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Barakat B, Franke K, May M, Gauger U, Vögeli TA. Efficacy and safety of desmopressin on frequency and urgency in female patients with overactive bladder and nocturia, current clinical features and outcomes: A systematic review. Asian J Urol 2022; 9:27-34. [PMID: 35198394 PMCID: PMC8841275 DOI: 10.1016/j.ajur.2021.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 08/03/2020] [Accepted: 12/23/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To evaluate the efficacy and safety of desmopressin on frequency and urgency in female patients with overactive bladder (OAB) and nocturia. METHODS A selective database search was conducted to validate the effectiveness of desmopressin in patients with OAB and nocturia. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were utilised. The meta-analysis included 378 women (five studies) with OAB. The clinical outcomes and adverse events were analysed. RESULTS The treatment strategy of all the studies included can be divided into three categories: (1) The effect of desmopressin compared with baseline, (2) desmopressin compared with placebo, and (3) desmopressin and anticholinergic combination versus desmopressin monotherapy. There was a significant (50%) reduction in nocturia and urgency episodes after using desmopressin alone. Combined desmopressin and anticholinergic led to a decrease in the frequency of nocturia voids when only using anticholinergic (65% vs. 33.2%). The time increased in the middle to the first nightly voids in the combination arm (65.11 min; p=0.045). The mean incidence (standard deviation) of leak-free episodes was higher under desmopressin than under placebo in the first 4 h (62% [35%] vs. 48% [40%]) and in the first 8 h (55% [37%] vs. 40% [41%]). The safety profile was comparable between treatments. CONCLUSION Available data indicate that desmopressin is efficacious in significantly reducing nighttime urine production, episodes of nocturia, and urgency episodes. The affectivity of the combination therapy was very high with least side effects for the treatment of OAB/nocturnal polyuria.
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Affiliation(s)
- Bara Barakat
- Hospital Viersen, Department of Urology and Pediatric Urology, Viersen, Germany
| | - Knut Franke
- Hospital Viersen, Department of Urology and Pediatric Urology, Viersen, Germany
| | - Matthias May
- Hospital St. Elisabeth, Department of Urology, Straubing, Germany
| | | | - Thomas-Alexander Vögeli
- University Hospital RWTH Aachen, Department of Urology and Pediatric Urology, Aachen, Germany
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Lee HY, Yun YJ, Choi JY, Hong JW, Lee I, Park SH, Kwon JN. Effectiveness and safety of moxibustion for alleviating symptoms of overactive bladder: A prospective, randomized controlled, crossover-design, pilot study. Medicine (Baltimore) 2018; 97:e12016. [PMID: 30142847 PMCID: PMC6113034 DOI: 10.1097/md.0000000000012016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND This study aimed to evaluate trial feasibility and explore the potential efficacy and safety of moxibustion in the treatment of overactive bladder (OAB). METHOD A randomized, controlled, cross-over, assessor blinded design was used. This study was conducted in an outpatient department of a university hospital in Republic of Korea. The overall study period was 8 weeks. Participants were randomly allotted to either Group A or Group B. Group A participants underwent 8 to 12 sessions of moxibustion with behavioral training during the first 4 weeks, while the Group B participants received behavioral training only. Over the next 4 weeks, the treatment offered to the 2 groups was reversed (Group A participants received behavioral training only, while Group B participants underwent the moxibustion session with behavioral training). The OAB-validated 8-question awareness tool (OAB-V8), OAB symptom scores (OABSS), visual analog scale (VAS) for lower urinary tract symptoms, and frequency voiding chart were used to assess outcomes. For analysis, we used effect size, measured as Hedge's g, to present descriptive results indicating the actual difference between the groups. RESULTS Compared to that in Group B, the Hedge's g of OAB-V8 for the former 4 weeks in Group A was -0.248, that of OABSS was -1.531, and that of VAS was -0.713. During the latter 4 weeks, Group B showed similar effect with g = 0.465, 1.207, and 0.427 for OAB-V8, OABSS, and VAS, respectively, compared to Group A. The portion of nocturnal voiding volume decreased (g = -0965), the mean voiding volume increased (g = 0.690), and the voiding frequency decreased (g = -0.498) with moxibustion. CONCLUSIONS Moxibustion might be considered as an alternative for OAB. A full-sized randomized controlled trial may be feasible with minimal modification in outcome measures and comparator population. OTHER INFORMATION This clinical trial has been registered on clinicaltrials.gov (NCT02271607).
