Risk Factors for Failure of Early Catheter Removal After Greenlight HPS Laser Photoselective Vaporization Prostatectomy in Men With Benign Prostatic Hyperplasia

배웅진,안선국,방준호,배장호,최용선,김수진,조혁진,홍성후,이지열,황태곤,김세웅 대한비뇨의학회 2013 Investigative and Clinical Urology Vol.54 No.1

Purpose: To assess the risk factors for developing urinary retention after removal of the urethral catheter on postoperative day 1 in benign prostatic hyperplasia patients who underwent Greenlight HPS laser photoselective vaporization prostatectomy (PVP). Materials and Methods: The study included 427 men who underwent Greenlight HPS laser PVP between 2009 and 2012, excluding patients in whom a catheter was maintained for more than 1 day because of urethral procedures. In all patients, a voiding trial was performed on postoperative day 1; if patients were unable to urinate, the urethral catheter was replaced before hospital discharge. The patients were divided into two groups: early catheter removal (postoperative day 1) and late catheter removal (urethral catheter reinsertion). Preoperative and perioperative parameters were compared between the groups. Results: Catheters were successfully removed in 378 (88.6%) patients on postoperative day 1. In 49 patients, the catheters were reinserted and removed a mean of 6.45±0.39 days after surgery. In a multivariate analysis, a history of diabetes was the most significant predictor (p=0.028) of failure of early catheter removal, followed by operative time (p=0.039). There were no significant differences in age, prostate volume, International Prostate Symptom Score, or urodynamic parameters between the two groups. Conclusions: It is feasible, safe, and cost-effective to remove the urethral catheter on postoperative day 1 after Greenlight HPS laser PVP, but the procedure should be done carefully in patients who have history of diabetes or an extended operative time.

발기부전 환자에서 심혈관계 위험인자와 음경 혈역동학적 지표와의 연관성

배웅진,손동완,김성대,김수진,홍성후,이지열,조용현,김세웅 대한비뇨의학회 2009 Investigative and Clinical Urology Vol.50 No.7

Purpose: The cause of erectile dysfunction (ED) is mostly organic in nature and is associated with cardiovascular disease. Therefore, the presence of ED has been shown to be related to cardiovascular risk factors such as coronary artery disease, hypertension, diabetes mellitus (DM), and hyperlipidemia. This study evaluated the correlation between cardiovascular risk factors and penile hemodynamic parameters in men with ED. Materials and Methods: The relationship between vascular risk factors and penile hemodynamic parameters were evaluated in a total of 149 men with ED. The patients were stratified according to the type and number of risk factors present. Each patient underwent a penile duplex Doppler ultrasound study after injections of intracavernous prostaglandin E1 to evaluate penile blood flow parameters. The rates of arterial insufficiency, venoocclusive dysfunction, and nonvascular etiologies were also evaluated. These results were statistically compared with those from patients with ED without vascular risk factors. Results: The poorest blood flow was found in patients with ED with DM. Arterial insufficiency was most prevalent in patients with coronary artery disease and DM (p<0.05). Venoocclusive dysfunction was observed most often in hypertensive patients with ED. Abnormal penile blood flow parameters correlated with the number of vascular risk factors present. Conclusions: This study shows that cardiovascular risk factors are associated with abnormal penile blood flow. In addition, the number of risk factors is correlated with an increased probability of having abnormal blood flow parameters. Purpose: The cause of erectile dysfunction (ED) is mostly organic in nature and is associated with cardiovascular disease. Therefore, the presence of ED has been shown to be related to cardiovascular risk factors such as coronary artery disease, hypertension, diabetes mellitus (DM), and hyperlipidemia. This study evaluated the correlation between cardiovascular risk factors and penile hemodynamic parameters in men with ED. Materials and Methods: The relationship between vascular risk factors and penile hemodynamic parameters were evaluated in a total of 149 men with ED. The patients were stratified according to the type and number of risk factors present. Each patient underwent a penile duplex Doppler ultrasound study after injections of intracavernous prostaglandin E1 to evaluate penile blood flow parameters. The rates of arterial insufficiency, venoocclusive dysfunction, and nonvascular etiologies were also evaluated. These results were statistically compared with those from patients with ED without vascular risk factors. Results: The poorest blood flow was found in patients with ED with DM. Arterial insufficiency was most prevalent in patients with coronary artery disease and DM (p<0.05). Venoocclusive dysfunction was observed most often in hypertensive patients with ED. Abnormal penile blood flow parameters correlated with the number of vascular risk factors present. Conclusions: This study shows that cardiovascular risk factors are associated with abnormal penile blood flow. In addition, the number of risk factors is correlated with an increased probability of having abnormal blood flow parameters.

Effects of Moderate Alcohol Intake in the Bladder of the Otsuka Long Evans Tokushima Fatty Diabetic Rats

배웅진,최용선,김수진,조혁진,홍성후,김세웅,황태곤,김대진,이지열 대한의학회 2015 Journal of Korean medical science Vol.30 No.9

Diabetes is related with a number of cystopathic complications. However, there have been no studies about the influence of alcohol consumption in the bladder of type 2 diabetes. Thus, we investigated the effect of moderate alcohol intake in the bladder of the Otsuka Long Evans Tokushima Fatty (OLETF) diabetic rat. The non-diabetic Long-Evans Tokushima Otsuka (LETO, n = 14) and the OLETF control group (n = 14) were fed an isocaloric diet; the LETO (n = 14) and the OLETF ethanol group (n = 14) were fed 36% ethanol 7 g/kg/day. After ten weeks, muscarinic receptors, RhoGEFs, myogenic change, and the level of oxidative stress were evaluated. Moderate alcohol intake significantly decreased excessive muscarinic receptor and Rho kinase expressions in the OLETF rats compared with the LETO rats. In addition, iNOS and collagen expression were not changed in the OLETF rats in spite of alcohol consumption. Superoxide dismutase levels, which is involved in antioxidant defense, in the LETO rats were significantly decreased after alcohol consumption, however those in the OLETF rats were similar. Moderate alcohol consumption reduces the oxidative stress, and may prevent molecular and pathologic changes of the bladder of rats with type 2 diabetes.

