Changes of Serum PSA after Alpha Adrenergic Blocker Treatment in Patients with BPH / 대한비뇨기과학회지

PURPOSE: To find if the alpha adrenergic blocker, terazosin, changes the PSA in BPH patients. MATERIALS AND METHODS: Patients with a PSA level over 2.5ng/ml, who visited our hospital with lower urinary tract symptoms, were reviewed, and excluded from having prostate cancer (n=101). After a routine check up for BPH, included history taking, a physical examination, laboratory examinations and a transrectal ultrasound, on their first visit, the PSA level and IPSS were checked again after 4 weeks of alpha adrenergic blocker (terazosin) management. RESULTS: The average size of the prostates and age of the patients were 40.6ml and 67.7 years, respectively. Overall, the PSA levels before the treatment was 4.12+/-2.03ng/ml, which decreased significantly, to 3.57+/-1.99ng/ml, after the terazosin treatment (p=0.002). The subgroups, divided by age, prostate size and IPSS score, all showed meaningful declines in the PSA levels, but with no statistical differences. CONCLUSIONS: The results from this research shows that terazosin treatment reduces the PSA levels in BPH patients complaining of lower urinary tract symptoms, and the changes in the pattern of the level may help to differentiate prostatic cancer, and reduce the incidence of a prostatic biopsy.

Experience with Extracorporeal Shock Wave Lithotripsy(ESWL): A Report of 400 Cases / 대한비뇨기과학회지

A total 400 patients underwent 676 treatments with E.D.A.P.-LTOI extracorporeal shock wave lithotripsy for urinary tract stones between February 25 and August 18, 1987. The results were obtained as follows; 1. sex ratio was about 3: 1, 292(73.0 %) in male and 108(27.0 %) in female patients. The average patient age was 43.9 years, with a range of 2 to 85 years. The fifth decade(30.5 %) was most followed by the forth decade (26.0 %) and sixth decade (20.7 %). 2. Treated stone locations were kidney in 286 (71.5 %);calyx in 187 (46.8%) and renal pelvis in 98 (24.5 %) and ureter in 144 (28.5 %); upper ureter in 71 (17.8%) and lower ureter 43(10.7 %). There were multiple renal stone in 83 (20.7 %), bilateral renal stone in 22(5.5 %), bilateral renal stone in 22 (5.5 %), bilateral ureteral stone in 3 (0.7 %) and unilateral renal and ureteral stones in 23 (5.8 %). The average stone size was 1.6 cm, with a range of 0.6 to 4.8 cm. 3. The average numbers of treatment were 1.4 sessions and the average treatment time was 13.7 minutes, with a range of 12 to 78 minutes. Of the patients, 81 (20.2 %) were complained severe pain but treatment interruption or anesthesia were not required. 4. The success rate of treatment-ended patients were 97.8 % in 0.6~1.0cm(137 cases), 89.2% in 1.0~2.0 cm (93 cases) and 89.2 % in 2.0~3.0 cm (37 cases). Therefore, the total average success rate was 93.6 %. 5. The method of pre-ESWL additional manipulation was used a ureteral stone `push up` in 12 (3.0 %). The post-ESWL additional measures were made in 10 (2.5%); ureteral manipulation in 8 cases and lithotomy in 2 cases. The causes of failed ESWL (21 cases) were stone components in 8, impacted stone in 8, incomplete stone localization in 4 and infundibular stricture in 1. 6. ESWL-complications were required admission and medical management in 18(4.5 %); colic in 12 (3.0 %), acute urinary retention in 2 (0.5 %) and subscapular hematoma in 1(0.3% ), Therefore, we confirmed that E.D.A.P.-LTOI ESWL is a safe and effective method for the treatment of urinary tract stones.