Twenty Years of Experience with Artificial Urinary Sphincter Implantation / 대한비뇨기과학회지

PURPOSE: The efficacy of the artificial urinary sphincter(AUS) in treating sphincteric incontinence has been clearly demonstrated. We report on 20 years of experience using artificial sphincter implantation at a single institute. MATERIALS AND METHODS: The follow-up data for 37 patients who received AUS(AMS 800(TM)) implantation between 1987 and 2006 at Yonsei University were available for this study. We investigated various components of the medical records, such as the number of pads used per day, results of pre-operative urodynamic studies, operative and post-operative complications, and revision rate. RESULTS: Mean patient age was 35.6 years(range 15-64 years), and mean follow-up duration was 12.4 years(range 1.4-19.8 years). Of the 37 patients, 21 had neurogenic bladder, and 9 had traumatic injury. Other causes of incontinence included post-operative complications(4 patients) and congenital anomalies(3 patients). The cuffs were placed were in the bladder necks of 21 patients and in the bulbous urethrae of 16 patients. The average number of pads used daily decreased significantly from 6.2 to 1.2 after the operation, and 27 patients(72.9%) were able to maintain 'dry-up status' (number of pads used< or=1). A total of 32 artificial sphincters remained in place(86.4% survival rate), with 8 revisions(21.6%) required secondary to infection, mechanical failure, or urethral stone. CONCLUSIONS: AUS implantation is a safe and durable treatment for urinary incontinence in patients with intrinsic sphincter deficiency from various underlying diseases.

Internet Based Multi-institute Prostate Research System: Pilot Experience with a Convenient, Secure and Efficient System / 대한비뇨기과학회지

PURPOSE: The process of transferring data from one medical center to another and sharing the results can be time-consuming and inconvenient. So, we introduce the multi-institutional clinical research that uses the Internet for conducting faster, safer and more convenient research. MATERIALS AND METHODS: Patients with benign prostatic hyperplasia (BPH) were prospectively enrolled from 3 remote participating medical centers by means of the Internet. When a patient with BPH came to the hospital, the BPH profile, medications and adverse events were entered into the Internet Based Multi-institute Prostate Research System (IBMPRS). Six investigators were educated on the use of the IBMPRS and we measured the mean data entering time and the user satisfaction. RESULTS: 763 patients with BPH from three institutions were enrolled and their data was collected through the Internet for 1 year. It took an average of 2 minutes 43 seconds to enter the information of one patient. All the investigators were satisfied about the IBMPRS and the system was very stable and safe. CONCLUSIONS: An Internet-based clinical research system has the advantage of being able to instantly share patient information and full-time access to the interim results is available if a large number of institutions participate in the clinical research. Clinical research using the Internet would be an invaluable method that is free to use with easy accessibility, and it could play the role of an excellent secretary on the web.