Apolipoprotein E Polymorphism and Impotence / 대한비뇨기과학회지

PURPOSE: Apolipoprotein E (Apo E) is composed of 299 amino acids, and is classified into three subtypes (E2, E3, E4), which respectively have influences on serum lipid levels. Arteriogenic erectile dysfunction (AED) is related to hyperlipidemia, hypertension, DM and traumas of the pelvis and perineum. Therefore, we evaluated the frequency and relationship of an apolipoprotein E gene in patients with erectile dysfunction. MATERIALS AND METHODS: 202 patients, with no history of either trauma in the pelvis or perineum, and radiation therapy, were selected from patients with erectile dysfunction. History taking, physical examination, Apo E genotyping and penile Doppler ultrasonography were performed. Serum cholesterol, triglyceride, high and low density lipoprotein (HDL and LDL), and apolipoprotein A and B were also measured. RESULTS: Apo E genotypes were E2/2, E2/3, E3/3, E2/4, E3/4 and E4/4, with distributions of 0.5, 11.7, 70.4, 0.5, 15.8 and 1.0%, respectively. As a result of penile Doppler ultrasonography, 112 patients turned out to have an AED. In the AED group, the serum triglyceride increased significantly (p<0.05), but there were no differences in the serum cholesterol, HDL, LDL or the apolipoprotein A and B. The distributions of apo E genotypes E2/3, E3/3 and E3/4 were 13.9, 68.6 and 17.6%, respectively, in the AED group. The serum triglyceride (TG) was significantly higher in the E3/4 than the E2/3 or E3/3 genotypes. CONCLUSIONS: AED is related to age, smoking, hypertension, DM and high TG, and the Apo E genotype of E3/4, with a high level of TG. However, an Apo E gene is, generally, not considered a diagnostic tool of erectile dysfunction. In the future, it should be clarified if the Apo E gene can be used as diagnostic tool for AED.

A Renal Malignant Fibrous Histiocytoma / 대한비뇨기과학회지

Malignant fibrous histiocytoma is a sarcoma composed of malignant spindle and pleomorphic cells, which is characterized histologically by a radiating cartwheel or interwoven mat-like arrangement. Primary involvement of the retroperitoneum or kidney is rare. We report a case of malignant fibrous histiocytoma in a 57-year-old male who was managed by surgery, radiotherapy and chemotherapy.

Cutaneous Fistula in Patient with Augmentation Penoplasty / 대한남성과학회지

A man's self-esteem can be influenced by his external genitalia. If a man perceives his penis as inadequate size, whether real or imagined, such feelings invade his sexual activities. Most patients seek increased thickness and length to improve appearance during intercourse. Many men want to enlarge their penes despite of normal function or above average size. Dermal fat graft is extracted from a patient and penile augmentation with it is highly satisfactory since the amount of dermal fat graft absorption to the body itself is pretty low and rare cases of complication, and its natural appearance of penis without physical comfort. The most common complications after dermal grafting are penile skin edema and erythema. Sebaceous glands usually disappear within 2 weeks and hair follicles generally within 2 months. We report our experience with the evaluation and management of patient who present with uncommon penile cutaneous fistula after penile augmentation with dermal fat grafting.

Double-Blind Study of Intrarectal Administration of Anesthetic Agent for Pain Control during Transrectal Prostatic Biopsy / 대한남성과학회지

PURPOSE: We evaluated the safety and efficacy of intrarectal administration of anesthetic agent for transrectal prostate biopsy. MATERIALS AND METHODS: For a double-blind prospective trial, 100 men undergoing transrectal prostate biopsy were randomized into three groups using an established list. In the control group (n=36), 40mL of normal saline was administered transrectally 10 min before the procedure. The lidocaine group (n=31) and the benzocaine group (n=33) were give 40 mL of 1% lidocaine and 0.3% benzocaine, respectively. Patients were asked to score the severity of the pain expected before and after the biopsy procedure using a self-administered verbal rating scale. Pain was assessed using a 10-point linear visual analog scale. RESULTS: The median pain score expected before the transrectal prostate biopsy was 6.7+/-0.3, 7.1+/-0.2, and 6.7+/-0.3 in the control, lidocaine, and benzocaine group, respectively. The median pain score during the biopsy was 6.1+/-0.3, 5.8+/-0.3 (P<0.05), and 5.9+/-0.4 in the control, lidocaine, and benzocaine group, respectively. Ninety seven percent of the control group, 100% of the lidocaine group, and 91% of the benzocaine group complained of severe and bothersome pain, with a score of 5 or greater during the biopsy. No adverse events were noted. CONCLUSIONS: Intrarectal administration of anesthetic agent is a simple, safe, and efficacious method of providing satisfactory anesthesia in patients undergoing transrectal prostate biopsy. We recommend 1% lidocaine solution in the patients to perform transrectal prostatic biopsy.

Capillary Hemangioma of the Testis / 대한비뇨기과학회지

Capillary hemangioma of the testis is extremely rare. Because it is difficult to differentiate from malignant testicular tumors clinically and radiologically, radical orchiectomy is usually performed. Although the fate of hemangiomas of the testis left untreated is unknown, there is no evidence that hemangiomas become malignant. We report a case of a 2-year-old child with capillary hemangioma of the testis which was diagnosed as a malignant tumor preoperatively.