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Cho J, Doo SW, Song N, Lee M, Lee H, Kim H, Jeon JS, Noh H, Kwon SH. Dapagliflozin Reduces Urinary Kidney Injury Biomarkers in Chronic Kidney Disease Irrespective of Albuminuria Level. Clin Pharmacol Ther 2024; 115:1441-1449. [PMID: 38451017 DOI: 10.1002/cpt.3237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/12/2024] [Indexed: 03/08/2024]
Abstract
The beneficial effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors in patients with chronic kidney disease (CKD) with low albuminuria levels have not been established. This study aimed to compare the effects of dapagliflozin on kidney injury biomarkers in patients with CKD stratified by albuminuria level. We prospectively enrolled healthy volunteers (HVs; n = 20) and patients with CKD (n = 54) with and without diabetes mellitus. Patients with CKD were divided into two age-matched and sex-matched subgroups according to urinary albumin-creatinine ratio (uACR) levels (<300 mg/g and ≥300 mg/g). The CKD group received dapagliflozin (10 mg/day). Urine samples were collected before treatment and after 3 and 6 months of dapagliflozin. Urinary kidney injury molecule-1 (KIM-1), interleukin-1β (IL-1β), and mitochondrial DNA nicotinamide adenine dinucleotide dehydrogenase subunit-1 (mtND1) copy number were measured. The estimated glomerular filtration rate (eGFR) of patients with CKD was lower than that of HVs (P < 0.001). During the study period, eGFR decreased and uACR did not change in the CKD group. Kidney injury markers were significantly elevated in patients with CKD compared with those in HVs. Dapagliflozin reduced urinary KIM-1, IL-1β, and mtDNA copy number in patients with CKD after 6 months of treatment. In further, the levels of urinary KIM-1 and IL-1β, patients with CKD decreased after 6 months of dapagliflozin treatment regardless of albuminuria level. Dapagliflozin reduced urinary kidney injury biomarkers in patients with CKD, regardless of albuminuria level. These findings suggest that SGLT2 inhibitors may also attenuate the progression of low albuminuric CKD.
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Affiliation(s)
- Junghyun Cho
- Division of Nephrology, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Nayoung Song
- Division of Nephrology, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Minsul Lee
- Hyonam Kidney Laboratory, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Haekyung Lee
- Division of Nephrology, Soonchunhyang University Seoul Hospital, Seoul, Korea
- Hyonam Kidney Laboratory, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Hyongnae Kim
- Division of Nephrology, Soonchunhyang University Seoul Hospital, Seoul, Korea
- Hyonam Kidney Laboratory, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Jin Seok Jeon
- Division of Nephrology, Soonchunhyang University Seoul Hospital, Seoul, Korea
- Hyonam Kidney Laboratory, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Hyunjin Noh
- Division of Nephrology, Soonchunhyang University Seoul Hospital, Seoul, Korea
- Hyonam Kidney Laboratory, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Soon Hyo Kwon
- Division of Nephrology, Soonchunhyang University Seoul Hospital, Seoul, Korea
- Hyonam Kidney Laboratory, Soonchunhyang University Seoul Hospital, Seoul, Korea
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Kim DK, Kim JH, Park JY, Gwon YN, Kim KM, Yang WJ, Doo SW, Song YS. Neoadjuvant Chemotherapy Prior to Radical Cystectomy for Muscle-Invasive Bladder Cancer With Variant Histology: A Systematic Review and Meta-Analysis of Survival Outcomes and Pathological Features. Clin Genitourin Cancer 2024; 22:e53-e65.e1. [PMID: 37598012 DOI: 10.1016/j.clgc.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 08/21/2023]
Abstract
PURPOSE To conduct systematic review and meta-analysis to evaluate effects of neoadjuvant chemotherapy (NAC) on survival and histopathological outcomes of variant histology (VH) of urothelial carcinoma (UC) of bladder. METHODS This systematic review was registered in PROSPERO (CRD42023389115). Literature search was conducted in PubMed/Medline, Embase, and Cochrane Library for studies published up to January 2023. Population, intervention, comparator, outcome, and study design were as follows: bladder cancer patients with VH (population), neoadjuvant chemotherapy (intervention), radical cystectomy only (comparators), oncological survival and pathologic response (outcomes), and retrospective or prospective (study design). RESULTS Finally, a total of 17 studies were included in the present study (quantitative analysis, n = 17; qualitative analysis, n = 12). Pooled HR was 0.49 (95% CI: 0.31-0.76; P = .002) for OS. Pooled HR was 0.61 (95% CI: 0.38-0.98; P = .04) for CSS. Pooled HR was 0.44 (95% CI: 0.21-0.93; P = .03) in PFS. Pooled OR was 6.61 (95% CI: 4.50-9.73; P < .00001) in complete pathologic response. Pooled OR was 9.59 (95% CI: 3.56-25.85; P < .00001) in any pathologic response. Evidence quality assessments for each 5 comparisons using the GRADE approach were that Certainty was moderate in 1, low in 1, and very low in 3. CONCLUSIONS Administration of NAC before surgery in bladder cancer patients with VH might confer better survival outcomes and higher pathologic down staging rate than no administration of NAC before surgery.
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Affiliation(s)
- Do Kyung Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Republic of Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Republic of Korea
| | - Jun Young Park
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Republic of Korea
| | - Yong Nam Gwon
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Republic of Korea
| | - Ki Min Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Republic of Korea
| | - Won Jae Yang
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Republic of Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Republic of Korea
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Republic of Korea.
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Park JY, Yang WJ, Doo SW, Park JJ, Gwon YN, Kim KM, Kim JH, Kim DK. Long-term end-stage renal disease risks after living kidney donation: a systematic review and meta-analysis. BMC Nephrol 2023; 24:152. [PMID: 37254087 DOI: 10.1186/s12882-023-03208-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 05/21/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Recent studies have shown that donor nephrectomy can induce renal function impairment. However, few meta-analysis studies about this have proceeded. Therefore, the objective of this systematic review and meta-analysis including all data of recent research studies was to determine whether living donor nephrectomy (LDN) could induce renal function impairment. METHODS By November 2020, comprehensive literature searches were performed on PubMed, Embase, and Cochrane databases. Inclusion criteria were: (1) observational studies with data about overall end-stage renal disease (ESRD) or chronic kidney disease (CKD) of living kidney donors, (2) control group consisted of people without donor nephrectomy, and (3) outcomes of studies included long-term end-stage renal disease risks after living kidney donation. Risk of Bias in Non-randomized Studies of interventions (ROBINS-I) assessment tool was used to evaluate our methodological quality. RESULTS The qualitative review included 11 studies and the meta-analysis included 5 studies. In the meta-analysis, the integrated overall ESRD risk was 5.57 (95% CI: 2.03-15.30). Regarding the overall risk of bias using ROBINS-I assessment tool, 0 studies was rated as "Low", 7 studies were rated as "moderate", 2 studies were rated as "Serious", and two studies were rated as "Critical". CONCLUSIONS Our study showed that LDN increased ESRD risk in LDN patients. However, in our meta-analysis, variables in included studies were not uniform and the number of included studies was small. To have a definite conclusion, meta-analyses of well-planned and detailed studies need to be conducted in the future.
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Affiliation(s)
- Jun Young Park
- Department of Urology, Soonchunhyang University Seoul Hospital, 59 Daesagwan-Ro, Yongsan-Gu, Seoul, 04401, Korea
| | - Won Jae Yang
- Department of Urology, Soonchunhyang University Seoul Hospital, 59 Daesagwan-Ro, Yongsan-Gu, Seoul, 04401, Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University Seoul Hospital, 59 Daesagwan-Ro, Yongsan-Gu, Seoul, 04401, Korea
| | - Jae Joon Park
- Department of Urology, Soonchunhyang University Seoul Hospital, 59 Daesagwan-Ro, Yongsan-Gu, Seoul, 04401, Korea
| | - Yong Nam Gwon
- Department of Urology, Soonchunhyang University Seoul Hospital, 59 Daesagwan-Ro, Yongsan-Gu, Seoul, 04401, Korea
| | - Ki Min Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, 59 Daesagwan-Ro, Yongsan-Gu, Seoul, 04401, Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, 59 Daesagwan-Ro, Yongsan-Gu, Seoul, 04401, Korea.
| | - Do Kyung Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, 59 Daesagwan-Ro, Yongsan-Gu, Seoul, 04401, Korea.
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Park JJ, Doo SW, Kwon A, Kim DK, Yang WJ, Song YS, Shim SR, Kim JH. Effects of Sexual Rehabilitation on Sexual Dysfunction in Patients with Cardiovascular Disease: A Systematic Review and Meta-Analysis. World J Mens Health 2023; 41:330-341. [PMID: 36593706 PMCID: PMC10042662 DOI: 10.5534/wjmh.220124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/31/2022] [Accepted: 08/10/2022] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Cardiovascular disease (CVD) is one of the leading causes of death, accounting for one-third of all deaths worldwide. Patients with CVD are three times more likely to complain of sexual dysfunction than healthy people. Causes of sexual dysfunction in patients with CVD include physical/mental changes and drug side effects. The prevalence of sexual dysfunction in patients with CVD has been estimated to be up to 89%. Ordinary treatments such as pharmacotherapy cannot effectively reduce sexual problems. Therefore, sexual rehabilitation has a broad spectrum, including exercise therapy such as pelvic floor muscle treatment, appropriate counseling, a multidisciplinary approach, and partner rehabilitation. In this study, systematic review and meta-analysis was performed to investigate the effect of sexual rehabilitation on sexual problems in patients with CVD. MATERIALS AND METHODS Comprehensive literature searches were conducted using MEDLINE, Cochrane Library electronic database, and EMBASE through June 2022. Questionnaire scores at the end point as outcomes of the study were recorded as were standardized mean difference (SMD) with their 95% confidence intervals (CIs). Meta-regression analysis was conducted for each moderator. We performed a risk of bias evaluation for included studies using the RoB 2 tool. RESULTS The overall SMD in the meta-analysis for sexual rehabilitation versus no-sexual rehabilitation was 0.430 (95% CI, 0.226-0.633). There was a statistical difference between groups. SMD changes were 0.674 (95% CI, 0.308-1.039) at one month and 0.320 (95% CI, 0.074-0.565) at six months. The regression analysis with all variables (number of patients, study duration, and questionnaire types) revealed no significance. CONCLUSIONS This study indicates that sexual rehabilitation is an effective method with high therapeutic potential for sexual dysfunction of patients with CVD. However, for clinical application, well-designed studies with many patients should be conducted in the future and the standardization of rehabilitation protocols is required.
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Affiliation(s)
- Jae Joon Park
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Allison Kwon
- Department of Biochemistry, College of Biological Science, University of California, Davis, CA, USA
| | - Do Kyung Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Won Jae Yang
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Sung Ryul Shim
- Department of Health and Medical Informatics, Kyungnam University College of Health Sciences, Changwon, Korea.
