De Ritis Ratio (Aspartate Transaminase/Alanine Transaminase) as a Significant Prognostic Factor With Upper Urinary Tract Carcinoma Who Underwent Radical Nephroureterectomy and Adjuvant Chemotherapy

Purpose@#To investigate the correlation between preoperative De Ritis ratio (aspartate transaminase [AST]/alanine transaminase [ALT]) and postoperative clinical outcome in patients with upper urinary tract carcinoma (UTUC) who underwent radical nephroureterectomy (RNU) and adjuvant chemotherapy (ACH). @*Materials and Methods@#We respectively analyzed the clinical and pathological data of 102 patients who underwent RNU and ACH for UTUC. Patients were divided into 2 groups, according to the optimal value of AST/ALT ratio. The effect of the AST/ALT ratio was analyzed by the Kaplan-Meier method and Cox regression hazard models for patients’ cancer-specific survival (CSS) and overall survival (OS). @*Results@#Mean survival time was 50.5±41.2 months. Mean age was 61.4±9.7years. Forty-one of the patients (46.5%) were in the high AST/ALT group. According to receiver operating characteristic analysis, the optimal AST/ALT ratio was 1.2. In Kaplan-Meier analyses, the high AST/ALT group showed worse outcomes in OS (p=0.007) and CSS (p=0.011). Using Cox regression models of clinical and pathological parameters to predict OS, high AST/ALT ratio (hazard ratio [HR], 5.428; 95% confidence interval [CI]; 1.803–16.334; p=0.002), pathological T3 (pT3) or higher (HR, 1.464; 95% CI; 1.156-1.857; p=0.002), and to predict CSS, high AST/ALT ratio (HR, 4.417; 95% CI; 1.545–12.632; p=0.005), and pT3 or higher (HR, 1.475; 95% CI; 1.172–1.904; p=0.002) were determined as independent prognostic factors. @*Conclusions@#Pretreatment AST/ALT ratio is a significant independent predictor of CSS and OS in advanced UTUC patients receiving systemic ACH after RNU.

One-Year Outcomes of Mid-urethral Sling Procedures for Stress Urinary Incontinence According to Body Mass Index

PURPOSE: The purpose of our study was to investigate the safety and efficacy of the suprapubic arch (SPARC) sling operation and the transobturator tape (MONARC) sling operation according to body mass index (BMI). MATERIALS AND METHODS: Between January 1, 2004, and July 12, 2009, a retrospective clinical trial was performed with 284 patients treated by the SPARC sling procedure and 49 patients treated by the MONARC sling procedure. The women were classified into 3 groups by BMI according to the WHO Expert Consultation: normal weight (A, BMI 18.5 to 22.9 kg/m2), overweight (B, BMI 23 to 27.5 kg/m2), and obese (C, BMI>27.6 kg/m2). Patients' characteristics and clinical outcomes of the operation were analyzed according to BMI at 1 year after surgery via questionnaires and interviews with the patients about their voiding symptoms and medical records. RESULTS: There were 103 patients in group A, 186 in group B, and 34 in group C. The objective cure rates for groups A, B, and C after the SPARC procedure were 94.4%, 96.7%, and 96.8%, respectively (p=0.321), and the subjective cure rates were 94.4%, 96.1%, and 96.8%, respectively (p=0.222). The objective cure rates for groups A, B, and C after the MONARC procedure were 100.0%, 90.9%, and 66.7%, respectively (p=0.742), and the subjective cure rates were 92.3%, 93.9%, and 66.7%, respectively (p=0.779). The complication rates were similar among the three study groups. CONCLUSIONS: Mid-urethral sling procedures for urinary incontinence result in similar objective and subjective cure rates and postoperative complications irrespective of BMI.

Effect of Prostatitis on Lower Urinary Tract Symptoms: Retrospective Analysis of Prostate Biopsy Tissue

