Correlation between Serum Total Testosterone and the AMS and IIEF Questionnaires in Patients with Erectile Dysfunction with Testosterone Deficiency Syndrome

PURPOSE: This study was conducted to investigate the relationship between serum total testosterone levels and scores on the Aging Male's Symptom (AMS) scale and the International Index of Erectile Function (IIEF) in men with erectile dysfunction with testosterone deficiency syndrome (TDS). MATERIALS AND METHODS: From January 2005 to July 2008, 134 patients who complained of sexual dysfunction such as erectile dysfunction or decreased libido as the main symptoms of TDS with serum total testosterone levels less than 3.5 ng/ml were evaluated by independent t-test and linear regression analysis, respectively. Patients with treated hypogonadism within 6 months, with a history of taking a PDE5 inhibitor or an antidepressant for a depressive disorder, or who had metabolic syndrome were excluded from this study. RESULTS: The AMS scale and its 3 subdomain scores were not significantly correlated with the total testosterone level. By contrast, the total IIEF score and the score of each IIEF domain except sexual desire showed a weakly significantly positive correlation with serum total testosterone. CONCLUSIONS: In TDS patients with erectile dysfunction, there was a low relationship between serum total testosterone levels and the AMS scale and a weakly positive correlation between total testosterone levels and all IIEF domains except sexual desire. There was a low relationship between the AMS scale, the sexual desire domain score of the IIEF, and total testosterone. We should understand these limitations when evaluating patients with erectile dysfunction with TDS. New scales should be developed for the evaluation of erectile dysfunction in these patients.

Calculi in a Female Urethral Diverticulum / 대한배뇨장애요실금학회지

Urinary stones are rarely seen in the urethra and are usually encountered in men with urethral stricture or diverticulum. The case of a 52-year-old woman presented, who consulted for weak stream associated with repeated urinary infections. The diverticulum was approached via vaginal route and the extraction was successful. The patient has been well, with no dysuria, dyspareunia, incontinence for 3-month follow-ups.

Clinical Implications of Residual Urine in Korean Benign Prostatic Hyperplasia (BPH) Patients: A Prognostic Factor for BPH-Related Clinical Events / 대한배뇨장애요실금학회지

PURPOSE: Although post-void residual urine (PVR) is frequently utilized clinically in patients with benign prostatic hyperplasia (BPH), mainly because of its procedural simplicity, its role as a clinical prognostic factor, predictive of treatment goals, is still under much dispute. We investigated the predictive value of PVR for BPH-related clinical events including surgery, acute urinary retention (AUR), and admission following urinary tract infection (UTI). METHODS: From January to June of 2006, patients over 50 years of age who were diagnosed with BPH for the first time at the outpatient clinic and were then treated for at least 3 years with medications were enrolled in this study. The variables of patients who underwent surgical intervention for BPH, had occurrences of AUR, or required admission due to UTI (Group 1, n=43) were compared with those of patients who were maintained with medications only (Group 2, n=266). RESULTS: Group 1 had a significantly higher PVR, more severe symptoms, and a larger prostate at the time of the initial diagnosis in both the univariate and the multivariate analysis. In the 39 patients who underwent BPH-related surgery, although there was a significant change in Qmax at the time of surgery (mean, 13.1 months), PVR and the symptom score remained unchanged compared with the initial evaluation. In the receiver-operating characteristic curve analysis, the area under the curve of Group 1 was in the order of prostate volume (0.834), PVR (0.712), and symptom score (0.621). When redivided by arbitrarily selected PVR cutoffs of 50 mL, 100 mL, and 150 mL, the relative risk of clinical BPH progression was measured as 3.93, 2.61, and 2.11. CONCLUSIONS: These data indicate that, in the symptomatic Korean population, increased PVR at baseline is a significant indicator of BPH-related clinical events along with increased symptom score or prostate volume.

Risk Factors of the Infectious Complications and Causative Microorganisms after Transrectal Ultrasound-guided Prostate Needle Biopsy / 대한남성과학회지

PURPOSE: Transrectal ultrasound-guided prostate needle biopsy (TRUS-PBx) is the standard procedure to diagnose prostate cancer. We evaluated the incidence and risk factors of infectious complications, the species cultured and rates of resistance for antibiotics of microorganism in infectious complications after TRUS-PBx. MATERIALS AND METHODS: We retrospectively evaluated the medical records of 742 patients who underwent TRUS-PBx from January 2004 to May 2007. All patients were treated with intravenous ciprofloxacin and oral ciprofloxacin for 1 week after discharge. Patients who presented infectious complications were performed chest x-ray, blood analysis, urine analysis and culture studies. RESULTS: Among 742 patients, 15 patients (2.0%) developed infectious complications. There were no significant differences between the complication and non-complications groups in age, PSA, prostate volume, nodule, hypoechoic lesion on transrectal sonography and underlying medical diseases. Twelve cases were performed in outpatient department and 3 cases were in operation room and that suggests high frequency of infectious complication when transrectal prostate biopsy is performed in outpatient department (p=0.007). Six kinds of microorganisms were cultivated in 12 patients (1.9%). E. coli (7/12) was most common. Extended-spectrum beta-lactamase suggesting nosocomial infection was positive in 3 cases of outpatient department. On logistic regression analysis, urethral catheter indwelling was a significant risk factor increasing infectious complications. CONCLUSIONS: After TRUS-PBx, the rate of severe infectious complications and nosocomial infections were more frequent in outpatient department. And urethral catheter indwelling significantly increased infectious complication rate. So we should sublate the urethral catheter and keep in mind the aseptic technique at outpatient department.