A Case of Xanthogranulomatous Prostatitis Concurrent with a Prostatic Abscess / 대한남성과학회지

Xanthogranulomatous prostatitis is a rare inflammatory condition of the prostate. We report a case of xanthogranulomatous prostatitis. An 82-year-old man presented to our emergency department complaining of gross hematuria. A hard, enlarged, non-tender prostate was palpated on digital rectal examination. Urinalysis showed hematuria and pyuria, and the complete blood count (CBC) revealed leukocytosis. The prostate-specific antigen (PSA) level was elevated at 86.8 ng/ml. Computed tomography (CT) showed an enlarged prostate (volume 100 ml) that protruded into the bladder base. In the left lobe of the prostate, a 1.2x1.1-cm abscess was seen. Transurethral resection of the prostate was done. The pathological diagnosis was xanthogranulomatous prostatitis. The natural progression of the disease is unknown because of the paucity of cases and long-term follow-up reports. To evaluate the pathogenesis and long-term features of progression of this disease, more clinical cases should be collected.

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.

Comparison of Effects of Preoperative Stenting for Obstructing Colorectal Cancers according to the Location of the Obstructing Lesion / 대한소화기학회지

BACKGROUND/AIMS: With the development of self-expanding metallic stents, colonic obstruction can be relieved without the need for surgery. The results of preoperative placement of stents for malignant colorectal obstruction might be different according to the obstructing lesion. The objective of this study was to compare clinical improvement rates and operative results after preoperative placement of stents for malignant colorectal obstruction according to the location of the obstructing lesion. METHODS: This is a retrospective study including 57 patients who underwent self-expanding metallic stent insertion for obstructing resectable colorectal cancers. Patients were classified into three groups according to the location of the lesion as follows: proximal to the sigmoid colon (Group A), sigmoid colon (Group B), and rectum (Group C). RESULTS: The number of patients in A, B, and C groups was 13, 22, and 22, respectively. No significant differences in age, gender, stent type, and accompanying diseases among the three groups were observed. There were no significant differences in stent-related complications, clinical improvement rates, and one-stage resection rates among the three groups. The postoperative complications, the requirement rate of ICU care, the period of ICU stay, postoperative hospital stay, and hospital mortality did not significantly differ among the three groups. CONCLUSIONS: Clinical improvement rates and operative results after successful placement of stents for obstructing resectable colorectal cancers are not different according to the location of the obstructing lesion, suggesting that preoperative stenting for one-stage curative resection is useful, irrespective of the location of lesion.

Effects of Prostate Volume and Lower Urinary Tract Symptoms on Erectile Function / 대한비뇨기과학회지

PURPOSE: To assess whether the prostate volume and two types of lower urinary tract symptoms independently affect erectile function. MATERIALS AND MATHODS: One hundred and fifty two men, who visited outpatient department of Urology and health examination center, were investigated using validated symptom scales, including International Prostatic Symptom Score (IPSS) and International Index of Erectile Function-5 (IIEF-5). The Prostate volume was measured by one examiner using transrectal ultrasonography (TRUS). The correlations between the IIEF-5, emptying and storage symptoms of IPSS, prostate volume and age were subjected to univariate and multivariate analyses. RESULTS: The mean age, prostate volume, and IPSS and IIEF-5 scores were 54.0+/-10.6 years (31-77), 29.1+/-20.4cm(3) (7.9-170.0), and 15.1+/-9.4 (1-35) and 14.6+/-7.1 (1-25), respectively. From the univariate analysis, significant correlations were found between the IPSS and IIEF-5 scores, and the prostate volume and IIEF-5 score, and the age and IIEF-5. When the data were subjected to a multivariate analysis, statistically significant correlations were still observed between the IPSS and IIEF-5 scores and the age and IIEF-5 score, but not between the prostate volume and IIEF-5 score. Furthermore, the storage symptoms of IPSS affected erectile function, with statistical significance, whereas the emptying symptoms did not. CONCLUSIONS: In patients with benign prostatic hyperplasia, lower urinary tract symptoms, especially storage symptoms and age, caused decreases in erectile function. However, the prostate volume itself did not reduce erectile function.

Spermatic Cord Leiomyoma / 대한비뇨기과학회지

A spermatic cord leiomyoma is an uncommon disease. A leiomyoma can originate anywhere, including the genitourinary system, where smooth muscle is present. 70 and 30% of spermatic cord leiomyomas are benign and malignant, respectively. The preoperative diagnosis of a leiomyoma is difficult; the only definite diagnostic method is histological confirmation. A retroperitoneal lipoma probably constitutes the largest group of solid abdominal tumors. However, their etiology is unknown and the symptoms insidious, and recurrences and sarcomatous changes frequently occur. The clinical diagnostic methods are the clinical symptoms, a physical examination and radiological evaluations, such as intravenous urography, computed tomography and angiography, and so on, but an abdominal CT scan provides the most useful information. A fifty-six-old man presented with a five-month history of a suddenly enlarging right inguinal mass. He had undergone a right inguinal hernia operation, with medication for hypertension. Herein, a rare case of a huge retroperitoneal lipoma, with a spermatic cord leiomyoma, is reported.