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
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Gwon YN, Park JJ, Yang WJ, Doo SW, Kim JH, Kim DK. Comparing effects of alpha-blocker management on acute urinary retention secondary to benign prostatic hyperplasia: A systematic review and network meta-analysis. Prostate Int 2022. [DOI: 10.1016/j.prnil.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Kim JH, Bak SH, Yang HJ, Doo SW, Kim DK, Yang WJ, Kim SU, Lee HJ, Song YS. Improvement of erectile dysfunction using endothelial progenitor cells from fetal cerebral vasculature in the cavernous nerve injury of rats. Basic Clin Androl 2022; 32:21. [PMID: 36451096 PMCID: PMC9714194 DOI: 10.1186/s12610-022-00171-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 09/05/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Because of limited differentiation to endothelium from mesenchymal stem cells, it has been strongly recommended to use endothelial progenitor cells for the regeneration of the damaged endothelium of corpora cavernosa. This study was performed to investigate the immortalized human cerebral endothelial cells and their capability for repairing erectile dysfunction in a rat model of cavernous nerve injury. Circulating endothelial progenitor cells were isolated from human fetal brain vasculature at the periventricular region of telencephalic tissues. Over 95% of CD 31-positive cells were sorted and cultured for 10 days. Human cerebral endothelial progenitor cells were injected into the cavernosa of rats with cavernous nerve injury. Erectile response was then assessed. In in vivo assays, rats were divided into three groups: group 1, sham operation: group 2, bilateral cavernous nerve injury: and group 3, treatment with human cerebral endothelial cells after cavernous nerve injury. RESULTS Established immortalized circulating endothelial progenitor cells showed expression of human telomerase reverse transcriptase transcript by RT-PCR. They also showed the expression of vascular endothelial growth factor, von Willebrand factor, vascular endothelial growth factor receptor, and CD31, cell type-specific markers for endothelial cells by RT-PCR. In in vitro angiogenesis assays, they demonstrated tube formation that suggested morphological properties of endothelial progenitor cells. In in vivo assays, impaired erectile function of rat with cavernous nerve injury recovered at 2, 4, and 12 weeks after transplantation of human cerebral endothelial cells into the cavernosa. CONCLUSIONS Telomerase reverse transcriptase-circulating endothelial progenitor cells from fetal brain vasculature could repair erectile dysfunction of rats with cavernous nerve injury.
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Affiliation(s)
- Jae Heon Kim
- grid.412674.20000 0004 1773 6524Department of Urology, Soonchunhyang University School of Medicine, 04401 Seoul, Republic of Korea
| | - Sang Hong Bak
- Research Institute, e-Biogen Inc., Seoul, Republic of Korea
| | - Hee Jo Yang
- grid.412674.20000 0004 1773 6524Department of Urology, Soonchunhyang University School of Medicine, Cheonan, Republic of Korea
| | - Seung Whan Doo
- grid.412674.20000 0004 1773 6524Department of Urology, Soonchunhyang University School of Medicine, 04401 Seoul, Republic of Korea
| | - Do Kyung Kim
- grid.412674.20000 0004 1773 6524Department of Urology, Soonchunhyang University School of Medicine, 04401 Seoul, Republic of Korea
| | - Won Jae Yang
- grid.412674.20000 0004 1773 6524Department of Urology, Soonchunhyang University School of Medicine, 04401 Seoul, Republic of Korea
| | - Seung U. Kim
- grid.416957.80000 0004 0633 8774Division of Neurology, Department of Medicine, UBC Hospital, University of British Columbia, Vancouver, Canada
| | - Hong J. Lee
- Research Institute, e-Biogen Inc., Seoul, Republic of Korea ,grid.254229.a0000 0000 9611 0917Medical Research Institute, Chungbuk National University, Cheongju, Chungbuk Republic of Korea
| | - Yun Seob Song
- grid.412674.20000 0004 1773 6524Department of Urology, Soonchunhyang University School of Medicine, 04401 Seoul, Republic of Korea
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Kim DK, Park JJ, Yang WJ, Doo SW, Kim JH. Relationship Between Androgen Deprivation Therapy for Prostate Cancer and Risk of SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis. J Korean Med Sci 2022; 37:e237. [PMID: 35942555 PMCID: PMC9359920 DOI: 10.3346/jkms.2022.37.e237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/30/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Several cohort studies have explored the relationship between androgen deprivation therapy (ADT) and the severity of coronavirus disease 2019 (COVID-19). This study aimed to characterize the relationship between ADT and the severity of COVID-19 in patients with prostate cancer. METHODS A systematic search was conducted using PubMed, Embase, and Cochrane Library databases from the inception of each database until February 31, 2020. Patients with prostate cancer who were treated with ADT were assigned to treatment group while those patients who were not treated with ADT were assigned to the control group. Outcomes were severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) positivity, hospitalization, intensive care unit (ICU) admission, and death. The risk of bias was evaluated using ROBINS-I (Risk Of Bias In Non-randomized Studies of Interventions) tool. RESULTS Three studies with qualitative synthesis were included. Finally, two studies with quantitative synthesis having a total of 44,213 patients were included for the present systematic review. There was no significant difference in SARS-CoV-2 positive rate (odds ratio [OR], 0.52; 95% confidence intervals [Cis], 0.13-2.09; P = 0.362), hospitalization (OR, 0.52; 95% CIs, 0.07-3.69; P = 0.514), ICU admission (OR, 0.93; 95% CIs, 0.39-2.23, P = 0.881), or death (OR, 0.88; 95% CIs, 0.06-12.06; P = 0.934) between ADT and non-ADT groups. CONCLUSION Qualitative and quantitative analyses of previous studies revealed no significant effect of ADT on COVID-19. However, more studies with higher quality that explore biochemical and immunological factors involved are needed to confirm this finding in the future.
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Affiliation(s)
- Do Kyung Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jae Joon Park
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Won Jae Yang
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
- Urological Biomedicine Research Institute, Soonchunhyang University Seoul Hospital, Seoul, Korea.
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Kim DK, Park JJ, Yang WJ, Doo SW, Kim JH, Song YS. Changes in diagnosis rate and treatment trends of benign prostatic hyperplasia in Korea: A nationwide population-based cohort study. Prostate Int 2021; 9:215-220. [PMID: 35059360 PMCID: PMC8740390 DOI: 10.1016/j.prnil.2021.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 07/24/2021] [Accepted: 08/24/2021] [Indexed: 11/28/2022] Open
Abstract
Purpose This study aimed to evaluate benign prostatic hyperplasia (BPH) diagnosis rate and the changing landscape of medical and surgical management of BPH over the last decade using national population data of South Korea. Methods The present study analyzed data of patients diagnosed with BPH (N40) who underwent medical treatment or surgery in 3% of the national patient sample of the Health Insurance and Review Assessment database each year between 2012 and 2018. The primary outcome was the proportion of medical and surgical treatment for BPH. It was evaluated each year between 2012 and 2018. Secondary outcomes included total BPH diagnosis rate in each year of the study period. BPH diagnosis rate by age group was evaluated. The proportion of medical and surgical treatment for BPH according to the type of medical institution was investigated. Results The proportion of surgical treatment was 1.2% in 2012, 1.0% in 2013, 1.0% in 2014, 0.9% in 2015, 0.8% in 2016, 0.7% 2018, and 0.8% 2018, showing a progressive overall decrease from 2012 to 2018. The rate of surgical treatment for BPH increased with increasing age during the study period, showing a progressive overall increase (from 9,202 per 100,000 men in 2012 to 11,610 per 100 000 men in 2018). The number of patients with BPH was increased steadily from 2012 to 2018 in all age groups. The rate of surgical treatment in tertiary referral hospitals was the highest during the study period, followed by that in general hospitals, hospitals, and clinics. Conclusions In Korea, the diagnosis rate of BPH was steadily increasing during the study period. Overall surgical treatment gradually decreased compared with an increase in medical treatment among all treatments for BPH. Thus, a comprehensive treatment plan for BPH should be established considering this trend.
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Affiliation(s)
- Do Kyung Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Korea
| | - Jae Joon Park
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Korea
| | - Won Jae Yang
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Korea
- Urological Biomedicine Research Institute, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Korea
- Corresponding author. Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, 59, Daesagwan-ro, Yongsan-gu, Seoul, Korea.
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Kim DK, Kim YH, Lee HY, Lee S, Doo SW, Yang WJ, Song YS, Kim KH, Kim JH. Diagnostic accuracy of Raman spectroscopy for the diagnosis of bladder cancer: A systematic review and meta-analysis. J Cancer Res Ther 2021; 17:426-433. [PMID: 34121688 DOI: 10.4103/jcrt.jcrt_891_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Introduction Although several studies have been conducted to evaluate the feasibility of Raman spectroscopy (RS) for the diagnosis of bladder cancer (BCa), it is difficult to use RS in real clinical settings based on the current limited evidence. Therefore, we performed a systematic review and meta-analysis to assess the diagnostic accuracy of RS in BCa. Materials and Methods Comprehensive literature searches were performed in the PubMed/Medline, Embase, and Cochrane Library databases up to March 2019. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, this study included reports according to the participant, intervention, comparator, outcomes, and study design approach. The methodological quality of the included studies was evaluated according to questionnaires and criteria suggested by the Quality Assessment of Diagnostic Accuracy Studies-2 tool. The quantitative outcomes included diagnostic accuracy (sensitivity and specificity). Results Fifteen studies were included for qualitative analysis and four studies (BCa cases, n = 139; control cases n = 107) were included in this analysis by screening the full text of the remaining articles based on the inclusion and exclusion criteria through a systematic review. The pooled sensitivity and specificity of RS were 0.91 (95% confidence interval [CI]: 0.85-0.95) and 0.93 (95% CI: 0.86-0.97), respectively. The among-study heterogeneity was statistically significant in the specificity results (Cochran Q statistic, P = 0.015; I2 statistic, 71.3%) but not in the sensitivity results (Cochran Q statistic, P = 0.189; I2 statistic, 37.2%). Conclusions RS showed the potential to be an efficient tool with high accuracy for detecting malignant bladder lesions. More studies with in vivo real-time settings are warranted to validate our results.
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Affiliation(s)
- Do Kyung Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Korea
| | - Yon Hee Kim
- Department of Pathology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Korea
| | - Hyun Young Lee
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Korea
| | - Soomin Lee
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Korea
| | - Won Jae Yang
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Korea
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Korea
| | - Ki Hyun Kim
- Korea Photonics Technology Institute, Gwangju, Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Korea
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Kim JH, Shim JS, Kim JW, Doo SW, Bae JH, Lee JH, Song YS, Kim JJ, Moon DG. Molecular and Histologic Evidence of Novel Erectile Dysfunction Rat Model as an Aging Atherosclerosis Model: A Preliminary Study. World J Mens Health 2019; 38:345-352. [PMID: 31385467 PMCID: PMC7308229 DOI: 10.5534/wjmh.190031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 04/28/2019] [Accepted: 05/07/2019] [Indexed: 11/15/2022] Open
Abstract
Purpose To validate a novel arteriogenic erectile dysfunction (ED) model with atherosclerosis (AS) based on molecular and histologic evidence induced by chronic pelvic ischemia (CPI) and determine effect of phosphodiesterase-5 inhibitor treatment. Materials and Methods Twenty 16-week-old male Sprague–Dawley rats were divided into three experimental groups (Group I, untreated sham-operated rats with regular diet; Group II, CPI with cholesterol diet; Group III, CPI model with cholesterol diet and mirodenafil). Erectile function was accessed using maximum intracavernous pressure (ICP) and ICP/mean arterial pressure (MAP). Molecular changes were examined by western blot analysis using hypoxia inducible factor 1-alpha (HIF-1α), endothelial nitric oxide synthase (eNOS), and transforming growth factor beta-1 (TGF-β1) antibodies. Collagen change was evaluated by Masson's trichrome staining. Results In vivo measurements of ICP and ICP/MAP in Group II were significantly lower than those in Group I (p<0.01). Smooth muscle/collagen ratio in Group II was significantly lower than that in Group I (p<0.05). After treatment with mirodenafil for four weeks, Group III showed significantly higher levels of ICP and ICP/MAP than Group II (p<0.05). Western blot analysis showed that HIF-1α and TGF-β1 levels were significantly higher in Group II whereas eNOS levels were significantly lower in Group II than those in Group I or III. Conclusions A novel arteriogenic ED with AS model is successfully induced by CPI and validated based on molecular and histologic evidences.
