Stuttering Priapism happened in Sleep / 대한남성과학회지

Priapism is an abnormal persistent penile erection that continues for more than 4 hours, without sexual stimulation according to the definition of the AUA (American Urological Association) guideline on the management of priapism. It was relatively rare in the past but has been increasing in the incidence since the advent of pharmacological agents. Stuttering priapism is a recurrent form of ischemic priapism and its treatment goal is to prevent the recurrences of priapism and resultant erectile dysfunction. We present the case of a patient who took tadalafil and thereafter had idiopathic recurrent episodes of ischemic priapism during the sleep and we show several treatment options of stuttering priapism with review of recent related articles.

The Risk Factors for Increased Post-Voiding Residual Urine Volume after Long-Term Anticholinergic Therapy in Patients with Benign Prostatic Hyperplasia and Overactive Bladder

PURPOSE: Adding anticholinergics to the treatment regimen of benign prostatic hyperplasia (BPH) patients with overactive bladder (OAB) elicits concern about deterioration of obstructive symptoms and the possibility of urine retention. We evaluated the risk factors increasing post-voiding residual (PVR) volume with long-term anticholinergics therapy of over 1 year in patients with BPH and OAB. MATERIALS AND METHODS: We selected patients with BPH and OAB from 2005 to 2007 who were more than 40 years old, were treated with alpha-blockers, had an International Prostate Symptom Score (IPSS) of 8 or more, and had an IPSS urgency score of 2 or more for OAB. The 98 patients selected were evaluated by age, diabetes mellitus, central nervous system (CNS) disease above the brain stem, prostate volume, uroflowmetry, PVR volume, prostate-specific antigen (PSA) level, and IPSS retrospectively. We evaluated risk factors for increasing PVR volume over 50 ml and 100 ml after treatment and analyzed the risk factors both univariately and multivariately. RESULTS: Age, diabetes mellitus, CNS disease, PSA level, prostate volume, initial PVR volume, peak urine flow rate ( or=65 years), initial PVR (> or=50 ml), long-term therapy with anticholinergics of over 1 year, and CNS disease appear to be risk factors for increasing PVR volume over 100 ml in patients with BPH and OAB.

Prevalence of Premature Ejaculation in Chronic Pelvic Pain Syndrome / 대한남성과학회지

PURPOSE: Premature ejaculation is a common male sexual dysfunction and has an adverse effect on QoL(quality of life). Chronic pelvic pain syndrome(CPPS) is also a common and serious health problem affecting QoL. Although both disorders are common their etiopathogeneses are not well understood. We investigated the prevalence and effect of premature ejaculation on erectile function in CPPS patients and compared these patients with healthy control subjects. MATERIALS AND METHODS: 638 CPPS patients and 102 healthy controls were enrolled in this study. Each patient was given a questionnaire consisting of 3 parts: a demographic data questionnaire, the Korean version of the NIH-CPSI(National Institutes of Health-Chronic Prostatitis Symptom Index), and IIEF(International Index of Erectile Function). Premature ejaculation was defined as intravaginal ejaculation latency of less than 3 minutes with the same partner for at least 6 months. RESULTS: 303 patients with CPPS and 83 healthy controls were eligible for the analysis. The rate of premature ejaculation was much higher in patients with CPPS(71.62%) than healthy controls(22.89%), and this difference was statistically significant(p < 0.01). In the patients with CPPS, the frequency of sexual intercourse per month during the last 3 months was 4.79+/-3.43. In the patients with CPPS, the mean scores for IIEF-EF(erectile function), IIEF-IS(intercourse satisfaction), IIEF-OF(orgasmic function), IIEF-SD(sexual desire) and IIEF-OS(overall satisfaction) were 21.7+/-6.4, 8.5+/-2.9, 7.4+/-2.5, 5.3+/-2.0 and 5.2+/-2.1, respectively. Each mean IIEF domain score was lower than healthy controls, and these differences were statistically significant. But in the patients with CPPS categorized in IIIa and IIIb, the frequency of sexual intercourse and each IIEF domain score showed no difference. CONCLUSIONS: The rate of premature ejaculation was higher in the patients with CPPS than healthy controls.