Role of Cytoreductive Radical Prostatectomy in the Treatment of Metastatic Prostate Cancer

There is controversy regarding the survival benefits of eliminating primary tumors via cytoreductive radical prostatectomy (CRP) in patients with metastatic prostate cancer (mPCa). The purpose of this article is to review the theoretical background of and rationale for CRP, and the current knowledge base. The Scopus and PubMed databases were searched for studies investigating CRP published between January 2000 and October 2019. The retrieved articles were nonsystematically reviewed. Based on preclinical data, retrospective patient case studies, retrospective population-based studies, and prospective studies, CRP has been reported to afford benefits for the treatment and prevention of local symptoms through the removal of primary tumors, and the management of neo-metastatic disease and overall survival. However, despite the results from these studies, the current review mostly addresses small case studies and uncontrolled population-based studies with weak evidence. Based on this weak evidence, therefore, clinical use has not yet been recommended. Further research investigating the role and timing of CRP in patients with mPCa is needed, in addition to studies screening the most suitable populations for CRP.

Role of Cytoreductive Radical Prostatectomy in the Treatment of Metastatic Prostate Cancer

There is controversy regarding the survival benefits of eliminating primary tumors via cytoreductive radical prostatectomy (CRP) in patients with metastatic prostate cancer (mPCa). The purpose of this article is to review the theoretical background of and rationale for CRP, and the current knowledge base. The Scopus and PubMed databases were searched for studies investigating CRP published between January 2000 and October 2019. The retrieved articles were nonsystematically reviewed. Based on preclinical data, retrospective patient case studies, retrospective population-based studies, and prospective studies, CRP has been reported to afford benefits for the treatment and prevention of local symptoms through the removal of primary tumors, and the management of neo-metastatic disease and overall survival. However, despite the results from these studies, the current review mostly addresses small case studies and uncontrolled population-based studies with weak evidence. Based on this weak evidence, therefore, clinical use has not yet been recommended. Further research investigating the role and timing of CRP in patients with mPCa is needed, in addition to studies screening the most suitable populations for CRP.

Percutaneous Nephrolithotomy: Comparison of the Efficacies and Feasibilities of Regional and General Anesthesia

PURPOSE: To compare surgical outcomes and complications after percutaneous nephrolithotomy (PCNL) under regional or general anesthesia. MATERIALS AND METHODS: One hundred and one patients who underwent PCNL as a first-line treatment for kidney calculi between June 2004 and June 2013 were enrolled in this retrospective study. Patients were classified into two groups by anesthetic method: 77 were allocated to the regional anesthesia group and 24 to the general anesthesia group. Patient general characteristics, stone features, surgical outcomes, and complications were compared between the two groups. RESULTS: The two groups were similar in terms of mean age and stone size, number, and type. Furthermore, they did not differ significantly in terms of general characteristics, treatment outcomes, or complications excluding postoperative fever. However, mean hospital stay was significantly shorter in the regional anesthesia group than in the general anesthesia group (8.9+/-3.2 days vs. 11.5+/-6.9 days, respectively, p=0.025). Also, the postoperative fever rate was significantly higher in the general anesthesia group (53.2% vs. 83.3%, respectively, p=0.007). CONCLUSIONS: Regional anesthesia is as effective as general anesthesia during percutaneous nephrolithotomy and is associated with shorter hospital stays and lower rates of postoperative fever.

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.

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.

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.

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).

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.

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.

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.

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.

