoma had a left cystic renal mass, which had irregular wall thickening, heterogeneously low attenuation, and soft tissue infiltration as determined by a computed tomography scan. The first impression was renal abscess. Left nephrectomy was performed and the nonencapsulated mass was gray in color macroscopically. Histological examination of the specimen revealed alveolar proliferation of small cancer cells, which was consistent with the original tumor of the intrahepatic bile duct. The left renal tumor was misdiagnosed as a renal abscess but finally diagnosed as squamous cell carcinoma metastasized from the intrahepatic bile duct. The patient expired because of lung metastasis after 14 months following left nephrectomy. In our opinion, this case would be the first report of a renal metastasis from a cholangiocarcinoma clinically and was treated with nephrectomy.
Abscess ; Bile Ducts, Intrahepatic ; Carcinoma, Adenosquamous ; Carcinoma, Squamous Cell ; Cholangiocarcinoma ; Cholecystectomy ; Humans ; Kidney ; Lung ; Neoplasm Metastasis ; Nephrectomy

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Vesico-Appendiceal Fistula Misdiagnosed as Meckel's Diverticulum: A Laparoscopic Approach.

Jung Woo LEE ; Jae Hyun AHN ; Hong Koo HA

The World Journal of Men's Health.2012;30(3):195-197. doi:10.5534/wjmh.2012.30.3.195

A 26-year-old man complained of a vague low abdominal discomfort for the previous 2 months. Radiologic evaluations demonstrated that there was tubular structure connected with the right side wall of the bladder, suggesting Meckel's diverticulum with fistula formation to the bladder as well as a mass-like bladder wall thickening. With an impression of Meckel's diverticulum with fistula with the bladder, laparoscopic surgery was performed to confirm a diagnosis and to manage the Meckel's diverticulum with fistula with the bladder. The distal tip of the appendix was firmly attached to the right side of the bladder. The final diagnosis was corrected by laparoscopy followed by laparoscopic appendectomy and fistula repair. Vesico-appendiceal fistula is an uncommon type of vesico-enteral fistula and a rare complication of unrecognized appendicitis. Additionally, this report showed the significant value of laparoscopy as a diagnostic and therapeutic tool to this entity.
Appendectomy ; Appendicitis ; Appendix ; Fistula ; Laparoscopy ; Meckel Diverticulum ; Urinary Bladder

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Inverted Papilloma of the Prostatic Urethra Arising in a Juvenile.

Yu Seob SHIN ; Jong Kwan PARK

The World Journal of Men's Health.2012;30(3):192-194. doi:10.5534/wjmh.2012.30.3.192

Inverted papilloma of the urinary tract is a rare benign lesion. We report, to our knowledge, the first case of inverted papilloma of the prostatic urethra arising in a juvenile. Our patient was referred for evaluation of painless, gross hematuria and voiding difficulty. Transrectal sonography demonstrated a 1.4 cm papillary lesion on the medial aspect of the prostatic urethra. Cystoscopy showed a solitary, papillary tumor on the prostatic urethra. Transurethral resection was performed and histological examination showed an inverted papilloma.
Cystoscopy ; Hematuria ; Humans ; Papilloma ; Papilloma, Inverted ; Prostate ; Urethra ; Urinary Tract

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Penile Abscess Secondary to Neglected Penile Fracture after Intracavernosal Vasoactive Drug Injection.

Wan SONG ; Kwang Jin KO ; Seung Jea SHIN ; Dong Soo RYU

The World Journal of Men's Health.2012;30(3):189-191. doi:10.5534/wjmh.2012.30.3.189

Penile abscesses are rare, but can develop after trauma, injection therapy, or surgery of the penis, or as an unusual presentation of sexually transmitted diseases. We report a case of penile abscess in a 51-year-old diabetic man, presented 9 days after neglected penile fracture following intracavernosal injection therapy and sexual intercourse. Penile ultrasonography and surgical exploration confirmed the physical examination findings of involvement of the corpus cavernosum. The pus culture from the abscess revealed Enterococcous faecalis. The patient was successfully treated by surgical drainage of the abscess and primary closure of the ruptured tunica albuginea.
Abscess ; Coitus ; Drainage ; Humans ; Male ; Penis ; Physical Examination ; Sexually Transmitted Diseases ; Suppuration

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Relationship between Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia and Metabolic Syndrome in Korean Men.

