Effect of Testosterone Replacement on Penile Erection in Castrated Rat / 대한남성과학회지

PURPOSE: This study examined the changes in intracavernous pressure, expression of nitric oxide synthase(NOS), and content of penile smooth muscle in castrated rats and testosterone-supplied castrated rats. MATERIALS AND METHODS: Sprague Dawley rats were used for this study and divided into control, castrated, and testosterone-supplied castrated groups. Castration was performed by bilateral orchietomy under general anesthesia, and testosterone propionate 3 mg/kg was injected subcutaneously daily for a week beginning 4 weeks after orchiectomy. Intracavernous pressure was measured by stimulating the cavernous nerve at 10 volts, 2.4 mA. Expression of NOS was measured by immunohistochemical staining for NADPH diaphorase, and content of penile smooth muscle was measured by H&E staining of the corpus cavernosum. The stained area-to-tissue ratio was calculated by computer scanning for each case. RESULTS: Compared with the control group(3.45+/-0.25 ng/ml), the serum testosterone level of the castrated group (0.78+/-0.34 ng/ml) was lower. Serum testosterone level was restored in the testosterone-supplied castrated group. Compared with the(67.2+/-14.3 cmH2O) was decreased (p <0.05). There was no significant difference between the testosterone-supplied group(94.7+/-11.4 cmH2O) and control group, so intracavernosal pressure was restored by testosterone treatment. Immunohistochemical staining for NOS showed that NADPH diaphorase was stained as brown nerve fiber. Compared with the control group(37.5+/-2.8%), the NOS activity of the castrated group(7.5+/-2.1%) was significantly decreased(p <0.05). NOS activity was slightly increased in the testosterone-supplied group(47.5+/-2.4%) compared with the control group, but the difference was not statistically significant. Thus, testosterone treatment restored NOS activity after castration. By H&E staining, the content of penile smooth muscle was 76.5+/-2.8% in the control group, but significantly lower in the castrated group(46.2+/-3.4% p <0.05). Smooth muscle content was slightly decreased in the testosterone-supplied group(63.8+/-4.7%) compared with control group, but the difference was not statistically significant. Thus, smooth muscle content was restored by testosterone treatment after castration. CONCLUSIONS: Decline of factors involved in erectile function can be restored by testosterone replacement after castration.

Retrospective Survival Analysis according to Prognostic Factors after Radical Cystectomy in Bladder Cancer / 대한비뇨기과학회지

PURPOSE: Radical cystectomy with pelvic lymphadenectomy is effective therapeutic modality in the management of invasive bladder cancer. We reviewed our experience in order to determine the prognostic factors on survival after radical cystectomy with pelvic lymphadenectomy. MATEIRALS AND METHODS: An analysis was performed of 113 patients with bladder cancer who underwent radical cystectomy with pelvic lymphadenectomy from 1988 to 1997. Ages ranged from 46 to 78-year-old, average age was 61.4+/-9.8 years old. The survival rate according to each factor was calculated by Kaplan-Meier method. Statistics was determined by the log-rank test. RESULTS: 3-year survival rate was 80% in the male patients and 66% in the female patients. Comparing between organ confined( or =pT3b), 3-year survival rate was 86% for organ confined disease and 34% for non-organ confined disease. 3-year survival rate of the patients with grade I cancer was 96%, grade II cancer 86% and grade III cancer 66%. According to microscopic vascular invasion of the bladder tumor, 3-year survival rate in vascular invasion was 66% and 80% in non-vascular invasion. According to microscopic lymphatic invasion of the bladder tumor, 3-year survival rate was 62% in lymphatic invasion and 88% in non-lymphatic invasion. According to the states of lymph node invasion, 3-year survival rate in the N0 was 84%, in N1 74% and in N2< or = 0%. According to the metastasis, 3-year survival rate in the absence of metastasis was 90%, in nodal invasion 32% and in visceral organ metastasis 26%. There were statistical significant differences in sex, pathologic stage, grade, lymph node invasion and distant metastasis(p<0.05). CONCLUSIONS: From this study, we think the prognostic factors affecting survival after radical cystectomy with pelvic lymphadenectomy may be sex, pathologic stage, grade, lymph node invasion and distant metastasis. Therefore, careful and more frequent followup is needed in patients with poor prognostic factor.

