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PURPOSE: The aim of this study was to compare the body images of patients who underwent radical cystectomy with an orthotopic ileal neobladder or an ileal conduit. MATERIALS AND METHODS: A total of 114 adult patients who underwent radical cystectomy between March 2006 and December 2012 at a single institution, Ewha Womans University Mokdong Hospital in Korea, were evaluated in this retrospective chart-review study. Forty-two patients (29 orthotopic ileal neobladder and 13 ileal conduit) who completed questionnaires were included in the final analysis; the remaining patients were excluded. The patients were assessed with two questionnaires: the Korean version of the Body Image Scale (K-BIS) and the self-designed questionnaire. RESULTS: The results did not differ significantly by age at surgery, time from surgery to survey, pathologic stage, grade, histologic subtype, education, residency, or Eastern Cooperative Oncology Group performance status, but did differ significantly by age at survey and sex. The mean summary score for K-BIS showed significant differences between the two groups (p=0.001). We found that patients who underwent an orthotopic ileal neobladder had a significantly better body image. The self-designed questionnaire score was not significantly different between the two groups (p=0.572). CONCLUSIONS: In our retrospective analysis, patients who underwent orthotopic ileal neobladder had a superior body image compared with those who underwent an ileal conduit.
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PURPOSE: Because acute bacterial prostatitis (ABP) is an urgent condition of the prostate but prostatic massage is contraindicated at the onset of ABP, clinical symptoms and urine tests are used for diagnosis. In this study, we compared the clinical symptoms and treatment outcomes of patients with negative urine culture results, to whom only empirical antibiotics were administered, with those of patients with positive urine culture results. MATERIALS AND METHODS: Patients were divided into two groups according to the results of urine culture. Then, the clinical symptoms and course of each group were analyzed. In addition, age, symptoms, antibiotics, mean inpatient and outpatient length of treatment, and the treatment outcome of each group were also analyzed. RESULTS: Of the total 144 patients, the positive urine culture group consisted of 51 patients (35.4%) and the most frequent bacterial strain causing ABP was reported to be Escherichia coli. Fever and storage symptoms were significantly more common in the positive urine culture group than in the negative urine culture group (p=0.031 and 0.047, respectively). Only inpatient treatment was significant longer in the positive urine culture group than in the negative urine culture group (p<0.05). The mean length of treatment of inpatients was 4.8±2.6 days and 6.2±2.9 days in the two groups, respectively. No sequelae such as prostatic abscess or chronic prostatitis were found in either group. CONCLUSIONS: In the treatment of ABP, the use of empirical antibiotics can be expected to have sufficient effects regardless of bacterial culture. However, it is hard to determine the causative bacteria of ABP by urine culture results only.
RESUMEN
PURPOSE: We aimed to determine the treatment of choice criteria for benign prostatic hyperplasia (BPH) by analyzing the factors causing alpha-adrenergic receptor blocker (alpha-blocker) monotherapy failure. MATERIALS AND METHODS: This retrospective study enrolled 129 patients with BPH who were prescribed an alpha-blocker. Patients were allocated to a transurethral resection of prostate (TURP) group (after having at least a 6-month duration of medication) and an alpha-blocker group. We compared the differences between the two groups for their initial prostate volume, serum prostate-specific antigen (PSA), maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS), and postvoid residual urine volume (PVR). RESULTS: Of the 129 patients, 54 were in the TURP group and 75 were in the alpha-blocker group. Statistically significant differences (p<0.05) between the two groups were found in the prostate volume (50.8 ml vs. 34.4 ml), PSA (6.8 ng/ml vs. 3.6 ng/ml), Qmax (6.84 ml/sec vs. 9.99 ml/sec), and IPSS (27.3 vs. 16.8). According to the multiple regression analysis, the significant factors in alpha-blocker monotherapy failure were the IPSS (p<0.001) and prostate volume (p=0.015). According to the receiver operating characteristic (ROC) curve-based prediction regarding surgical treatment, the best cutoff value for the prostate volume and IPSS were 35.65 ml (sensitivity 0.722, specificity 0.667) and 23.5 (sensitivity 0.852, specificity 0.840), respectively. CONCLUSIONS: At the initial diagnosis of BPH, patients with a larger prostate volume and severe IPSS have a higher risk of alpha-blocker monotherapy failure. In this case, combined therapy with 5-alpha-reductase inhibitor (5-ARI) or surgical treatment may be useful.