Yeon Won PARK ; Seung Ki MIN ; Jun Ho LEE

The World Journal of Men's Health.2012;30(3):183-188. doi:10.5534/wjmh.2012.30.3.183

PURPOSE: To investigate any associations between lower urinary tract symptoms (LUTS)/benign prostate hyperplasia (BPH) and metabolic syndrome (MetS). MATERIALS AND METHODS: In all, 1,224 male police officers in their 50s who had participated in health examinations were included. LUTS/BPH was assessed by serum prostate-specific antigen, International Prostate Symptom Score (IPSS), transrectal ultrasonography, maximum urinary flow rate (Q max), and postvoid residual urine volume (PVR). In addition, testosterone was also examined. The MetS was defined using NCEP-ATP III guidelines. We used the multiple linear regression test and logistic regression analyses to examine the relationships. RESULTS: MetS was diagnosed in 29.0% of participants. There was no significant difference in the percentage of cases of BPH (IPSS >7, Q max <15 ml/sec, and prostate gland volume > or = 20 ml) (14.2% in the non-MetS group vs. 17.2 in the MetS group; p value=0.178). The total IPSS score and the Q max were not significantly different. The prostate volume and PVR were significantly greater in the subjects with MetS. After adjusting for age and testosterone, the presence of MetS was not associated with BPH (multivariate odds ratio, 1.122; 95% confidence interval, 0.593~2.120). Additionally, MetS was not related to IPSS (Beta, -0.189; p value=0.819), prostate volume (Beta, 0.815; p value=0.285), Q max (Beta, -0.827; p value=0.393), or PVR (Beta, 0.506; p value=0.837). CONCLUSIONS: According to our results, the MetS was not clearly correlated with LUTS/BPH in Korean men in their 50s.
Humans ; Hyperplasia ; Linear Models ; Logistic Models ; Lower Urinary Tract Symptoms ; Male ; Odds Ratio ; Police ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Testosterone ; Urinary Tract

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Preoperative Factors Influencing Postoperative Results after Vasovasostomy.

Yu Seob SHIN ; Sang Deuk KIM ; Jong Kwan PARK

The World Journal of Men's Health.2012;30(3):177-182. doi:10.5534/wjmh.2012.30.3.177

PURPOSE: The purpose of this study is to evaluate the preoperative factors that influenced postoperative sperm concentration after vasovasostomy. MATERIALS AND METHODS: We retrospectively reviewed 97 consecutive single-layer vasovasostomy procedures performed by a single surgeon between March 2003 and September 2010. The patients were stratified into three groups based on sperm concentration at 1 month follow-up: group I-azoospermia, group II-oligospermia, and group III-normal. We evaluated the preoperative factors that may have influenced sperm concentration at postoperative 1 month. Patients with serial semen analysis were divided into four groups according to the change in postoperative sperm concentration at the 6-month visit: group II-N-from oligospermia to normal, group II-O-from oligospermia to oligospermia, group III-O-from normal to oligospermia, group III-N-from normal to normal. We compared the pregnancy rate among the four groups. RESULTS: The mean obstructive interval was 9.69 years in group I, 6.02 years in group II, and 7.82 years in group III. There were significant differences found among the groups (p=0.035). There was significantly different change in sperm concentration, sperm motility, and sperm morphology between each of the groups. A total of 32 patients underwent serial semen analyses at 1 month, 3 months, and 6 months after vasovasostomy. There was no significant difference in patient age, obstructive interval, or follicle-stimulating hormone among the groups. The natural pregnancy rate in group II-O was lower than that in group II-N, and in group III-O was lower than that in group III-N. However, there was no significant difference among each of the groups. CONCLUSIONS: The sperm concentration after vasovasostomy was significantly related to the obstructive interval between vasectomy and reversal.
Follicle Stimulating Hormone ; Humans ; Male ; Oligospermia ; Pregnancy Rate ; Retrospective Studies ; Semen Analysis ; Sperm Count ; Sperm Motility ; Spermatozoa ; Vasectomy ; Vasovasostomy

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Survey on the Perception of Urogenital Complications in Diabetic Patients.