The Effect of Insulin Therapy on the Collagen of the Corpus Cavernosum in Diabetic Rat / 대한비뇨기과학회지

PURPOSE: The purpose of this study was to investigate the changes of collagen and the effect of insulin therapy on the collagen of the corpus cavernosum in diabetes mellitus(DM). MATERIALS AND METHODS: Twenty seven rats were included for this study and divided into control, diabetic and insulin treated diabetic group. DM was induced by intravenous injection of streptozotocin 65mg/kg and NPH insulin (initially 4IU/d for 3 days and then 6IU/d) was administered for 4 weeks for insulin treatment. After 4 weeks of experiment, the collagen concentration was evaluated with hydroxyproline quantitative analysis and collagen distribution within the corpus cavernosum. Collagen(type I, III and IV) was obsened with Masson-trichrome and immunohistochemical staining. RESULTS: 1. Body weights of control, diabetic group and insulin treated diabetic group were 315.0 +/-14.2gm, 230.8+/-15.2gm and 310.1+/-15.4gm, respectively, at 4 weeks of experiment. Control and insulin treated diabetic group progressively increased in body weight(p<0.05), while diabetic group decreased in body weight. 2 Collagen concentration of control, diabetic and insulin treated diabetic group expressed 465.2+/-24microgram, 590.3+/-43.7microgramand 567.1+/-34.8microgram respectively. Collagen concentration in corpus cavemosum significantly increased in diabetic and insulin treated diabetic group compared with control group(p<0.05). No significant difference was noted between diabetic and insulin treated diabetic group. 3. Immunohistochemical staining revealed collagen types I and III were distributed evenly in the corporal interstitial tissue, but type IV collagen was noted along the basement membrane of the cavernosal sinusoid in the both control and experimental groups. Collagen type 1 of diabetic and insulin treated diabetic group, as compared with control group, was noted thin staining in the corporeal tissue. There were no significant differences in collagen type 111 among control, diabetic and insulin treated diabetic groups. Collagen type IV of diabetic and insulin treated diabetic group, as compared with control group, was noted dense staining in the basement membrane of the cavernosal sinusoidal space. And the intensity for collagen type IV was not significantly different between diabetic and insulin treated diabetic group. 4. Masson-trichrome staining showed no significant differences among control, diabetic and insulin treated diabetic groups. CONCLUSIONS: These results suggest that the DM changes quantitatively the collagen type IV of corpus cavernosum and the insulin treatment had no effect on the collagen alteration in DM.

Uroflow Rate Nomograms related to Age and Voiced Volume in Korea Pediatric Males / 대한비뇨기과학회지

PURPOSE: To determine the uroflow rates of normal Korean pediatric male, uroflowmetry was peformed. MATERIALS AND METHODS: A total of the 237 normal children who ranged in age from 2 to 14 years(mean: 7.2+/-2.1years)was available for this study. Uroflow 1 data(peak and average flow) were plotted in volume-related nomograms in 3 different age groups : 2 to 4, 5 to7 and 8 to 14 years old. RESULTS: The mean peak flow(10.3+/-3.7, 12.2+/-4.9 and 14.3+/-5.2m1/sec) and average flow(6.4+/-2.6, 7.1)3.0 and 8.3+/-3.4m1/sec) were increased significantly with increasing age(p<0.05). In a same voided volume the peak and average flow rates were not increased significantly with increasing age but, in a same age group they were significantly increased according to the volume voided (p<0.05). Peak and average flow rates in the circumcision group(13.7+/-6.7, 8.3+/-4.7m1/sec) was not significantly different from non-circumcision group(10.9+/-5.0, 16.1+/-3.0ml/sec). CONCLUSIONS: These uroflow rate nomograms will be useful for the assessment of voiding action related to the voided volume and age in Korean pediatric males.