PURPOSE: Most patients, even some urologists, assume that prostate volume is the most important prognostic factor for lower urinary tract symptoms (LUTS). In some cases, however, prostatic inflammation is a more important factor in LUTS than is prostate volume. For this reason, comparison of the impact on LUTS of inflammation and prostate volume is an attractive issue. MATERIALS AND METHODS: From January 2000 to May 2009, 1,065 men aged between 47 and 91 years (who underwent transrectal ultrasound-guided prostate needle biopsy and transurethral prostatectomy) were retrospectively investigated. Components such as age, serum prostate-specific antigen (PSA) level, prostate volume, and the presence of prostatitis were investigated through independent-sample t-tests, chi-square tests, and univariate and multivariate analyses. RESULTS: Chi-square tests between prostatitis, prostate volume, serum PSA, and severe LUTS showed that prostate volume (R=0.173; p=0.041) and prostatitis (R=0.148; p<0.001) were related to LUTS. In particular, for a prostate volume under 50 ml, prostatitis was a stronger risk factor than was prostate volume. Among the multivariate predictors, prostatitis (odds ratio [OR]: 1.945; p<0.001) and prostate volume (OR, 1.029; p<0.001) were found to be aggravating factors of LUTS. CONCLUSIONS: For patients with prostate volume less than 50 ml, prostatitis was found to be a more vulnerable factor for LUTS. For those with prostate volume over 50 ml, on the other hand, the volume itself was a more significant risk factor than was prostatitis. In conclusion, the presence of prostatitis is one of the risk factors for LUTS with increased prostate volume.

Efficacy and Safety of Emergency Ureteroscopic Management of Ureteral Calculi

PURPOSE: To evaluate the efficacy and safety of the ureteroscopic management of ureteral stones immediately after a first colic attack. MATERIALS AND METHODS: We retrospectively analyzed the data of 226 patients with obstructive ureteral stones who underwent ureteroscopy with stone retrieval. The 67 patients in group A underwent ureteroscopy within 48 hours of admission to our emergency department, whereas the 159 patients in group B underwent ureteroscopy more than 48 hours after admission. The chi-square test was used to evaluate and compare stone-free status, auxiliary procedures, and complications and the Kruskal-Wallis and Fisher's exact tests were used to analyze qualitative data. RESULTS: Mean stone sizes in groups A and B were 2.41+/-1.62 mm and 4.11+/-2.64 mm, respectively. No patient experienced a major complication during or after the procedure. Stone-free rates were 89.55% and 89.93%, respectively. CONCLUSIONS: Emergency ureteroscopy in cases of obstructive ureteral stones is both safe and effective and offers the advantages of immediate stone fragmentation and the relief of acute-onset colic pain.

Evaluation of Possible Predictive Variables for the Outcome of Shock Wave Lithotripsy of Renal Stones

PURPOSE: The aim of this study was to evaluate possible predictive variables for the outcome of shock wave lithotripsy (SWL) of renal stones in a single center. MATERIALS AND METHODS: Between March 2008 and March 2010, a retrospective review was performed of 115 patients who underwent SWL for solitary renal stones. The patients' characteristics and stone size, location, skin-to-stone distance (SSD), and Hounsfield units (HU) of stone were reviewed. The impact of the possible predictors on the disintegration of the stones was evaluated by logistic regression analysis. Receiver operator characteristic (ROC) curves were generated to compare the predictive powers of the variables. RESULTS: Seventy-nine patients (68.7%) had successful outcomes, whereas 36 patients (31.3%) had residual stones. Significant differences were found in the mean size and mean HU of the stones (size: 8.34+/-3.58 mm vs. 13.57+/-5.41 mm, p<0.001; HU: 675.29+/-254.34 vs. 1,075.00+/-290.41, p<0.001). In the unadjusted model, age, stone size, and stone density were significant predictors. In the reduced model, stone density and size were significant predictors for the outcome of SWL. The area under the ROC curve (AUC) was significantly higher for stone density and size than for the other parameters, but the AUC between stone density and size did not differ significantly (stone density: 0.874, stone size: 0.827, p=0.388). CONCLUSIONS: Stone density and size were significant predictors of the outcome of SWL for renal stones less than 2.0 cm in diameter. We should consider HU and stone size when making decisions on the treatment of renal stones.

Comparison of Percutaneous Nephrolithotomy Using Pneumatic Lithotripsy (Lithoclast(R)) Alone or in Combination with Ultrasonic Lithotripsy

