Effect of Pelvic Floor Magnetic Stimulation Therapy on the Patient with Female Stress Urinary Incontinence / 대한비뇨기과학회지

Purpose: Pulsed magnetic technology has been developed for pelvic floor muscle strengthening in the treatment of stress urinary incontinence (SUI). This report includes a prospective multi-center study of pelvic floor magnetic stimulation (PMS) for SUI. Materials and Methods: Sixty-four women, with demonstrable SUI, were studied. Fifty-six completed the PMS therapy and were available for analyzed. Evaluations, both before and 6 weeks after treatment included bladder diaries, 1-hour pad weight test, perineometry and a quality-of-life survey. For the treatments the patients were seated, fully clothed, in a PMS system, with a magnetic field therapy head in the seat. The treatment sessions were for 20 minutes, twice a week, for 6 weeks. To compare the results, the patients were divided into pure SUI and mixed urinary incontinence groups. Results: Of the 56 patients, 13 were completely dry (23.2%). The mean weight of the used pad was reduced from 15.26 to 2g (p8 times/day) was also reduced from 10.55 to 8.14/day following the treatment (p<0.001). The pressure of the pelvic muscle contractions increased from 30.3 to 36.95cmH2O (p<0.001). Forty-five patients (80.35%) were satisfied with the results of the PMS. At the baseline, the number of incontinence episodes, weight of used pads and pressure of the pelvic muscle contractions were significantly higher in the mixed incontinence (n=17) than in the pure SUI (n=39) group. There were no differences in the treatment results between the pure SUI and mixed urinary incontinence groups. No adverse events were reported during the study period. Conclusions: PMS therapy is effective for both stress and mixed urinary incontinence. A longer follow-up will be required to determine how long the benefits of treatment last, and whether retreatment will be required.

Urodynamic Analysis of Men with Lower Urinary Tract Symptoms without Benign Prostatic Hyperplasia / 대한비뇨기과학회지

Purpose: The pathogenesis of lower urinary tract symptoms (LUTS) without benign prostatic hyperplasia (BPH) in men is unclear. In this study, patients with LUTS without BPH were analyzed with a urodynamic study to search for effective treatments. MATERIALS AND METHODS: Ninety nine men with LUTS without BPH were assessed by their medical history, symptom score, uroflowmetry, filling cystometry and a pressure- flow study. The patients were divided into irritating and obstructive symptom groups according to their chief complaints. The urodynamic parameters between the two groups were compared. RESULTS: On urodynamics, 33 (33.3%) patients showed demonstrable evidence of detrusor instability (DI) of whom 10 had a concomitant bladder outlet obstruction (BOO), while 8 had concomitant detrusor underactivity (DU). BOO and DU was identified in 21 (21.2%) and 30 (30.3%) patients, respectively. Of the 61 patients presented with irritating symptoms, DI, BOO and an impaired contractility (IC) was found in 26.3, 13.1, and 13.1% of patients, respectively. Of the 38 patients with obstructive symptoms, DI, BOO and IC was found in 7.1, 8.1, and 17.2%, respectively. There was a significant positive correlation between the irritating symptoms and the presence of DI. CONCLUSIONS: Lower urinary tract symptoms in men are common and often misdiagnosed. This study demonstrated that 84 (84.8%) patients with lower urinary tract symptoms without a benign prostatic hyperplasia had urodynamic abnormalities such as DI, BOO and IC. A urodynamic study may to be useful in establishing a correct diagnosis and launching the appropriate therapy.

The Effects of Sildenafil Citrate as an Intracavernosal Agent / 대한남성과학회지

PURPOSE: Treatment of impotence has advanced considerably by an orally active, effective and well-tolerated drug, sildenafil citrate. However, Sildenafil citrate is not so effective for the treatment of severe organic impotence patients. Intracavernosal injection of vasoactive substance is still the most effective therapy for those patients but side effects, e.g. pain, priapism, require a more comfortable therapy. We performed this study to assess the feasibility of sildenafil citrate as a new intracavernosal agent. MATERIALS AND METHODS: In New Zealand white male rabbits (n=11), relaxations of precontracted cavernosal smooth muscle strips were studied after administration of sildenafil citrate, acetylcholine and sodium nitroprusside (SNP), respectively. In separate in vivo experiment, changes of intracavernosal pressure (ICP), duration of increased ICP and changes of systemic arterial blood pressure after retrograde selective internal pudendal arterial administration of four separate doses (0.1 mg, n=5; 0.3 mg, n=6; 0.5 mg, n=7; 1.0 mg, n=7) of sildenafil citrate were monitored in adult male cats (n=25). RESULTS: Acetylcholine, SNP and sildenafil citrate effectively relaxed the precontracted strips in a dose-dependent manner (3x10 8-3x10 3 M), respectively. Maximal relaxation of strips to acetylcholine, SNP and sildenafil citrate were 50.11%, 98.65%, and 68.32%, respectively. The order of potency was acetylcholine