Multiple, Bilateral Fibroepithelial Polyps Causing Acute Renal Failure in a Gastric Cancer Patient

We report a case of primary fibroepithelial polyps (FEPs) in the middle of both ureters in a patient with advanced gastric cancer and acute renal failure. Ureteral FEPs are rare benign lesions, and multiple, bilateral lesions are extremely rare. To our knowledge, this report is the seventh case of bilateral FEPs in the literature. Our case has clinical implications because FEPs should be considered as a cause of ureteral obstruction inducing acute renal failure in advanced gastric cancer.

Comparison of the Efficacy of Antibiotic Monotherapy and Antibiotic Plus Alpha-blocker Combination Therapy for Patients with Inflammatory Chronic Prostatitis/Chronic Pelvic Pain Syndrome / 대한비뇨기과학회지

PURPOSE: The objectives of this study was to compare the efficacy of antibiotic monotherapy with antibiotic plus alpha-blocker combination therapy for the treatment of inflammatory chronic pelvic pain syndrome (CPPS) patients. MATERIALS AND METHODS: Between October 2005 and May 2006, 69 patients who were diagnosed as CPPS(National Institutes of Health; NIH-catagory IIIa), were included in this study. The patients were randomly placed into two groups: group I was treated with gatifloxacin alone(35 patients), and group II was treated with gatifloxacin and doxazosin(34 patients) for 6 weeks. For all the patients, the urinalysis, expressed prostatic massage, the National Institute of Health-Chronic Prostatitis Symptom Index(NIH-CPSI) and a distal rectal examination(DRE) were performed at the initial visit. The NIH-CPSI was compared both before and after the treatment. RESULTS: On the initial diagnosis, the mean CPSI of the group I patients was 24.0+/-6.3, and that for the group II patients was 24.7+/-6.9. After the treatment, that of the group I was 16.6+/-5.4, and that of group II was 13.4+/-5.3. After 6 weeks of treatment, the changes in the total CPSI scores had significantly improved in group II compared with group I(p<0.05). A statistically significant improvement occurred in the pain score, the voiding symptom score and the quality of life in the group II compared with group I(p<0.05) CONCLUSIONS: This study suggests that combination therapy of antibiotic plus alpha-blocker would be more effective than antibiotic monotheraphy for treating patients with inflammatory chronic prostatitis/chronic pelvic pain syndrome.

The Quality of Life after Tension-Free Vaginal Tape and Transobturator Vaginal Tape Inside-Out for the Surgical Treatment of Female Stress Urinary Incontinence

PURPOSE: The change of quality of life following a tension-free vaginal tape (TVT) and transobturator vaginal tape (TVT-O) procedure was investigated in patients with stress urinary incontinence. MATERIALS AND METHODS: We included 86 women with stress urinary incontinence who underwent the TVT or TVT-O procedure and followed up for at least 1 year. Preoperatively, the patients were evaluated with history taking, physical examination, urodynamics to determine abdominal leak point pressure (ALPP) and pre- and postoperative quality of life was evaluated by incontinence quality of life questionnaire (I-QoL). The success after operation was defined as the absence of any subjective complaint of leakage. RESULTS: The rate of cure of TVT and TVT-O procedure were 84%, 92% and the rate of improvement of them were 16%, 8%, respectively. Preoperative patient characteristics including uroflowmetric parameters and ALPP were comparable in the two groups. The I-QoL parameters one year after surgery were statistically significant increase in I-QoL scores in each groups. There were no serious or long-term complications related to both procedures. CONCLUSIONS: These data suggest that the TVT and TVT-O procedure are effective for treating female stress incontinence and also in the aspect of improving quality.

