Inflammatory myofibroblastic tumor (IMT) of the urethra is a tumor composed of myofibroblasts and a mixed inflammatory infiltrate that rarely undergoes malignant transformation. The etiology and the biologic behaviors of IMTs are still unknown. Extensive pathologic examination is important to prevent misdiagnosis and the need for long-term follow up is emphasized. Recently, we experienced a case of a inflammatory myofibroblastic tumor of the urethra in a young female. To our knowledge, this is the first documentation of such an entity in published reports. So we present our experience with a review of literature.
Diagnostic Errors ; Female ; Humans ; Myofibroblasts* ; Urethra* ; Urinary Bladder, Overactive*

PURPOSE: The aim of this study was to analyze the influence on voiding symptoms when performing sling operation on patients with stress urinary incontinence with detrusor underactivity. MATERIALS AND METHODS: We analyzed medical records of 100 patients who received the sling operation. Based on their preoperative urodynamic study, we defined "stress urinary incontinence with detrusor underactivity (SUI with DU)" group as these findings; peak flow less than 11 ml/s or void with abdominal pressure instead of detrusor contraction or residual urine volume more than 100 ml. And the others were defined as the "stress urinary incontinence only (SUI)"group. We compared two groups and analyzed the changes of pre- and postoperative uroflowmetry. RESULTS: The number of patients with the "SUI with DU" group was 30 and that with the "SUI" group was 70. In the "SUI with DU" group, there were no changes in peak flow rate and residual urine volume between postoperative uroflowmetry and preoperative urodynamic study (15.1 +/- 7.9 vs. 14.7 +/- 7.1 ml/s, 123.1 +/- 79.2 vs. 127.3 +/- 91.9 ml) (p>0.05). Twenty four patients underwent urinary drainage with nelatone catheter either on postoperative first or second day. However, 22 patients did not need to continue self catheterization. CONCLUSION: Sling operation could be performed on patients who are diagnosed as stress urinary incontinence with detrusor underactivity without aggravating their voiding symptoms.
Catheterization ; Catheters ; Drainage ; Humans ; Medical Records ; Urinary Incontinence* ; Urination Disorders ; Urodynamics

PURPOSE: This study aimed to examine the effects of cyclooxgenase-2 inhibitors on patients with nocturia, whose symptoms persisted after the use of first-line drug therapy, such as alpha blockers and/or anticholinergics. MATERIALS AND METHODS: Thirty-three patients whose symptoms persisted after more than three months of first-line drug therapy were chosen to receive additional COX-2 inhibitors or antidiuretic hormones orally. Seven patients (group 1) were given 80mg of zaltoprofen at night, while 15 (group 2) were given 100mg of nimesulide at night. Desmopressin acetate (0.2mg) was administered at night to 11 patients (group 3) as a control group. Median follow up was 35 days (range, 28~90 days). RESULTS: In 25 patients (75.8%), the severity of nocturia was reduced. The median decline of nocturia in the COX-2 inhibitor groups (groups 1 and 2) was once, and it was statistically significant (p<0.001), while the median decline in each of these groups was twice (p=0.026) and once (p=0.002), respectively. The reduction of nocturia in the control group was once (p=0.011). The differences in reduction between the COX-2 inhibitor group and the control group were not statistically significant (p=0.418). CONCLUSIONS: The effects of the COX-2 inhibitors were not significantly different from those of desmopressin. Combination therapy with COX-2 inhibitors can effectively reduce nocturia in patients with refractory nocturia, following first-line drug therapy.
Cholinergic Antagonists ; Cyclooxygenase 2 Inhibitors ; Deamino Arginine Vasopressin ; Drug Therapy ; Follow-Up Studies ; Humans ; Nocturia* ; Vasopressins

PURPOSE: The aim of this study was to evaluate the reliability of 1-day frequency-volume charts in assessing lower urinary tract symptoms (LUTS) in patients with benign prostate hyperplasia (BPH). MATERIALS AND METHODS: Between Jan. 2006 and Dec. 2006, we retrospectively analyzed the medical records of men with LUTS due to BPH who visited our out-patient department. All of 70 men completed 3-days frequency-volume chart for the initial evaluation of their LUTS. We compared mean values of variables with values from respective days. Test-retest reliability was evaluated by calculating intraclass correlation coefficient. RESULTS: The mean age was 66.7 years, mean prostate size was 33.6ml, mean IPSS was 18, and mean maximal flow rate was 13.8ml/s. The mean total voided volume was 1716.3ml/day, mean number of voids was 9.2/day, mean number of daytime voids was 7.1, and mean number of nocturnal voids was 2.0. No significant differences were found between the three 24-hr periods for the variables from the charts by ANOVA test. The intraclass correlation coefficients were mostly 0.7-0.9. But nocturnal bladder capacity was slightly less reliable than other variables, 0.557. Mean voiding volume, total voiding number, and daytime frequencyhad the high reliability. CONCLUSIONS: A 1-day frequency-volume charts can be sufficiently reliable to provide an insight into a patient's voiding behavior. But more research of high quality is required, especially into the relationship of frequency-volume charts duration with compliance.
Compliance ; Humans ; Hyperplasia* ; Lower Urinary Tract Symptoms* ; Male ; Medical Records ; Outpatients ; Prostate* ; Retrospective Studies ; Urinary Bladder