PURPOSE: Percutaneous nephrolithotomy (PCNL) is the procedure of choice for treating large renal stones. Pneumatic lithotripsy (Lithoclast(R)) is effective regardless of the stones' composition, and ultrasonic lithotripsy allows the aspiration of small debris during lithotripsy. We investigated the efficacy and safety of PCNL via Lithoclast(R) alone or combined with ultrasonic lithotripsy. MATERIALS AND METHODS: Thirty-five (group A) and 39 (group B) patients underwent Lithoclast(R) PCNL and combination therapy, respectively, from May 2001 to March 2010, and the two groups were compared in terms of stone size, location, and composition; operative time; average number of treatments; hospital days; hemoglobin loss; ancillary procedures; rate of device failure; and initial and total stone-free rates. RESULTS: The two groups did not differ significantly in preoperative stone size, location, or composition; the average number of treatments; or the initial and overall stone-free rates. However, combination therapy was associated with a significantly lower operative time (181+/-50 vs. 221+/-65 min, respectively, p=0.004), number of hospital days (11.6+/-3.8 vs. 14.2+/-4.4 days, respectively, p=0.009), and average hemoglobin loss (1.12+/-0.61 vs. 1.39+/-1.02 g/dl, respectively, p=0.013). Transfusions were required in 6 patients (4 and 2 in each group, respectively), but there were no significant complications related to percutaneous access. There were 2 (5.7%) mechanical failures (Lithoclast(R) probe fracture) in the group A and 5 (12.8%) in the group B (2 cases of suction tube obstruction, 3 cases of overheating). CONCLUSIONS: The combination of ultrasonic lithotripter and Lithoclast(R) is more effective than Lithoclast(R) alone because it significantly decreases operative time, hemoglobin loss, and the hospital stay. This may reflect the superior power of Lithoclast(R) and the ability to aspirate the debris during ultrasonic lithotripsy.

Long-Term Results of Immediate Surgical Treatment of Penile Fracture

PURPOSE: Penile fracture is a rare but serious urological condition. Immediate surgical repair is widely accepted as the treatment of choice in penile fracture. The aim of this study is to investigate the long-term outcome of immediate surgical treatment of penile fracture. MATERIALS AND METHODS: This is a retrospective study of 12 men with penile fracture who were treated in the Department of Urology, Sanggyepaik Hospital, Seoul, Korea from January 2000 to June 2005. Diagnosis was made clinically and was confirmed by cavernosography in all our patients. All patients underwent immediate surgical repair, within two days after trauma, using a degloving incision. The long term results of the immediate surgical repair were evaluated using questionnaire on outpatient department visiting or telephoning. RESULTS: The median patient age was 43 years (range, 18 to 57 years). The median follow-up was 32 months (range, 14 to 60 months). Of these patients, 8 (66.7%) patients were injured during sexual intercourse, whereas 4 (33.3%) patients were injured during masturbation. All patients were treated by immediate surgery. All patients reported satisfactory, painless erectile function; two developed penile curvature and one had a penile nodule. CONCLUSIONS: Immediate surgical repair of penile fracture is effective, restores erectile function, and the incidence of complications is low.

Treatment in Pediatric Renal Trauma: A Conservative Management Approach

PURPOSE: The management of pediatric trauma is substantially derived from the results of adult trauma patient. Despite the increasing of pediatric renal trauma, the management of them still remains controversial. The aim of this study is to evaluate our experience with the expectant conservative management of blunt trauma in children. MATERIALS AND METHODS: We retrospectively studied 45 pediatric patients with renal trauma between 1995 and 2007. We reviewed medical records for clinical symptoms, mechanism of injury, assigned grade of renal injury, associated injuries, indication of surgery, and treatment outcomes. We graded renal injuries according to the American Association for the Surgery of Trauma Organ Injury Scale. RESULTS: All patients of grade I, II, III, and IV were managed conservatively at beginning, if the hemodynamic state is stable. Among them, 2 patients of grade IV were done delayed operation. One patient underwent delayed renorrhaphy for persistent anemia and hypotension, and the other patient needed delayed nephrectomy because of persistent fever and worsening abdominal pain with significant urinary extravasation. All patients of grade V were undergone early nephrectomy. CONCLUSIONS: Except for persistent fever with significant extravasation and grade V injury, initial conservative management of blunt renal trauma in children is effective and recommendable at beginning, if the hemodynamic state is stable. Prospective larger randomized controlled trials will be needed.

Staghorn Stones Combined with Transitional Cell Carcinoma of the Renal Pelvis

Longstanding, unrecognized staghorn stones remain a major cause of morbidity in the form of pain, infection, and functional impairment of the affected kidney. Squamous cell carcinoma of the upper urinary tract is associated with stone disease and chronic infection, but the association with transitional cell carcinoma (TCC) has not been proven. We report a case of a 73-year-old man presenting with right flank pain with episodes of total gross hematuria for 1 year. An abdominopelvic computed tomography scan showed decreased parenchymal enhancement and staghorn stones in the right renal pelvis and multiple tiny calyceal stones with severe hydronephrosis. The patient underwent a simple nephrectomy. Histopathologic analysis revealed staghorn stones combined with high-grade papillary TCC of the renal pelvis. The tumor was extended into the peripelvic fat and renal parenchyme (pT3NoMo).

