Could Serum Level of Prostate-specific Antigen after High Energy Transurethral Microwave Thermotherapy for Benign Prostatic Hyperplasia Predict and Represent Efficacy of the Treatment? / 대한비뇨기과학회지

PURPOSE: To investigate serum level of prostate-specific antigen(PSA) after high energy transurethral microwave thermotherapy(HE-TUMT) for benign prostatic hyperplasia(BPH) could predict and represent efficacy of the treatment. MATERIALS AND METHODS: In patients with BPH who underwent HE-TUMT using Prostatron with Prostasoft 2.5(EDAP-Technomed, France), serum levels of PSA at 7 days(n=37), 3 months(n=40), and 6 months(n=26) after the treatment were compared with Madsen and international prostate symptom score(MSS and IPSS), maximal and average uroflow rate(MFR and AFR), and postvoiding residual urine(PVR) of 6 months after the treatment. RESULTS: The subjective(MSS and IPSS) and objective(PFR, AFR, and PVR) parameters were significantly(p<0.05) improved at 6 months after the treatment. The postoperative serum level of PSA showed a 643.2% increase(0.5-2870%) at 7 days(more than 500% increase in 18 men and less than 500% in 19), a 34.9% increase(79% decrease?303% increase) at 3 months, and a 8.5% decrease(74.7% decrease?53.7% increase). There was no significant difference in the both subjective and objective parameters at 6 months between the two groups; more and less than 500% increase on the 7th day, and among the three groups; more than 20% decrease(n=14), less than 20% decrease or increase(n=13), and more than 20% increase(n=13). However, improvement of MFR and AFR was significantly(p<0.05) higher at 6 months in 20% decrease group(n=9) compared with that of the remainder(n=17) although symptom scores and PVR not significantly different. CONCLUSIONS: Serum level of PSA at 7 days and 3 months after HE-TUMT could not predict efficacy of the treatment at 6 months. However, the extent of decrease in PSA level may represent relieved bladder outlet obstruction resulting from reduction of prostate volume.

Stone Localization by Use of Intravenous Contrast Material during in-situ SWL of Ureteral Stones / 대한비뇨기과학회지

PURPOSE: We studied the usefullness of intravenous administration of contrast material to facilitate in situ shock wave lithotripsy(SWL) of ureteral stones in cases that stone localization was difficult as radioluscent, less radiodense, small stone, and interference with visualization by bone or intestinal gas. MATERIALS AND METHODS: From March 1992 to June 1997 we treated 831 patients with ureteral stone by in-situ SWL using EDAP-LT02 piezoelectric lithotriptor which utilizes ultrasono and fluroscopy for stone localization. Among 831 patients, intravenous contrast material were used in 53 cases to facilitate stone localization during SWL treatments. To evaluate the effectiveness of stone localization by the assistance of intravenous contrast media we compared success rate, storages, treatment sessions, durations, and side effects of two groups with or without intravenous contrast material, based on the location and the size of stones. RESULTS: Among 53 patients, stone was localized without ureteral catheterization in 5.7%(25/437) of upper ureteral stone, 18.2%(18/99) of mid-ureteral stone, and 3.4%(10/295) of lower ureteral stone after administration of intravenous contrast material. There were no significant differences in success rate, storages, treatment sessions, and durations(p>0.05). There were no significant complications except dye hypersensitivity in two patients, who were managed conservatively. CONCLUSIONS: The administration of intravenous contrast material during SWL allows effective localization of ureteral stones that otherwise could not be imaged adequately without ureteral catheterization. We believe that the use of intravenous contrast material for localization of ureteral stone in SWL have the benefits of inexpensiveness, noninvasiveness, and painlessness.

Intracavernosal Self-Injection Therapy for the Patients with Erectile Dysfunction: Comparison of Erectile Response and Complications between Bimix and Trimix Solution / 대한비뇨기과학회지

PURPOSE: To compare the efficacy of Bimix solution (27.3 mg/ml papaverine and 0.9 mg/ml phentolamine) versus Trimix solution (18.8 mg/ml papaverine, 0.6 mg/ml phentolamine and 6.3ug/ml prostaglandin El) in terms of erectile response and complications. MATERIALS AND METHODS: We comparatively analyzed the erectile response and the incidence of pain, prolonged erection (>4 hours), and corporal fibrosis of either medication in the 155 impotent patients who used Bimix solution for intracavernous pharmacotherapy (mean duration: 15 months) and thereafter used Trimix solution (mean 12 months). RESULTS: Erectile response to Trimix solution was significantly better than Bimix solution (p<0.01). The mean dose of Bimix solution was higher than Trimix solution (0.43 ml. vs. 0.34 ml, p<0.05). The severe pain enough for impediment to ntercourse occurred in 6.5% of the Trimix group, while no patient of the Bimix group experienced (p<0.01). The corporal fibrosis was noted in 8.4% of the Trimix group and 16.1% of the Bimix group. However, there was no significant difference between the two groups (p=0.08). The incidence of prolonged erection was significantly lower (p<0.05) in the Trimix group (2.6%) than in the Bimix group (12.3%). A total of 139 patients (89.7%) finally selected Trimix solution. CONCLUSIONS: The Trimix solution was more effective and safer than Bimix solution for the treatment of erectile dysfunction.