Improvement of Lower Urinary Tract Symptoms and Sexual Function after Treatment with Alpha-Blocker

PURPOSE: The association of lower urinary tract symptoms (LUTS) and erectile dysfunction has not been investigated comprehensively concerning which LUTS are associated with sexual function. Therefore, we investigated the association of each domain of the International Prostate Symptom Score (IPSS), nocturia, prostate volume, and uroflowmetry with each domain of the International Index of Erectile Function (IIEF)-5. MATERIALS AND METHODS: The correlation of sexual function and LUTS was investigated in 365 men with benign prostatic hyperplasia. To measure the level of LUTS, the IPSS was calculated; uroflowmetry, residual urine measurement, and transrectal ultrasonography (TRUS) were performed; and the level of erectile dysfunction was assessed by the IIEF-5. Three months after treatment with alpha-blocker (tamsulosin 0.2 mg/day), IPSS, uroflowmetry, residual urine, nocturia, and IIEF-5 were assessed again to evaluate the effectiveness of treatment. RESULTS: Erectile function deteriorated more in individuals with severe LUTS (IPSS>20) than in those with mild LUTS (IPSS<8), and IPSS, age, and nocturia correlated significantly with all IIEF-5 domains. The maximal urine velocity and the average urine velocity on uroflowmetry correlated significantly with all IIEF domains. After the administration of alpha-blocker for 3 months, the changed rates of the IPSS-obst domain, average uroflow, and quality of life (QoL) correlated significantly with the improvement in the total IIEF-5. CONCLUSIONS: Changes in the IPSS-obst domain, QoL, and average uroflow rate correlated significantly with changes in the total IIEF-5. Thus, it is expected that the improvement of obstructive symptoms could effectively improve erectile function.

Diagnosis of Prostatic Abscess and Utility of Transrectal Ultrasonography Guided Abscess Aspiration / 대한남성과학회지

PURPOSE: Prostatic abscess is a very rare disease whose incidence has been reported to be approximately 0.2% in patients with urologic symptoms. Besides, it cannot be diagnosed by interview and physical examination, for which imaging studies must also be performed. In the current study, we examined the clinical usefulness of imaging studies in making a diagnosis of prostatic abscess and the effect of a fine needle aspiration based on trans-rectal ultrasonography on the treatment outcomes. MATERIALS AND METHODS: In ten patients who were diagnosed with prostatic abscess and then treated during a period ranging from January of 1995 to June of 2008 (mean age: 61.8 years, range: 40-89 years), a past history, clinical symptoms, physical examination findings, laboratory findings, trans-rectal ultrasonography findings, computed tomography findings, treatment modalities and complications were retrospectively analyzed. RESULTS: All patients complained fever and voiding dysfunction as chief complaint. On trans-rectal ultrasonography and computed tomography scans, all the ten patients had abnormal findings. In five patients, there were nonhomogenous hypo-echoic lesions on trans-rectal ultrasonography. All the patients had cystic abscess lesions detected on computed tomography scans. In four patients, in whom the diameter of lesions was greater than 1cm on computed tomography scans, a fine needle aspiration was performed on trans-rectal ultrasonography and antibiotic treatment was performed. In six patients, in whom the diameter of lesions was smaller than 1 cm on computed tomography scans, antibiotic treatment was performed. There were statistically significant differences in the length of hospital stay and the size of prostate gland between the group where a fine needle aspiration was performed using trans-rectal ultrasonography and the group where antibiotic treatment was performed (p0.05). Length of antibiotic therapy was shorter in antibiotic therapy only group, but there was no statistically significant difference (P>0.05). CONCLUSIONS: A computed tomography is a useful diagnostic modality for prostatic abscess. Besides, a fine needle aspiration based on trans-rectal ultrasonography is one of the minimally invasive treatment regimens for prostatic abscess, whose good treatment outcomes have been well documented. Furthermore, there were no severe complications in our series.

