The Influence of Treatment-emergent Adverse Reactions on Selecting Phosphodiesterase Type 5 Inhibitors / 대한비뇨기과학회지

PURPOSE: This study was conducted to determine how treatment-emergent adverse reactions (ARs) of each of the phosphodiesterase type 5 inhibitors (PDE5Is) influenced the patient when selecting a drug. MATERIALS AND METHODS: For our study, we recruited a total of 123 patients who were suffering with erectile dysfunction and they randomly took 3 different PDE5Is (sildenafil, tadalnafil, and vardenafil), at least 4 times each and then had successful intercourse after using each PDE5I. We investigated the influence of the treatment-emergent ARs on the patients selecting a PDE5I. RESULTS: Sixty eight out of 123 patients (55.3%) showed more than one AR. Five patients (4.1%) did not select any of the PDE5Is due to their treatment-emergent ARs, and 15 patients (12.2%) did not select the PDE5Is due to the severity and/or duration of the AR. Facial flushing was the most common cause of non-selection; this was followed by headache. Fifteen patients (12.2%) selected one specific PDE5I because they experienced a less severe AR with that drug. The severity and duration of the ARs increased in the group of elderly men and the group of men who took larger doses of the drug. CONCLUSIONS: ARs had an important effect on the patients' selection of a PDE5I, although the impact was quite low compared with its overall occurrence rate. The severity and/or duration of the AR were so variable, depending on the patient, that no PDE5I was better than the others in terms of attributing the selection of a PDE5I to its reduced AR.

The Effects of Sex Steroids on the Maxi-K Channel Activity of Human Vas Deferens / 대한비뇨기과학회지

Purpose: We investigated the effects of sex steroids on the maxi-K channel activities of the single smooth muscle cells of the human vas deferens. Materials and Methods: Human vas deferens cells were isolated using proteolytic enzymes (collagense and papain), and then they were employed for an electrophysiological study with using the inside-out patch clamp configurations. The intracellular calcium concentrations were adjusted between 0.1mum to 1mum, and the membrane potentials were depolarized. Results: The maxi-K channels were identified by their single channel conductance and calcium dependency. The application of 10ng/dl estrogen induced a significant increment of the maxi-K channel activities. The effects were not affected by the change of the intracellular calcium concentration. The other sex steroids (progesterone and testosterone) rarely affected the maxi-K channel activities. Conclusions: Estrogen has stimulatory effects on the maxi-K channel activity of human vas deferens. This suggests that estrogen may relax the human vas deferens via maxi-K channel activation.

Replantation of a Completely Amputated Penis, which Occurred in a Child during Circumcision / 대한비뇨기과학회지

Penile amputation during circumcision is a quite rare event. So far, replantation generally requires microsurgical techniques. Yet herein, we report on the successful replantation of a completely amputated penis; the amputation occurred during the circumcision of a 9-year-old boy, and we did not use microsurgical technique for the replantation.

Comparison of Metabolic Risk Factors in Patients with 1st Episode Urolithiasis Stratified according to Age / 대한비뇨기과학회지

PURPOSE: The metabolic parameters were compared with the 1st episode calcium oxalate urolithiasis in 3 age groups and according to gender. MATERIALS AND METHODS: A total of 167 patients (114 male and 53 female) with their 1st episode calcium oxalate urolithiasis, including 21 patients aged <30 years (group A), 99 aged 30-59 years (group B) and 47 aged 60 years (group C), were investigated by metabolic evaluation. The items of metabolic change evaluated were the low 24-hour urine volume (<1,500cc), hypercalciuria, hyperoxaluria, hyperuricosuria and hypocitraturia. RESULTS: A low 24-hour urine volume was more common in group A (46.6%) than groups B (24.2%) or C (23.4%). Hypercalciuria was more common in group B (16.2%, p<0.05) than groups A (0%) or C (2.1%). There were 14.3% hyperoxaluric patients in group A and 34.3% in group B, which was statistically significant (p<0.05). Of the 167 patients, 101 had hypocitraturia, but seemed to show no statistically significant difference between the groups. Hyperuricosuria was more common in group A (33.3%) than groups B (11.1) or C (2.1%). CONCLUSIONS: In patients with 1st episode calcium oxalate urolithiasis, hypocitraturia is the most common risk factor, regardless of age or gender. Hypercalciuria was more common in group B (age 30-59) than the other age groups, while low urine output and hyperuricosuria were more common in group A (age<30). Considering the significant differences in the various risk factors between the different age groups, the specific prevention and treatment of certain risk factors for calculus formations according to age and gender seem necessary.