Median Raphe Cyst on Glans Penis / 대한남성과학회지

Median raphe cyst is a relatively uncommon disease and is caused by a defect in the embryonic development of male genitalia. Here, we report a case of median raphe cyst on the glans penis in a 20-year-old male, which was successfully treated by surgical excision.

Ability of Core Biopsies to Predict Extracapsular Extension of Prostate Cancer / 대한비뇨기과학회지

PURPOSE: To assess the ability of multiple variables to predict the extracapsular extension and lateralities of the extension on ten-core prostate needle biopsies. MATERIALS AND METHODS: Eighty-five ten-core prostate biopsies and corresponding radical prostatectomy specimens were studied. Using univariate and multivariate regression analyses, variables, such as Gleason score, preoperative PSA, bilaterality of cancer, number of positive cores, total length of cancer, maximum length and percent of cancer on one core and maximum percent of cancer on one site were determined for their prediction of extracapsular extension. RESULTS: Thirty-seven of the 85 patients (44%) showed extracapsular extension. In a univariate analysis, all variables, with the exception of the PSA, were significant. The number of positive cores was the only independent predictive factor in a multivariate analysis (p=0.0007). Nineteen (39.6%) of the 48 unilateral cancers cases on biopsy showed ipsilateral extracapsular extension, including 3 bilateral extensions on prostatectomy specimens. Significant differences in the Gleason score and number of positive cores were noted between organ confined and extracapsular tumors on the prostatectomy specimens. Among 37 bilateral cancers on biopsy, the probability of organ confined, unilateral extracapsular and bilateral extracapsular diseases were 51, 16 and 32%, respectively. The number of positive cores had a significant impact on the extension of tumors, with a dominant number of positive cores on the ipsilateral side. CONCLUSIONS: The number of positive cores is the most important predictive factor for the extracapsular extension. The laterality of the extracapsular extension can be predicted by the laterality and dominance of positive cores on biopsies.

Risk Factors Predicting Voiding Difficulty Following Tension-Free Vaginal Tape Procedure

PURPOSE: Among complications after the tension-free vaginal tape(TVT) procedure for female stress urinary incontinence, the voiding dysfunction is one of the most common complaints of the patients. The aim of the study was to assess the incidence of objective voiding dysfunction and evaluate the clinical, uroflometric and urodynamic risk factors predisposing to voiding dysfunction following the TVT procedure. MATERIALS AND METHODS: 437 women with stress urinary incontinence underwent the TVT procedure in our institution for recent three years. Among them, 285 patients with post-operative uroflowmetry were evaluated. Objective voiding dysfunction was defined as a peak-flow rate less than 12 ml/sec(voided volume greater than 100 ml), or inability to void at least 75% of bladder capacity, on two or more readings. Clinical and urodynamic parameters and global satisfaction were analyzed and compared between patients(objective voiding dysfunction, n=33, 11.6%) who had uroflowmetric parameters of voiding difficulties after TVT procedure and patients(well- voiding, n=252, 88.4%) who had not. RESULTS: Two hundred sixty-one patients (91.6%) answered satisfied by global satisfaction questionnaire. Subjective and objective cure rates were 93.9% and 90.9% at least 6 months follow-up. Among parameters, patient's age, peak-flow rate, and 1 hour pad test showed significant differences between voiding dysfunction group and well-voiding group(average age: 54.9 vs 50.9 years-old, p=0.024, peak urinary flow rate: 30.9 vs 24.1 ml/sec, p=0.003, 1 hour pad test: 53.8 vs 81.6 gm, p=0.035). There was no statistically significant difference in subjective and objective cure rates and satisfaction rates between the two groups. CONCLUSIONS: Women with the old age, low peak urinary flow rate, and large volume with 1 hour pad test are most likely to have voiding dysfunction after TVT procedure. Patients with these risk factors should be given more counsel regarding post-operative voiding dysfunction before the surgery.

Long-Term Follow-Up of Abnormal Spermatogenesis after Exposure to Solvent Containing 2-Bromopropane / 대한남성과학회지

PURPOSE: Solvent containing 2-bromopropane has been widely used as a detergent in the electronic industries. The long-term toxic effects of this chemical on spermatogenesis were investigated. MATERIALS AND METHODS: All eight employees (mean age 33 years) who were exposed to the solvent underwent semen analysis, hormonal tests, and testicular biopsies 2 to 3 months after cessation of the exposure. The patients' semen quality had been followed at regular intervals for 1 year as long as the results remained abnormal. We monitored the long-term outcome of 3 patients whose semen remained abnormal during 1 year of follow-up. RESULTS: All patients had decreased sperm counts, with azoospermia being found in one patient. Six patients showed abnormal histologic findings such as atrophy of the seminiferous tubules, thickening of the basement membrane, and hyperplasia of Leydig cells. Of 8 patients, 5 (mean age 37.3 years) showed complete recovery of semen quality during the year after exposure ceased. These patients initially had sperm numbers more than 75 104/mL and a normal serum concentration of FSH. Of 3 patients with abnormal serum FSH and sperm numbers below 3,000/mL, 2 recovered normal sperm numbers at 18th and 24th months after cessation of exposure. Their ages and initial serum FSH concentration were 29 and 26 years and 19.6 and 74.7 mIU/mL, respectively. One patient (37 years old) with relatively normal testicular histology and a serum FSH concentration of 23.7 mIU/mL still had abnormal findings at the last semen analysis, performed 6 years after cessation of exposure. CONCLUSIONS: Solvent containing 2-bromopropane can impair spermatogenesis. This process may be reversed by avoidance of the exposure to this chemical substance. However, an abnormally elevated serum FSH concentration after exposure is an ominous sign for recovery of semen quality.