Early Experience with Hyaluronic Acid Instillation to Assist with Visual Internal Urethrotomy for Urethral Stricture

PURPOSE: The clinical usefulness of hyaluronic acid (HA) instillation during visual internal urethrotomy (VIU) for decreasing the incidence of recurrent urethral stricture was assessed. MATERIALS AND METHODS: Twenty-eight patients were treated by VIU with HA instillation between May 2007 and June 2009. After insertion of a Foley catheter following urethrotomy, HA was instilled via an 18-gauge tube catheter between the urethral lumen and Foley catheter. Seventeen cases were analyzed retrospectively 12 months postoperatively. We evaluated the success rate of this procedure by comparing retrograde urethrography (RGU) results, maximum flow rates, and postvoid residual urine volumes preoperatively and 3 and 12 months postoperatively. Success was defined as either a maximum flow rate of at least 15 ml/s or no visible urethral stricture on RGU at 12 months postoperatively. RESULTS: Total success rates were 76.5% (13/17) and 52.9% (9/17) at 3 and 12 months postoperatively, respectively. By etiology, success rates at 3 and 12 months postoperatively, respectively, were 66.7% and 33.3% for inflammation, 66.7% and 50.0% for trauma, and 83.3% and 66.7% for unknown causes. Success rates were 63.6% for strictures less than 10 mm in length and 33.3% for strictures of 10 mm or more in length at 12 months postoperatively. Success rates were 61.5% for single strictures and 25% for multiple strictures at 12 months postoperatively. CONCLUSIONS: The success rate of VIU with HA instillation was not better than that observed in the literature for conventional VIU.

Short Term Effect and Safety of Antidiuretic Hormone in the Patients with Nocturia / 대한배뇨장애요실금학회지

PURPOSE: To investigate the short-term safety of antidiuretic hormone in elderly patients with nocturnal polyuria, focus on hyponatremia and others electrolytes disturbances and to assess short-term effects on nocturnal urine output and number of nocturnal voids. METHODS: Between June 2005 and August 2006, a total of 34 patients with nocturnal polyuria were orally administered 0.2 mg desmopressin tablet at bedtime for two weeks. Serum sodium, others electrolytes, urine sodium and urine osmolarity were assessed in the third days, one week and two weeks after treatment with desmopressin and compared adult group ( or =65 years of age). We assessed the effect of desmopressin using a frequency-volume charts and analysed. RESULTS: In total 34 patients (20 adult, 14 elderly) were analyzed. Desmopressin treatment did not significantly change serum and urine electrolytes include soduim concentration in elderly patients comparied with adult patients. Serum sodium concentration below normal range was recorded in 2 patients in elderly group, but no serious adverse events occurred and recovered without sequelae. The mean number of nocturnal voids decresed (54% reduction) and nocturnal urine output decreased (57% reduction) after using desmopressin. CONCLUSIONS: Desmopressin was well tolerated and effective in elderly patients with nocturnal polyuria without clinically significant hyponatremia.

A Survey of Understanding of Viagra in primary Physician and General Population / 대한남성과학회지

PURPOSE: Sildenafil citrate(Viagra(R)), a PDE-5 inhibitor in the corpus carvenosum to facilitate penile erection has improved impaired erectile responses in men and has been accepted as a primary treatment of erectile dysfunction. However, complications occurred by Viagra have increased due to its overuse and misuse. Therefore, we have performed a survey to compare physicians and general population in Busan, Korea to assess their understanding of Viagra. Methods and Materials: In 2007, printed surveys were mailed to randomly sampled candidates of 197 primary physicians and 696 individuals from general population, 327 medical students in Busan were surveyed by door-to-door visits. We assessed opinions associated with Viagra eliciting their understanding about its safety, direction, and complications. Data were analyzed using SPSS and were identified by crosstabulation analysis using Ki-square test. RESULTS: Of 1,265 eligible responses, several differences were found between the 3 groups. Compared to general population, the others were more likely to understand the efficacy, directions, and complications of Viagra. Physicians and medical students(43.1% and 39.0%) gave more preference than general population(26.1%) to using Viagra. There were differences in understanding of Viagra with changes of education level. However, it showed no significant differences about idea of illegal Viagra and combination usage with nitrates. Conclusion: The number of patients using Viagra is increasing but their understanding about Viagra is still poor. Moreover, general populations understand Viagra as 'assistant' for erection poorly. Even some medical students understand more than physicians. The ideas of complications would likely affect to negative thinking about usage for Viagra. Therefore more active and continuous educations for proper use of Viagra are suggested for medical efficacy and less complications.