Development of Korean Academy of Medical Sciences Guideline Rating the Physical Impairment; Kidney, Bladder, Urethra, Male and Female Reproductive Systems (Preliminary Report)

For the evaluation of the kidney impairment, serum creatinine concentrations or glomerular filtration rates are mainly used, and the conditions of solitary or transplanted kidney and chronic dialysis are also taken into the considerations. Some symptoms and signs of the chronic renal disability in spite of adequate treatment add one additional grade. For evaluating bladder and urethral impairment, the criteria include voiding symptoms and signs. The patients with urinary diversions have impairment grades depending on the alteration of upper urinary tract function. For penile impairment, the degrees are evaluated using the international index of erectile function, nocturnal penile tumescence and color doppler ultrasonography. For evaluating impairment of other male reproductive organs, functional and anatomical changes of these organs, analysis of the semen or hormones and the state of solitary testis are used as the criteria. For evaluating impairment of female reproductive organs, pregnancy potential, requirement of continuous treatment and the ability of sexual intercourse are used. Also, degree of impairment is modified according to the ages in evaluating female reproductive systems. We have tried to make this evaluation system objective, scientific, and convenient, but still find it leaving much to be desired.

Suprapubic Arch Procedure for the Treatment of Urinary Incontinence in Elderly Female Patients / 대한비뇨기과학회지

PURPOSE: There has been considerable controversy regarding the treatment of urinary incontinence(UI). The aim of our study was to investigate the efficacy and safety of the suprapubic arch(SPARC) procedure for the management of UI in elderly women. MATERIALS AND METHODS: A retrospective analysis was conducted on 301 women who underwent the SPARC procedure for SUI. The patients were divided into two groups: group A( or=65 years). Among these patients, women with mixed urinary incontinence(MUI) were assigned to either group C( or=65 years). The objective and subjective SPARC success rates were evaluated postoperatively. RESULTS: There were 258 patients in group A, 43 patients in group B, 44 patients in group C, and 11 patients in group D. The objective surgical success rates for groups A and B were 97.7% and 95.3%, respectively (p=0.304). The subjective success rates for groups A and B were 97.3% and 95.3%, respectively(p=0.311). Recommendation rates for the SPARC procedure were 93% in group A and 93% in group B(p=0.5). In patients with MUI(groups C and D), the objective success rates were 93.2%(group C) and 81.8%(group D)(p=0.286). The subjective success rates were 93.2% (group C) and 81.8%(group D)(p=0.286). The complication rates were similar between the two study groups: 5.4%(group A) vs 7.0%(group B) (p=0.359). CONCLUSIONS: The SPARC procedure is effective and safe, and it offers a satisfactory success rate in elderly women with UI.

The Effectiveness of Transurethral Resection of the Prostate Combined with High Power Potassium-titanyl-phosphate(KTP) Laser Vaporization for Patients with a Prostate Volume Greater than 45cc / 대한비뇨기과학회지

PURPOSE: We compared the effectiveness of transurethral resection of the prostate(TURP) with the effectiveness of high power potassium-titanyl-phosphate(KTP) laser vaporization combined with TURP in patients with a prostate volume over 45cc. MATERIALS AND METHODS: Between March 2004 and March 2007, we analyzed all the patients with a prostate volume over 45cc and who underwent TURP or KTP laser vaporization combined with TURP for treating symptomatic benign prostatic hyperplasia(BPH). The patients were divided into two groups(Group I: TURP: n=53, Group II: KTP laser vaporization combined with TURP: n=54). The initial evaluation included a digital rectal examination, urinalysis, determining the hemoglobin, electrolyte and prostate-specific antigen(PSA) levels, the International Prostate Symptom Score(IPSS), the quality of life(QoL), the maximum urine flow rate (Qmax), the postvoiding residual urine(PVR), transrectal ultrasonography (TRUS) and urodynamic study. The postoperative hemoglobin and electrolyte levels were checked promptly, and the total operation time, the foley indwelling period and the number of hospital days were recorded afterwards. The IPSS, QoL, Qmax, and PVR were evaluated at 1 and 3 months postoperatively. RESULTS: The baseline characteristics and postoperative outcomes of the two groups were similar. The total blood loss during operation was significantly lower in Group II(p=0.02). CONCLUSIONS: KTP laser vaporization combined with TURP resulted in less blood loss than TURP and it provided a good operation field in those patients who have over 45cc of prostate. Thus, KTP laser vaporization combined with TURP is safer than performing only TURP.

