The Relationship of Pressure-Flow Parameters and Urethral Pressure in Female Patients with Lower Urinary Tract Symptoms

PURPOSE: This study aimed to evaluate the relationship between pressure-flow parameters and urethral pressure in women with lower urinary tract symptoms (LUTS). MATERIALS AND METHODS: Urodynamic traces of women with stress urinary incontinence (SUI), mixed urinary incontinence (MUI), and detrusor overactivity (DO) were retrospectively studied. The urodynamic parameters such as detrusor opening pressure (DOP), detrusor pressure at maximum flow rate (PdetQmax), maximum flow rate (Qmax), detrusor closing pressure (DCP), and maximal urethral closing pressure (MUCP) were measured and compared. The relationship between pressure-flow parameters and MUCP were evaluated as well as the differences between each urodynamic group. RESULTS: One hundred fifty-one women were investigated between June 2004 and May 2008. One hundred twenty-one (80%) women had good-quality urodynamic studies and were included in the present study. The mean age was 56 years (range, 32-77). Women with DO had higher DOP, PdetQmax, and MUCP than did women with SUI (p<0.05). Qmax was significantly greater in women with SUI than in women who had DO (p<0.05). Women with MUI had DOP, PdetQmax, and Qmax that were intermediate between women with SUI and those with DO. There was a significant positive correlation between DOP, PdetQmax, DCP, and MUCP measurements and a significant negative correlation between Qmax and MUCP measurements (p<0.01). CONCLUSIONS: Pressure-flow parameters are reliable surrogates of urethral pressure. Therefore, an accurate evaluation of the pressure-flow parameters might give important information in the assessment of urethral and detrusor function in women with LUTS. Further study is needed to confirm our results.

Diagnostic Value of Polymerase Chain Reaction in Patients with Chronic Pelvic Pain Syndrome: using Semen as a Specimen / 대한비뇨기과학회지

PURPOSE: Specific microorganisms, such as Chlamydia and Mycoplasma, are rarely detected in chronic pelvic pain syndrome, but fastidious and non-culturable microorganisms may be important in its etiology. The objective of this study was to evaluate the usefulness and significance of polymerase chain reaction (PCR) in the diagnosis of the etiologies of chronic pelvic pain syndrome, especially using semen as a specimen. MATERIALS AND METHODS: Between August 2005 and July 2006, 237 patients, with a mean age of 39 years (range 25-67 years), were evaluated for chronic pelvic pain syndrome. PCR testing of the semen was performed in all cases to establish the persistence of C. trachomatis, T. vaginalis, M. hominis, M. genitalium and U. urealyticum. RESULTS: Of the 237 patients, 79 (33.3%) and 158 (66.7%) were categories IIIa and IIIb, respectively. On PCR, using semen, 18 (22.8%) of the 79 category IIIa and 26 (16.5%) of the 158 category IIIb cases were found to have positive PCRs for the causative microorganisms of CPPS. In a total of 53 isolates presenting positive PCR, the common causative microorganisms were U. urealyticum, C. trachomatis, M. genitalium, T. vaginalis and M. hominis in 23 (43.4%), 16 (30.1%), 11 (20.8%), 2 (3.8%) and 1 case (1.9%), respectively. CONCLISIONS: PCR is revolutionizing the diagnosis of many infectious diseases, particularly those caused by microorganisms that are difficult to cultivate. Moreover, PCR shows nearly 100% accuracy in terms of sensitivity and specificity. PCR using semen, which can detect various microorganisms suggestive of the etiologies of chronic pelvic pain syndrome, is expected to play an important role in the diagnosis, treatment and follow up of chronic pelvic pain syndrome in urology.

Comparative Analysis of Short-term Efficacy and Complication of Photoselective Vaporization for Benign Prostatic Hyperplasia which was Classified by Prostate Size / 대한비뇨기과학회지