Jong Wook KIM ; Ji Yun CHAE ; Jin Wook KIM ; Cheol Yong YOON ; Mi Mi OH ; Je Jong KIM ; Du Geon MOON

The World Journal of Men's Health.2012;30(3):172-176. doi:10.5534/wjmh.2012.30.3.172

PURPOSE: Retinopathy, neuropathy, and nephropathy are well-known complications of diabetes; they are often expected to occur and, therefore, are usually tested for. However, urogenital complications, such as sexual and voiding dysfunctions, are less well known, and consequently, many patients are not treated appropriately despite their symptoms. Thus, we surveyed diabetic patients with regard to their perception of urogenital complications. MATERIALS AND METHODS: We designed a survey for patients in our hospital who were being treated for diabetes mellitus (DM). The questionnaire included items on age, sex, treatment duration, treatment options for and the level of perception of urogenital symptoms, the presence of urogenital symptoms, and whether treatment was intended or had been initiated. RESULTS: In total, 275 patients participated in the survey. The perception questions on DM-associated urogenital complications showed that 89 patients (32.4%) had no knowledge, 84 patients (30.5%) had some knowledge, and 102 patients (37.1%) had detailed knowledge about these complications. A total of 124 patients (45.1%) reported urogenital symptoms: 93 patients (75.0%) reported voiding dysfunction and 61 patients (49.2%) reported sexual dysfunction. Common symptoms of voiding dysfunction were urinary frequency, nocturia, sense of residual urine, weak stream, and urinary incontinence. Common symptoms of sexual dysfunction were reduced libido, and erectile and ejaculatory dysfunction. CONCLUSIONS: The survey showed that the subjective prevalence rate of urogenital symptoms in diabetic patients was 45.1%. However, only a small percentage (37.1%) of the patients cognized that these symptoms were associated with DM. Therefore, it is necessary to properly inform and educate diabetic patients on possible urogenital complications that may occur.
Diabetes Mellitus ; Humans ; Libido ; Nocturia ; Prevalence ; Surveys and Questionnaires ; Rivers ; Urinary Incontinence ; Urogenital System

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Sexual Behavior of the Elderly in Urban Areas.

Hyun Cheol JEONG ; Sin Uk KIM ; Wan Chul LEE ; Ma Tae KIM ; Won Ki LEE ; Ha Young KIM ; Sung Yong KIM ; Dae Yul YANG

The World Journal of Men's Health.2012;30(3):166-171. doi:10.5534/wjmh.2012.30.3.166

PURPOSE: This study aimed at investigating sexual behavior patterns of elderly residents of urban areas in South Korea and their correlation with lower urinary tract symptoms. MATERIALS AND METHODS: From May, 2009 to October, 2009, 154 males and 299 females over 60 years old who visited senior welfare centers of Seoul were administered a questionnaire on sex life patterns and voiding symptoms. RESULTS: Among the 154 males, 59 (38.3%) had sexual intercourse at least one time per month. The remaining 95 males (61.7%) did not have sexual intercourse, because of impotence for 52 males (52.6%), no sexual desire for 28 males (29.4%), and sex partner's problems for 15 males (15.7%). The higher International Prostate Symptom Score was, the lower International Index of Erectile Dysfunction-5 was (p=0.035). Among 299 females, 37 (12.4%) had sexual intercourse at least one time per month. The remaining 262 females (87.6%) did not have sexual intercourse, because of no spouse for 163 females (63.2%), no sexual desire for 48 females (18.6%), the spouse's impotence for 34 females (13.2%), and the spouse's bad health for 10 females (3.9%). It was found that self-diagnosis of overactive bladder affects sex life negatively. CONCLUSIONS: The sexual behaviors of the elderly included varying activity. Sexual intercourse were significantly associated with lower urinary tract symptoms. Our results suggest that the counseling with the elderly about sexual health is as important as it is with non-elderly individuals.
Aged ; Coitus ; Counseling ; Erectile Dysfunction ; Female ; Humans ; Lower Urinary Tract Symptoms ; Male ; Prostate ; Surveys and Questionnaires ; Reproductive Health ; Republic of Korea ; Sexual Behavior ; Spouses ; Urinary Bladder, Overactive ; Urinary Tract

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Can 80 W KTP Laser Vaporization Effectively Relieve the Obstruction in Benign Prostatic Hyperplasia?: A Nonrandomized Trial.

