여성에서 야간뇨가 삶의 질과 수면에 미치는 영향

최향식,권동득,박광성,류수방,김선옥 대한배뇨장애요실금학회 2008 International Neurourology Journal Vol.12 No.2

Puropose: To evaluate the effects of nocturia on health-related quality of life (HRQoL) and sleep. Material and methods: From January 2007 to December 2007, 180 patients with lower urinary tract symptoms were prospectively selected for this study. Study was conducted among respondents with nocturia (void/night≥1) (n=119) and age matched controls (no nocturia) (n=61), with participants completing a series of questionnaires on HRQoL (OAB-q short form) and Medical Outcomes Study (MOS) sleep scale and frequency voiding chart. Results: The patients population had a mean age of 57.2 years. In the patients, the mean number of void per night was measured, 58 patients reported 2>void/night≥1, 32 patients reported 3> voids/night≥2 and 29 patients reported void/night≥3. The number of nocturia episodes/night was significantly associated with the overactive bladder (OAB) symptom score (p=0.001), symptom bother (p=0.001) and the MOS sleep index (p=0.016). Conclusions: Increases in the number of voids/night have further negative effects on sleep, symptom bother and HRQoL. (J Korean Continence Soc 2008;12:178-84)

근치적 전립선절제술 후 배뇨증상의 변화: 초기 연구

최향식,임창민,김선옥,김명기,권동득,류수방 대한비뇨의학회 2008 Investigative and Clinical Urology Vol.49 No.8

Purpose: The primary objective of this study was to evaluate the impact of radical retropubic prostatectomy(RRP) on lower urinary tract symptoms(LUTS) in patients with clinically localized prostate cancer. Materials and Methods: Between 2000 and 2006, 82 men with clinically localized prostate cancer underwent RRP. The International Prostate Symptom Score(IPSS) and the IPSS quality of life(QoL) score, and uroflowmetry were administered both prior to and 1 year after RRP. Results: The overall mean total IPSS, maximal flow rate, and postvoid residual volume did not change over time after RRP. Prior to and after RRP, the mean maximal flow rate and residual urine changed from 17.6ml/sec to 17.9ml/sec(p=0.566) and 16.9ml to 15.8ml(p=0.777), respectively. Total IPSS also changed after RRP, from 12.8 to 12.5(p=0.731). The reduction of the IPSS was more prominent in patients with severe symptoms(IPSS≥20), whereas in those with moderate symptoms(8≤IPSS<20), the score did not change significantly after RRP. Furthermore, in those patients with no or mild symptoms(IPSS<8), the score increased after RRP. Conclusions: RRP was not shown to improve uroflowmetric parameters, including maximal flow rate, postvoid residual urine, and IPSS, in cases of moderate LUTS. However, RRP may exert a beneficial effect in those patients with severe LUTS, and may also have adverse effects on some individuals with no or mild symptoms. We believe that these results might be utilized when counseling patients about treatment options for localized prostate cancer. Purpose: The primary objective of this study was to evaluate the impact of radical retropubic prostatectomy(RRP) on lower urinary tract symptoms(LUTS) in patients with clinically localized prostate cancer. Materials and Methods: Between 2000 and 2006, 82 men with clinically localized prostate cancer underwent RRP. The International Prostate Symptom Score(IPSS) and the IPSS quality of life(QoL) score, and uroflowmetry were administered both prior to and 1 year after RRP. Results: The overall mean total IPSS, maximal flow rate, and postvoid residual volume did not change over time after RRP. Prior to and after RRP, the mean maximal flow rate and residual urine changed from 17.6ml/sec to 17.9ml/sec(p=0.566) and 16.9ml to 15.8ml(p=0.777), respectively. Total IPSS also changed after RRP, from 12.8 to 12.5(p=0.731). The reduction of the IPSS was more prominent in patients with severe symptoms(IPSS≥20), whereas in those with moderate symptoms(8≤IPSS<20), the score did not change significantly after RRP. Furthermore, in those patients with no or mild symptoms(IPSS<8), the score increased after RRP. Conclusions: RRP was not shown to improve uroflowmetric parameters, including maximal flow rate, postvoid residual urine, and IPSS, in cases of moderate LUTS. However, RRP may exert a beneficial effect in those patients with severe LUTS, and may also have adverse effects on some individuals with no or mild symptoms. We believe that these results might be utilized when counseling patients about treatment options for localized prostate cancer.

Impact of Nocturia on Health-Related Quality of Life and Medical Outcomes Study Sleep Score in Men

김선옥,최향식,김영중,김희선,황인상,황의창,오경진,정승일,강택원,박광성,류수방,권동득 대한배뇨장애요실금학회 2011 International Neurourology Journal Vol.15 No.2

Purpose: To evaluate the impact of nocturia on health-related quality of life and sleep in men. Methods: From January 2008 to December 2008, 284 patients with lower urinary tract symptoms were selected for this study. The participants completed a series of questionnaires on health-related quality of life (the overactive bladder questionnaire, or OAB-q), the Medical Outcomes Study (MOS) sleep scale, and the frequency volume chart. Results: The patient population had a mean age of 60.0±13.4 years (range, 40 to 79 years). The mean duration of symptoms was 28.8±34.6 months. The mean number of voiding episodes per night was measured as follows: 88 patients (31.0%) reported no nocturia, 60 patients (21.1%) reported 2>voids/night ≥1, 56 patients (19.7%) reported 3>voids/night ≥2, and 80 patients (28.2%) reported ≥3 voids/night. The mean number of nocturia episodes increased with age (P=0.001), and the number of nocturia episodes was significantly associated with the OAB-q symptom score (P=0.001) and symptom bother (P=0.001). Among the categories of the MOS sleep scale, sleep index I (P=0.020), sleep disturbance (P=0.010), adequacy of sleep (P=0.005), and somnolence (P=0.041) were significantly associated with an increased number of nocturia episodes. Conclusions: The number of nocturia episodes increased with age in men. Nocturia appeared to be associated with further negative effects on sleep quality, health-related quality of life, and symptom bother.

