Effect of Shifting from Combination Therapy to Monotherapy of alpha-Blockers or 5alpha-Reductase Inhibitors on Prostate Volume and Symptoms in Patients with Benign Prostatic Hyperplasia

PURPOSE: Combination therapy of alpha-blockers and 5alpha-reductase inhibitors (5-ARIs) is widely used for the treatment of benign prostatic hyperplasia (BPH). We aimed to study the effect on prostate volume and symptoms of shifting to monotherapy in patients who previously received a combination therapy. MATERIALS AND METHODS: A prospective study was conducted of 60 patients who were diagnosed with BPH. Patients were aged 45 years or older and had a prostate volume of 30 cc or more, International Prostate Symptom Score (IPSS) of 12 or above, maximal flow rate (Qmax) of 15 ml/s or less, and prostate-specific antigen (PSA) level of less than 10 ng/ml. The patients initially received a combination therapy of doxazosin 4 mg/day and finasteride 5 mg/day for 3 months and were then randomly assigned to receive monotherapy for 3 months. The factors were then compared. RESULTS: A total of 30 patients were assigned to doxazosin (group 1) and 30 to finasteride (group 2) after the combination therapy. The percentage changes in prostate volume, IPSS, and Qmax during the period from post-combination therapy to post-monotherapy were not significantly different between the two groups (p=0.052, 0.908, 0.081), whereas PSA significantly decreased in group 2 (p<0.001). IPSS was not significantly different at post-combination therapy and at post-monotherapy in both groups (p=0.858, 0.071). The prostate volume significantly increased from 40.97 cc at post-combination therapy to 44.29 cc at post-monotherapy in group 1 (p=0.001) and insignificantly increased from 38.32 cc to 38.61 cc in group 2 (p=0.696). CONCLUSIONS: Although the duration of drug administration was short in this study, 5-ARI monotherapy could maintain the alleviated symptoms and reduce the risk of acute urinary retention and surgery due to prostate regrowth in BPH patients whose symptoms improved with combination therapy.

A Case of Sparganosis Infesting in the Scrotum / 대한비뇨기과학회지

Sparganum mansoni is an animal parasite infesting principally in cats and dogs, but sometimes it also infests human bodies. We have experienced a case of sparganosis in scrotum. Herein we report this case with a brief review of the literatures.

Renal Surgery Using Hypothermia Technique / 대한비뇨기과학회지

Temporary occlusion of the renal artery may be necessary for the extensive kidney operation. Performance of kidney operation requires an understanding of renal responses to warm ischemia and available methods of protecting the kidney while arterial occlusion. To minimize the loss of kidney function cooling of the organ is mandatory. The cooling can be accomplished either by perfusion with cold solution or by in situ surface cooling During the last 41 months, we performed renal surgery using hypothermia technique with good results in l5 patients.

Indwelling of Dormia Stone Basket in the Ureter for Removal of Lower Ureteral Calculi: A Modified Method / 대한비뇨기과학회지

No abstract available.

A Case of Spontaneous Rupture of Renal Angiomyolipoma / 대한비뇨기과학회지

We experienced a case of spontaneous rupture of renal angiomyolipoma appeared unilateral and solitary tumor without stigma of tuberous sclerosis in 49 years old women. Renal angiomyolipoma which are not associated with tuberous sclerosis appear at an average of 48 years and are more common in women with a ratio of 6:1 and is a benign tumor. Angiography may be helpful in the differentiation of an angiomyolipoma from renal cell carcinoma. The first symptoms are often due to sudden spontaneous perineal hemorrhage. The patient was managed by left total nephrectomy with good result.

Leiomyoma of the Urinary Bladder A Case Report / 대한비뇨기과학회지

A case of leiomyoma arising from the urinary bladder in a 34-year-old woman is presented.

A Case of Rhabdomyosarcoma of the Bladder in an Old Adult / 대한비뇨기과학회지

An unusual case of embryonal rhabdomyosarcoma of the bladder in a 77 year old man, who presented with difficult urination, gross hematuria and vague lower abdominal pain. Herein, we report a case of rhabdomyosarcoma. which revealed early recurrence and rapid growing up after partial cystectomy.

