The epidemiology of male lower urinary tract symptoms associated with benign prostatic hyperplasia: Results of 20 years of Korean community care and surveys.

PURPOSE: To investigate the prevalence of lower urinary tract symptoms/benign prostatic hyperplasia in a Korean population. MATERIALS AND METHODS: The Korean Prostate & Voiding Health Association provided free prostate-related community health care and conducted surveys in all regions of Korea from 2001 to 2022 with the cooperation of local government public health centers. A total of 72,068 males older than 50 were surveyed and analyzed. History taking, International Prostate Symptom Score (IPSS), transrectal ultrasonography, prostate-specific antigen (PSA) testing, uroflowmetry, and urine volume testing were performed. RESULTS: The mean prostate volumes in males in their 50s, 60s, 70s, and 80s or above were 24.7 g, 27.7 g, 31 g, and 33.7 g, respectively. The proportion of males with high PSA greater than 3 ng/mL was 3.8% among males in their 50s, 7.7% among males in their 60s, 13.1% among males in their 70s, and 17.9% among males 80 years of age or older. The mean IPSS total scores in males in their 50s, 60s, 70s, and 80s or above were 10.7, 12.7, 14.5, and 16, respectively. Severe symptoms were reported by 27.3% of males, whereas 51.7% reported moderate symptoms. The mean Qmax in males in their 50s, 60s, 70s, and 80s or above were 20 mL/s, 17.4 mL/s, 15.4 mL/s, and 13.8 mL/s, respectively. CONCLUSIONS: In this population-based study, mean prostate volume, IPSS, PSA, and Qmax were 30.6±15.1 g, 14.8±8.2, 1.9±4.7 ng/mL, and 15.6±6.5 mL/s, respectively. Aging was significantly associated with increased prostate volume, PSA levels, and IPSS scores, and with decreased Qmax and urine volume.

Robotic-assisted simple prostatectomy after prostatic arterial embolization for large benign prostate hyperplasia: Initial experience.

Background and objective: We aimed to evaluate the safety and efficacy of robot-assisted simple prostatectomy (RASP) after prostatic arterial embolization (PAE) in large benign prostatic hyperplasia (BPH). Material and methods: This retrospective study included 11 cases of PAE and subsequent RASP, performed on 11 patients with BPH from March 2018 to September 2020. Clinical information on the patients was collected before surgery and 3 months after surgery. For the quantification of lower urinary tract symptoms (LUTS), International Prostate Symptom Scores (IPSSs), prostate-specific antigen (PSA) levels, urinary peak flow rate (Qmax), voided volume (Vvol), and postvoid residual volume (PVR) were measured. Results: PAE and the subsequent RASP were successfully performed in all 11 patients. The mean total prostate volume was 129.7 ± 65.1 mL, and the transitional zone volume was 71.7 ± 5.9 mL. The mean resected prostate volume was 60.8 ± 26.1 mL. The mean hemoglobin level of the patients prior to PAE was 14.2 ± 2.3 g/dL, and one day after RASP, the hemoglobin level was 12.4 ± 1.9 g/dL. The outcome indicated that there was a considerable decline in IPSS and PVR after RASP was performed compared to before PAE (21.6 ± 9.4 vs. 10.6 ± 8.0 and 159.4 ± 145.8 mL vs. 43.9 ± 45.9 mL). Qmax and Vvol significantly improved after RASP was performed (7.6 ± 5.2 mL/s vs. 26.1 ± 12.6 mL/s; 114.2 ± 92.5 mL vs. 192.4 ± 91.8 mL, respectively). Conclusion: This research demonstrated that RASP could be performed safely and effectively after PAE in patients with large BPH.

Cryptotanshinone, a lipophilic compound of Salvia miltiorrriza root, inhibits TNF-alpha-induced expression of adhesion molecules in HUVEC and attenuates rat myocardial ischemia/reperfusion injury in vivo.

