Spermatic Cord Leiomyoma / 대한비뇨기과학회지

A spermatic cord leiomyoma is an uncommon disease. A leiomyoma can originate anywhere, including the genitourinary system, where smooth muscle is present. 70 and 30% of spermatic cord leiomyomas are benign and malignant, respectively. The preoperative diagnosis of a leiomyoma is difficult; the only definite diagnostic method is histological confirmation. A retroperitoneal lipoma probably constitutes the largest group of solid abdominal tumors. However, their etiology is unknown and the symptoms insidious, and recurrences and sarcomatous changes frequently occur. The clinical diagnostic methods are the clinical symptoms, a physical examination and radiological evaluations, such as intravenous urography, computed tomography and angiography, and so on, but an abdominal CT scan provides the most useful information. A fifty-six-old man presented with a five-month history of a suddenly enlarging right inguinal mass. He had undergone a right inguinal hernia operation, with medication for hypertension. Herein, a rare case of a huge retroperitoneal lipoma, with a spermatic cord leiomyoma, is reported.

The Early Experience of Various Treatment Modalities for Female Sexual Dysfunction / 대한비뇨기과학회지

PURPOSE: The aim of this study was to evaluate various medical treatments for the improvement of sexual function in women with sexual dysfunction. MATERIALS AND METHODS: Forty two patients that complained of desire and arousal disorders received treatments with androgen replacement, local administration of prostaglandin E1 (PGE1), administration of apomorphine and phosphodiesterase 5 inhibitor (PDE5I), and the application of a clitoral suction device. The treatment options were applied sequentially in some case. The improvement in sexual function was evaluated with respect to sexual desire, sexual sensation, sexual excitement, vaginal lubrication, orgasm and sexual satisfaction, using the Female Sexual Function Index and a subjective assessment, during masturbation. RESULTS: Androgen replacement over a 3 month period increased the sexual desire and sexual arousal response in 35.7% (5/14) and 21.4% (3/14) of the subjects, with no side effects. The local application of PGE1 improved the vaginal lubrication in 42.8% (3/7). Apomorphine increased vaginal lubrication in 12.5% (2/16) of the subjects. PDE5I improved sexual excitement and vaginal lubrication in 26.3% (5/19) of the subjects. A clitoral suction device improved the sexual sensation in 62.5% (25/40) and vaginal lubrication in 45.0% (18/40) of the subjects. Each treatment modality was more effective in secondary than in primary female sexual dysfunction. All of these modalities tested demonstrated an improvement in at least part of the sexual response, but not in the general sexual satisfaction. CONCLUSIONS: Although no improvement in sexual satisfaction was demonstrated, further studies to develop a proper indication for each treatment modality, due to their partial effectiveness toward each sexual response are warranted. Since female sexual dysfunction is not solved with a simple treatment, various treatment modalities must be applied for a significant time period.