PURPOSE: This study was conducted to compare the short term clinical efficacy and complications of photoselective vaporization for benign prostatic hyperplasia(BPH), which was classified by the prostate size. MATERIALS AND METHODS: The clinical data of 309 men with BPH, who had undergone photoselective vaporization for prostate(PVP) using potassium-titanyl-phosphate(KTP) laser, between January 2005 and December 2006, were retrospectively analyzed. All patients were classified into three groups by their prostate size(60cc; group III). The clinical efficacy of each group was compared in terms of the International Prostate Symptom Score(IPSS), quality of life(QoL) index, changes in the maximum urinary flow rate(Qmax), postvoid residual urine(PVR), complications and postoperative outcomes. The mean follow-up period was 6.4 months. RESULTS: The postoperative parameters were significantly improved in all patients(p<0.05). With respect to each of the three classified groups, the postoperative parameters of each group were also significantly improved (p<0.05). However, in group III, the postoperative IPSS and QoL index were lower than the average value. Especially, the items for frequency, nocturia and urgency of the IPSS resulted in bad grades. The rate of complications in group III were higher than those in groups I and II, such as urinary retention, delayed hematuria, urethral stricture and bladder neck contracture. CONCLUSIONS: Despite the excellence of KTP, careful consideration must be given when the operation is performed on patients with a large prostate size.

Adenocarcinoma Arising in Augmented Bladder / 대한비뇨기과학회지

Adenocarcinoma arising in an augmented bladder is a relative rare neoplasm. We report here on 2 cases of adenocarcinoma that developed in augmented bladders 23 and 30 years after ileocystoplasty, and both tumors were associated with contracted bladder due to tuberculosis. We also reviewed the literatures related to neoplasms occurring after urinary diversion procedures.

Abscess of the Penile Corpus Cavernosum / 대한비뇨기과학회지

We present an unusual case of a penile cavernosal abscess. This patient did not improve clinically despite repeat percutaneous aspiration of the abscess and administration of oral fluoroquinolone. Surgical drainage was required. Culture of pus and infected tissues were negative. Three months postoperatively, penile deviation to the left side and erectile dysfunction occurred but the patient was able to have sexual intercourse by using the medication of oral vardenafil. Colchicine was administered orally to the patient for 9 months and the penile curvature was improved.

The Effects of Combination of Intrarectal Lidocaine-gel with Periprostatic Lidocaine Injection on the Pain Relief in Repeated Transrectal Prostate Biopsy / 대한비뇨기과학회지

PURPOSE: We evaluated the effectiveness of intrarectal lidocaine-gel and periprostatic nerve block, or the combined method, on the reduction of pain during repeated transrectal prostate biopsy. MATERIALS AND METHODS: 61 patients with a negative pathology after an initial sextant biopsy, with no sedatives or analgesia, were rebiopsied using the 12 extended biopsy technique. The patients scheduled for a repeat prostate biopsy were randomized to the combination method (group 1, 19 patients), periprostatic nerve block (group 2, 23 patients) or intrarectal lidocaine-gel (group 3, 19 patients). After the repeat biopsy, the rectal pain during probe insertion, pain intensity during prostate biopsy and complication rates were recorded. Pain was evaluated by a 10-point linear visual analogue scale (VAS). An ANOVA test was used as the statistical analysis for the assessment of VAS, with p<0.05 considered significant. RESULTS: No significant difference was found in mean patient age, prostate specific antigen level, prostate volume and complication rates between the groups. The VAS during probe insertion were significantly lower in group 1 and 3 (mean 1.74 and 1.84) than in group 2 (mean 3.96, p<0.001). The VAS during biopsy was significantly lower in group 1 (mean 3.05) than group 3 (mean 4.63, p<0.001). CONCLUSIONS: Periprostatic nerve block decreased pain during the repeated prostate biopsy, but had no effect on the pain felt during transrectal probe insertion. Intrarectal lidocaine-gel decreased the pain only during probe insertion. However, the combination of intrarectal lidocaine-gel and periprostatic nerve block was effective in reducing the pain, both at biopsy and during probe insertion, in the repeated 12 core biopsy.

Adenomatoid Tumor of the Tunica Vaginalis Testis / 대한비뇨기과학회지

Adenomatoid tumors arising in the tunica vaginalis are relative rare neoplasms, and usually benign in nature. An appropriate treatment of an adenomatoid tumor is local excision. Herein, a case of an adenomatoid tumor of the tunica vaginalis, in a 40-year-old man, is described. An orchiectomy was performed to excise the mass, and pathologic evaluation revealed an adenomatoid tumor of the tunica vaginalis.

Adenomatoid Tumor of the Tunica Vaginalis Testis / 대한비뇨기과학회지

Adenomatoid tumors arising in the tunica vaginalis are relative rare neoplasms, and usually benign in nature. An appropriate treatment of an adenomatoid tumor is local excision. Herein, a case of an adenomatoid tumor of the tunica vaginalis, in a 40-year-old man, is described. An orchiectomy was performed to excise the mass, and pathologic evaluation revealed an adenomatoid tumor of the tunica vaginalis.

