PurposeThis study was conducted to investigate the relationship between serum total testosterone levels and scores on the Aging Male's Symptom (AMS) scale and the International Index of Erectile Function (IIEF) in men with erectile dysfunction with testosterone deficiency syndrome (TDS).Materials and MethodsFrom January 2005 to July 2008, 134 patients who complained of sexual dysfunction such as erectile dysfunction or decreased libido as the main symptoms of TDS with serum total testosterone levels less than 3.5 ng/ml were evaluated by independent t-test and linear regression analysis, respectively. Patients with treated hypogonadism within 6 months, with a history of taking a PDE5 inhibitor or an antidepressant for a depressive disorder, or who had metabolic syndrome were excluded from this study.ResultsThe AMS scale and its 3 subdomain scores were not significantly correlated with the total testosterone level. By contrast, the total IIEF score and the score of each IIEF domain except sexual desire showed a weakly significantly positive correlation with serum total testosterone.ConclusionsIn TDS patients with erectile dysfunction, there was a low relationship between serum total testosterone levels and the AMS scale and a weakly positive correlation between total testosterone levels and all IIEF domains except sexual desire. There was a low relationship between the AMS scale, the sexual desire domain score of the IIEF, and total testosterone. We should understand these limitations when evaluating patients with erectile dysfunction with TDS. New scales should be developed for the evaluation of erectile dysfunction in these patients.

PurposeAlthough post-void residual urine (PVR) is frequently utilized clinically in patients with benign prostatic hyperplasia (BPH), mainly because of its procedural simplicity, its role as a clinical prognostic factor, predictive of treatment goals, is still under much dispute. We investigated the predictive value of PVR for BPH-related clinical events including surgery, acute urinary retention (AUR), and admission following urinary tract infection (UTI).MethodsFrom January to June of 2006, patients over 50 years of age who were diagnosed with BPH for the first time at the outpatient clinic and were then treated for at least 3 years with medications were enrolled in this study. The variables of patients who underwent surgical intervention for BPH, had occurrences of AUR, or required admission due to UTI (Group 1, n=43) were compared with those of patients who were maintained with medications only (Group 2, n=266).ResultsGroup 1 had a significantly higher PVR, more severe symptoms, and a larger prostate at the time of the initial diagnosis in both the univariate and the multivariate analysis. In the 39 patients who underwent BPH-related surgery, although there was a significant change in Qmax at the time of surgery (mean, 13.1 months), PVR and the symptom score remained unchanged compared with the initial evaluation. In the receiver-operating characteristic curve analysis, the area under the curve of Group 1 was in the order of prostate volume (0.834), PVR (0.712), and symptom score (0.621). When redivided by arbitrarily selected PVR cutoffs of 50 mL, 100 mL, and 150 mL, the relative risk of clinical BPH progression was measured as 3.93, 2.61, and 2.11.ConclusionsThese data indicate that, in the symptomatic Korean population, increased PVR at baseline is a significant indicator of BPH-related clinical events along with increased symptom score or prostate volume.

Urinary stones are rarely seen in the urethra and are usually encountered in men with urethral stricture or diverticulum. The case of a 52-year-old woman presented, who consulted for weak stream associated with repeated urinary infections. The diverticulum was approached via vaginal route and the extraction was successful. The patient has been well, with no dysuria, dyspareunia, incontinence for 3-month follow-ups.

metastases, and significant differences existed in the status of surgical margins and the depth of invasion (P=0.015, P=0.01). Inguinal lymph nodes were generally involved. The difference of the delay of diagnosis between metastasis and non-metastasis was significant (P=0.04). 5-year survival rate of overall and invasive patients were 33.7% and 27.9% respectively. Conclusions: Primary PSPD, with the characteristic of long duration, high invasive tendency and high incidence of local recurrence or metastases, generally occurs in the elderly. Surgery should be performed at first. The delay of diagnosis, positive surgical margins and inguinal lymph node involved are important risk factors. Biopsy, frozen section and inguinal lymph node biopsy (ILNB) can promote prognosis.

Objective: To describe a novel transurethral front-firing Greenlight bladder autoaugmentation for the treatment of bladder contracture and report initial clinical outcomes. Methods: Between April 2014 and August 2015, five patients diagnosed with contracted bladder were all refractory to conservative treatment and received novel transurethral autoaugmentation. CT scan and urodynamics examination were conducted before operation for disease assessment. Mucosal and muscular layers of bladder wall in fundus was incised vertically and horizontally with frontfiring Greenlight laser to enlarge bladder capacity in the operation. Imaging examination and periodical urodynamics study were performed to evaluate the clinical outcomes of the procedure in postoperative follow-up. Results: Transurethral front-firing Greenlight bladder autoaugmentation was performed successfully on all the patients. The mean operative time was 59 min (range, 52 to 65 min) with no significant blood loss. Urodynamic parameters of these patients after operation improved significantly compared with that before operation. Average maximum cystometric capacity (Vmax) increased from 91.2 to 333 mL (P<0.01), average maximum flow rate (Qmax) ascended from 12.6 to 18.62 mL/min (P<0.01), and average flow rate (Qave) also increased from 5.74 to 13.18 mL/min (P<0.01). At last follow-up, all the patients could void spontaneously with good bladder emptying and their symptoms improved significantly. Conclusions: Our novel transurethral front-firing Greenlight bladder autoaugmentation is a safe and effective treatment for contracted bladders. Future studies with larger sample size and long-term follow-up are needed to confirm our findings. Objective: It is generally assumed that there is a negative linear association between androgen receptor (AR) sensitivity and the CAG repeat length. However, correlation between CAG repeat length and clinical factors of metabolic syndrome (MS), late onset hypogonadism is unclear. In this study we explored the relationship between AR CAG repeat length polymorphism and MS, late onset hypogonadism (LOH) in a Korean male population. Methods: The association between AR CAG repeat length polymorphism and MS was analyzed in 241 Korean men (20-90 years old). MS was diagnosed according to the NCEP criteria (any three or more of the following components were present: abdominal obesity [waist circumference (WC) >102 cm], triglycerides >150 mg/dL, HDL cholesterol <40 mg/dL, fasting glucose >110 mg/dL, or blood pressure of >130/85 mmHg). LOH was diagnosed by serum testosterone level of <3.5 ng/mL and androgen deficiency in the aging male questionnaire positive. AR CAG repeat length polymorphism was determined by microsatellite fragment sizing and association with clinical factors and questionnaire related with LOH [patient health questionnaire-9 (PHQ), aging male symptom scale (AMS),