Socioeconomic Costs of Overactive Bladder and Stress Urinary Incontinence in Korea / 대한배뇨장애요실금학회지

PURPOSE: We quantified and described the economic burden of overactive bladder and stress urinary incontinence in Korea. We calculated direct costs by identifying public and private data sources that contain population-based data on resource utilization by patients with stress urinary incontinence and overactive bladder. METHODS: For estimating indirect costs (productivity loss), the human capital approach was applied. Data were collected from several institutes, including the Health Insurance Review Agency. RESULTS: The estimated total economic cost in treating overactive bladder was 117 billion Korean Won (KRW, the currency of South Koea) in 2006 and 145 billion KRW in 2007. The estimated total cost in treating stress urinary incontinence was 122 billion KRW in 2006 and 59 billion KRW in 2007. CONCLUSIONS: By quantifying the total economic costs of overactive bladder and stress urinary incontinence, this study provides an important perspective in Korea. Because the average age of the Korean population is rapidly increasing, this study provides important information on the direct and indirect costs of overactive bladder and stress urinary incontinence for an aging society.

Neuroanatomical Study of Periprostatic Nerve Distributions Using Human Cadaver Prostate

We investigated the distribution and navigation of periprostatic nerve fibers and constructed a 3-dimensional model of nerve distribution. A total of 5 cadaver specimens were serially sectioned in a transverse direction with 0.5 cm intervals. Hematoxylineosin staining and immunohistochemical staining were then performed on whole-mount sections. Three representative slides from the base, mid-part, and apex of each prostate were subsequently divided into 4 sectors: two lateral, one ventral, and one dorsal (rectal) part. The number of nerve fibers, the distance from nerve fiber to prostate capsule, and the nerve fiber diameters were analyzed on each sector from the representative slides by microscopy. Periprostatic nerve fibers revealed a relatively even distribution in both lateral and dorsal parts of the prostate. There was no difference in the distances from the prostate capsule to nerve fibers. Nerve fibers in the ventral area were also thinner as compared to other areas. In conclusion, periprostatic nerve fibers were observed to be distributed evenly in the periprostatic area, with the exception of the ventral area. As the number of nerve fibers on the ventral part is fewer in comparison, an excessive high up incision is insignificant during the nerve-sparing radical prostatectomy.

Paraurethral Cyst Discovered in Misdiagnosed Urethral Diverticulum of an Adult Female / 대한비뇨기과학회지

A paraurethral cyst is a rare congenital or acquired abnormality in females that is characterized by a round, yellow or orange-colored cystic mass on either side of the urethral meatus. We report a patient who presented with frequent, postvoiding dribbling. The important differential diagnostic considerations in infants and adults are an ectopic ureterocele, urethral diverticulum, cystocele and paraurethral tumors. Intravenous pyelography, voiding cystourethrogram, cystourethroscopy are essential for differentiating these lesions. This case of a paraurethral cyst was treated with complete excision.

The Effect of the Serum Cholesterol Level on the Clinicopathologic Characteristics of Prostate Cancer / 대한비뇨기과학회지

PURPOSE: We assessed the relationship between the serum cholesterol level and the clinicopathologic characteristics of prostate cancer patients who had undergone a radical retropubic prostatectomy. MATERIALS AND METHODS: We enrolled 70 prostate cancer patients who had relevant data available for this study. All of the patients had their serum cholesterol level checked at least three times for a month preoperatively. We divided them into three groups according to: 1) a mean preoperative cholesterol level less than 180mg/dl, 2) between 180mg/dl and 200mg/dl, and 3) more than 200mg/dl. The serum cholesterol levels and other clinicopathologic characteristics were then compared and analyzed. The clinicopathologic findings included the pathologic T stage, Gleason score, prostate-specific antigen(PSA) and the other pathologic findings that included perineural invasion, vascular invasion, lymphatic invasion and capsular invasion. All the data was retrospectively collected from the patients' medical records. RESULTS: The mean cholesterol level was 181.1+/-4.1mg/dl. There was a statistically significant difference in the incidence of perineural invasion among these three groups according to the cholesterol level, with linear correlation(p=0.015). This correlation was more significant among the T2 patients or the patients with a total PSA value of 4ng/dl to 10ng/dl. Furthermore, the preoperative serum cholesterol level was significantly affected by the pathologic finding of perineural invasion(p=0.024, odd ratio=3.565). CONCLUSIONS: There was a direct correlation between the increase incidence of perineural invasion with the increased preoperative serum cholesterol level for prostate cancer patients who had undergone radical prostatectomy.