염증성 만성골반통증후군 환자에서 항생제 단독요법과 항생제 및 알파차단제 병합요법의 치료효과 비교

윤철웅,손경철,최향식,권동득,박광성,류수방 대한비뇨의학회 2008 Investigative and Clinical Urology Vol.49 No.1

Purpose: The objectives of this study was to compare the efficacy of antibiotic monotherapy with antibiotic plus alpha-blocker combination therapy for the treatment of inflammatory chronic pelvic pain syndrome (CPPS) patients. Materials and Methods: Between October 2005 and May 2006, 69 patients who were diagnosed as CPPS(National Institutes of Health; NIH-catagory IIIa), were included in this study. The patients were randomly placed into two groups: group I was treated with gatifloxacin alone(35 patients), and group II was treated with gatifloxacin and doxazosin(34 patients) for 6 weeks. For all the patients, the urinalysis, expressed prostatic massage, the National Institute of Health-Chronic Prostatitis Symptom Index(NIH- CPSI) and a distal rectal examination(DRE) were performed at the initial visit. The NIH-CPSI was compared both before and after the treatment. Results: On the initial diagnosis, the mean CPSI of the group I patients was 24.0±6.3, and that for the group II patients was 24.7±6.9. After the treatment, that of the group I was 16.6±5.4, and that of group II was 13.4±5.3. After 6 weeks of treatment, the changes in the total CPSI scores had significantly improved in group II compared with group I(p<0.05). A statistically significant improvement occurred in the pain score, the voiding symptom score and the quality of life in the group II compared with group I(p<0.05) Conclusions: This study suggests that combination therapy of antibiotic plus alpha-blocker would be more effective than antibiotic monotheraphy for treating patients with inflammatory chronic prostatitis/chronic pelvic pain syndrome. (Korean J Urol 2008;49:72-76) Purpose: The objectives of this study was to compare the efficacy of antibiotic monotherapy with antibiotic plus alpha-blocker combination therapy for the treatment of inflammatory chronic pelvic pain syndrome (CPPS) patients. Materials and Methods: Between October 2005 and May 2006, 69 patients who were diagnosed as CPPS(National Institutes of Health; NIH-catagory IIIa), were included in this study. The patients were randomly placed into two groups: group I was treated with gatifloxacin alone(35 patients), and group II was treated with gatifloxacin and doxazosin(34 patients) for 6 weeks. For all the patients, the urinalysis, expressed prostatic massage, the National Institute of Health-Chronic Prostatitis Symptom Index(NIH- CPSI) and a distal rectal examination(DRE) were performed at the initial visit. The NIH-CPSI was compared both before and after the treatment. Results: On the initial diagnosis, the mean CPSI of the group I patients was 24.0±6.3, and that for the group II patients was 24.7±6.9. After the treatment, that of the group I was 16.6±5.4, and that of group II was 13.4±5.3. After 6 weeks of treatment, the changes in the total CPSI scores had significantly improved in group II compared with group I(p<0.05). A statistically significant improvement occurred in the pain score, the voiding symptom score and the quality of life in the group II compared with group I(p<0.05) Conclusions: This study suggests that combination therapy of antibiotic plus alpha-blocker would be more effective than antibiotic monotheraphy for treating patients with inflammatory chronic prostatitis/chronic pelvic pain syndrome. (Korean J Urol 2008;49:72-76)

여성 복압성요실금 환자에서 TVT와 TVT-O 수술 후 삶의 질의 변화

김선옥,권동득,강택원,류수방,박광성,최향식,김준석,주재상,윤철웅,정승일 대한배뇨장애요실금학회 2008 International Neurourology Journal Vol.12 No.1

Purpose: The change of quality of life following a tension-free vaginal tape (TVT) and transobturator vaginal tape (TVT-O) procedure was investigated in patients with stress urinary incontinence. Materials and Methods: We included 86 women with stress urinary incontinence who underwent the TVT or TVT-O procedure and followed up for at least 1 year. Preoperatively, the patients were evaluated with history taking, physical examination, urodynamics to determine abdominal leak point pressure (ALPP) and pre- and postoperative quality of life was evaluated by incontinence quality of life questionnaire (I-QoL). The success after operation was defined as the absence of any subjective complaint of leakage. Results: The rate of cure of TVT and TVT-O procedure were 84%, 92% and the rate of improvement of them were 16%, 8%, respectively. Preoperative patient characteristics including uroflowmetric parameters and ALPP were comparable in the two groups. The I-QoL parameters one year after surgery were statistically significant increase in I-QoL scores in each groups. There were no serious or long-term complications related to both procedures. Conclusions: These data suggest that the TVT and TVT-O procedure are effective for treating female stress incontinence and also in the aspect of improving quality. (J Korean Continence Soc 2008;12:58-63)