Cancer of the Prostate Risk Assessment (CAPRA) Preoperative Score Versus Postoperative Score (CAPRA-S): Ability to Predict Cancer Progression and Decision-Making Regarding Adjuvant Therapy after Radical Prostatectomy

The University of California, San Francisco, announced in 2011 Cancer of the Prostate Risk Assessment Postsurgical (CAPRA-S) score which included pathologic data, but there were no results for comparing preoperative predictors with the CAPRA-S score. We evaluated the validation of the CAPRA-S score in our institution and compare the result with the preoperative progression predictor, CAPRA score. Data of 130 patients were reviewed who underwent radical prostatectomy for localized prostate cancer from 2008 to 2013. Performance of CAPRA-S score in predicting progression free probabilities was assessed through Kaplan Meier analysis and Cox proportional hazards regression test. Additionally, prediction probability was compared with preoperative CAPRA score by logistic regression analysis. Comparing CAPRA score, the CAPRA-S score showed improved prediction ability for 5 yr progression free survival (concordance index 0.80, P = 0.04). After risk group stratification, 3 group model of CAPRA-S was superior than 3 group model of CAPRA for 3-yr progression free survival and 5-yr progression free survival (concordance index 0.74 vs. 0.70, 0.77 vs. 0.71, P < 0.001). Finally the CAPRA-S score was the more ideal predictor concerned with adjuvant therapy than the CAPRA score through decision curve analysis. The CPARA-S score is a useful predictor for disease progression after radical prostatectomy.

Cancer of the Prostate Risk Assessment (CAPRA) Preoperative Score Versus Postoperative Score (CAPRA-S): Ability to Predict Cancer Progression and Decision-Making Regarding Adjuvant Therapy after Radical Prostatectomy

The University of California, San Francisco, announced in 2011 Cancer of the Prostate Risk Assessment Postsurgical (CAPRA-S) score which included pathologic data, but there were no results for comparing preoperative predictors with the CAPRA-S score. We evaluated the validation of the CAPRA-S score in our institution and compare the result with the preoperative progression predictor, CAPRA score. Data of 130 patients were reviewed who underwent radical prostatectomy for localized prostate cancer from 2008 to 2013. Performance of CAPRA-S score in predicting progression free probabilities was assessed through Kaplan Meier analysis and Cox proportional hazards regression test. Additionally, prediction probability was compared with preoperative CAPRA score by logistic regression analysis. Comparing CAPRA score, the CAPRA-S score showed improved prediction ability for 5 yr progression free survival (concordance index 0.80, P = 0.04). After risk group stratification, 3 group model of CAPRA-S was superior than 3 group model of CAPRA for 3-yr progression free survival and 5-yr progression free survival (concordance index 0.74 vs. 0.70, 0.77 vs. 0.71, P < 0.001). Finally the CAPRA-S score was the more ideal predictor concerned with adjuvant therapy than the CAPRA score through decision curve analysis. The CPARA-S score is a useful predictor for disease progression after radical prostatectomy.

Erratum: Correction of Title. Correlation Between Lower Urinary Tract Symptoms and Premature Ejaculation in Korean Men Older Than 40 Years Old

In this paper, the title was described incorrectly.

Assessing Quality of Life Related to Voiding Symptoms and Sexual Function in Menopausal Women

PURPOSE: To evaluate the correlation between lower urinary tract symptoms (LUTS) and premature ejaculation (PE) in Korean men older than 40 years. MATERIALS AND METHODS: In total, 258 men older than 40 years completed the International Prostate Symptom Score (IPSS; total score, storage symptoms [ST], and voiding symptoms [VD]), a 5-item version of the International Index of Erectile Function (IIEF-5), and the Premature Ejaculation Diagnostic Tool (PEDT). The study examined the relationship between LUTS and PE. In the PEDT, PE is defined as a score > or =11. RESULTS: The prevalence of PE was 29.1% with the PEDT versus a self-reported value of 49.5%. The prevalence of PE was 30.9% in 40 to 59-year-old men (21.3%) and 28.1% in 60 to 79 year-old men (78.7%). In men 40 to 59 and 60 to 79 years old, the mean PEDT, IPSS, and IIEF-5 scores were 8.65 and 7.88, 13.5 and 12.38, and 15.83 and 13.69, respectively. No significant correlations were observed between the total and subscale scores of the IPSS (p=0.204) and the PEDT (p=0.309) with increasing age, whereas a significant negative correlation was detected between the IIEF-5 and age (p=0.002). The PEDT score was significantly correlated with the IPSS-ST (r=0.326, p<0.001), IPSS-VD (r=0.183, p=0.005), IPSS-total (r=0.310, p<0.001), and IIEF-5 total (r=-0.248, p<0.001). CONCLUSIONS: LUTS, especially storage symptoms, were related to PE. In elderly men, control of both erectile dysfunction and LUTS may play an important role in managing PE.