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Affiliation(s)
- Jae Heon Kim
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Ji Sung Shim
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Jong Wook Kim
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jae Hyun Bae
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Ju Han Lee
- Department of Pathology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Je Jong Kim
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Du Geon Moon
- Department of Urology, Korea University College of Medicine, Seoul, Korea.
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Lee HY, Kim DK, Doo SW, Yang WJ, Song YS, Lee B, Kim JH. Time Trends for Prostate Cancer Incidence from 2003 to 2013 in South Korea: An Age-Period-Cohort Analysis. Cancer Res Treat 2019; 52:301-308. [PMID: 31401823 PMCID: PMC6962480 DOI: 10.4143/crt.2019.194] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/28/2019] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Prostate cancer (PCa) incidence is affected by aging phenomenon and performance of screening test. In United States, PCa incidence is affected by period effect of U.S. Preventive Services Task Force (USPSTF) recommendation. However, no study has reported the effect of USPSTF recommendation or aging phenomenon on PCa incidence in South Korea. Thus, the objective of this study was to investigate effects of age, period, and birth cohort on PCa incidence using age-period-cohort analysis. Materials and Methods Annual report of cancer statistics between 2003 and 2013 from National Health Insurance Service (NHIS) in South Korea for the number of PCa patients and Korean Statistical Information Service (KOSIS) data between 2003 and 2013 from national statistics in South Korea for the number of Korean male population were used. Age-period-cohort models were used to investigate effects of age, period, and birth cohort on PCa incidence. RESULTS Overall PCa incidence in South Korea was increased 8.8% in annual percentage (95% confidential interval, 6.5 to 11.2; p < 0.001). It showed an increasing pattern from 2003 to 2011 but a decreasing pattern from 2011 to 2013. Age increased the risk of PCa incidence. However, the speed of increase was slower with increasing age. PCa incidence was increased 1.4 times in 2008 compared to that in 2003 or 2013. Regarding cohort effect, the risk of PCa incidence started to increase from 1958 cohort. CONCLUSION PCa incidence was affected by period of specific year. There was a positive cohort effect on PCa incidence associated with age structural change.
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Affiliation(s)
- Hyun Young Lee
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Do Kyoung Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Won Jae Yang
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Bora Lee
- Department of Statistics, Graduate School of Chung-Ang University, Seoul, Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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Lee HY, Park S, Doo SW, Yang WJ, Song YS, Kim JH. Trends in Prostate Cancer Prevalence and Radical Prostatectomy Rate according to Age Structural Changes in South Korea between 2005 and 2015. Yonsei Med J 2019; 60:257-266. [PMID: 30799588 PMCID: PMC6391527 DOI: 10.3349/ymj.2019.60.3.257] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 01/22/2019] [Accepted: 01/24/2019] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Radical prostatectomy (RP) is one of main treatments for prostate cancer (Pca). The prevalence of Pca has been decreasing in recent reports. However, no study has reported trends in Pca prevalence or RP rate according to age structural changes. The objective of this study was to investigate trends in Pca prevalence and frequency of RP according to age structural change. MATERIALS AND METHODS We evaluated trends in Pca prevalence and RP rate using National Health Insurance Data from 2005 to 2015. Relationships for Pca prevalence and RP rate with age structural change were also determined. Primary outcomes included trends in Pca prevalence and RP rates according to age groups, comparing those before and after 2011. RESULTS Pca prevalence tended to increase before 2011 and decreased after 2011 in persons in the 60-years age group. RP rate increased pattern before 2011 and decreased after 2011 in age groups of 50s, 60s, and over 70s. Pca prevalence and age structural change showed a significantly positive relationship in all age groups, except for the age group under 40 years. RP rate and age structural change also showed a significantly positive relationship in all age groups. CONCLUSION Age structural change can affect the decreasing trend in Pca prevalence and RP rate in South Korea. Future studies are needed to validate this result.
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Affiliation(s)
- Hyun Young Lee
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Korea
| | - Suyeon Park
- Department of Biostatistics, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Korea
| | - Won Jae Yang
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Korea
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, Korea.
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Lee HY, Doo SW, Yang WJ, Song YS, Sun HY, Nho EJ, Lee B, Kim JH. Efficacy and Safety of Noninvasive Intravesical Instillation of Onabotulinum Toxin-A for Overactive Bladder and Interstitial Cystitis/Bladder Pain Syndrome: Systematic Review and Meta-analysis. Urology 2018; 125:50-57. [PMID: 30552935 DOI: 10.1016/j.urology.2018.11.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 11/27/2018] [Accepted: 11/30/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the efficacy and safety of noninvasive intravesical instillation of onabotulinum toxin-A (OBTX-A) through systematic review and meta-analysis. Recently, several studies of noninvasive intravesical instillation of OBTX-A have been published. However, its efficacy is not well validated yet compared to well-known efficacy of minimally invasive intravesical injection of OBTX-A. METHOD Systematic review and meta-analysis were performed to evaluate the efficacy of noninvasive intravesical instillation of OBTX-A in patients with overactive bladder and interstitial cystitis/bladder pain syndrome by measuring outcomes such as urgency episode per 72 hours, frequency per 72 hours, urgency urinary incontinence, voided volume (VV), postvoided residual volume, maximum flow rate, and patient perception of bladder condition. RESULT Six trials in 4 studies that compared instillation of OBTX-A and placebo involving 248 patients (121 experimental and 127 controls) were included for final data extraction. Instillation of OBTX-A significantly increased VV, with a mean difference of 38.48 (95% confidence interval: 76.05, 0.92) compared to the placebo group. However, other outcomes showed statistically insignificant changes. Major adverse events were not reported in the group receiving intravesical instillation of OBTX-A. CONCLUSION Intravesical instillation of OBTX-A showed limited efficacy with improvement of VV for treatment of overactive bladder or interstitial cystitis/bladder pain syndrome. More studies are needed to overcome the efficacy of current noninvasive bladder instillation of OBTX-A regarding effective drug transport.
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Affiliation(s)
- Hyun Young Lee
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, South Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, South Korea
| | - Won Jae Yang
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, South Korea
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, South Korea
| | - Hwa Yeon Sun
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, South Korea
| | | | - Bora Lee
- Department of Statistics, Graduate School of Chung-Ang University, Seoul, South Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, South Korea.
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Lee HY, Moon JE, Sun HY, Doo SW, Yang WJ, Song YS, Lee SR, Park BW, Kim JH. Association between lower urinary tract symptoms and cardiovascular risk scores in ostensibly healthy women. BJU Int 2018; 123:669-675. [PMID: 30281886 DOI: 10.1111/bju.14577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To investigate the association between lower urinary tract symptoms (LUTS) and cardiovascular disease (CVD) risk in women, as severe LUTS are known to be associated with CVD risk in men but few studies have focused on this issue in women. SUBJECTS AND METHODS A total of 1014 ostensibly healthy women, who participated in a voluntary health check in a health promotion centre from November 2013 to October 2015, were enrolled. LUTS were assessed using the International Prostate Symptom Score (IPSS) and Overactive Bladder Symptom Score (OABSS). CVD risk scores were calculated using the Framingham risk score and the American College of Cardiology/American Heart Association Atherosclerotic Cardiovascular Disease (ASCVD) score. Correlation, partial correlation, and multiple logistic regression analyses were conducted. RESULTS The mean age and body mass index (BMI) of the women were 51 years and 22.6 kg/m2 , respectively. The ASCVD score showed significant positive correlations with IPSS items Question 2 (Q2), Q3, Q5, and Q7 (all P < 0.05), total IPSS (P = 0.001), IPSS storage (P = 0.006) and IPSS voiding symptoms scores (P = 0.001) based on partial correlation analysis after adjustment for BMI. For the OABSS, the ASCVD score showed significant positive correlations with OABSS items Q2, Q3, and Q4 (P < 0.001, P = 0.017, and P < 0.001, respectively) and total OABSS (P < 0.001). Multiple logistic regression analysis showed that the moderate-severe risk groups of the OABSS and IPSS were associated with the ASCVD risk score in adjusted models (P < 0.001) compared to the none-mild OABSS and mild IPSS groups. After adjustment for age and BMI, IPSS storage score was significantly related with the ASCVD risk score (B = 0.855, P = 0.016) CONCLUSIONS: LUTS, especially storage symptoms, might be risk factors for predicting future CVD risk in women. Further prospective or cohort studies are needed to validate this possibility.
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Affiliation(s)
- Hyun Young Lee
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, South Korea
| | - Ji Eun Moon
- Department of Biostatistics, Clinical Trial Center, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - Hwa Yeon Sun
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, South Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, South Korea
| | - Won Jae Yang
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, South Korea
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, South Korea
| | - So-Ryoung Lee
- Department of Cardiology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, South Korea
| | - Byoung-Won Park
- Department of Cardiology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, South Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University Medical College, Seoul, South Korea
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Kim HJ, Sun HY, Choi H, Park JY, Bae JH, Doo SW, Yang WJ, Song YS, Ko YM, Kim JH. Efficacy and Safety of Initial Combination Treatment of an Alpha Blocker with an Anticholinergic Medication in Benign Prostatic Hyperplasia Patients with Lower Urinary Tract Symptoms: Updated Meta-Analysis. PLoS One 2017; 12:e0169248. [PMID: 28072862 PMCID: PMC5224810 DOI: 10.1371/journal.pone.0169248] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 12/14/2016] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND There is still controversy as to whether initial combination treatment is superior to serial addition of anticholinergics after maintenance or induction of alpha blockers in benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS). OBJECTIVE The objective of this study was to determine the benefits and safety of initial combination treatment of an alpha blocker with anticholinergic medication in BPH/LUTS through a systematic review and meta-analysis. METHODS We conducted a meta-analysis of improvement in LUTS using International Prostate Symptom Score (IPSS), maximal urinary flow rate (Qmax), post-voided residual volume (PVR), and quality of life (QoL). RESULTS In total, 16 studies were included in our analysis, with a total sample size of 3,548 subjects (2,195 experimental subjects and 1,353 controls). The mean change in total IPSS improvement from baseline in the combination group versus the alpha blocker monotherapy group was -0.03 (95% CI: -0.14-0.08). The pooled overall SMD change of storage IPSS improvement from baseline was -0.28 (95% CI: -0.40 - -0.17). The pooled overall SMD changes of QoL, Qmax, and PVR were -0.29 (95% CI: -0.50 - -0.07), 0.00 (95% CI: -0.08-0.08), and 0.56 (95% CI: 0.23-0.89), respectively. There was no significant difference in the number of acute urinary retention (AUR) events or PVR. CONCLUSIONS Initial combination treatment of an alpha blocker with anticholinergic medication is efficacious for in BPH/ LUTS with improved measures such as storage symptoms and QoL without causing significant deterioration of voiding function.
