A Short-term Comparative Study on Efficacy and Safety of Standard Transurethral Resection and High Power (80W) Potassium-Titanyl-Phosphate Laser Vaporization of the Prostate / 대한비뇨기과학회지

PURPOSE: Transurethral resection of the prostate (TURP) is the gold standard treatment for symptomatic benign prostate hyperplasia, but significant complications are associated with this procedure. The aim of this study was to compare the standard TURP with the high power (80W) potassium-titanyl-phosphate laser (KTP/532; Greenlights PVTM laser system; Laserscope, San Jose, USA) to elucidate the efficacy and safety of laser treatment. MATERIALS AND METHODS: We performed comparative trials of 40 patients suffering with symptomatic bladder outlet obstruction due to benign prostatic hyperplasia from February 2005 to June 2005. Twenty patients were treated with TURP (Group I) and 20 patients were treated with KTP (Group II). All patients were assessed preoperatively and at an interval of 3 months postoperatively based on the International Prostate Symptom Score (IPSS), the quality of life (QoL) index, changes in maximum urinary flow rate (Qmax), and the postvoid residual urine (ml). The safety parameters we evaluated included the operative time (minutes), the postoperative catheterization time (day) and the blood loss (ml). The Kolmogorov- Smirnov & Shapiro-Wilk test, Student's t-test, Student's t-test (paired), and Fisher's Exact test were performed for statistical analysis. RESULTS: The mean age of each group was 68.9+/-9.9 years (group 1) and 63.9+/-9.7 years (group II), and the prostate weight was 49.5+/-15.4cc and 45.0+/-17.3cc, respectively. The mean operation time was shorter for group II (27.7+/-13.6min) than for group I (48.1+/-22.6min) (p<0.05). The mean catheterization time was 5.6+/-1.82 and 1.36+/-1.64 days, respectively, (p<0.001). The blood loss was lower in group II (11.7+/-11.4ml) than in group I (181.9+/-168.17ml, respectively) (p<0.001). CONCLUSIONS: In this preliminary short-term study, KTP Laser enucleation of the prostate was shown to be an effective alternative for treating benign prostate hyperplasia as compared with standard TURP.

Efficacy of alpha-Blocker and Finasteride Combination Therapy for Benign a Prostatic Hyperplasia with a Prostate Volume Less than 40 Grams / 대한비뇨기과학회지

PURPOSE: The aim of this study was to evaluate the efficacy of a combination drug therapy (tamsulosin plus finasteride) for benign prostatic hyperplasia, with a small prostate volume of less than 40 grams. MATERIALS AND METHODS: One hundred and twenty-three patients, with symptomatic benign prostatic hyperplasia of less than 40 grams, were analysed. Group 1 (n=67) had been treated with a combination of finasteride (5mg/day) and tamsulosin (0.2mg/ day), and Group 2 (n=56) with tamsulosin only (0.2mg/day) over a 12 month period. The patients were periodically assessed by IPSS (international prostate symptom score), uroflowmetry and residual urine, during the treatment period. RESULTS: The mean changes in the total symptom score, obstructive and irritative symptom score for group 1 and group 2 at 1 year were -7.21+/-7.44 (39.86%), -4.79+/-5.07 (45.02%) and -2.42+/-3.25 (48.11%), and -7.39+/-9.98 (43.06%), -4.82+/-6.91 (45.21%) and -2.39+/-4.00 (37.82%) points, respectively. The mean changes in the peak urinary-flow rates and postvoid residual urine for group 1 and group 2 at 1 year were 2.07+/-5.42 (16.65%)ml/s and -31.58+/-60.99 (56.47%)ml, and 2.38+/-6.57 (16.53%)ml/s and -34.78+/-86.77 (50.24%)ml, respectively. The effects of the combination of finasteride and tamsulosin were no greater than the tamsulosin monotherapy (p>0.01). CONCLUSIONS: A combination of finasteride and tamsulosin is no more effective than tamsulosin alone, in patients with benign prostatic hyperplasia, with a prostate volume of less than 40 grams.

Effect of Percutaneous Aspiration with Sclerotherapy of the Simple Renal Cyst / 대한비뇨기과학회지

PURPOSE: Recently, a percutaneous aspiration with sclerotherapy has become the treatment of choice for the symptomatic, large, and simple renal cyst because of its minimal invasiveness and high effectiveness. The recurrence rate of a percutaneous aspiration only, was reported to range from 30 to 70%. This study was performed to evaluate the effects of percutaneous aspiration with sclerotherapy. MATERIALS AND METHODS: The results of the treatment in 36 cases of simple renal cysts from October 1993 to December 1999 were evaluated. The symptoms associated with simple renal cysts were: flank pain or discomfort (50%), none (47.2%) and a palpable mass (2.8%). The simple renal cysts were treated with a percutaneous aspiration only in 6 cases, a percutaneous aspiration with sclerotherapy using 99% ethanol in 21 cases or a 10% minocycline solution in 9 cases. All patients were followed up by ultrasound for 6 to 56 months (mean 18 months). RESULTS: Complete collapse, and partial collapse rate of the renal cysts were 1/6 (16.7%), 2/6 (33.3%) in the aspiration only group, 6/21 (28.6%), 14/21 (66.7%) in the 99% ethanol group and 3/9 (33.3%), 4/9 (44.4%) in the 10% minocycline solution group, respectively. CONCLUSIONS: Therefore, a percutaneous aspiration with sclerotherapy using either 99% ethanol or 10% minocycline solution appears to be an effective way to the prevent re-accumulation of cystic fluid. However, the success rates in the percutaneous aspiration with sclerotherapy using 99% ethanol and 10% minocycline solution were not significantly different.