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Affiliation(s)
- Hye-Yoon Lee
- Pusan National University Korean Medicine Hospital
| | - Young-Ju Yun
- Pusan National University Korean Medicine Hospital
- School of Korean medicine, Pusan National University, Republic of Korea
| | - Jun-Yong Choi
- Pusan National University Korean Medicine Hospital
- School of Korean medicine, Pusan National University, Republic of Korea
| | - Jin-Woo Hong
- Pusan National University Korean Medicine Hospital
- School of Korean medicine, Pusan National University, Republic of Korea
| | - In Lee
- Pusan National University Korean Medicine Hospital
- School of Korean medicine, Pusan National University, Republic of Korea
| | - Seong-Ha Park
- Pusan National University Korean Medicine Hospital
- School of Korean medicine, Pusan National University, Republic of Korea
| | - Jung-Nam Kwon
- Pusan National University Korean Medicine Hospital
- School of Korean medicine, Pusan National University, Republic of Korea
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Voiding characteristics and related hormonal changes in peri-menopausal and post-menopausal women: a preliminary study. Maturitas 2014; 79:311-5. [PMID: 25150899 DOI: 10.1016/j.maturitas.2014.07.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 07/09/2014] [Accepted: 07/11/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To characterize voiding symptoms during the peri- and post-menopausal periods and to investigate related hormonal changes. METHODS We enrolled a total of 55 patients between February 10, 2013, and August 15, 2013, to participate in this cross-sectional study. To characterize patients' voiding symptoms, we administered voiding questionnaires, including the International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), and Sandvik Severity Index. Measured hormones included E2, FSH, TSH, prolactin, progesterone, and testosterone. RESULTS In the univariate analysis, there were significant intergroup differences for all of the hormones except progesterone. Among the voiding symptoms, straining (IPSS question 1), frequency (IPSS question 2), and SUI were significantly different between the two groups (p=0.039. 0.010, and 0.017, respectively). In the multivariate analysis, frequency (IPSS question 2) and SUI were significantly different between the two groups (p=0.020 and 0.011, respectively). Among the hormones, only testosterone was marginally different between the two groups (p=0.059). CONCLUSIONS During the transition to menopause, voiding symptoms, such as frequency, can potentially worsen in the peri-menopausal period, and SUI is more prevalent in the post-menopausal period. Additionally, testosterone may have a role in voiding changes that occur during the menopausal transition.
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Lee KS, Lee YS, Kim JC, Seo JT, Lee JZ, Choo MS. Patient-reported goal achievement after antimuscarinic treatment in patients with overactive bladder symptoms. Int J Clin Pract 2012; 66:663-70. [PMID: 22698418 DOI: 10.1111/j.1742-1241.2012.02951.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AIM Standardised traditional outcome measures may fail to address factors that are important to patients and address irrelevant factors. Aim of this study was to assess patient-reported goals and goal achievement (GA) in the antimuscarinic treatment for overactive bladder (OAB) patients. METHODS Men and women aged ≥ 18 years with OAB symptoms were eligible for the study. Treatment began with a dose of 10 mg oxybutynin, to be increased if necessary to 30 mg. Before treatment, each patient's primary treatment goal was identified. After 12-week treatment, patients reported GA using a Likert scale from 0 (no achievement) to 5 (complete achievement). Successful achievement was defined as a score of 4 or 5. Traditional outcome measures including voiding diaries, the OAB questionnaire short form, patient perception of bladder condition, and treatment benefit and satisfaction were assessed. Baseline characteristics affecting GA and the correlation between GA and traditional outcome measures were evaluated. RESULTS A total of 303 goals were identified from 303 patients (51 men, 252 women). Of those, 72.3% addressed symptom relief and frequency as the most common target symptom. Other goals addressed were improving quality of life (13.5%) and eliminating coping behaviours (14.2%). After treatment, 42% had a successful GA with a median score of 3 (interquartile range; 2-4). Age had a negative effect on GA. Goal achievement was the outcome measure most correlated with treatment benefit and satisfaction. DISCUSSION AND CONCLUSIONS Goal achievement can be a valuable outcome measure in OAB patients, addressing individual treatment goals and reflecting treatment benefit and patient satisfaction.