Comparative Analysis of Clinical Parameters in Acute Pyelonephritis / 대한비뇨기과학회지

PURPOSE: To compare the variable inflammatory parameters of acute pyelonephritis patients treated with inpatient therapy at 13 hospitals, according to the age and gender distributions. MATERIALS AND MATHODS: A total of 3,544 medical records of patients with confirmed acute pyelonephritis, and admitted to hospital between January 2000 and December 2005, were retrospectively analyzed. RESULTS: The mean age of the patients was 43.2+/-16.2 years old, with a male:female ratio of 1 : 5.1. The average duration of hospital admission was 7.9+/-5.3 days. Underlying diseases were found in 23.0% (749/3,252 patient), largely due to diabetes (35.1%). Radiological abnormal findings were found in 13.7%. The leukocyte count, ratio of segmented form, erythrocyte sedimentation rate (ESR), c-reactive protein, pyuria, positive blood culture, positive urine culture were 11,014+/-5,778/mm(3), 74.8+/-14.5%, 44.0+/-32.0 mm/hr, 12.4+/-9.3mg/dl, 83.9%, 10.5% and 46.7%, respectively. E. coli grow in 79% of the urine culture positive patients. In a comparison of 3 age groups (61 years), the elderly patients had a greater number of underlying diseases and more pathogens in cultured blood. When divided into males and females, the elderly male patients had more pathogen in cultured urine, but contrary to the male patients, the elderly female patients had elevated leukocyte count and erythrocyte sedimentation rate. Also, the old patient group had more resistance to ampicillin when they had E. coli as the uropathogen (p=0.021). Patients with higher ESR required longer hospital admission periods. CONCLUSIONS: It was found that variable clinical parameters of acute pyelonephritis patients treated with inpatient therapy differed according to both gender and age group in Korea. Therefore, these factors should be taken into account in the treatment plan.

Renal Angiomyolipoma Partially Containing Epithelioid Component / 대한비뇨기과학회지

Epithelioid renal angiomyolipoma is a recently recognized pathologic variant of angiomyolipoma, which represents a more malignant course than a classical renal angiomyolipoma. We report a case of histologically proven renal angiomyolipoma. The patient presented with the symptoms and signs of spontaneous rupture of the kidney. On surgical exploration, the ruptured kidney with upper pole kidney mass was resected. The enlarged regional lymph nodes were also removed, which showed the same pathology.

The Usefulness of Ureteral Stenting for Acute Ureteral Obstruction in Pregnancy / 대한비뇨기과학회지

Purpose: An acute ureteral obstruction during pregnancy presents both diagnostic and therapeutic challenges. When conservative therapy fails, temporary measures, such as ureteral stenting, are often chosen as a first- line intervention, which postpones definitive management until delivery. The usefulness of ureteral stenting was evaluated as an emerging strategy for the symptoms of an acute ureteral obstruction during pregnancy. Materials and Methods: Between 1996 and 2005, a retrospective analysis was performed on 53 pregnant patients with an acute ureteral obstruction. Eighteen of the patients were treated by ureteral stenting, as they failed to improve with conservative management. They were followed up until the removal of the ureteral stent. Results: Seventeen patients (95%) experienced significant pain relief within at least 2 days, but one patient (5%) did not. On ultrasound, 16 patients (88%) had resolution of hydronephrosis. Twelve patients (66%) continued to have problems with post-therapeutically irritative voiding symptoms, but 11 (61%) experienced relief of symptoms within 10 days. One patient (5%) had the ureteral stent removed due to the continuous complaint of irritative voiding symptoms. After delivery, all patients were taken intravenous pyelography (IVP). Fourteen patients showed normal findings, but 4 were diagnosed with a ureteral stone. Three patients were treated by extracorporeal shock wave lithotripsy (ESWL) for a stone in the upper and lower urinary tract. One patient, with a mid ureteral stone, was treated by ureteroscopic lithotripsy. Conclusions: Ureteral stents were usually placed without any major problems, and well tolerated, with only minor and short post-therapeutic discomfort. We concluded that ureteral stenting is a simple, safe and effective first-line therapeutic option in case of symptomatic and acute ureteral obstruction during pregnancy.

Comparison between Rigid Ureteroscopic Stone Removal (URS) and Extracorporeal Shock Wave Lithotripsy (ESWL) for Large (>10mm) Upper Ureteral Stones / 대한비뇨기과학회지

Purpose: The aim of this study was to compare the efficacy, safety and compliance of ureteroscopic stone removal (URS) patients who were treated with extracorporeal shock wave lithotripsy (ESWL) for large (>10mm) proximal ureteral stones. Materials and Methods: We reviewed 123 patients who were treated for upper ureteral stones (>10mm) between January 2000 and March 2005. URS and ESWL were performed in 51 and 72 patients, respectively. Success was defined as the patients achieving a stone-free status on radiography at 1 month after treatment. We analyzed the success rates of stone removal, the reasons for failure and the complication rates of each procedure. Results: The overall success rate of URS was 90.2%. For the ESWL treatments, the overall success rates after the first, second, third and more sessions were 47.2%, 61.1%, 76.4% and 81.9%, respectively. Notably, the stone free rate of the URS group was better than that of the 1st, 2nd and 3rd session ESWL group (p10mm) upper ureteral calculi. Thus, this procedure should be considered as first line therapy for large (>10mm) upper ureteral stones. In addition, for the proper selection of patients for ESWL and URS, analysis of the cost effectiveness, compliance and recurrence rates of the two groups should be done in the future.