Effects of Intracavernosally Injected Embryonic Stem Cells in Aged Rat / 대한남성과학회지

PURPOSE: Stem cell-based cell therapy has recently been tried as a way to restore cavernosal function in an animal model. The aims of this study were to elucidate the effect of intracavernosally injected embryonic stem cells(ESCs) in aged rat. MATERIALS AND METHODS: Male Sprague Dawley rats were divided into 3 groups: young control(12 weeks old; n=10), old with vehicle injection(24 months old; n=7), and old with ESC injection(24 months old; n=8). ESCs were transfected with firefly luciferase attached to adenovirus and then injected intracavernously 2 times with a 1-week interval. Cell survival was assessed by optical molecular imaging 2 days after the last ESC injection. At 4 weeks after the last injection, intracavernosal pressure and systemic arterial pressure were recorded after pelvic nerve stimulation. Serum testosterone levels were measured by radioimmunoassay. RESULTS: We observed fluorescent signals around the external genitalia of animals injected with ESCs. The serum testosterone level of the old group(1.39+/-0.07 ng/ml) was significantly lower compared to the young control group(2.98+/-0.31 ng/ml)(p=0.03). The percentage of intracavernosal pressure/systolic blood pressure was significantly lower in the old group(58.5+/-8.6%) compared to the young control group(69.5+/-6.6%)(p=0.034). However, the old group with ESC injection(61.6+/-9.9%) did not show any significant differences from the old group(p>0.05). The old group with ESC injection showed histomorphometry similar to the old group. CONCLUSIONS: The presence of intracavernosal ESCs can be noninvasively monitored with optical molecular imaging. However, the intracavernosal injection of ESCs did not improve erectile function in the aging rat. Further studies are needed to elucidate the regulatory factors of stem cell differentiation in the corpus cavernosum.

Changes in the Serum Prostate-specific Antigen Level One Year after Transurethral Resection of the Prostate / 대한비뇨기과학회지

PURPOSE: We wanted to investigate how transurethral resection of the prostate(TURP), for treating patients with benign prostate hyperplasia(BPH), affected the serum prostate-specific antigen(PSA) levels. MATERIALS AND METHODS: The serum PSA levels were measured before and 12 months after operation in 57 patients who underwent TURP for BPH. The total prostate weight, as measured by transurethral ultrasonography (TRUS), and the weight of the surgical specimen were examined in relation to the pretreatment PSA value and the changes in the PSA levels after the operation. RESULTS: The preoperative mean PSA density was 0.10+/-0.08ng/ml/cc. The postoperative serum PSA levels were decreased significantly after TURP (p=0.002). Removal of 1g of BPH tissue reduced the serum PSA levels by an average of 0.22+/-0.4ng/ml. The changes in the serum PSA level one year after TURP correlated with the resected chip weights[Y=0.406+0.176x (r=0.526, p<0.05)]. CONCLUSIONS: TURP caused a long term decrease in the serum PSA level. One year after TURP, the PSA levels should be expected to decrease according to the resected chip weights.

The Significance of Biopsy of the Erythematous Lesion at Cystoscopy / 대한비뇨기과학회지

PURPOSE: At cystoscopy, bladder cancer shows various presentations; these are papillary, flat, elevated and ulcerated. Erythematous lesions could be carcinoma in situ (CIS), cancer or benign lesion, so biopsy should be done to exclude malignancy. However, this might cause many problems such as bleeding, inflammation and the added cost. The objectives of this study were to evaluate the significance of erythematous lesion biopsy at cystoscopy and to identify the factors related to the detection of bladder cancer. MATERIALS AND METHODS: From January 1999 to June 2006, 337 biopsies were taken from the erythematous lesions seen at cystoscopy. We reviewed the pathologic results of the erythematous lesions. We also investigated the patients' histories of bladder cancer, the urine cytology performed at cystoscopy, the intravesical therapy for bladder cancer and the complications after biopsy. A logistic regression analysis was performed to determine the factors associated with the diagnosis of bladder cancer. RESULTS: In 337 erythematous lesion biopsies, malignancy was found in 36 (10.9%), and 19 of 36 (52.8%) were CIS. Among the benign lesions, chronic cystitis was most common. Bladder cancer was detected more often in patient with a history of transitional cell carcinoma (TCC) and in patients over the age of 65 years. Especially, a history of TCC was an independent risk factor for bladder cancer [odds ratio: 2.974, 95% confidence interval (CI): 1.163-7.604]. After biopsy, hematuria that was needed management occurred in 3.6% of the lesions. CONCLUSIONS: Erythematous lesion biopsy yields a positive finding of malignancy in 10.9% of the lesions and could be a valuable exam, particularly for the follow-up for TCC, and for patients over the age of 65 years.