Can the PDE5 Inhibitor Replace Intracavernosal Injection as a Method for Inducing a Penile Erection during the Evaluation of Erectile Dysfunction Using Penile Duplex Ultrasonography? / 대한비뇨기과학회지

PURPOSE: To clarify whether vardenafil can be used as a substitute for intracavernosal injection as a method of induction of penile erection, we compared the outcome of penile duplex Doppler ultrasonography using both methods in the same patient with erectile dysfunction. MATERIALS AND METHODS: A total of 23 patients underwent penile duplex ultrasonography twice with a one week interval between procedures. Twelve were randomly selected for intracavernosal injection first with prostaglandin E1(PGE1) 20microgram and the remaining 11 were initially treated with oral vardenafil 20mg 1 hour before the Doppler study and in addition had visual sexual stimulation using a head-mounted display during the study. The peak systolic velocity(PSV), end diastolic velocity(EDV) and the degree of maximum erectile response were measured and compared between the two groups. RESULTS: Measurements from the PGE1 treatment were not significantly different from those with the vardenafil treatment. The percentage of compatibility between the two methods with regard to hemodynamic diagnosis and pharmaceutical erectile response was as high as 83%(19 of 23) and 91%(21 of 23), respectively. Both methods were tolerable and safe without severe complications. However, in 4 patients where the diagnosis was uncertain, the injection method provided a more accurate interpretation of the penile vascular status with duplex ultrasonography. CONCLUSIONS: These results suggest that oral vardenafil can be used as an initial method for inducing penile erection when assessing erectile dysfunction with penile duplex Doppler ultrasonography in selected patients with erectile dysfunction.

A Pattern on the Male LUTS Related with Chronic Kidney Disease

PURPOSE: We examined an occurrence of the lower urinary tract symptoms (LUTS) within the chronic kidney disease (CKD) comparatively analyzed implications with components of the CKD. MATERIALS AND METHODS: We surveyed eighty-two CKD patients who were over than 50-year-old, micturated upward of 1,000cc a day. The check list concerned with the LUTS consists of International Prostate Symptom Score (IPSS), quality of life, volume of prostate, maximal flow rate and residual urine volume and we evaluated GFR, serum creatinine, prevalence period, causative disease and diabetes. We analyzed correlations between the CKD and components of the LUTS and examined an aspect of LUTS concerned with the degree of CKD, prevalence period and diabetes. A control group composed of twenty-eight male adults who visited to the general medical examination center and they were examined by the same checklist. RESULTS: The group of CKD is significantly worse than the control group over the whole items of LUTS beside the volume of prostate; they were on the average 57.3+/-3.8 years old, 17.1+/-2.3 of IPSS, 3.8+/-1.2 of quality of life, 12.6+/-3.2ml/sec of maximal flow rate and 38.9+/-4.3ml of residual urine, 25.9+/-3.4g of prostate in the group of CKD. Furthermore, a group of patients who had suffered from the CKD for over than 3 years and combined with diabetes is significantly worse than control group. CONCLUSIONS: The study revealed that a number of CKD have LUTS and they seem to be influenced by prevalence period, stage and causative disease of CKD rather than the volume of prostate.

Xanthogranulomatous Pyelonephritis in an Infant / 대한비뇨기과학회지

Xanthogranulomatous pyelonephritis (XGP) is an uncommon, severe, chronic infection of the kidney, which results in the normal renal parenchyma being replaced by characteristic lipid-laden macrophages (foam cells). It can occur at any age, but is extremely rare in children. Herein, the case of a 6-month-3-week-old girl with XGP, pre-operatively diagnosed with a Wilms' tumor, is reported. This is the youngest age of any patient with such a condition reported in the Korean literatures. Excretory urography, abdominal sonogram, computed tomogram and magnetic resonance imaging revealed a right renal round mass, without any calcifications. Her pathological findings after a radical nephrectomy revealed XGP.