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Affiliation(s)
- Hyun Jung Kim
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Hwa Yeon Sun
- Department of Urology, Soonchunhyang University Hospital, Sonchunhyang University College of Medicine, Seoul, Korea
| | - Hoon Choi
- Department of Urology, Korea University Hospital, Korea University College of Medicine, Ansan, Korea
| | - Jae Young Park
- Department of Urology, Korea University Hospital, Korea University College of Medicine, Ansan, Korea
| | - Jae Hyun Bae
- Department of Urology, Korea University Hospital, Korea University College of Medicine, Ansan, Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University Hospital, Sonchunhyang University College of Medicine, Seoul, Korea
| | - Won Jae Yang
- Department of Urology, Soonchunhyang University Hospital, Sonchunhyang University College of Medicine, Seoul, Korea
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University Hospital, Sonchunhyang University College of Medicine, Seoul, Korea
| | - Young Myoung Ko
- Department of Industrial and Management Engineering, Pohang University of Science and Technology, Pohang, Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Hospital, Sonchunhyang University College of Medicine, Seoul, Korea
- * E-mail:
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Kim JH, Sun HY, Kim TH, Shim SR, Doo SW, Yang WJ, Lee EJ, Song YS. Prevalence of antibiotic susceptibility and resistance of Escherichia coli in acute uncomplicated cystitis in Korea: Systematic review and meta-analysis. Medicine (Baltimore) 2016; 95:e4663. [PMID: 27603359 PMCID: PMC5023881 DOI: 10.1097/md.0000000000004663] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The aim of this study is to determine the prevalence of antibiotic susceptibility and resistance of Escherichia coli Escherichia coli (E coli) in female uncomplicated cystitis in Korea using meta-analysis. METHODS A cross-search of the literature was performed with MEDLINE for all relevant data published before October 2015 and EMBASE from 1980 to 2015, the Cochrane Library, KoreaMed, RISS, KISS, and DBPia were also searched. Observational or prospective studies that reported the prevalence of antimicrobial susceptibility and resistance of E coli were selected for inclusion. No language or time restrictions were applied. We performed a meta-analysis using a random effects model to quantify the prevalence of antimicrobial susceptibility and resistance of E coli. RESULTS Ten studies were eligible for the meta-analysis, which together included a total of 2305 women with uncomplicated cystitis. The overall resistance rate to antibiotics was 0.28 (95% confidence interval [CI]: 0.25, 0.32). The pooled resistance rates were 0.08 (95% CI: 0.06, 0.11) for cephalosporin, 0.22 (95% CI: 0.18, 0.25) for fluoroquinolone (FQ), and 0.43 (95% CI: 0.35, 0.51) for trimethoprim/sulfamethoxazole (TMP/SMX). Regression analysis showed that resistance to FQ is increasing (P = 0.014) and resistance to TMP/SMX is decreasing (P = 0.043) by year. The generation of cephalosporin was not a significant moderator of differences in resistance rate. CONCLUSION The resistance rate of FQ in Korea is over 20% and is gradually increasing. Although the resistance rate of TMP/SMX is over 40%, its tendency is in decreasing state. Antibiotic strategies used for the treatment of uncomplicated cystitis in Korea have to be modified.
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Affiliation(s)
| | | | - Tae Hyong Kim
- Department of Internal Medicine
- Correspondence: Tae Hyong Kim, Department of Internal Medicine, Soonchunhyang University, Seoul Hospital, 59, Daesagwan-ro, Yongsan-gu, Seoul 140-743, Republic of Korea (e-mail: )
| | - Sung Ryul Shim
- Institute for Clinical Molecular Biology Research, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
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Shim SR, Kim JH, Doo SW, Yang WJ, Song ES, Song YS. Association Between Ambient Temperature and Lower Urinary Tract Symptoms: A Hospital-Based Cross-Sectional Analysis. Low Urin Tract Symptoms 2016; 10:38-44. [PMID: 27438480 DOI: 10.1111/luts.12138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 04/03/2016] [Accepted: 04/10/2016] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To date, there is no overall agreement as to risk of ambient temperature for lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). Thus, we focused on ambient temperature as an environmental factor affecting LUTS and attempted to explain the temperature differences in LUTS severity in cases in real clinical practice. METHODS This was a multicenter, cross-sectional survey. The study involved 1612 men aged 40 years and older who visited 23 university hospitals in 10 major areas in South Korea between September 2010 and December 2011. The participants who had good overall mental and physical health, and complaint of LUTS were included. Korea Meteorological Administration data were used to determine daily average temperatures and daily temperatures on the interview dates at each site. RESULTS The average age of the 1612 men was 66.57 ± 10.03 years. The mean International Prostate Symptom Score (IPSS) and symptom duration were 18.51 ± 6.77 and 3.79 ± 3.89 years, respectively. Daily average temperature and temperature difference ranged from -13.1 to 28.5 °C and 0 to 20.6 °C, respectively. Age was a significant risk factor for IPSS, symptom duration, prostate volume (PV), maximal urinary flow rate (Qmax), average urinary flow rate (Qave) and total voiding volume (P < 0.001) but not QOL. Logistic regression analysis after adjustment for age and PV revealed that Qave and total voiding volume were increased as the temperature declined. However, IPSS and Qmax did not show a statistically significant difference as the temperature declined. CONCLUSION Our findings did not demonstrate an increased clinically significant risk of LUTS severity in connection with ambient temperature in clinical practice.
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Affiliation(s)
- Sung Ryul Shim
- Institute for Clinical Molecular Biology Research, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Won Jae Yang
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Eun Seop Song
- Department of Obstetrics and Gynecology, Inha University School of Medicine, Incheon, Korea
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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Song YA, Kwon SS, Doo SW, Kim JH, Yang WJ, Song YS. Is There Any Relation Between the Degree of Fatty Liver Disease and Severity of Lower Urinary Tract Symptoms? Urology 2016; 89:90-5. [DOI: 10.1016/j.urology.2015.11.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 11/21/2015] [Accepted: 11/24/2015] [Indexed: 11/29/2022]
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Yoon JH, Yang HJ, Kim JH, Doo SW, Yang WJ, Hwang J, Hong SS, Park S, Cho DY. The likelihood of having a serum PSA level of ≥2.5 ng/mL according to the degree of fatty liver disease in a screened population. Can Urol Assoc J 2016; 9:E868-72. [PMID: 26788237 DOI: 10.5489/cuaj.2395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We sought to investigate the impact of fatty liver disease (FLD) on prostate cancer (PCa) screening by estimating the odds of having a prostate-specific antigen (PSA) value over the cutoff used to prompt for the recommendation of prostate biopsy. METHODS Between 2007 and 2013, 18 533 native Korean men eligible to receive a serum PSA test, liver profiles, and abdominal ultrasonography were recruited. Logistic regression was used to estimate the odds of an abnormal PSA (≥2.5 ng/mL) in these men (age 45-75 years, PSA≤10 ng/mL) in relation to FLD. The FLD status was categorized as normal, mild, moderate, and severe grade by abdominal sonography. RESULTS A total of 16 563 men (89.4%) were included in the study after applying the inclusion criteria. Liver profiles were negatively correlated with the serum PSA level. After controlling for age and obesity, there was a statistically significant trend towards a lower likelihood of having a serum PSA level of ≥2.5 ng/mL with severe FLD, having a 34.7% lower likelihood (odds ratio 0.653, 95% confidence interval 0.477-0.88; p<0.01) compared to men in the normal group. CONCLUSIONS Severe FLD is an independent predictor of a lower likelihood of having abnormal PSA level. Further studies are needed to better define these results in clinical biopsy practice.
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Affiliation(s)
- Jong Hyun Yoon
- Department of Urology, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Hee Jo Yang
- Department of Urology, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Won Jae Yang
- Department of Urology, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Jiyoung Hwang
- Department of Radiology, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Seong Sook Hong
- Department of Radiology, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Suyeon Park
- Department of Biostatistics, Soonchungyang University, College of Medicine, Seoul, Republic of Korea
| | - Dae Yeon Cho
- Department of Urology, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Lee HJ, An J, Doo SW, Kim JH, Choi SS, Lee SR, Park SW, Song YS, Kim SU. Improvement in Spinal Cord Injury-Induced Bladder Fibrosis Using Mesenchymal Stem Cell Transplantation into the Bladder Wall. Cell Transplant 2015; 24:1253-63. [DOI: 10.3727/096368914x682125] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Experiments on spinal cord injury (SCI) have largely focused on the transplantation of stem cells into injured spinal cords for motor recovery while neglecting to investigate bladder dysfunction. The present study was performed to investigate the effect of B10 human mesenchymal stem cells (hMSCs) directly transplanted into the bladder wall of SCI rats and to determine whether they are capable of inhibiting collagen deposition and improving cystometric parameters in SCI rats. Forty 6-week-old female Sprague–Dawley rats were divided into four groups (group 1: control, group 2: sham operated, group 3: SCI, group 4: SCI rats that received B10 cells). B10 cells were labeled with fluorescent magnetic nanoparticles (MNPs). Four weeks after the onset of SCI, MNP-labeled B10 cells were injected to the bladder wall. Serial magnetic resonance (MR) images were taken immediately after MNP-B10 injection and at 4 weeks posttransplantation. Voiding function was assessed at 4 weeks posttransplantation, and the bladder was harvested. Improvements in bladder fibrosis and bladder function were monitored by molecular MR imaging. Transplantation of B10 cells into the SCI rats markedly reduced their weights and collagen deposition. MR images showed a clear hypointense signal induced by the MNP-labeled B10 cells at 4 weeks posttransplantation. Transplanted B10 cells were found to differentiate into smooth muscle cells. The intercontraction interval decreased, and the maximal voiding pressure increased after SCI but recovered after B10 cell transplantation. Survival of B10 cells was found at 4 weeks posttransplantation using anti-human mitochondria antibody staining and MR imaging. The transplanted B10 cells inhibited bladder fibrosis and ameliorated bladder dysfunction in the rat SCI model. MSC-based cell transplantation may be a novel therapeutic strategy for bladder dysfunction in patients with SCI.