Sertoli Cell Tumor of the Testis in a Young Child / 대한비뇨기과학회지

Prepubertal Sertoli cell tumor of testis is very rare and most of them are benign. The choice of treatment is radical orchiectomy but careful follow-up for possible retro peritoneal spread is appropriate. We report a rare case of Sertoli cell tumor of testis in a 8-year-old boy. His chief complaint was a painless left testicular swelling from birth. Serum levels of tumor markers were within normal limits. Radical orchiectomy was performed, and cut surface of testis was yellowish and was completely displaced by lobulated tumor mass. Postoperative CT and chest x-ray showed no evidence of metastasis. The patient is alive without evidence of disease for 8 months postopera tively.

Epidemiologic Study of the Male Erectile Dysfunction with Risk Factors in Rural Area / 대한남성과학회지

PURPOSE: The interest has been growing in the investigation and management of erectile dysfunction, but there is few report about prevalence of erectile dysfunction in Korea. The object of this study was to determine the prevalence of erectile dysfunction of men in rural region in Korea through a community based survey. Also, we investigated the relationship between risk factors and erectile dysfunction. MATERIALS AND METHODS: A total of 255 men aged 30 and over in chonnam province, Korea was randomly selected for determination of the prevalence of erectile dysfunction, and they participated in questionnaire survey including International Index of Erectile unction (IIEF), and clinical and laboratory examination that include blood pressure, ECG, blood glucose, urinalysis, serum level of lipid profiles, GOT, GPT and creatinine etc. Information on erectile dysfunction were collected by direct personal interview using IIEF. High risk factors of erectile dysfunction were divided according to estimated level and determined relationship with erectile dysfunction. RESULTS: Overall mean IIEF score was 20.6 7.3, and based on IIEF score, the prevalence of erectile dysfunction was 66.3% (169 of 255 men). The prevalence of erectile dysfunction of older aged men over 50 years was significantly higher than younger aged men. Also strong correlation was found between erectile dysfunction and diabetes mellitus, smoking. Although there was no statistical significance by multiple regression analysis, educational level, abnormal findings in ECG, history of chronic disease, hypertension, hypercholesterolemia and hyperlipidemia had relation to erectile dysfunction by ANOVA and Student t-test. And alcohol drinking, triglyceride and HDL-cholesterol were not statistically significant for development of erectile dysfunction. CONCLUSIONS: Our data showed that the prevalence and correlations with risk factors of erectile dysfunction in local community. We hope that this study will aid in larger epidemiologic study and prevention of erectile dysfunction in whole land.

Early Experience of Clitoral Color Duplex Doppler Ultrasonography with Audiovisual Sexual Stimulation / 대한비뇨기과학회지

PURPOSE: Female sexual dysfunction may have its origin in abnormal blood flow into the clitoris during sexual stimulation. There have been few studies to measure the clitoral blood flow by color duplex Doppler ultrasonography. The goal of this study was to evaluate the diagnostic values of clitoral color duplex Doppler ultrasonography with audiovisual sexual stimulation (AVSS). MATERIALS AND METHODS: Clitoral color duplex Doppler ultrasonography was performed during AVSS with glasses-type monitor. A total of fourteen women were included in the study; five premenopausal volunteers (mean age; 35, range; 24-50), five sexual arousal disorder patients (mean age; 38, range; 31-45) and four menopausal volunteers (mean age; 53, range; 47-56). Peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI) of clitoral cavernosal arteries were measured during AVSS in each patients. RESULTS: In the premenopausal volunteer group, PSV of clitoral arteries (mean SD) showed 38.7 +/- 9.7cm/sec, EDV 14.9 +/- 3.2cm/sec, RI 0.59 +/- 0.04, respectively. PSV of clitoral arteries decreased to 27.3 9.6cm/sec in sexual arousal disorder group, 18.1 +/- 6.5cm/sec in menopausal group. PSV significantly decreased in menopausal group (p<0.05) compared to the premenopausal volunteer group, but RI did not be changed significantly. CONCLUSIONS: These results suggest that clitoral duplex Doppler ultrasonography with AVSS may be used to evaluate clitoral arterial function in the female sexual dysfunction patients. However, further studies are needed in a large group to define normal clitoral blood flow parameters.