Urodynamic Findings of Chronic Nonbacterial Prostatitis Patients with Urinary Symptoms / 대한비뇨기과학회지

PURPOSE: Chronic nonbacterial prostatitis represents a major portion of all the chronic prostatitis syndromes. Yet its pathogenesis is not definitive. Therefore, the treatment of chronic nonbacterial prostatitis in men is unclear. In this study, the patients with chronic nonbacterial prostatitis, especially those with complaints of voiding difficulty, were analyzed with conducting a urodynamic study to search for the pathophysiology and the effective treatments. MATERIALS AND METHODS: Sixty men (mean age: 38.9+/-8.3 years) diagnosed with chronic nonbacterial prostatitis were included in this study after excluding the patients with prostatic infection via the standard bacteriological methods. Thereafter, the patients were evaluated urodynamically, including measurements by uroflowmetry, cystometry and a pressure flow study. RESULTS: According to their symptoms, 37 (61.7%) patients complained of frequency, 28 (46.7%) patients complained of a weak stream, 10 (16.7%) patients complained about urgency, and 5 (8.3%) patients complained about pelvic pain. Of the 60 patients, detrusor underactivity (DU), detrusor overactivity (DO), and bladder outlet obstruction (BOO) were found in 19 (31.7%), 12 (20.0%), and 11 (18.3%) patients respectively; there were equivocal findings in 30.3% of patients. CONCLUSIONS: This study demonstrated that 42 (70%) patients suffering with chronic nonbacterial prostatitis had different urodynamically abnormal patterns such as DU, DO and BOO. A urodynamic study may to be useful in establishing a correct diagnosis and for launching the appropriate therapy for the selected group of patients who were not helped by general treatments.

Chronic Cyclophosphamide Induced Cystitis that is Improved by Mesna / 대한비뇨기과학회지

Cyclophosphamide is alkylating agent used in the treatment of various solid tumors. Mucosal irritation by acrolein, the metabolite of cyclophosphamide, is believed to cause various symptoms of cystitis. The thiol compound, sodium 2-mercaptoethane sulfonate (Mesna), has been found to inactivate acrolein. We present an unusual case of a 64-year-old woman, who was treated as chronic cystitis. Her symptoms did not improve, so she was treated with Mesna under the assumption of cyclophosphamide induced cystitis; her symptoms then improved.