PURPOSE: To evaluate the psychometric properties of the Korean version of the Incontinence-Quality of Life (I-QOL) instrument in Korean women with symptoms of stress urinary incontinence. MATERIAL AND METHODS: Prospective study involving women with stress urinary incontince, who eventually underwent anti-incontinence surgery (n=89) was undertaken. Convergent and discriminant validity were assessed. Reliability was assessed by calculating Cronbach's alpha coefficient, and stability was assessed as well. Sensitivity to clinical change before and after operation was also evaluated. RESULTS: The Korean version of I-QOL proved to be not difficult to understand and acceptable to the patients. Significant association was found between the I-QoL scores and clinical parameters including overall symptom severity. The domain score were significantly different between control group and patient groups. Convergent validity of the I-QOL also proved adequate. Cronbach's alpha coefficients (>0.78) indicated reasonable internal consistency. Results from test-retest showed reproducible. I-QOL domains were generally responsive to clinical efficacy variables; the I-QOL also showed statistically significant sensitivity to changes in patients' perceptions of bladder condition in all domains. CONCLUSION: The Korean version of the I-QOL is valid and reliable for clinical use in Korean patients with stress urinary incontinence.
Female ; Humans ; Prospective Studies ; Psychometrics* ; Quality of Life* ; Surveys and Questionnaires ; Translations ; Urinary Bladder ; Urinary Incontinence ; Urination

PURPOSE: Anticholinergic agents are effective in relieving overactive bladder symptoms and historically has been contraindicated in benign prostatic hyperplaisa (BPH) patients because of concerns for developing acute urinary retention. Recently, however, treatment for men with predominant storage symptoms is combined with an antichoilnergic agents. We evaluated the efficacy, discontinuation rate, adverse events and clinical parameters of alpha-blockers and/or 5alpha-reductase inhibitors treatment combined with anticholinergic agents in patients with lower urinary tract symptoms (LUTS). MATERIALS AND METHODS: 137 patients with BPH, who had treated with alpha-blockers and/or 5alpha-reductase inhibitors combined with anticholinergic agents at our department from January 2003 to November 2008, were retrospectively studied. In 92 patients, anticholinergic agents continued to be administered (group I) and in 45 patients, ceased to be given (group II). The efficacy and adverse events of anticholinergics treatment were estimated. The International Prostate Symptom Score (IPSS), serum prostate specific antigen (PSA) level, prostate volume, maximum urinary flow rate and residual urine volume before administration of anticholinergics were evaluated. The change in maximum urinary flow rate and residual urine volume and the presence of acute urinary retention after giving anticholinergics were compared. RESULTS: There was no significant difference comparing age, IPSS, serum PSA levels, prostate volum, maximum urinary flow rate and residual urine volume except IPSS storage subscore between the two groups. In group I, there was no significant change in maximum urinary flow rate and residual urine volume after administering anticholinergics. IPSS storage subscore were more significant in group I (9.0+/-3.4 vs 7.4+/-3.4, p<0.05). The duration of anticholinergics administration was longer in group I than II (325.0+/-316.7 vs 95.5+/-96.1). The discontinuation rate was 32.8%. Nocturia (n=48), frequency (n=28) and urgency (n=16) were significantly improved in group I after additional anticholinergic medication. Adverse events causing discontinuation in group II were the increase of residual sensation (n=13), difficult voiding (n=12), dry mouth (n=6), hesitancy (n=6) and constipation (n=2). Acute urinary retention was not reported in both groups. CONCLUSIONS: In men with LUTS suggestive of BPH, anticholinergic treatment appears to be safe and when the storage symptoms were severer, the better compliance was. The overall discontinuation rate was 32.8%, and acute urinary retention was not reported.
Cholinergic Antagonists ; Compliance* ; Constipation ; Humans ; Lower Urinary Tract Symptoms ; Male ; Mouth ; Nocturia ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia* ; Retrospective Studies ; Sensation ; Urinary Bladder, Overactive ; Urinary Retention