The Relationship of Prostate Volume and the Grade of Prostate Cancer / 대한비뇨기과학회지

PURPOSE: A prostate cancer prevention trial has demonstrated a higher incidence of high-grade prostate cancers(HGPC, Gleason pattern 4 or greater) among men randomized to receive treatment with finasteride. One of the hypotheses was finasteride causes a detection bias with regards to HGPC by reducing the prostate volume. We investigated the relationship between prostate volume and HGPC in prostate biopsy specimens and prostatectomy specimens(RP) from the same patients. MATERIALS AND METHODS: We retrospectively reviewed a cohort of 173 consecutive patients that underwent a radical prostatectomy. We identified risk factors for HGPC on 12 core needle biopsies and then on RP specimens using univariate and multivariate logistic regression analysis. In transrectal ultrasound(TRUS) volume quartiles, the relationship of HGPC and prostate volume was analyzed between the lowest and the highest quartile. RESULTS: By multivariate analysis, risk factors of HGPC were age and prostate-specific antigen(PSA), but TRUS volume was not associated with HGPC in both biopsy and RP specimens. In TRUS volume quartiles, the relationship of HGPC and prostate volume was not significant. In addition, in a comparison of the lowest and the highest quartile, the relationship of HGPC and prostate volume was not significant. CONCLUSIONS: Prostate volume may not be significantly associated with the grade of prostate cancers diagnosed at 12 core(or more) needle biopsies and at a radical prostatectomy.

Comparative Analysis of the Clinicopathological Characteristics of Patients with Prostate Cancer with a Pathological Gleason Score 3+4 versus Gleason Score 4+3 / 대한비뇨기과학회지

PURPOSE: Gleason score(GS) 7 tumors contain patterns 3 and 4 in various proportions. The clinical and pathological characteristics of patients with GS 3+4 and GS 4+3 found during a radical prostatectomy(RP) were retrospectively evaluated. MATERIALS AND METHODS: 124 cases of GS 7 prostate cancer were identified between April 2004 and February 2006. None of these patients had received either preoperative hormonal therapy, including 5alpha-reductase inhibitors, or radiation therapy. After classifying patients with GS 7 tumors into those with GS 4+3 and GS 3+4 tumors, the two groups were compared according to various clinicopathological parameters. RESULTS: In total, 84(67.7%) and 40(32.3%) of patients had final GS of 3+4 and 4+3, respectively. A final GS of 4+3 was associated with a higher pre-biopsy level of prostate-specific antigen(p<0.001) and a higher biopsy Gleason sum(p<0.001). Also, a higher pathological T stage(p=0.005), tertiary Gleason pattern 5(p<0.001), seminal vesicle invasion(p=0.008), bladder neck invasion(p=0.002), angiolymphatic invasion(p=0.008), perineural invasion(p=0.045), positive surgical margins(p=0.038) and larger tumor volumes(p<0.001) were associated with GS of 4+3. CONCLUSIONS: Our results demonstrated that the statistically significant differences exist between GS 3+4 and 4+3 prostate cancers. Thus, GS 7 prostate cancers may be considered heterogeneous in their biological behaviors, and GS 7 prostate cancers with a GS of 4+3 may be considered more aggressive tumors compared to those with a GS of 3+4.

Efficacy of Radical Retropubic Prostatectomy as the Primary Treatment for Patients with Clinically Localized Prostate Cancer and a Serum PSA Level >or=20ng/ml / 대한비뇨기과학회지

PURPOSE: We retrospectively reviewed the clinicopathological characteristics ofpatients who underwent radical retropubic prostatectomy(RRP), and these patients had clinically localized prostate cancer and a preoperative serum prostate-specific antigen(PSA) level >or=20ng/ml. MATERIALS AND METHODS: Among the 266 patients who underwent RRP without any prior neoadjuvant therapy between March 2004 and March 2006, 29 patients had clinically localized prostate cancer and a preoperative serum PSA level >or=20ng/ml. We analyzed several clinicopathologic factors that might predict organ-confined disease. RESULTS: Of the 29 patients, 11(37.9%) had organ-confined cancer. The level of serum PSA, the PSA density(PSAD), the Gleason score(3+4 or less), the prostate volume, tumor volume and the tumor percentage were significant factors for predicting organ-confined cancer(por=20ng/ml, radical prostatectomy can be considered as the primary treatment for some cases that have a relatively lower PSA and PSAD, a biopsy Gleason score of 3+4 or less and low predictive volume of the tumor from the biopsy results.