Malignant Prostatic Hemangiopericytoma / 대한비뇨기과학회지

Hemangiopericytoma is a relatively uncommon vascular tumor. It was first described by Stout and Murray in 1942. Here, we report a case of a primary prostatic hemangiopericytoma, which has been reported approximately <10 cases. This may be the first case of a prostatic hemangiopericytoma in Korea. A 35-year-old male patient presented with an episode of dysuria and perineal discomfort over the past 3 months. The radiological and histological features indicated a malignant hemangiopericytoma. Systemic chemotherapy was selected as the primary treatment. After 5 cycles of chemotherapy, the size of masses of the prostate and lung decreased. Four months after then, the patient died from hemoptysis.

Malignant Prostatic Hemangiopericytoma / 대한비뇨기과학회지

Hemangiopericytoma is a relatively uncommon vascular tumor. It was first described by Stout and Murray in 1942. Here, we report a case of a primary prostatic hemangiopericytoma, which has been reported approximately <10 cases. This may be the first case of a prostatic hemangiopericytoma in Korea. A 35-year-old male patient presented with an episode of dysuria and perineal discomfort over the past 3 months. The radiological and histological features indicated a malignant hemangiopericytoma. Systemic chemotherapy was selected as the primary treatment. After 5 cycles of chemotherapy, the size of masses of the prostate and lung decreased. Four months after then, the patient died from hemoptysis.

Staged Transurethral Resection of Prostate for Large Benign Prostatic Hyperplasia: A Comparative Study with Open Prostatectomy / 대한비뇨기과학회지

PURPOSE: Although open prostatectomy is usually considered when the prostate gland is greater than 50cc, it needs an incision and relatively longer hospital days and has a potential for intraoperative hemorrhage. For these reasons, we performed staged transurethral resection of the prostate (TURP) consecutively instead of open prostatectomy for benign prostatic hyperplasia (BPH) patient with a prostate larger than 50cc. MATERIALS AND METHODS: Among total 30 BPH patients with a prostate larger than 50cc in volume, 14 patients underwent immediate repeat TURPs (group A) and 16 patients underwent suprapubic prostatectomies (group B). Preoperative international prostate symptom score (IPSS), uroflowmetry, pressure-flow study, operative data, postoperative immobilization period because of hematuria and other complications were reviewed. IPSS and uroflowmetry were followed up to 6 months after operation. RESULTS: There were no statistically significant differences in age, preoperative IPSS and Qmax between the two groups. At 6 months after the operation mean Qmax and IPSS were improved in both groups significantly, and while Qmax was higher in the group B, there was no significant difference in decreasing IPSS. In the group A, hospital stay and immobilization period were shorter and there was no patient who needed transfusion because of bleeding or suffered from TUR symdrome. In contrast, 9 (75%) patients needed transfusion because of bleeding in the group B. CONCLUSIONS: Staged TURP is a valuable surgical method with respect to absence of incision, effective symptom improvement, short hospital stay and postoperative immobilization perod and low risk of complications such as bleeding and TUR syndrome in symptomatic BPH patient who has a prostate volume over 50cc.

Complete Androgen Insensivity Syndrome in Sisters / 대한비뇨기과학회지

No abstract available.

The Correlation between Ultrasonic Prameters of the Prostate and the Bladder Outlet Obstruction in BPH Patients / 대한비뇨기과학회지

No abstract available.

2 Cases of Prostatic Myosarcoma : Rhabdomyosarcoma andn Leiomyosarcoma / 대한비뇨기과학회지

No abstract available.

The Role of Partial Cystectomy for Transitional Cell Carcinoma of the Urinary Bladder / 대한비뇨기과학회지

No abstract available.

Urodynamic Predictive Factors for Surgical Treatment Outcome of Benign Prostatic Hyperplasia / 대한비뇨기과학회지