The aim of the present study was to evaluate the protective effect of cryptotanshinone (CTS), one of active ingredients of Salvia miltiorrhiza root, on myocardial ischemia-reperfusion injury in rat due to inhibition of some inflammatory events that occur by NF-kappaB-activation during ischemia and reperfusion. Myocardial ischemia and reperfusion injury was induced by occluding the left anterior descending coronary artery for 30 min followed by either 2 h (biochemical analysis) or 24 h (myocardial function and infarct size measurement) reperfusion. CTS injected (i.v.) 10 min before ischemia and reperfusion insult. CTS significantly reduced the infarct size and improved ischemia and reperfusion-induced myocardial contractile dysfunction. Furthermore, CTS inhibited NF-kappaB translocation, expression of pro-inflammatory cytokines (TNF-alpha, IL-1beta, IL-6), neutrophil infiltration and MPO activity in ischemic myocardial tissues. CTS also significantly reduced plasma levels of TNF-alpha, IL-1beta due to ischemia and reperfusion. Interestingly, H(2)O(2)-stimulated NF-kappaB-luciferase activity and TNF-alpha-induced expression of vascular cell adhesion molecule-1 (VCAM-1) and intracellular adhesion molecule-1 (ICAM-1) expressions in human umbilical vein endothelial cells (HUVEC) were significantly inhibited by CTS. Taken together, it is concluded that CTS may attenuate ischemia and reperfusion-induced microcirculatory disturbances by inhibition of proinflammatory cytokine production, reduction of neutrophil infiltration and possibly inhibition of adhesion molecules through inhibition of NF-kappaB-activation during ischemia and reperfusion.

Sexual dysfunction in male stroke patients: correlation between brain lesions and sexual function.

OBJECTIVES: To identify the sexual function of, and effect of the location of brain lesions on sexual function in, stroke patients. METHODS: We conducted a survey on 109 stroke patients (64.93 +/- 8.81 years) and 109 age-matched controls (64.69 +/- 8.85 years). We used a questionnaire that included the five-item version of the International Index of Erectile Function (IIEF-5) and questions about changes in sexual desire, ejaculatory function, and sexual satisfaction after a stroke. We analyzed the correlation between the results of the questionnaire and the locations of brain lesions. RESULTS: Erectile function was significantly decreased in the stroke patient group (IIEF-5, 5.89 +/- 7.08) compared with the control group (IIEF-5, 10.67 +/- 7.10). In most patients, the frequency of intercourse and sexual desire decreased after stroke, and an ejaculation disorder accompanied intercourse, but fear regarding intercourse was not severe. A lack of sexual desire was the largest cause (59.4%) of an absence of sexual intercourse. In cases with lesions in the right cerebellum and the left basal ganglia, a significant ejaculation disorder and decrease of sexual desire were more likely to occur, respectively. CONCLUSIONS: The sexual desire, erectile function, and ejaculatory function were impaired after stroke. A lack of sexual desire was the major cause of an absence of sexual intercourse. The specific locations of the stroke lesions, such as the left basal ganglia and right cerebellum, might be associated with sexual desire and ejaculation disorder, respectively.

Changes of cerebral current source by audiovisual erotic stimuli in premature ejaculation patients.

INTRODUCTION: Premature ejaculation (PE) is one of the most common forms of male sexual dysfunction. The mechanisms of PE remain poorly understood, despite its high prevalence. AIM: To investigate the pathophysiology and causes of PE in the central nervous system, we tried to observe the changes in brain current source distribution by audiovisual induction of sexual arousal. METHODS: Electroencephalograpies were recorded in patients with PE (45.0 +/- 10.3 years old, N = 18) and in controls (45.6 +/- 9.8 years old, N = 18) during four 10-minute segments of resting, watching a music video excerpt, resting, and watching an erotic video excerpt. Five artifact-free 5-second segments were used to obtain cross-spectral low-resolution brain electromagnetic tomography (LORETA) images. MAIN OUTCOME MEASURES: Statistical nonparametric maps (SnPM) were obtained to detect the current density changes of six frequency bands between the erotic video session and the music video session in each group. Comparisons were also made between the two groups in the erotic video session. RESULTS: In the SnPM of each spectrum in patients with PE, the current source density of the alpha band was significantly reduced in the right precentral gyrus, the right insula, and both superior parietal lobules (P < 0.01). Comparing the two groups in the erotic video session, the current densities of the beta-2 and -3 bands in the PE group were significantly decreased in the right parahippocampal gyrus and left middle temporal gyrus (P < 0.01). CONCLUSIONS: Neuronal activity in the right precental gyrus, the right insula, both the superior parietal lobule, the right parahippocampal gyrus, and the left middle temporal gyrus may be decreased in PE patients upon sexual arousal. Further studies are needed to evaluate the meaning of decreased neuronal activities in PE patients.