Effect of Cocoa Extract on Tension of the Corpus Cavernosal Tissue in Rat / 대한남성과학회지

PURPOSE: Cocoa has antihypertensive activity, improves cerebral blood flow, and is an antioxidant. We evaluated the effect of cocoa extract on penile erection using the relaxation of the corpus cavernosal tissue in rat. MATERIALS AND METHODS: We used male 8-week-old Sprague-Dawley rats weighting 250-350 g divided into three groups: corpus cavernosal tissue with the endothelium (group 1), tissue without the endothelium (group 2), and endothelium pretreated with L-NAME (group 3). Changes in isometric tension were examined in an organ bath. Aortic tissues were divided into three groups and treated in similar experiments simultaneously. RESULTS: Cocoa extract dose-dependently relaxed corpus cavernosal tissue pre-contracted by phenylephrine (10-6). In group 1, cocoa extract (10-3g/ml) induced relaxation by 97+/-5% (mean+/-SD). The extract was still effective but less potent tissue without endothelium or pretreated with L-NAME (10-4M). Similar effects were seen in aortic rings. CONCLUSION: Cocoa extract relaxes corpus cavernosal tissue in a dose-dependent manner via NOS and the endothelium. Cocoa extract may therefore be effective for improving erectile function.

Effect of Cocoa Extract on Tension of the Corpus Cavernosal Tissue in Rat / 대한남성과학회지

PURPOSE: Cocoa has antihypertensive activity, improves cerebral blood flow, and is an antioxidant. We evaluated the effect of cocoa extract on penile erection using the relaxation of the corpus cavernosal tissue in rat. MATERIALS AND METHODS: We used male 8-week-old Sprague-Dawley rats weighting 250-350 g divided into three groups: corpus cavernosal tissue with the endothelium (group 1), tissue without the endothelium (group 2), and endothelium pretreated with L-NAME (group 3). Changes in isometric tension were examined in an organ bath. Aortic tissues were divided into three groups and treated in similar experiments simultaneously. RESULTS: Cocoa extract dose-dependently relaxed corpus cavernosal tissue pre-contracted by phenylephrine (10-6). In group 1, cocoa extract (10-3g/ml) induced relaxation by 97+/-5% (mean+/-SD). The extract was still effective but less potent tissue without endothelium or pretreated with L-NAME (10-4M). Similar effects were seen in aortic rings. CONCLUSION: Cocoa extract relaxes corpus cavernosal tissue in a dose-dependent manner via NOS and the endothelium. Cocoa extract may therefore be effective for improving erectile function.

Efficacy and Safety of a Herbal Formula that Mainly Consists of Cornus Officinalis for Erectile Dysfunction: A Double-blind, Placebo-controlled Study / 대한비뇨기과학회지

PURPOSE: The aim of this study was to evaluate the efficacy and safety of a herbal formula that mainly consists of Cornus officinalis for treating erectile dysfunction. MATERIALS AND METHODS: Eighty patients suffering with erectile dysfunction were enrolled in this randomized, double-blinded, placebo-controlled study. The average duration of erectile dysfunction of the herbal formula group(n=40) vs. the placebo group(n=40) were 19.33+/-18.13 months vs. 19.33+/-25.62 months, respectively. The safety variables we examined were the history, physical examination, vital signs, EKG, clinical laboratory tests and hormonal tests. Efficacy assessments included the International Index of Erectile Function(IIEF), the sexual encounter profile(SEP) diary and Global Assessment Questions(GAQ). RESULTS: No significant changes in the laboratory values, hormone tests and blood pressure were observed in both groups. In comparison with the placebo group(6.57+/-11.72), the herbal formula group experienced a significant improvement of the IIEF(11.13+/-11.83)(por=50) of the herbal formula group significantly improved their IIEF score(p<0.05). The herbal formula group significantly improved their GAQ score(p<0.05). The herbal formula was well tolerated. The common adverse events were headache(2.5%) and nausea(5%). CONCLUSIONS: In conclusion, the herbal formula that mainly consists Cornus officinalis was not only effective at improving erectile function, but it was also safe for the treatment of erectile dysfunction.