Urothelial Carcinoma Arising from a Large Ureteral Polyp

We report an unusual case of a urothelial tumor on a ureteral polyp without hydronephrosis. The patient was a 50-year-old male. He had experienced several episodes of gross hematuria. Cystoscopy revealed a tumor that periodically prolapsed into the bladder. The tumor had a smooth-surfaced stalk with an erythematous, edematous lesion at the end. Tomography showed a mass and filling defect at the left ureterovesical junction. The results of urine cytology tests were negative. After the tumor was identified as a urothelial carcinoma by frozen biopsy analysis, a ureteroscopic resection was performed. The final pathological diagnosis was urothelial carcinoma arising in a ureteral polyp. No recurrence of the tumor or polyp was observed at the 3-month follow-up. To our knowledge, this is the first report in the Korean population of a urothelial tumor arising from a ureteral polyp.

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.

Effect of Tamsulosin 0.2 mg on the Short-Term Treatment of Urinary Stones: Multicenter, Prospective, Randomized Study

PURPOSE: We evaluated the effect of tamsulosin for the short-term treatment of urinary stones. MATERIALS AND METHODS: Two hundred forty-seven patients who were diagnosed with urinary stones were enrolled in this prospective, randomized multicenter study. The treatment and extracorporeal shock wave lithotripsy (ESWL) group (Group 1, n=115) was given diclofenac sodium 100 mg plus tamsulosin 0.2 mg for 1 week. The control and SWL group (Group 2, n=92) was given diclofenac sodium for 1 week. The treatment and no SWL group (Group 3, n=19) was treated the same as Group 1. The control and no SWL group (Group 4, n=21) was given diclofenac sodium only. Patients in Groups 3 and 4 did not want to take SWL treatment. The size of the stone, expulsion rate according to stone location and ESWL machines, changes in pain score, and distance of stone migration when expulsion of the stone failed were compared among the groups. RESULTS: There were no differences in the 4 groups in sex or stone size. The stone expulsion rate of lower ureter stones in group 1 (59.6%) was significantly higher than in group 2 (30.8%) (p=0.01). The distance of stone migration in group 3 was longer than that in group 4 (5.63+/-5.48 cm compared with 0.33+/-0.68 cm; p=0.002). Although the difference was not significant in the SWL groups, the distance of stone migration in group 1 was longer than that in group 2 (7.08+/-6.9 cm compared with 5.46+/-7.4 cm; p>0.05). There were no significant differences in changes on the pain scale among the groups. CONCLUSIONS: These results suggest that adjunctive medical therapy for 1 week with tamsulosin after SWL increases the stone expulsion rate of lower ureteral stones and increases the distance of stone migration in case of failure of stone expulsion.

The Effect of a Transition Zone Resection Rate of the Transurethral Resection of Prostate (TURP) according to the Prostate Volume / 대한비뇨기과학회지

PURPOSE: Transurethral resection of prostate (TURP) was the gold standard for the treatment of benign prostatic hyperplasia (BPH). BPH is the enlargement of the transition zone; so a TURP was the resection of the enlarged transition zone. The transition zone resection rate is important if a good result is expected. The effect of the transition zone resection rate of TURP was evaluated according to the prostate volume. MATERIALS AND METHODS: Between January 2000 and December 2003, 61 patients with symptomatic BPH, who had undergone TURP by one surgeon, were enrolled in this retrospective study. 25 patients with a BPH less than 60cc (Group I), and 36 equal or greater than 60cc (Group II) were evaluated using the International Prostate Symptom Score (IPSS), uroflowmetry and post voiding residual urine volume (PRV) both before and after the TURP. The total prostate volume, transition zone volume (TZV), transition zone resection ratio (TZRR), total volume of resected prostate, operating time, period of hospital stay and complications were assessed. RESULTS: In groups I and II, the TZV was 21.3 6.9cc and 38 19.5cc (p=0.43), respectively. The resected prostate volumes were 16.5 7.1gm and 26.6 10.34gm in groups I and II (p=0.050), respectively. The TZRR were equal, at 0.8 0.4, in both groups. The postoperative IPSS, voiding volume, PRV and maximal flow rate (Qmax) were significantly improved in both groups. Overall, the IPSS, VV and PRV were significantly improved after the TURP when the TZRR was greater than 0.5. However, the Qmax was significantly improved when the TZRR was greater than 0.7. There were no significant differences in the periods of hospital stay or complications between the two groups. CONCLUSIONS: With TURP, the transition zone resection ratio was important, without concern of the prostate size. Also, to obtain good results, more than 70% of the enlarged transition zone has to be resected.

Retroperitoneal Lymphangioma Following Pyeloplasty in Child / 대한비뇨기과학회지

A lymphangioma is a rare benign congenital tumor of the lymphatic system, resulting from the failure of lymphatic drainage into the venous system, which is due to atresia or the insufficiency of an efferent lymphatic channel. A lymphangioma usually occurs in the neck or axillary region. A retroperitoneal lymphangioma is very rare. Herein, a case of a retroperitoneal lymphangioma incidentally found four months after performing pyeloplasty on a child, is reported.