Prostate-Specific Antigen Test Interval according to Baseline Prostate-Specific Antigen and Age

PURPOSE: The optimal interval at which to repeat prostate-specific antigen (PSA) measurement is controversial. We evaluated the probability of the serum PSA value increasing above specific cutoff values (4.0 ng/ml, 3.0 ng/ml, and 2.5 ng/ml) on annual follow-up visits in men with a lower baseline PSA than each cutoff value. MATERIALS AND METHODS: Between 2002 and 2006, a total of 14,459 men aged 40 to 79 years who underwent serum PSA determinations at least twice during health examinations at 11 medical centers were enrolled in this study. To reduce probable bias, we excluded men with pyuria, those with a baseline or follow-up PSA level of 10.0 ng/ml or more, and those with a history of medication with 5 alpha-reductase inhibitors. Serum PSA underwent logarithmic conversion to work out the normal distribution. The cumulative rate of freedom from increase in PSA above 4.0 ng/ml, 3.0 ng/ml, and 2.5 ng/ml was estimated with the Kaplan-Meier method according to baseline PSA range and age. The significance level was 1%. RESULTS: The rate of increase in PSA was lower in men who had a baseline PSA value in the low range and whose age was in the 40s or 50s. However, the cumulative rate of freedom from increase in PSA decreased as the PSA cutoff value was lowered. The optimal screening interval for men in their 40s and 50s whose baseline serum PSA level was 1.0 ng/ml or lower was 3 years when the significance level for PSA rising above 4.0 ng/ml was 1%. It was 2 years and 1 year, respectively, when the cutoff value was lowered to 3.0 ng/ml or 2.5 ng/ml. An annual PSA screening interval was recommended in men older than their 60s. CONCLUSIONS: The PSA test interval should be individualized according to baseline PSA, age, and PSA cutoff value.

Traumatic Ureteral Avulsion due to Blunt Trauma / 대한비뇨기과학회지

Complete proximal ureteral avulsion owing to blunt trauma is quite rare. Prompt diagnosis and repair are important in saving the kidney. Herein is reported the observation on one case of traumatic ureteral avulsion which has been treated successfully by end-to-end ureteroureterostomy.

Unusual Bladder Stones -Report of Three Cases- / 대한비뇨기과학회지

Bladder stone formation is secondarily associated with bladder outlet obstruction, such as neurogenic bladder and benign prostatic hyperplasia, and intravesical foreign body. 1. A case of unexpected giant bladder stone weighed 580gm associated with missed intravesical bullet after gun shut injury during Korean War in a 55-year-old man. 2. A case of giant bladder stone weighed 260gm associated with urinary stasis and urinary tract infection due to neurogenic bladder in a 46-year-old woman. 3. A case of multiple bladder stone, total number of 107, associated bladder outlet obstruction due to benign prostatic hyperplasia in a 63-year-old man.

Giant Bladder Stone Associated with Missed Intravesical Bullet: Report of a Case / 대한비뇨기과학회지

Bladder stone formation may be associated with intravesical foreign body. We report a rare case of unexpected giant bladder stone weighted 580gm associated with missed intravesical bullet after gunshut injury during Korean War in a 55-year-old man with brief review of literature.