A Case of Diverticulum of Female Urethra / 대한비뇨기과학회지

Diverticulum of the female urethra is rather unusual disease which is relatively frequent in older women in whom it occurs more often than males; it is most rare in the young. A case of urethral diverticulum that occurred in a 50 years old women was presented. This patient was performed physical examination, cystoscopy, cystourethrogram and urethral soundation in order to know accurate size, location, extension and contents of the diverticulum. The transvaginal resection of the urethral diverticulum was performed, and the postoperative complication was not occurred.

Clinical Observation on 6 Cases of Bladder Tumor / 대한비뇨기과학회지

A clinical observation was made on the patients with bladder tumor admitted to the Department of Urology, Seoul Adventist Hospital during the periods from January 1978 to December 1981. The following results were obtained. 1. During the periods, 930 patients were hospitalized, and there were 36 cases of bladder tumor giving an incidence rate of 3.9%. 2. There were 25 males and 11 females with a ratio of 2.3:1. 3. Age distribution was between 23 and 77 years, the highest incidence rate was in the age group of 60-69years. 4. The clinical manifestation included gross hematuria (88.9%), frequency (69.4%), dysuria (44.4%) and the others. 5. On I.V.P. findings, 29 cases (80.6%) revealed normal upper tract, 6 cases (16.7%) were unilateral hydronephrosis, and 31 cases (86.1%) revealed filling defect in the bladder. 6. The tumors were located mainly at the lateral wall and trigonal area of bladder (50.0%). 7. Of 36 cases of bladder tumor, 30 cases (83.3%) were transitional cell carcinoma, 3 cases (8.3%) squamouscell carcinoma, and each 1 case (2.8%) adenocarcinoma, metastatic carcinoma and leiomyoma. 8. Among 36 cases, T.U.R. was performed in 17 cases, and intravesiCal chemotherapy in 11 cases. 9. Of 11 patients who received intravesical chemotherapy, 6 were recurred within 1 year showing a recurrencerate of 54.5%.

A Statistical Observation on Tumors of Genitourinary Tract / 대한비뇨기과학회지

A statistical observation was made on tumors of genitourinary tract of the in-patients in Dept. of Urology, Seoul Adventist Hospital during 6 years from January 1975 to December 1980. The results were obtained as follows. 1. During this period, 1009 cases (male 650, female 359} were hospitalized, among them 117 cases (male 100, female 17) were tumors of genitourinary tract giving a rate Of 11.6%. The ratio between male and female was 5.9:1. 2. A gradual tendency of annual increase of tumors war observed. 3. Age distribution ranged from 1 month to 82 years, and the cases over 40 years old were 101 among 117 cases. 4. In 117 cases of genitourinary tract tumors, 50 cases (42.7%} were benign, and 67 cases (57.3%) were malignant tumors. 5. Among 117 cases, 45 cases (38.5%) were prostatic, 43 cases (36.8%) vesical, 12 cases (10.3%) renal, 11 cases testicular, 4 cases penile and each 1 case ureteral and urethral tumor. 6. Major symptoms of genitourinary tract were frequent urination and dysuria in 58 cases (49.6%), gross hematuria in 51 cases (43.6%), acute urinary retention in 24 cases (20.5%). 7. Operations were performed in 109 cases (93.2%). 8. Histopathologically, B.P.H. was observed in 44 cases (37.6%), transitional cell carcinoma of bladder in 38 cases (32.5%) and renal cell carcinoma in 8 cases (6.8%).

Two Cases of Vesicovaginal Fistula / 대한비뇨기과학회지

We experienced 2 cases of vesicovaginal fistula and obtained good results in the Department of Urology, Seoul Adventist Hospital, Seoul, Korea. The causes of vesicovaginal fistula were corrosive agent and prolonged labor, the ages were 42 and 52 years old, the locations were in the trigonal area in both cases and the sizes were 3cm and 1.5cm respectively. Both cases were treated successfully with suprapubic transvesical approach.