PURPOSE: We tried to discover the voiding patterns, which was diurnal & nocturnal urinary volume and voiding frequencies in women with overactive bladder (OAB). MATERIALS AND METHODS: All voided volumes, times and frequencies were recorded in 249 women with overactive bladder. The subjects age related changes in bladder capacity, urinary volume and frequency were evaluated. The causes of nocturnal urinary frequency and its increase with age in older women with OAB were evaluated using 3 days of voiding diaries. Nocturia was devided into three types: nocturnal polyuria, decreased nocturnal bladder capacity and mixed type. RESULTS: Total voided volume, daytime urine volume, functional bladder capacity were decreased with the age. Nocturnal urine volume and nocturnal urinary frequency were increased with age. Nocturnal polyuria was the major cause for nocturia, and mixed type was increased with age. CONCLUSIONS: Voiding symptoms as well as storage symptoms were increased with age in OAB female. In most cases, nocturia was caused by nocturnal polyuria.
Aging ; Female ; Humans ; Nocturia ; Polyuria ; Urinary Bladder ; Urinary Bladder, Overactive*

PURPOSE: Recently as ultrasonography is increasingly used to evaluate lower urinary tract symptoms (LUTS) in the elderly patients, prostatic calculi are more often revealed; however, the mechanism of formation of prostatic calculi is not clearly known, and their impacts on LUTS are controversial. We investigated whether the type and location of prostatic calculi might influence LUTS in benign prostatic hyperplasia (BPH) patients. MATERIALS AND METHODS: From July 2003 to January 2008, 1,437 consecutive patients underwent transrectal ultrasonography. Of these patients 383 with clinical BPH were retrospectively studied. According to the type (type A: a discrete small reflection; type B: a large mass of multireflection; type M: mixed) and location (periurethral vs. non-periurethral) of prostatic calculi, the serum prostate-specific antigen (PSA) levels, volume of prostate, maximum urinary flow rate and residual urine volume, and International Prostate Symptom Score (IPSS) were compared. RESULTS: Prostatic calcification was found in 70% (268/383), and type A in 38%, type B in 46% and type M in 16%. There was no significant difference according to the presence or types of prostatic calcification, comparing serum PSA levels, volume of prostate, maximum urinary flow rate and residual urine volume. And there was no significant correlation between the types of prostatic calcificaton and each item of IPSS. Periurethral and non-periurethral prostatic calcification failed to show the significant difference in each items of IPSS. CONCLUSIONS: There is no significant difference in LUTS according to presence, types, or locations of prostatic calculi in clinical BPH patients.
Aged ; Calculi* ; Humans ; Lower Urinary Tract Symptoms* ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia* ; Retrospective Studies ; Ultrasonography

PURPOSE: Nocturia has been one of the most bothersome symptoms in benign prostatic hyperplasia (BPH) patients. Therefore, the authors evaluated the effect of tolterodine and oxybutyninin on nocturia in BPH patients. MATERIALS AND METHODS: From September 2006 to March 2007, 82 patients who presented over than 2 in nocturnal bladder capacity index (NCBI) in spite of having alpha blockers for 6 months were enrolled. Group I (n=38) took alpha blocker with tolterodine, group II (n=44) took alpha blocker with oxybutynin. The number of their nocturia episodes was separately evaluated by the time before and after the medication. The complications were assessed using a questionnaire. RESULTS: The number of nocturia episodes decreased by at least 1 in 68.4% (26/38), 84.1% (37/44) of patients in group I, II, respectively, and decreased by 2 or more, 1 and were unchanged or increased were 36.8, 31.6, 31.6% in group I patients and 45.5, 38.6, 15.9% in group II patients, respectively. In baseline nocturia > or =6 group, the nocturia decreased by 1 or more in 66.7%, 77.8% in group I, II, respectively. Adverse events, including dry mouth, dizziness, headache, etc, occurred in 21.1% (8/38) in group I and 27.3% (12/44) in group II patients. The complications between two groups showed no significant differences. CONCLUSIONS: Alpha blockers with tolterodine or oxybutynin can be effectively combined as a treatment option for patients with BPH complaining of unresolved nocturia.
Dizziness ; Headache ; Humans ; Mouth ; Nocturia* ; Prostatic Hyperplasia* ; Surveys and Questionnaires ; Urinary Bladder ; Tolterodine Tartrate

Overactive bladder is a chronic condition defined by bothersome urgency with or without urgency incontinence, usually associated with daytime frequency and nocturia. The treatment of this condition is to control bothersome urinary symptoms and is therefore to improve quality of life. The Korean Continence Society published the overactive bladder guideline in 2007, which suggested the mainstay of management is behavioral therapy and antimuscarinic pharmacotherapy. With growing awareness toward overactive bladder and quality of life, clinical information regarding antimuscarinic agents should be updated. There are several agents with good level of evidence and good grade of recommendation. Newer antimuscarinic agents are available or will be available in near future. The pharmacological properties, efficacy and tolerability of oxybutynin, trospium, propiverine, tolterodine, darifenacin, solifenacin, fesoterodine and imidafenacin are reviewed and discussed here. The results of major clinical studies are summarized.
Cholinergic Antagonists* ; Drug Therapy ; Muscarinic Antagonists ; Nocturia ; Quality of Life ; Urinary Bladder, Overactive* ; Solifenacin Succinate ; Tolterodine Tartrate