The Significance of Uroflowmetry after Repair of Hypospadias / 대한비뇨기과학회지

PURPOSE: To determine the role of uroflowmetry in the evaluation of the functional results of hypospadias repair we reviewed the asymptomatic patients who underwent hypospadias repair. MATERIALS AND METHODS: A total of the 34 patients was available for this study. Age of patient were ranged from 3 to 14 years(mean; 8.8+/-4.67 years) at the time of uroflowmetry and followup ranged from 7 months to 3.5 years(mean; 2.4+/-0.88 years) after repair of hypospadias. The peak uroflow were compared to age dependent nomograms that indicate the normal range of peak flows according to the voided volumes. Flow rates were defined as low if they decreased below 90 percentile of the expected normal range. RESULTS: The peak urine flow in hypospadias repair patients(12.1 +/-8.74m1/sec) was not significantly different from normal control(12.9+/-5.10 ml/sec). Five of the 34 patients had peak flow below the normal ranges. One of the 17 patients with chordee and one of the 11 without chordee showed low peak urine flow. One of the 14 patients with anterior hypospadias, one of the 8 with posterior hypospadias and none with mid hypospadias showed low peak urine flow. According to the methods of repair one of the 12 patients with onlay island flap, one of the 5 with pyramidal procedure and three of the 6 who had undergone previous attempts at hypospadias in other hospital showed low peak urine flow Two of the 5 patients who revealed low peak uroflow rate were managed with periodic meatal dilatation and the 3 were managed with internal urethrotomy for proximal urethral stricture. CONCLUSIONS: The uroflowmetry is an easy and noninvasive method to detect asymptomatic urethral stricture In hypospadias repair patients.

The Pharmacological and Histological Comparison Between Detubularized and Tubularized Cystoplasty Ileum in the Rat / 대한비뇨기과학회지

Bowel segments are used either in a tubular or detubular configuration in bladder augmentation and substitutions. The majority of urologists agree that detubularized segments give better clinical results,but detailed studies were not investigated in animals. The present study compared the contractile response of autonomic agonists including carbachol, isoproterenol,alpha, beta-methylene ATP on detubularized and tubularized cystoplastic ileal segments. In addition, histological examinations of cystoplastic ileal segments were performed. Five rats underwent Sham operation as control and eight rats underwent detubularized ileocystoplasty and seven rats underwent tubularized ileocystoplasty. Analysis was done six weeks after surgery. The contractile responses of detubularized cystoplasty ileum to carbachol, alpha, beta-methylene ATP were significantly increased when compared to the responses of tubularized ileum and control ileum. The relaxation responses of detubularized cystoplasty ileum to isoproterenol were significantly higher than control ileum. However, in tubularized ileum, the responses to carbachol, alpha, beta-methylene ATP, isoproterenol were similar for control ileum. The responses of detubularized cystoplasty ileum to carbachol, alpha, beta -methylene ATP were significantly different from control bladder, but detubularized cystoplasty ileum showed responses that resemble control bladder more closely when compared to the responses of tubularized ileum.The histological examination showed urothelialization of cystoplastic ileum with transitional epithelium extending over and covering the junction margin of the cystoplastic ileum. These results suggest detubularized ileocystoplasty induced closer pharmacological changes in the ileal segment towards the bladder than tubularized ileocystoplasty and so we can expect detubularized ileocystoplasty gives better clinical outcome.

A Case of Extra-adrenal Paraganglioma of the Scrotum / 대한비뇨기과학회지

Extra-adrenal paragangliomas are rare tumors of neural crest origin, usually arising from the carotid bodies, the glomus jugulare, or the retroperitoneum. And, though ten percents of cases are presented with malignancy, it`s prognosis is relatively good. In genitourinary area, there are a few reported cases of extra-adrenal paragangliomas of the urinary bladder and the spermatic cord. Herein, we report a case of paraganglioma arising in the scrotum, which is an extremely rare location.

Expression of Heat Shock Protein 70 m-RNA in Non-obstructed Bladder Tissue in Rats with Diuresis

No abstract available.