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Affiliation(s)
- Hong Jun Lee
- Biomedical Research Institute, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jin An
- Biomedical Research Institute, Chung-Ang University College of Medicine, Seoul, Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University School of Medicine, Seoul, Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University School of Medicine, Seoul, Korea
| | - Sung Sik Choi
- Biomedical Research Institute, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sang-Rae Lee
- National Primate Research Center, Korea Research Institute of Bioscience and Biotechnology, Ochang, Korea
| | - Seung Won Park
- Department of Neurosurgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University School of Medicine, Seoul, Korea
| | - Seung U. Kim
- Biomedical Research Institute, Chung-Ang University College of Medicine, Seoul, Korea
- Division of Neurology, Department of Medicine, UBC Hospital, University of British Columbia, Vancouver, Canada
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Kim JH, Doo SW, Yang WJ, Song YS, Kwon SS. Association Between High-sensitivity C-reactive Protein and Lower Urinary Tract Symptoms in Healthy Korean Populations. Urology 2015; 86:139-44. [DOI: 10.1016/j.urology.2015.03.035] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 03/20/2015] [Accepted: 03/31/2015] [Indexed: 10/23/2022]
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Kim JH, Shim SR, Doo SW, Yang WJ, Yoo BW, Kim JM, Ko YM, Song ES, Lim IS, Lee HJ, Song YS. Bladder recovery by stem cell based cell therapy in the bladder dysfunction induced by spinal cord injury: systematic review and meta-analysis. PLoS One 2015; 10:e0113491. [PMID: 25781610 PMCID: PMC4363872 DOI: 10.1371/journal.pone.0113491] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 10/23/2014] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Bladder dysfunction induced by spinal cord injury (SCI) can become problematic and severely impair the quality of life. Preclinical studies of spinal cord injury have largely focused on the recovery of limb function while neglecting to investigate bladder recovery. OBJECTIVE The present study was performed to investigate and review the effect of stem cell-based cell therapy on bladder recovery in SCI. METHODS We conducted a meta-analysis of urodynamic findings of experimental trials that included studies of stem cell-based cell therapy in SCI. Relevant studies were searched using MEDLINE, EMBASE and Cochrane Library (January 1990 - December 2012). Final inclusion was determined by a urodynamic study involving detailed numerical values. Urodynamic parameters for analysis included voiding pressure, residual urine, bladder capacity and non-voiding contraction (NVC). Meta-analysis of the data, including findings from urodynamic studies, was performed using the Mantel-Haenszel method. RESULTS A total of eight studies were included with a sample size of 224 subjects. The studies were divided into different subgroups by different models of SCI. After a stem cell-based cell therapy, voiding pressure (-6.35, p <0.00001, I2 = 77%), NVC (-3.58, p <0.00001, I2 = 82%), residual urine (-024, p = 0.004, I2 = 95%) showed overall significant improvement. Bladder capacity showed improvement after treatment only in the transection type (-0.23, p = 0.0002, I2 = 0%). CONCLUSION After stem cell-based cell therapy in SCI, partial bladder recovery including improvement of voiding pressure, NVC, and residual urine was demonstrated. Additional studies are needed to confirm the detailed mechanism and to obtain an ideal treatment strategy for bladder recovery.
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Affiliation(s)
- Jae Heon Kim
- Department of Urology, Soonchunyang University Hospital, Soonchunhyang University School of Medicine, Seoul, Korea
| | - Sung Ryul Shim
- Institute for clinical molecular biology research, Soonchunyang University Hospital, Soonchunhyang University School of Medicine, Seoul, Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunyang University Hospital, Soonchunhyang University School of Medicine, Seoul, Korea
| | - Won Jae Yang
- Department of Urology, Soonchunyang University Hospital, Soonchunhyang University School of Medicine, Seoul, Korea
| | - Byung Wook Yoo
- Department of Family Medicine, Soonchunhyang University School of Medicine, Seoul, Korea
| | - Joyce Mary Kim
- International Clinic Center, Soonchunhyang University Hospital, Seoul, Korea
| | - Young Myoung Ko
- Department of Industrial and Management Engineering, Pohang University of Science and Technology, Pohang, Korea
| | - Eun Seop Song
- Department of Obstetrics and Gynecology, Inha University School of Medicine, Incheon, Korea
| | - Ik Sung Lim
- Department of Industrial Management and Engineering, Namseoul University College of Engineering, Cheonan, Korea
| | - Hong Jun Lee
- Medical Research Institute, Chung-Ang University College of Medicine, Seoul, Korea
- * E-mail: (HJL); (YSS)
| | - Yun Seob Song
- Department of Urology, Soonchunyang University Hospital, Soonchunhyang University School of Medicine, Seoul, Korea
- * E-mail: (HJL); (YSS)
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Kim JH, Doo SW, Cho KS, Yang WJ, Song YS, Hwang J, Hong SS, Kwon SS. Which anthropometric measurements including visceral fat, subcutaneous fat, body mass index, and waist circumference could predict the urinary stone composition most? BMC Urol 2015; 15:17. [PMID: 25887850 PMCID: PMC4381452 DOI: 10.1186/s12894-015-0013-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Accepted: 02/26/2015] [Indexed: 11/21/2022] Open
Abstract
Background Although there is growing evidence of relationship between obesity and some specific stone compositions, results were inconsistent. Due to a greater relationship between metabolic syndrome and some specific stone type, obesity measured by body mass index (BMI) has limitation in determining relationship between obesity and stone compositions. The aim of this study was to determine the relationship among BMI, visceral fat, and stone compositions. Methods We retrospectively reviewed data of patients with urinary stone removed over a 5 year period (2011–2014). Data on patient age, gender, BMI, urinary pH, stone composition, fat volumes (including visceral fat, subcutaneous fat, total fat, waist circumference), and ratio for visceral to total fat using computed tomography based delineation were collected. To figure out the predicting factor while adjusting other confounding factors, discriminant analysis was used. Results Among 262 cases, average age was 52.21 years. Average BMI and visceral fat were 25.03 cm2 and 124.75 cm2, respectively. By chi square test, there was significant (p < 0.001) difference in stone types according to sex. By ANOVA test, BMI, visceral fat, visceral to subcutaneous fat ratio, the percentage of visceral fat and total fat showed significant association with stone types. By discriminant analysis, visceral fat was proved to be a powerful factor to predict stone composition (structure matrix of visceral fat = −0.735) with 42.0% of predictive value. Conclusion Visceral fat adiposity strongly related with uric acid stone and has better predictive value than BMI or urinary pH to classify the types of stone.
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Affiliation(s)
- Jae Heon Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
| | - Kang Su Cho
- Department of Urology, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
| | - Won Jae Yang
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
| | - Jiyoung Hwang
- Department of Radiology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine Seoul, Seoul, Korea.
| | - Seong Sook Hong
- Department of Radiology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine Seoul, Seoul, Korea.
| | - Soon-Sun Kwon
- Biomedical Research Institute, Seoul National University Bundang Hospital, Seongnam, Korea.
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Kim JH, Doo SW, Yun JH, Yang WJ. Lower Likelihood of Having Moderate-to-severe Lower Urinary Tract Symptoms in Middle-aged Healthy Korean Men With Metabolic Syndrome. Urology 2014; 84:665-9. [DOI: 10.1016/j.urology.2014.05.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 04/29/2014] [Accepted: 05/13/2014] [Indexed: 10/24/2022]
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Yun JH, Kim JH, Kim JH, Lee SW, Yang HJ, Doo SW, Yang WJ. Can we decide the optimal initial treatment for male lower urinary tract symptoms patients with overactive bladder by the most bothersome symptom? A randomized, prospective, open-label study. Urol Int 2014; 93:338-43. [PMID: 25171502 DOI: 10.1159/000365335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 06/17/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To compare the treatment outcome of tamsulosin 0.4 mg (TAM) with or without solifenacin 5 mg (SOL) for the most bothersome symptom in male lower urinary tract symptoms (LUTS) with overactive bladder (OAB). SUBJECTS AND METHODS Male LUTS/OAB (≥50 years) patients who had a total International Prostate Symptom Score (I-PSS) of ≥12, I-PSS urgency-related question of ≥2, and quality of life (QoL) of ≥3 points were enrolled. Patients who complained of storage symptoms as the most bothersome were included in the 'storage' group. Patients who complained of voiding symptoms as the most bothersome were included in the 'voiding' group. The change in the I-PSS was compared between the two groups 4 weeks after commencing treatment. RESULTS In the storage group, 172 were able to finish this study (TAM: 88, TAM + SOL: 84). The improvement of I-PSS and QoL with TAM + SOL was significantly greater than with TAM alone (p < 0.001). In the voiding group, 108 were able to finish the study (TAM: 54, TAM + SOL: 54). The improvement of I-PSS and QoL with TAM alone was significantly greater than with TAM + SOL (p < 0.001). CONCLUSIONS The most bothersome symptom in male LUTS/OAB should be considered when choosing the appropriate medical treatment.
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Affiliation(s)
- Jong Hyun Yun
- Department of Urology, Soonchunhyang University College of Medicine, Gumi Hospital, Gumi, South Korea
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Kim JH, Choi H, Sun HY, Doo SW, Yoon JH, Yang WJ, Yoo BW, Kim JM, Kwon SS, Song ES, Lee HJ, Lim IS, Song YS. Measuring the improvement in health-related quality of life using King's health questionnaire in non-obese and obese patients with lower urinary tract symptoms after alpha-adrenergic medication: a preliminary study. BMC Urol 2014; 14:60. [PMID: 25099073 PMCID: PMC4126641 DOI: 10.1186/1471-2490-14-60] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 07/31/2014] [Indexed: 11/20/2022] Open
Abstract
Background The efficacy of medical treatment among obese men with lower urinary tract symptoms (LUTS) has been less clear, especially regarding the improvement of QoL. We aimed to investigate the difference in efficacy and consequent satisfaction of life quality after medical treatment of male LUTS according to obesity. Methods An 8-week prospective study was performed for a total of 140 patients >50 years old with International Prostate Symptom Scores (IPSS) > 12 points and prostate volume > 20 mL. Obesity was determined by either body mass index (BMI) or waist circumference (WC). Patients were divided into 2 groups according to BMI or WC. Patients received tamsulosin at a dose of 0.4 mg daily for 8 weeks. The changes from baseline in the IPSS, maximal urinary flow rate (Qmax), post-void residual volume, questionnaire of quality of life (QoL), and King’s Health Questionnaire (KHQ) were analyzed. Results Of the 150 enrolled patients, 96 completed the study. Seventy-five patients (78.1%) had BMI ≥ 23 kg/m2, and 24 (25.0%) had WC > 90 cm. Overall, the IPSS, IPSS QoL, and total KHQ showed significant improvement. Obese (BMI ≥ 23 kg/m2) and non-obese (BMI < 23 kg/m2) both showed improvement of the IPSS and IPSS QoL scores, but only the obese (BMI ≥ 23 kg/m2) group showed improvement of the total KHQ score (P < 0.001 vs. P = 0.55). Only the obese (WC > 90 cm) group showed improvement of the IPSS and total KHQ scores (P < 0.001). Conclusions Our preliminary study showed the different efficacy of an alpha-blocker for improvement of LUTS and life quality according to obesity. Obese patients, defined by BMI or WC, showed the tendency toward a more favorable improvement of LUTS and life quality. Trial registration Current Controlled Trials 2010–058. Registered 2 September 2010 in Soonchunhyang Univeristy Hospital
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Yun Seob Song
- Department of Urology, Soonchunhyang University College of Medicine, Seoul Hospital, 59, Daesagwan-ro, Yongsan-gu, Seoul 140-743, The Republic of Korea.