Mucinous Adenocarcinoma of the Renal Pelvis with Giant Hydronephrosis / 대한비뇨기과학회지

Mucinous adenocarcinoma of the renal pelvis is a rare tumor, and this is associated with renal stone, hydronephrosis and pyelonephritis. We report here on a case of mucinous adenocarcinoma of the renal pelvis with a review of the relevant literatures. The patient was a 74 year-old woman who had left giant hydronephrosis with multiple renal stones.

Effects of Administration of Tadalafil for 24 Weeks on Lower Urinary Tract Symptoms and Erectile Dysfunction / 대한남성과학회지

PURPOSE: Numerous studies of the effect of tadalafil on sexual function have been performed. However, its effects on lower urinary tract symptoms (LUTS) are unclear. Therefore, the long-term effects of tadalafil on the improvement of LUTS as well as erectile dysfunction were examined. MATERIALS AND METHODS: 69 patients who visited our hospital reporting LUTS and erectile dysfunction as chief complaints were divided into 3 groups. Group 1 received 10 mg/day alfuzosin (39 patients, age: 61.36+/-8.69), group 2 received 10 mg/day alfuzosin and 5 mg/2 day tadalafil (15 patients, age: 58.00+/-7.91), and group 3 received 5 mg/2day tadalafil (15 patients, age: 54.70+/-10.01). Drugs were administered for 24 weeks. At before and 12 weeks and 24 weeks after drug administration, maximum flow rate, IPSS, quality of life, IIEF-5, and self satisfaction were measured and analyzed. The SPSS 14.0 was used as statistical software, and the data were validated using ANOVA. RESULTS: Between pre- and post-administration, the maximum flow rate significantly increased in all groups (p<0.05). The IPSS of groups 1 and 2 were significantly reduced (p<0.05). Quality of life significantly decreased in group 3 (p<0.05). IIEF-5 for groups 2 and 3 significantly increased (p<0.05). Self satisfaction significantly decreased in groups 2 and 3 (p<0.05). CONCLUSIONS: When alfuzosin and tadalafil were administered together for 24 weeks, both LUTS and erectile dysfunction improved significantly. In the group administered tadalafil alone, LUTS improved. Thus, administration of tadalafil for 24 weeks is able to improve not only erectile dysfunction but also LUTS.

Location of Brain Electrical Source Activation according to Visually Stimulated Sexual Arousal: A Cross Spectral Analysis using Low Resolution Brain Electromagnetic Tomography (LORETA) / 대한비뇨기과학회지

PURPOSE: Low resolution brain electromagnetic tomography (LORETA) is a kind of functional imaging technique and it is also an up-to-date technique for conducting electroencephalography (EEG) analysis. We tried to investigate the locations on the cerebral cortex that are activated by visually stimulated sexual arousal. MATERIALS AND METHODS: Thirty-three male volunteers (age range: 24.7+/-1.7 years) among all the right-handed medical students at our university were enrolled in this study. The EEGs included the segments recorded during resting, watching a music-video, intermission and watching a porno-video. The LORETA images of the cross-spectral analysis were obtained with using segments of LORETA-KEY (KEY Institute for Brain-Mind Research, Switzerland) software. RESULTS: In the statistical nonparametric maps (SnPM) of each spectrum and the delta, theta and alpha waves did not show the increased current density. The beta 1, 2 and 3 activity showed the point of maximal current densities in the anterior parahippocampal gyrus of the left limbic lobe and the superior temporal gyrus of both temporal lobes, the superior temporal gyrus of the right temporal lobe, the precuneus of the right parietal lobe, the medial frontal gyrus of the left frontal lobe, the middle occipital gyrus of the right occipital lobe, the superior temporal gyrus of both temporal lobes and the superior frontal gyrus of the right frontal lobe. CONCLUSIONS: The sexual arousal by visual stimulation may activate the anterior parahippocampal gyrus of the left limbic lobe, the superior temporal gyrus of both temporal lobes, the precuneus of the right parietal lobe, the medial frontal gyrus of the left frontal gyrus, and the middle occipital gyrus of the right occipital lobe.