Malignant Pheochromocytoma that Recurred in the Contralateral Adrenal Gland and Metastasized to the Bladder / 대한비뇨기과학회지

Pheochromocytoma is an uncommon neoplasm and it is derived from the neural crest. It is one of the surgically curable hypertensive syndromes. The sequela of this disease can be serious if definite treatment is not promptly performed. We report here on a case of malignant pheochromocytoma that recurred in the contralateral adrenal gland and it subsequently metastasized to the bladder after the patient refused treatment of the contralateral adrenal tumor.

Clinical Outcome of Acute Bacterial Prostatitis, a Multicenter Study / 대한비뇨기과학회지

PURPOSE: Few studies have examined acute prostatitis in Korea. To initiate the investigation of this topic, a multi-center retrospective analysis of acute prostatitis was conducted. MATERIALS AND METHODS: The clinical records of 335 patients from 13 hospitals, diagnosed with acute prostatitis, between January of 1994 and October of 2004, were reviewed. For each patient, the urine culture, changes in the PSA (prostate-specific antigen) value and the prostate volume, the incidence of prostate abscess, the use of antibiotics, and whether the disease went into remission or progressed to chronic prostatitis were analyzed. RESULTS: The mean age of the patients, time from the onset of symptom to admission and number of days of admitted were 54.9+/-15.1 (16-85) years, 2.4+/-3.4 (16-85) days and 7.5+/-3.9 (1-25) days, respectively. The chief symptoms of the patients were high fever, dysuria and urinary frequency. Routine urinalysis found pyuria in 82% and hematuria in 70% of patients. The causative organisms of 43.0% of the patients were cultured, with the chief organisms found to be E. coli (67%) and P. aeruginosa (13%), et al. The mean PSA and prostate volume on initial diagnosis were 24.6+/-30.2ng/ml and 45.8 +/-17.4ml, respectively, and a prostate abscess was found in 4 patients (3.1%). The antibiotics injected during patient admission were: cephalosporin family (68%), aminoglycosides (70%) and quinolone family (43%). An additional alpha blocker was used in 49% of cases. Oral quinolone (91%), cephalosporin (9%) and alpha blocker (44%) were prescribed for a mean 32.5 (2-180) days after discharge. 259 (77%) of the patients were available for follow-up. Of these, 21% took antibiotics over an 8 week treatment period, and 8% over a 12 week period. The disappearance of pyuria after treatment was observed in a mean of 13 days after the end of treatment. After 13 weeks of treatment, 11 (50%) of the 22 patients who received prostate massage (4.2% of all follow up patients) were found to have chronic prostatitis. The mean PSA and prostate volume declined during follow up, to 6.13+/-10.38ng/ml and 37.5+/-13.5ml, respectively. CONCLUSIONS: In our study, the most common chief symptom of acute prostatitis was a high fever, with the most common causative organism being E. coli. Patients were admitted for approximately one week, and treated with antibiotic for about one month, after which time PSA elevation was observed in 80% of patients. Although all acute prostatitis patients were treated with proper antibiotics, progression to chronic prostatitis was observed in 4.2% of patients.

Traumatic Dislocation of Testis / 대한비뇨기과학회지

Traumatic dislocation of the testis is defined as an ectopically displaced testis as the result of trauma. It is usually associated with motorcycle accidents, but a few cases have been reported from incidents ranging from kicks to the perineum to falling accidents. Traumatic dislocation of the testis occurs as a result of direct pressure exerted on the scrotum causing the testicle to be expelled into the surrounding tissue. We experienced 3 varying cases of superficial inguinal dislocations of the testis. One was due to a motorcycle accident, another to kicks and one to a falling accident. Spontaneous reduction is rare, and early surgical reduction is often required.