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Kim JH, Doo SW, Yang WJ, Lee KW, Lee CH, Song YS, Jeon YS, Kim ME, Kwon SS. Impact of obesity on the predictive accuracy of prostate-specific antigen density and prostate-specific antigen in native Korean men undergoing prostate biopsy. Int J Urol 2014; 21:987-90. [DOI: 10.1111/iju.12486] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 04/06/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Jae Heon Kim
- Department of Urology; College of Medicine; Soonchunhyang University; Cheonan South Korea
| | - Seung Whan Doo
- Department of Urology; College of Medicine; Soonchunhyang University; Cheonan South Korea
| | - Won Jae Yang
- Department of Urology; College of Medicine; Soonchunhyang University; Cheonan South Korea
| | - Kwang Woo Lee
- Department of Urology; College of Medicine; Soonchunhyang University; Cheonan South Korea
| | - Chang Ho Lee
- Department of Urology; College of Medicine; Soonchunhyang University; Cheonan South Korea
| | - Yun Seob Song
- Department of Urology; College of Medicine; Soonchunhyang University; Cheonan South Korea
| | - Yoon Su Jeon
- Department of Urology; College of Medicine; Soonchunhyang University; Cheonan South Korea
| | - Min Eui Kim
- Department of Urology; College of Medicine; Soonchunhyang University; Cheonan South Korea
| | - Soon-Sun Kwon
- Medical Research Collaborating Center; Seoul National University Bundang Hospital; Seongnam South Korea
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Kim JH, Lee SW, Kim JH, Yang HJ, Doo SW, Yoon JH, Kim DS, Yang WJ, Lee KW, Kim JM, Lee C, Kwon SS. Association between obesity, prostate-specific antigen level and prostate-specific antigen density in men with a negative prostate biopsy. J Int Med Res 2014; 42:821-7. [PMID: 24743874 DOI: 10.1177/0300060513518038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 12/03/2013] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine the association between body mass index (BMI), serum prostate-specific antigen (PSA) level and PSA density (PSAD) in patients with an elevated serum PSA level but a negative prostate biopsy. METHODS This retrospective study enrolled men with a negative prostate biopsy but a serum PSA level of 3.0-10 ng/ml. All men underwent anthropometric measurements, serum PSA determination and transrectal ultrasound examination. BMI was grouped according to the Asia-Pacific obesity criteria: nonobese (<25 kg/m(2)) versus obese (≥ 25 kg/m(2)). Partial correlation and linear regression models between PSA, PSAD and BMI were conducted after adjusting for age. RESULTS A total of 907 men were enrolled in this study. On multivariate analyses, PSA showed no significant correlation with age or BMI, whereas PSAD had a negative correlation with age and BMI. Similar results were obtained when patients were categorized as having low (3.0 < PSA ≤ 6.5 ng/ml) or high PSA (6.5 < PSA ≤ 10.0 ng/ml) levels. CONCLUSION PSAD, but not PSA, demonstrated a significant negative correlation with BMI. This indicates that a new strategy including PSAD rather than simple PSA levels should be adopted in the study of obesity-adjusted PSA cut-offs.
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Affiliation(s)
- Jae Heon Kim
- Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Sang Wook Lee
- Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Jae Ho Kim
- Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Hee Jo Yang
- Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Seung Whan Doo
- Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Jong Hyun Yoon
- Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Doo Sang Kim
- Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Won Jae Yang
- Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Kwang Woo Lee
- Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Jun Mo Kim
- Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Changho Lee
- Department of Urology, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Soon-Sun Kwon
- Medical Research Collaborating Centre, Seoul National University Bundang Hospital, Seongnam, Korea
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Kim JH, Doo SW, Yang WJ, Park JY, Song YS. PD8-06 IMPROVEMENT OF BLADDER FIBROSIS USING DIRECT TRANSPLANTATION OF MESENCHYMAL STEM CELL INTO BLADDER WALL IN RATS WITH SPINAL CORD INJURY. J Urol 2014. [DOI: 10.1016/j.juro.2014.02.800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Doo SW, Kim JH, Yang WJ, Song YS. Is There Any Objective Improvement of Nocturia by Combination Treatment of Zolpidem and Alpha-Blocker Therapy for Unresponsive to Alpha-Blocker Monotherapy in Men with Lower Urinary Tract Symptoms? Low Urin Tract Symptoms 2013; 5:134-9. [PMID: 26663448 DOI: 10.1111/luts.12001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of the present study was to determine whether administration of zolpidem, a nonbenzodiazepine sedative-hypnotic agent, at night would improve the nocturia unresponsive to alpha-blocker monotherapy in men with lower urinary tract symptoms (LUTS). METHODS This was a prospective observational study comprised of 39 men aged 50 years and older. The study inclusion criteria were age more than 50 years, and nocturia twice or more per night after taking alpha-blockers for more than 8 weeks. A total of 39 patients met the criteria and constituted the study cohort. Pittsburgh Sleep Quality Index (PSQI), International Prostate Symptom Score (IPSS), frequency volume chart (FVCs) and uroflowmetry were recorded. Patients were given 10 mg alfuzosin and 10 mg zolpidem once at night for the 8 weeks. RESULTS There were no serious side-effects in any patient. Nocturia decreased from a baseline (3.1 ± 0.1) to 8 weeks (1.6 ± 0.2) (P = 0.001). After treatment, global PSQI scores and severe sleep disorders improved. Storage and voiding symptoms including total IPSS scores and quality of life index improved. Nocturnal urine volume and functional bladder capacity improved. Maximum flow rate, voided volume increased and residual urine volume decreased. CONCLUSION Combined zolpidem and alpha-blocker therapy resulted in a subjective and objective reduction in nocturia episodes when given to men with nocturia unresponsive to alpha-blocker monotherapy.
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Affiliation(s)
- Seung Whan Doo
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Won Jae Yang
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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Kim JH, Lee MH, Doo SW, Yang WJ, Song YS, Yoo BW, Kwon SS. Re-categorisation of male lower urinary tract symptoms based on the international prostate symptom score questionnaire. Int J Clin Pract 2013; 67:789-94. [PMID: 23668808 DOI: 10.1111/ijcp.12091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 11/06/2012] [Indexed: 11/30/2022] Open
Abstract
AIMS The purpose of this study was to develop a new sub-classification system for male lower urinary tract symptoms (LUTS)-mild, moderate and severe-using the conventional International Prostate Symptoms Score (I-PSS). METHODS From October 2007 to March 2012, a total of 2234 male patients (≥ 50 years old) presenting with LUTS were enrolled in this study. Patients were sorted according to their I-PSS (ranging from 1 to 35 points) and divided into three groups based on their quality of life (QoL) score. A chi-square automatic interaction detection (CHAID) algorithm, based on adjusted significance testing, was used. The Kappa coefficient was calculated for the agreement of original and new categorisation. RESULTS Mean total I-PSS and QoL scores were 11.0 and 2.9 respectively. According to the original classification, 838 patients (38.6%) had mild, 1053 (48.5%) had moderate and 282 (13.0%) had severe symptoms. After the CHAID algorithm was applied, the scores were re-categorised as 'mild' (1-6 points), 'moderate' (7-21 points) and 'severe' (22-35 points). The overall model was able to correctly predict whether an I-PSS was associated with mild, moderate or severe symptoms, with 70.1% accuracy. According to this new classification, 704 patients (32.4%) were shown to have mild, 1255 (57.8%) to have moderate and 214 (9.8%) to have severe LUTS. The agreement of conventional and new categorisation is very strong (Kappa coefficient = 0.84). CONCLUSIONS Conventional categorisation of LUTS by I-PSS needs to be updated and the category of moderate LUTS should be broadened.
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Affiliation(s)
- J H Kim
- Department of Urology, College of Medicine, Soonchunhyang University, Seoul Hospital, Seoul, Korea
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Lee HJ, Doo SW, Kim DH, Cha YJ, Kim JH, Song YS, Kim SU. Cytosine deaminase-expressing human neural stem cells inhibit tumor growth in prostate cancer-bearing mice. Cancer Lett 2013; 335:58-65. [DOI: 10.1016/j.canlet.2013.01.048] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Revised: 01/29/2013] [Accepted: 01/29/2013] [Indexed: 01/14/2023]
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Kim JH, Doo SW, Yang WJ, Song YS. Homogeneity among the korean international prostate symptom score questionnaires used in real practice. Korean J Urol 2013; 54:249-51. [PMID: 23614062 PMCID: PMC3630344 DOI: 10.4111/kju.2013.54.4.249] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 11/09/2012] [Indexed: 11/18/2022] Open
Abstract
PURPOSE We analyzed whether any problems existed in terms of the homogeneity of the Korean International Prostate Symptom Score (IPSS) questionnaire used in real practice. MATERIALS AND METHODS Between July 2012 and August 2012, 48 Korean IPSS questionnaires used in real practice were collected. All the items on the questionnaire, including the quality of life (QoL) questions, were compared and we then determined the homogeneity of each question in comparison with the originally validated Korean version of the IPSS from 1996. RESULTS Only 5 of 48 sources (10.4%) of the Korean IPSS totally corresponded with the original Korean version of the IPSS questionnaire. The consistency rate with the originally validated version was generally low for the answer choice items for each question, ranging from 16.6% for "less than half the time" to 35.4% for "almost always," with the exception of the item "not at all" (100.0%). The consistency rate was 60.4% for question 3 (intermittency) and 18.8% for question 6 (straining). No homogeneity was found in any of the QoL-related questions. The average consistency rate with the originally validated version was 42.2% and ranged from 22.9% for "unhappy" to the highest rate of 95.8% for "mostly satisfied." CONCLUSIONS Compared with the originally validated Korean version of the IPSS, various Korean IPSS questionnaires used in real practice had significant problems in terms of homogeneity for both the questions and the answer choice items. Efforts are needed to ensure the uniform use of the validated Korean version of the IPSS questionnaire.
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Affiliation(s)
- Jae Heon Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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Doo SW, Kim WB, Kim BK, Yang WJ, Yoon JH, Jin SY, Song YS. Metastasis of renal cell carcinoma to the bladder. Korean J Urol 2013; 54:69-72. [PMID: 23362452 PMCID: PMC3556558 DOI: 10.4111/kju.2013.54.1.69] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Accepted: 07/15/2011] [Indexed: 11/18/2022] Open
Abstract
Renal cell carcinoma is an uncommon source of bladder metastases. Here we report a case of renal cell carcinoma that metastasized to the bladder. A 73-year-old woman complained of gross hematuria. Abdominopelvic computerized tomography showed a bladder mass and a heterogenous enhancing mass in the lower pole of the left kidney with left vein thrombosis. The pathological analysis of the resected bladder specimen revealed metastatic renal cell carcinoma of the clear cell type.