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Affiliation(s)
- K-S Lee
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Chung JH, Kim SA, Choi BY, Lee HS, Lee SW, Kim YT, Lee TY, Moon HS. The association between overactive bladder and fibromyalgia syndrome: A community survey. Neurourol Urodyn 2012; 32:66-9. [DOI: 10.1002/nau.22277] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Accepted: 05/01/2012] [Indexed: 11/10/2022]
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Lee YS, Choo MS, Cho WJ, Lee KS. Patient-reported Goal and Goal Achievement: The Most Individualized Method of Outcome Assessment in Patients with Lower Urinary Tract Symptoms. Low Urin Tract Symptoms 2012; 4 Suppl 1:56-61. [PMID: 26676701 DOI: 10.1111/j.1757-5672.2011.00137.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Patients with lower urinary tract diseases often have a constellation of symptoms, and the degree of distress due to individual symptoms varies. In particular, some symptoms are more bothersome to patients and lead to treatment. However, traditional outcomes, such as urodynamic data, voiding diaries, and standardized patient-reported outcomes, may fail to address the individual factors. In contrast, patient-centered outcomes rely on patients to assess treatment outcomes in terms of their concerns or goals. Goal achievement is a patient-centered outcome that was pioneered in prolapse surgery. Recently, this most individualized outcome measure has been evaluated in the context of lower urinary tract symptoms (LUTS). According to the studies, most patients with LUTS have symptom-related goals. After treatment, goal achievement in patients with overactive bladder or benign prostatic obstruction was low even when there were significant improvements in symptom severity in terms of traditional outcome measures. On the other hand, most women with stress incontinence achieved their treatment goals after midurethral sling surgeries. There are ongoing efforts to develop valid and reliable methods for assessing goal achievement that can facilitate the complex rating process and have responsiveness. Goal achievement shows a limited correlation with standardized patient-reported outcomes and no significant correlation with objective outcomes. Thus, at the moment, it can be used as a complimentary outcome measure along with other traditional methods. Further research is needed to reveal the correlation between goal achievement and overall patient satisfaction and, ultimately, to determine if assessing goal achievement can enhance patient satisfaction.
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Affiliation(s)
- Young-Suk Lee
- Department of Urology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, KoreaDepartment of Urology, Asan Medical Center, Ulsan University College of Medicine, Seoul, KoreaDepartment of Urology, Chosun University Hospital, College of Medicine, Chosun University, Gwangju, KoreaDepartment of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Myung-Soo Choo
- Department of Urology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, KoreaDepartment of Urology, Asan Medical Center, Ulsan University College of Medicine, Seoul, KoreaDepartment of Urology, Chosun University Hospital, College of Medicine, Chosun University, Gwangju, KoreaDepartment of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won Jin Cho
- Department of Urology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, KoreaDepartment of Urology, Asan Medical Center, Ulsan University College of Medicine, Seoul, KoreaDepartment of Urology, Chosun University Hospital, College of Medicine, Chosun University, Gwangju, KoreaDepartment of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyu-Sung Lee
- Department of Urology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, KoreaDepartment of Urology, Asan Medical Center, Ulsan University College of Medicine, Seoul, KoreaDepartment of Urology, Chosun University Hospital, College of Medicine, Chosun University, Gwangju, KoreaDepartment of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lee YS, Choo MS, Lee JY, Oh SJ, Lee KS. Symptom change after discontinuation of successful antimuscarinic treatment in patients with overactive bladder symptoms: a randomised, multicentre trial. Int J Clin Pract 2011; 65:997-1004. [PMID: 21849011 DOI: 10.1111/j.1742-1241.2011.02728.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
AIMS Efficacy of antimuscarinic therapy for overactive bladder (OAB) has been demonstrated; however, the durability of its effects is unknown. The study was conducted to evaluate symptom change and retreatment rate after discontinuation of antimuscarinic therapy. Also, we tried to find risk factors for retreatment. METHODS This was a prospective, randomised, open-label, multicentre trial at four university hospitals. Women who had OAB symptoms for ≥ 6 months and who showed successful response to 1 month of Tolterodine 4 mg medication were randomly assigned to one of three groups: (A) discontinue medication, (B) 2-month additional medication and (C) 5-month additional medication. After completion of the 1-, 3- or 6-month treatment, patients stopped the medication and were followed up for additional 3 months to assess symptom relapse and retreatment rates. Risk factors for retreatment were evaluated. RESULTS Of a total of 558 patients who took the study medication, 173 were randomised and 108 (A: 40, B: 40, C: 28) were included in the analysis. At the end of the treatment, the mean micturition frequency was decreased to 8.3/24 h from 11.7/24 h, and the mean urgency episode was decreased to 2.2/24 h from 8.0/24 h. Three months after discontinuation, the micturition frequency and the urgency episode were increased to 9.1/24 and 4.4/24 h respectively. Sixty five per cent of patients requested retreatment, and 62% experienced symptom relapse. Baseline health-related quality of life was the only independent risk factor for retreatment. DISCUSSION AND CONCLUSION Discontinuation of antimuscarinic therapy resulted in high symptom relapse and retreatment rates regardless of treatment duration. The results provide new information on the durability of the efficacy of antimuscarinics, and may improve treatment efficacy by promoting the medication persistence of antimuscarinics in OAB patients.