PURPOSE: Transurethral prostatectomy(TURP) or open prostatectomy were considered as standard treatments for benign prostatic hyperplasia(BPH), but these treatments showed high morbidity and mortality. We searched urodynamic predictive factors for successful surgical outcome to select patients who would benefit from prostatectomy pre-operatively. MATERIALS AND METHODS: Retrospectively, we reviewed preoperative urodynamic findings of 114 patients with BPH undergoing TURP(104cases) or open prostatectomy(10cases). RESULTS: In the follow-up period of 1 month to 19 months, a strict successes were achieved in 83 patients(73%). On analysis of the success rate, 4 favorable urodynamic factors and 8 unfavorable urodynamic factors were noted. 4 favorable factors were as follows; maximal flow rate6cm and presence of peak elevation on prostatic urethra pressure. 8 unfavorable factors were as follow; intermittent or normal flow pattern, prostatic urethral length100cmH2O, prostatic pressure area <70cm cmH2O, non-obstructive pattern on Abrams-Griffiths nomogram and detrusor pressure at maximal flow rate <50cmH2O. CONCLUSIONS: Patients with more than 1 unfavorable urodynamic factor should be investigated carefully before surgery and be treated with other non-invasive treatment for BPH. The presence of 2 favorable urodynamic factors without unfavorable factor will usually predict the best surgical outcome.

Retroviral Vector-mediated Interleukin-2 Gene Transfer into Human Renal Cell Carcinoma Cell Line / 대한비뇨기과학회지

PURPOSE: The therapeutic dose of cytokine for patients with advanced renal cell carcinoma is very high and leads to toxic side effects and a substantial cost to the patients. Interleukin-2(IL-2) could be released continuously and slowly in the host by genetic engineering of IL-2 genes and increase host immunity with decreasing the a verse effects of the drug. We investigated the IL-2 gene expression, amplification of viral titer, and transduction of IL-2 gene into human renal cell carcinoma cell line with retroviral vectors. MATERIALS AND METHODS: For the production of retroviral vectors with the IL-2 gene, we used PA-317 as a packaging cell and Caki-2 as a renal cell carcinoma cell. Retroviral supernatants were added to culture flask containing Caki-2 cells and after 48 hours, replacement with a media containing G418(Gibco, Grand Island, NY) 800 microgram/m1 was done for selection of transfected colonies. The selected colonies were cultured and then measured the amount of IL-2 production per 1xl0(6) for 24 hours using an ELISA assay kit(BioSource International, USA) for IL-2. RESULTS: Thirteen colonies were selected and the amount of IL-2 production was 143.1 +/-75.3pg/m1/10(6) cells/24hr(range: 51.5-370.7). CONCLUSIONS: The success of transduction of the IL-2 gene into human renal cell carcinoma cell lines with a retroviral vector will give a possibility in gene therapy for advanced renal cell carcinoma and may have promising results

A Clinical Survey on Renal and Perinephric Abscess / 대한비뇨기과학회지

Renal and perinephric abscess are uncommon entities with a multitude of clinical presentations. Delay in diagnosis and treatment contributes to the high morbidity and mortality rate in the past. Recently, the introduction of newer imaging modalities, such as ultrasonography and CT scanning, has allowed accurate diagnosis and treatment. We reviewed retrospectively 12 cases of renal or perinephric abscess who were admitted to the National Medical Center during the period from January, 1981 to January, 1991. The following results were observed. 1. Among 12 patients, 7 patients were women and 5 patients were men and their age ranged from 11 to 59 years old with mean of 34 years. In 9 cases, the right kidneys were involved and in 3 cases, the left kidneys were involved. 2. On laboratory findings, 5 cases(42%) of pyuria and 1 case(8%) of positive urine culture and 11 cases(92%) of leukocytosis were seen. 3. Among 10 cases performed pus culture, causative organism was recovered in 8 cases: Gram-positive coccus in 5 cases and Gram-negative rod in 3 cases. 4. Urologic underlying diseases were identified in 5 cases and non-urologic associated diseases were in 5 cases. 5. Among 12 cases, 2 cases were treated by antibiotics only, 1 case was treated by nephrectomy, 4 cases underwent open drainage and 5 cases were managed successfully by closed drainage.

Case of Giant Ureteral Polyp / 대한비뇨기과학회지

A case of giant ureteral polyp is presented. The patient was 76- year-old female complaining of left flank discomfort and irritative voiding symptoms. Radiologic examination revealed filling defects of left lower ureter. Cystoscopic finding showed a tubular mass, to-and-pro movement through left ureteral orifice. Excision of ureteral polyp and left ureteroureterostomy were performed. Pathologic findings showed fibroepithelial polyp and it's narrow pedicle was 10cm in length and 5-8mm in diameter.

A case of crossed renal ectopia with fusion / 대한비뇨기과학회지

Crossed fused renal ectopia is an uncommon congenital anomaly. The patients have often another congenital anomalies that may make the diagnosis. We report a case of crossed fused renal ectopia with review of literatures.