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Affiliation(s)
- Seung Whan Doo
- Department of Urology, Soonchunhyang University College of Medicine, Seoul, Korea
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Song YS, Lee HJ, Doo SW, An J, Kim SU. Enhanced angiogenesis and relaxation of bladder as early response to bladder outlet obstruction. Int J Urol 2012; 20:116-22. [DOI: 10.1111/j.1442-2042.2012.03217.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2012] [Accepted: 09/30/2012] [Indexed: 11/27/2022]
Affiliation(s)
- Yun Seob Song
- Department of Urology; Soonchunhyang University School of Medicine; Seoul; Korea
| | | | - Seung Whan Doo
- Department of Urology; Soonchunhyang University School of Medicine; Seoul; Korea
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Kim JH, Doo SW, Yang WJ, Song YS. Laparoscopic transvesical excision and reconstruction in the management of mid-urethral tape mesh erosion and stones around the bladder neck: initial experiences. BJU Int 2012; 110:E1009-13. [PMID: 23046315 DOI: 10.1111/j.1464-410x.2012.11563.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
UNLABELLED Study Type--Prevalence (prospective cohort) Level of Evidence 1b. What's known on the subject? and What does the study add? Managing foreign bodies, including mesh and stones, after anti-incontinence surgery is important because complete removal is necessary to prevent infection and recurrence of stone formation. Traditionally, surgical management of such complications has involved excision using a transurethral approach, with or without a laparoscopic transvesical procedure. The study shows that mesh complications, including exposure and adherent stones, can be successfully treated and a fast recovery can be achieved using transvesical laparoscopic excision and reconstruction. Transvesical laparoscopy is especially suitable for cases that have a restricted visual field with cystoscopy; the technique allows complete removal of mesh/stones and reconstruction with the help of an excellent visual field. OBJECTIVES • To evaluate laparoscopic transvesical excision and reconstruction for the management of vesical mesh or stones around the bladder neck as complications of anti-incontinence intervention. • To compare the techniques, outcomes and recurrence rates of laparoscopic transvesical excision and reconstruction with published results from studies using laparoscopic transvesical procedures. PATIENTS AND METHODS • We conducted a retrospective review of three patients who underwent laparoscopic transvesical excision and reconstruction for vesical mesh and stones around the bladder neck. • Patients were identified from operating records including recorded video and electronic data records. • We also conducted a literature review of the available evidence on transvesical laparoscopy for lower urinary tract complications of anti-incontinence procedures. RESULTS • Between March 2005 and May 2011, three women underwent laparoscopic transvesical excision and reconstruction. All presented with storage symptoms and gross haematuria. The interval between surgery and the diagnosis of presence of a foreign body was 1-3 years. • Two women had previously undergone transobturator tape procedures and one had undergone a retropubic procedure. • Complete excision including the mucosa and muscle layer and reconstruction with intravesical sutures was achieved in all cases. • Storage symptoms were resolved within 3 days and haematuria was not observed. • None of the women had recurrent erosion at follow-up. CONCLUSIONS • Laparoscopic transvesical excision and reconstruction is a technically feasible method. • This procedure offers excellent visualization of mesh materials and stones, especially in cases of location near the anterior bladder neck. • In selected patients, laparoscopic transvesical excision and reconstruction is an acceptable technique for first-line treatment of complications of anti-incontinence procedures.
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Affiliation(s)
- Jae Heon Kim
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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Doo SW, Lee HJ, Ahn J, Kim JH, Yun JH, Yang WJ, Song YS. Strong impact of nocturia on sleep quality in patients with lower urinary tract symptoms. World J Mens Health 2012; 30:123-30. [PMID: 23596599 PMCID: PMC3623520 DOI: 10.5534/wjmh.2012.30.2.123] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 06/19/2012] [Accepted: 06/28/2012] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Nocturia is a bothersome symptom that impacts sleep quality in patients with lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH). This study was performed to evaluate the impact of nocturia on sleep quality. MATERIALS AND METHODS A total of 58 male patients with LUTS/BPH were enrolled. LUTS/BPH patients without nocturia were included in the control group. The inclusion criteria were eight or more points on the International Prostate System Score (IPSS) including more than one episode of nocturia and a prostate volume larger than 20 ml. IPSS, prostate volume, uroflowmetry, and the Pittsburgh Sleep Quality Index (PSQI) from each patient were recorded. RESULTS Patients with nocturia showed a higher mean global PSQI (8.5±0.4) than patients without nocturia (4.82±0.4) (p<0.01). Patients with nocturia showed a higher percentage of severe sleep disorders (74.1%) than patients without nocturia (35.3%) (p<0.01). The regression coefficient between the number of episodes of nocturia and mean global PSQI was 0.42 (p<0.01). CONCLUSIONS Patients with nocturia showed poor sleep quality, and this was related to the number of episodes of nocturia. This suggests that nocturia has a strong impact on sleep quality in patients with LUTS/BPH.
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Affiliation(s)
- Seung Whan Doo
- Department of Urology, Soon Chun Hyang University College of Medicine, Seoul, Korea
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Doo SW, Kim JH, Yang WJ, Kim SI, Lee DW, Hong SS, Song YS. A case of tuberculous prostatitis with abscess. World J Mens Health 2012; 30:138-40. [PMID: 23596601 PMCID: PMC3623522 DOI: 10.5534/wjmh.2012.30.2.138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 07/19/2012] [Accepted: 07/23/2012] [Indexed: 11/15/2022] Open
Abstract
We present a case of acute prostatitis with abscess. The patient had undergone intravesical bacillus Calmette-Guérin (BCG) immunotherapy for bladder cancer. A prostate biopsy demonstrated tuberculous prostatitis with abscess. This case illustrates that when bladder cancer is treated with BCG, a tuberculous prostate abscess can develop.
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Affiliation(s)
- Seung Whan Doo
- Department of Urology, Soon Chun Hyang University College of Medicine, Seoul, Korea
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Kim WB, Lee SW, Doo SW, Yang WJ, Song YS, Jeon JS, Choi IH, Jin SY. Category migration of renal cystic masses with use of gadolinium-enhanced magnetic resonance imaging. Korean J Urol 2012; 53:573-6. [PMID: 22950004 PMCID: PMC3427844 DOI: 10.4111/kju.2012.53.8.573] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Accepted: 07/28/2011] [Indexed: 12/05/2022] Open
Abstract
The Bosniak renal cyst classification has been accepted by urologists and radiologists as a way of diagnosing cystic renal masses and determining the management approach. We report two cases of a renal cystic mass that showed a category change from category II on the basis of enhanced computed tomography to category IV after further gadolinium-enhanced magnetic resonance imaging. In both cases, the cysts were later confirmed as kidney cancer by pathology.
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Affiliation(s)
- Woong Bin Kim
- Department of Urology, Soonchunhyang University College of Medicine, Seoul, Korea
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Lee SW, Doo SW, Yang WJ, Song YS. Importance of relieving the most bothersome symptom for improving quality of life in male patients with lower urinary tract symptoms. Urology 2012; 80:684-7. [PMID: 22770617 DOI: 10.1016/j.urology.2012.03.049] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 03/06/2012] [Accepted: 03/09/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To highlight the importance of relieving the most bothersome symptom for improving quality of life (QoL) in male patients with lower urinary tract symptoms. METHODS From January 2010 to March 2011, 242 men with lower urinary tract symptoms visited our clinic, and 194 finished this study. At first visit, the most bothersome symptom was selected as the "core symptom." The sum of other symptoms except the core symptom was defined as "peripheral symptoms." All patients underwent empirical medical treatment for male lower urinary tract symptoms during an 8- to 12-week period, thereafter, recorded a follow-up International Prostate Symptom Score (I-PSS) questionnaire. We multivariately analyzed the patients' data after medical treatment to assess the influence of relieving their core symptom on the improvement of QoL. RESULTS The patients' mean age was 64.7 years and the mean total I-PSS was 19.7 points. Nocturia was the most common core symptom (29.9%), followed by weak stream (16.5%). Multiple logistic regression revealed that relieving the core symptom (odds ratio [OR] = 39.163, 95% confidence interval [CI] = 13.536-113.309) was significantly associated with QoL improvement. Improvement of peripheral symptoms (OR = 4.849, 95% CI = 1.629-14.433) and the inclusion of the moderate symptom group at first visit (OR = 2.622, 95% CI = 1.009-6.811) were also significant factors in predicting QoL improvement. CONCLUSION In treating benign prostatic hyperplasia or lower urinary tract symptoms, we should focus more on relieving the individual patient's most bothersome symptom to help improve patient QoL.
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Affiliation(s)
- Seung Woo Lee
- Department of Urology, Soonchunhyang University, Seoul Hospital, Seoul, Korea
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Doo SW, Cho KH, Kim JS, Yang WJ, Choi IH, Lee DW, Hong SS, Song YS. Radiologic Findings of Mesothelioma at the Tunica Vaginalis. Urology 2012; 80:e3-5. [DOI: 10.1016/j.urology.2012.02.050] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Revised: 02/15/2012] [Accepted: 02/29/2012] [Indexed: 10/28/2022]
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Kim WB, Jeong JY, Doo SW, Yang WJ, Song YS, Lee SR, Park JW, Kim DW. Myotonic dystrophy type 1 presenting as male infertility. Korean J Urol 2012; 53:134-6. [PMID: 22379595 PMCID: PMC3285710 DOI: 10.4111/kju.2012.53.2.134] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Accepted: 08/17/2011] [Indexed: 11/18/2022] Open
Abstract
Myotonic dystrophy 1 (DM1) is a multi-system disorder characterized by endocrine defects that include testicular and tubular atrophy, oligospermia and azoospermia, and increased follicle-stimulating hormone levels. We describe a rare case of DM1 presenting as infertility in a 29-year-old man.
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Affiliation(s)
- Woong Bin Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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Doo SW, Kim WB, Kim BK, Yang WJ, Yoon JH, Song YS, Choi IH. Skeletal muscle metastases from urothelial cell carcinoma. Korean J Urol 2012; 53:63-6. [PMID: 22323978 PMCID: PMC3272560 DOI: 10.4111/kju.2012.53.1.63] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Accepted: 08/01/2011] [Indexed: 12/19/2022] Open
Abstract
Hematogenous metastasis to skeletal muscle from urothelial carcinoma is extremely rare and metastatic disease to skeletal muscle tends to be found in people with advanced-stage neoplasm. We report in this paper a case of left sartorius muscle metastasis from urothelial cell carcinoma. A left nephroureterectomy with bladder cuff excision was performed and revealed a high-grade papillary transitional cell carcinoma (TCC) of the pelvis. And 6 month later, recurrent bladder cancer was found regular cystoscopy and then treated with transurethral resection of the bladder. After 6 times resection of bladder, an invasion into the bladder muscle layer was found. We recommended additional radical cystectomy to prevent the disease from advancing. However, the patient refused additional surgery. 6 month later, the patient complained of left thigh pain, so ultrasonography-guided biopsy of the nodular mass lesion in the left sartorius muscle was performed. The pathological analysis of the biopsy specimen revealed poorly differentiated metastatic urothelial carcinoma.
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Affiliation(s)
- Seung Whan Doo
- Department of Urology, Soonchunhyang University College of Medicine, Seoul, Korea
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Kim WB, Lee ES, Doo SW, Yang WJ, Song YS, Noh H. Spontaneously ruptured renal cell carcinoma during hemodialysis in two patients with end-stage renal disease. Korean J Urol 2012; 52:865-7. [PMID: 22216401 PMCID: PMC3246521 DOI: 10.4111/kju.2011.52.12.865] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Accepted: 08/02/2011] [Indexed: 01/01/2023] Open
Abstract
Spontaneously ruptured renal cell carcinoma (RCC) in end-stage kidney disease is very rare. Preoperative diagnosis is difficult because of the relatively small tumor size, associated hematoma, and surrounding acquired cysts. Two middle-aged men who were maintained on hemodialysis (HD) for over 10 years suddenly developed flank pain during HD. Computed tomography scans revealed an enhancing ruptured renal mass in one patient, and no obvious tumor lesion except for a hematoma in the other, both of which were later confirmed as RCCs by pathologic specimens.