Efficacy of Radical Retropubic Prostatectomy in Patients with Clinically Localized Prostate Cancer and a Biopsy Gleason Score of 8 or Higher / 대한비뇨기과학회지

PURPOSE: We retrospectively reviewed clinicopathological characteristics in patients who underwent radical retropubic prostatectomy (RRP) with clinically localized prostate cancer and a biopsy Gleason score of 8 or higher. MATERIALS AND METHODS: Among 266 patients who underwent RRP without prior any neoadjuvant therapy between March 2004 and March 2006, 29 patients had clinically localized prostate cancer and a biopsy Gleason score of 8 or higher. We analyzed several clinicopathologic factors that predict organ-confined disease, and also investigated the impact on postoperative changes of the biopsy Gleason score. RESULTS: Of 29 patients, 12 (41.4%) had organ-confined cancer. Serum prostate-specific antigen (PSA), prostate-specific antigen density (PSAD), tumor volume, and tumor percentage were significant factors for predicting organ-confined cancer (p<0.05). The number of the positive core, percentage of the positive core, sum of the tumor length of the positive core, tumor percentage of total core length, and tumor percentage of the positive core lngth were also significantly higher in the group with an extraprostatic extension compared to the organ-confined cancer group (p<0.05). Of 29 patients, 14 (48.3%) were downgraded to a Gleason score of 7 or less and had a higher chance (64.3%; p=0.016) of experiencing organ- confined disease than those that remained at Gleason scores of 8-10. CONCLUSIONS: Among patients with clinical localized prostate cancer and a biopsy Gleason score of 8 or higher, radical prostatectomy can be considered for primary treatment in some cases with low PSA and PSAD and low predictive volume of the tumor from biopsy results.

Predictive Factor to Regain Erectile Function after Bilateral Nerve Sparing Radical Retropubic Prostatectomy in Korean Men / 대한비뇨기과학회지

PURPOSE: To investigate the significance of various preoperative factors with regard to postoperative erectile function in Korean men undergoing a bilateral nerve sparing radical retropubic prostatectomy (BNSRRP), using the validated Korean version of the International Index of Erectile Function (IIEF-5). MATERIALS AND METHODS: Between March 2004 and March 2005, 83 consecutive patients, who underwent a BNSRRP, with preoperative IIEF-5 scores greater than 13, were retrospectively analyzed. All patients were asked to answer the IIEF-5 questionnaire during the preoperative period and 1 year postoperatively. The responses were stratified on the basis of the clinical characteristics and the preoperative predictive factors for regaining a normal erectile function (NEF: IIEF-5 score> or =18) investigated. RESULTS: At the baseline, 56 patients (67.5%) had NEF. At the 1 year follow-up after the BNSRRP, 58 (70.5%) patients reported a return of a sufficient erection for sexual intercourse, with or without oral phosphodiesterase type 5 (PDE5) inhibitors, but 37 (44.6%) patients regained a NEF. Of these 37 patients, 15 (40.5%) were able to spontaneously regain a NEF, but 22 (59.5%) needed the help of oral PDE5 inhibitors. When the patients were divided according to postoperative NEF and erectile dysfunction (ED: 14< or =IIEF-5 score<18), the preoperative IIEF-5 score was the only significant factor for predicting postoperative NEF after a BNSRRP in univariate (p=0.018) and multivariate analyses [p=0.030, odds ratio: 3.482, 95% confidence interval (CI): 1.125-10.774]. Changes in the IIEF-5 score after a BNSRRP significantly decreased for those with preoperative NEF compared with ED ( 6.1+/-5.24 vs. 9.1+/-7.34, p=0.039). CONCLUSIONS: Our data indicated that preoperative erectile function, as assessed using the IIEF-5 questionnaire, was an independent variable for predicting the recovery of erectile function after a BNSRRP when performed in Korean men.