Deok Hyun HAN ; Seol Ho CHOO ; Jin Woo CHUNG ; Jeong Hee HONG ; Sung Won LEE

The World Journal of Men's Health.2012;30(3):160-165. doi:10.5534/wjmh.2012.30.3.160

PURPOSE: There is little data evaluating the changes of severity of bladder outlet obstruction after 80 W-potassium-titanyl-phosphate (KTP) photoselective laser vaporization prostatectomy (PVP) by pressure-flow study. We evaluated the efficacy of PVP to relieve the obstruction in benign prostate hyperplasia (BPH) compared with transurethral resection of the prostate (TURP). MATERIALS AND METHODS: This is a prospective, non-randomized single center study. The inclusion criteria were as follows: Men suffering from lower urinary tract symptoms (LUTS) secondary to BPH, age > or =50 years, International Prostatic Symptom Score (IPSS) > or =13, maximum flow rate (Qmax) < or =15 ml/s, and ability to give fully informed consent. Patients with neurogenic cause or detrusor underactivity were excluded. The IPSS, bother score, Qmax, postvoid residual volume (PVR), detrusor pressure at maximum flow rate (PdetQmax), bladder outlet obstruction index (BOOI), and prostate volume were measured before and 6 months after surgery and compared between PVP and TURP. RESULTS: Sixty-seven patients (53 in PVP, 14 in TURP) were evaluable. In both groups, the IPSS, bother score, Qmax, and PVR had significantly improved (p<0.05), and there were no differences between the changes in those parameters. PVP could effectively reduce the PdetQmax, prostate volume, and BOOI from baseline (from 68.7+/-23.3 to 40.6+/-11.2 cmH2O, 49.5+/-16.3 to 31.3+/-12.1 ml, 49.8+/-25.6 to 9.8+/-20.7), similar to TURP. There were no differences in postoperative PdetQmax, prostate volume, or BOOI between the two groups. The percentage of patients with BOOI > or =40 was decreased from 64% to 4% in the PVP group and from 86% to 14% in the TURP group. CONCLUSIONS: PVP could reduce the prostate volume effectively and relieve bladder outlet obstruction similar to TURP by the 6-month follow up in men with BPH.
Follow-Up Studies ; Humans ; Hyperplasia ; Informed Consent ; Laser Therapy ; Lasers, Solid-State ; Lower Urinary Tract Symptoms ; Male ; Prospective Studies ; Prostate ; Prostatectomy ; Prostatic Hyperplasia ; Residual Volume ; Stress, Psychological ; Transurethral Resection of Prostate ; Urinary Bladder Neck Obstruction ; Volatilization

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Antipsychotic-Induced Sexual Dysfunction and Its Management.

Yeon Won PARK ; Yooseok KIM ; Jun Ho LEE

The World Journal of Men's Health.2012;30(3):153-159. doi:10.5534/wjmh.2012.30.3.153

Sexual dysfunction is a common condition in patients taking antipsychotics, and is the most bothersome symptom and adverse drug effect, resulting in a negative effect on treatment compliance. It is known that hyperprolactinemia is a major cause of sexual dysfunction. Based on the blockade of dopamine D2 receptors, haloperidol, risperidone, and amisulpride are classed as prolactin-elevating antipsychotics, while olanzapine, clozapine, quetiapine, ziprasidone, and aripiprazole are classed as prolactin-sparing drugs. Risperidone and the other typical antipsychotics are associated with a high rate of sexual dysfunction as compared to olanzapine, clozapine, quetiapine, and aripiprazole. With regard to treatment in patients suffering from sexual dysfunction, sildenafil was associated with significantly more erections sufficient for penetration as compared to a placebo. Subsequent studies are needed in order to provide physicians with a better understanding of this problem, thereby leading toward efficacious and safe solutions.
Antipsychotic Agents ; Benzodiazepines ; Clozapine ; Compliance ; Dibenzothiazepines ; Haloperidol ; Humans ; Hyperprolactinemia ; Piperazines ; Purines ; Quinolones ; Receptors, Dopamine D2 ; Risperidone ; Stress, Psychological ; Sulfones ; Sulpiride ; Thiazoles ; Aripiprazole ; Quetiapine Fumarate ; Sildenafil Citrate

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