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Affiliation(s)
- Woong Bin Kim
- Department of Urology, Soonchunhyang University College of Medicine, Seoul, Korea
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Kim WB, Doo SW, Yang WJ, Song YS. Influence of prostatic calculi on lower urinary tract symptoms in middle-aged men. Urology 2011; 78:447-9. [PMID: 21689847 DOI: 10.1016/j.urology.2010.12.056] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Revised: 12/11/2010] [Accepted: 12/29/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To investigate the incidence and echographic patterns of prostatic calculi, and to determine whether the presence of prostatic calculi is an associated factor for moderate lower urinary tract symptom (LUTS) in middle-aged men. METHODS Between October 2007 and June 2010, 1575 consecutive ostensibly healthy Korean men aged 40-59 years visited the health promotion center for a routine check-up and were enrolled. All men had a complete history, physical examination, and an international prostate symptom score (IPSS) questionnaire. Based on the echo patterns of the prostatic calculi by transrectal ultrasound, the men were divided in 3 groups-no calculi; type A calculi (discrete, small echoes); and type B calculi (large masses of multiple echoes, much coarser). RESULTS In total, 1563 men were included. Measurable calcifications in the prostate gland were found in 799 men (51.1%). Small calculi (type A) were found in 615 men (39.3%) and large calculi (type B) were found in 184 men (11.8%). In the multivariate analysis, old age (>50 years), obesity (body mass index >25 kg/m(2)), and large calculi (type B) were significant associated factors for higher IPSS ≥8. The likelihood of IPSS being ≥8 was related to large calculi group with a 1.784-fold increase in risk over no and small calculi (P <.001). CONCLUSIONS The presence of large prostatic calculi is a significant associated factor of moderate LUTS, whereas there was no statistical difference in IPSS analyzed between the no calculi and small calculi group.
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Affiliation(s)
- Woong Bin Kim
- Department of Urology, Soonchunhyang University, Seoul Hospital, Seoul, Korea
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Jeong JY, Doo SW, Yang WJ, Lee KW, Kim JM. Differences in Urinary Stone Composition according to Body Habitus. Korean J Urol 2011; 52:622-5. [PMID: 22025958 PMCID: PMC3198236 DOI: 10.4111/kju.2011.52.9.622] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Accepted: 07/19/2011] [Indexed: 11/18/2022] Open
Abstract
PURPOSE We analyzed differences in urinary stone composition according to body mass index (BMI). MATERIALS AND METHODS Between January 2007 and December 2010, 505 ureteral or renal stones were collected from 505 patients who underwent surgical intervention. Data on patient age, gender, BMI, urinary pH, and stone composition were collected. RESULTS The patients' mean age was 49.2 years (range, 20 to 83 years). Of the 505 patients, 196 (38.7%) had calcium oxalate (CO) stones, 172 (33.9%) had mixed calcium oxalate and calcium phosphate (COP) stones, 72 (14.2%) had calcium phosphate (CP) stones, 50 (9.8%) had uric acid (UA) stones, and 15 (2.9%) had struvite stones. We excluded struvite stones in the statistical analysis because of the small number of patients; a total of 490 patients were included in this study. In the multinomial logistic regression analysis, obesity was found to be associated with UA stones compared with COP stones (odds ratio [OR] 3.488; 95% confidence interval [CI] 1.732-7.025; p<0.001) and CP stones (OR 2.765; 95% CI 1.222-6.259; p=0.015). Similar results were observed for CO stones compared with COP stones (OR 2.682; 95% CI 1.727-4.164; p<0.001) and CP stones (OR 2.126; 95% CI 1.176-3.843; p<0.013). CONCLUSIONS Obesity was associated with UA and CO stones compared with the occurrence of COP and CP stones.
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Affiliation(s)
- Ji Yun Jeong
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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Song JH, Doo SW, Yang WJ, Song YS. Influence of obesity on urinary pH with respect to sex in healthy Koreans. Urology 2011; 78:1244-7. [PMID: 21696809 DOI: 10.1016/j.urology.2011.04.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Revised: 03/28/2011] [Accepted: 04/12/2011] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To evaluate the association between urinary pH and metabolic risk factors, including obesity according to sex in a Korean population recruited through the health promotion center. METHODS From 2008 to 2010, a total of 22 297 ostensibly healthy adult Koreans who visited our health promotion center were enrolled in the present study. The relationship between urinary pH and various metabolic risk factors, including obesity, were evaluated. RESULTS The mean age ± SD of the study population was 45.0 ± 9.1 years. The men had a significantly greater body mass index and lower urinary pH than the women. Using multivariate logistic regression analysis, obesity significantly correlated with a lower urinary pH (≤5.5) only in men (odds ratio [OR] 1.095, P = .015) and not in women (OR 1.004, P = 0.945). Among the various factors examined, older age (>45 years), greater fasting blood glucose, and hyperuricemia were factors significantly associated with a lower urinary pH in both groups. Hypertriglyceridemia was a significant factor associated with lower urinary pH only in men, and a lower high-density lipoprotein cholesterol was the significant factor for a lower urinary pH in women. CONCLUSIONS The results of the present study revealed that obesity is significantly correlated with lower urinary pH (≤5.5) only in men.
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Affiliation(s)
- Jin Hyun Song
- Department of Urology, Soonchunhyang University, Seoul Hospital, Seoul, Korea
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Song JH, Doo SW, Yang WJ, Song YS, Kim GW, Ku JH, Lee CH. Value and Safety of Midazolam Anesthesia during Transrectal Ultrasound-Guided Prostate Biopsy. Korean J Urol 2011; 52:216-20. [PMID: 21461288 PMCID: PMC3065136 DOI: 10.4111/kju.2011.52.3.216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2010] [Accepted: 02/24/2011] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Although transrectal ultrasound-guided prostate biopsy is useful for diagnosing prostate cancer, it is a painful procedure. There are many methods for providing pain relief and for treating discomfort during the procedure, but occasionally these are reported to be of limited use. We aimed to evaluate the value and safety of midazolam-induced anesthetic transrectal ultrasound-guided prostate biopsy. MATERIALS AND METHODS From August 2008 to December 2009, 104 male patients, who were examined with transrectal ultrasound-guided prostate 12-core biopsy, were randomly assigned to two groups. Group 1 (n=51) received ketorolac (Tarasyn®) 30 mg. Group 2 (n=53) was treated with midazolam (Dormicum®) 3 mg, which was increased to 5 mg if necessary. Immediately after the procedure, the patients were asked to rate their comfort level by using a 10-point visual analog self-assessment pain scale. RESULTS The pain scale in group 2 was significantly lower than that in group 1 (p<0.05). The patients assigned to group 2 experienced no side-effects from midazolam and were more satisfied than the patients in group 1 (p<0.05). CONCLUSIONS Midazolam anesthesia relieves pain effectively, and the patient's satisfaction is better than with conventional transrectal ultrasound-guided prostate biopsy. Midazolam-induced anesthetic transrectal ultrasound-guided prostate biopsy is useful and safe.
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Affiliation(s)
- Jin Hyun Song
- Department of Urology, Soonchunhyang University College of Medicine, Seoul, Korea
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Cho KH, Doo SW, Yang WJ, Song YS, Lee KH. Suprapubic cystostomy: risk analysis of possible bowel interposition through the percutaneous tract by computed tomography. Korean J Urol 2010; 51:709-12. [PMID: 21031092 PMCID: PMC2963785 DOI: 10.4111/kju.2010.51.10.709] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Accepted: 09/17/2010] [Indexed: 11/18/2022] Open
Abstract
PURPOSE The most serious complication of suprapubic cystostomy is bowel injury. By computed tomography (CT), we investigated the risk factors of possible bowel interposition through the percutaneous suprapubic cystostomy tract. MATERIALS AND METHODS From September to October 2009, we consecutively reviewed 795 abdominopelvic CT scans of adult patients performed for various reasons in our hospital. From these scans, we selected the films wherein the urinary bladder was distended more than 6 cm above the symphysis pubis. We then determined whether the bowel was interposed between the bladder and the skin at the routine puncture site of suprapubic cystostomy (the midline of the abdomen 3 cm above the upper margin of the symphysis pubis). We analyzed which factors influenced the possibility of the bowel being interposed between the bladder and the skin at the suprapubic puncture site. RESULTS A total of 226 CT (148 males, 78 females) scans were selected. The mean patient age was 63 years (range, 26-84 years). The mean distance between the upper margin of the symphysis pubis and the umbilicus was 14.4 cm (range, 7.2-21.0 cm). In the multivariate analysis, obesity, a positive history of radical pelvic surgery, and a short distance (≤11 cm) between the symphysis pubis and the umbilicus had significant correlations with bowel interposition in the assumed tract. CONCLUSIONS When performing a suprapubic cystostomy, extreme caution is needed to avoid possible bowel injury in patients who are obese, had a previous radical pelvic operation, or have a short distance between the upper margin of the symphysis pubis and the umbilicus.
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Affiliation(s)
- Kyu Hyoung Cho
- Department of Urology, Soonchunhyang University College of Medicine, Seoul, Korea
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Kim GW, Doo SW, Yang WJ, Song YS. Effects of obesity on prostate volume and lower urinary tract symptoms in korean men. Korean J Urol 2010; 51:344-7. [PMID: 20495698 PMCID: PMC2873889 DOI: 10.4111/kju.2010.51.5.344] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2010] [Accepted: 04/13/2010] [Indexed: 11/29/2022] Open
Abstract
Purpose We investigated the effects of obesity on prostate volume (PV) and lower urinary tract symptoms (LUTS) in Korean men. Materials and Methods From December 2007 to 2009, a total of 10,383 ostensibly healthy Korean men aged ≥50 years visited our health promotion center for a routine check-up. Among them, 872 men who wanted a prostate evaluation were enrolled in this study. All men underwent detailed clinical evaluations with the International Prostate Symptom Score (IPSS) questionnaire. Anthropometric measurements, including height, weight, and waist and hip circumferences, were determined. A blood sample was obtained for serum prostate-specific antigen (PSA) measurement. Thereafter, a digital rectal examination and transrectal ultrasound were performed. Results In total, 465 men with moderate to severe LUTS (IPSS≥8 points) were included in this prospective study. The participants' mean age was 57.2 years. Multivariate analysis demonstrated that only waist circumference was a significant factor in predicting PV besides age and serum PSA. The univariate analysis showed no statistically significant relations between any of the obesity-related parameters and LUTS. The PV was also not correlated with LUTS. Conclusions Central obesity is the more important predictor of PV than overall obesity. There are no significant relations between obesity-related parameters and LUTS.
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Affiliation(s)
- Geun Woo Kim
- Department of Urology, Soonchunhyang University College of Medicine, Seoul, Korea
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