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Affiliation(s)
- Y-S Lee
- Department of Urology, Sungkyunkwan University School of Medicine, Samsung Changwon Hospital, Changwon, Korea
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Han YK, Lee WK, Lee SH, Yang DY, Kim H. Effect of desmopressin with anticholinergics in female patients with overactive bladder. Korean J Urol 2011; 52:396-400. [PMID: 21750750 PMCID: PMC3123815 DOI: 10.4111/kju.2011.52.6.396] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Accepted: 05/23/2011] [Indexed: 12/22/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate the effect of desmopressin combined with anticholinergics on daytime frequency and urgency in female patients with overactive bladder (OAB). MATERIALS AND METHODS We included 68 female patients with OAB. Patients were randomly assigned to receive 5 mg of solifenacin (group I) or 5 mg of solifenacin and 0.2 mg of desmopressin (group II) for 2 weeks. A pre/post-treatment 3-day voiding diary and the Urinary Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7) were used to assess changes in voiding symptoms and quality of life (QoL); results were compared between the two groups. RESULTS Groups I and II included 31 and 37 patients, respectively. Time to first void was 12 min later in group II (105 min vs. 117 min), but this difference was not statistically significant. However, time to the second and third voids (203 min vs. 255 min, 312 min vs. 368 min) and the first urgency episode (212 min vs. 255 min) were significantly longer in group II. Compared with group I, patients in group II showed significant improvement in QoL scores. When improvement after treatment was defined as increase in time to first void of greater than 10% after 2 weeks of treatment, desmopressin with anticholinergics was more effective in patients over the age of 65 years and with more than 150 ml of voided volume. CONCLUSIONS Desmopressin combined with anticholinergics was more effective than anticholinergics only in the treatment of female patients with OAB.
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Affiliation(s)
- Young Kook Han
- Department of Urology, School of Medicine, Hallym University, Seoul, Korea
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Kim SA, Kim EH, Do HJ, Lym YL, Choi JK, Joh HK, Kweon HJ, Cho DY, Kim TW. The Relating Factor and Quality of Life of Overactive Bladder in Adults. Korean J Fam Med 2009. [DOI: 10.4082/kjfm.2009.30.11.872] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Seun-Ah Kim
- Department of Family Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Eun-Hae Kim
- Department of Family Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Hyun-Jin Do
- Department of Family Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Youl-Lee Lym
- Department of Family Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Jae-Kyung Choi
- Department of Family Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Hee-Kyung Joh
- Department of Family Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Hyuk-Jung Kweon
- Department of Family Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Dong-Yung Cho
- Department of Family Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Tong-Wook Kim
- Department of Urology, Konkuk University School of Medicine, Seoul, Korea
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Kim IH, Kim JT, Lee SH, Kim SJ, Kim YS, Choi JB. The Relation between Autonomic Nervous System Activity and Lower Urinary Tract Symptoms: An Analysis of Heart Rate Variability in Men with Lower Urinary Tract Symptoms. Korean J Urol 2009. [DOI: 10.4111/kju.2009.50.5.475] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Il Han Kim
- Department of Urology, Ajou University College of Medicine, Suwon, Korea
| | - Jin Tae Kim
- Department of Urology, Kyonggi University Graduate School of Sport Science, Suwon, Korea
| | - Soo Hyung Lee
- Department of Urology, Ajou University College of Medicine, Suwon, Korea
| | - Se Joong Kim
- Department of Urology, Ajou University College of Medicine, Suwon, Korea
| | - Young Soo Kim
- Department of Urology, Ajou University College of Medicine, Suwon, Korea
| | - Jong Bo Choi
- Department of Urology, Ajou University College of Medicine, Suwon, Korea
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Chun KM, Yoon H. A Short-Term Analysis of Parameters Affecting the Outcome of Sacral Neuromodulation. Korean J Urol 2009. [DOI: 10.4111/kju.2009.50.2.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Kye Min Chun
- Department of Urology, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hana Yoon
- Department of Urology, Ewha Womans University School of Medicine, Seoul, Korea
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Kuo HC. Recent Investigations of Urinary Nerve Growth Factor as a Biomarker for Overactive Bladder Syndrome. Korean J Urol 2009. [DOI: 10.4111/kju.2009.50.9.831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
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Lee BY, Jin LH, Yoon SM, Lee T. The Different Mechanisms of Awake Micturitions between Male and Female Rats Using an Overactive Model with Intravesical PGE2 Instillation. Korean J Urol 2008. [DOI: 10.4111/kju.2008.49.9.837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Byoung Youn Lee
- Department of Urology, Inha University College of Medicine by BK21 Project, Incheon, Korea
| | - Long Hu Jin
- Department of Urology, Inha University College of Medicine by BK21 Project, Incheon, Korea
| | - Sang Min Yoon
- Department of Urology, Inha University College of Medicine by BK21 Project, Incheon, Korea
| | - Tack Lee
- Department of Urology, Inha University College of Medicine by BK21 Project, Incheon, Korea
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