급성세균성전립선염의 임상적 특징 및 치료 결과

조수연,배웅진,조용현,이승주 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Acute bacterial prostatitis is an uncommon male urinary tract infection that is the result of severe prostatic infection mainly by gram-negative bacteria. We conducted a retrospective study to report clinical outcomes of patients with acute bacterial prostatitis. Materials and Methods : The clinical records of 49 patients diagnosed with acute bacterial prostatitis were reviewed retrospectively and patients' symptoms, investigations, and treatments were analyzed. Results : All patients presented with fever and voiding symptoms. Some patients (22.4%) had a history of prior manipulation of the lower urinary tract including transrectal prostate biopsy. Urine cultures were positive for 51% of the patients. The most common pathogen was Escherichia coli (60%), followed by Pseudomonas aeruginosa (20%) and Staphylococcus aureus (12%). The ciprofloxacin susceptibility against E. coli was 80%. All patients were treated with parenteral antibiotics in the hospital followed by oral antibiotics for average of three weeks. The major drugs used for empirical treatment were cephalosporins, aminoglycosides, and fluoroquinolones. Prostatic abscess was found in two (4.1%) Patients and chronic pelvic pain syndrome developed in six (12.2%) patients during follow-up. Conclusion : The currently used empirical antibiotics were mostly effective in the treatment of acute bacterial prostatitis. Continuous monitoring on antimicrobial susceptibility of acute bacterial prostatitis was necessary for providing proper treatment guideline.

완전 고환 파열의 일차 복원술

손동완,배웅진,이병희,이남석,김성대,김두배,김현우,조용현,김세웅 대한남성과학회 2008 The World Journal of Men's Health Vol.26 No.2

Testicular rupture most commonly occurs in young men. Although it is not life threatening, loss of a testicle could impair future fertility, contribute to a hypogonadal state, and affect social confidence. We report primary testicular reconstruction over orchiectomy even in the setting of a severe injury with a critical review of the literature.

Synergistic effects of extracorporeal shockwave therapy and modified Ojayeonjonghwan on erectile dysfunction in an animal model of diabetes

정현철,배웅진,Guan Qun Zhu,전승환,최세웅,김수진,조혁진,홍성후,이지열,황성연,김세웅 대한비뇨의학회 2019 Investigative and Clinical Urology Vol.60 No.4

Purpose: We investigated the synergy effect of extracorporeal shock wave therapy (ESWT) with modified Ojayeonjonghwan (Korean herbal formula, KH-204) in an animal model of diabetes mellitus (DM)-induced erectile dysfunction (ED). Materials and Methods: Eight-week-old male Sprague-Dawley rats were used in this study. DM was induced by an intraperitoneal injection of streptozotocin. DM rats were divided into 5 groups (n=10 per group): group 1, control; group 2, DM; group 3, DM+ESWT; group 4, DM+KH-204; and group 5, DM+ESWT+KH-204. In ESWT groups, rats were treated with ESWT at the penis 3 times a week for 2 weeks under anesthesia. The KH-204 groups were treated with a daily oral dose of KH-204 for 12 weeks. After all treatments, intracavernosal pressure (ICP) was measured, and the cavernous tissues were evaluated by Masson's trichrome, immunohistochemistry and western blot analysis. Results: ICP was evaluated as a measurement of erectile function. The DM+ESWT, DM+KH-204, and DM+ESWT+KH-204 groups showed significantly restored erectile function compared with the DM group (p<0.05). Among these groups, the DM+ESWT+KH-204 group showed the highest ICP. Moreover, ESWT and KH-204 treatment restored smooth muscle contents and many parameters related to potency (vascular endothelial growth factor, neuronal nitric oxide synthase (NOS), endothelial [NOS] and platelet endothelial cell adhesion molecule-1) compared with the DM group (p<0.05). Conclusions: We confirmed the potential efficacy of ESWT and KH-204 in the treatment of ED patients using an animal model. The combination treatment of KH-204 and ESWT is expected to have good potential clinical results in the future treatment of refractory ED.

Influence of solifenacin on the improvement of storage symptoms in the early period after photoselective vaporization of the prostate

김수진,배웅진,김세웅 대한비뇨의학회 2019 Investigative and Clinical Urology Vol.60 No.6

Purpose: We studied the effect of solifenacin on reducing storage symptoms after photoselective vaporization of the prostate (PVP). Materials and Methods: This study included patients with persistent storage symptoms of urgency and frequency in a 3-day voiding diary, International Prostate Symptom Score (IPSS) storage subscore (IPSS-s) ≥5, overactive bladder symptom score (OABSS) ≥5, and OABSS for question 3 ≥4 at 5 days after urethral catheter removal. The patients were randomly assigned to receive once-daily solifenacin 5 mg or placebo for 4 weeks. Evaluation of the 3-day voiding diary, IPSS, and OABSS was performed at 2 and 4 weeks after treatment. Results: At 2 and 4 weeks after treatment, the urgency and frequency in the 3-day voiding diary, IPSS, IPSS-s, and OABSS were decreased in the solifenacin group. Although the OABSS of the solifenacin group was not significantly different from that of the placebo group, the OABSS of the placebo group increased at 4 weeks compared with that at 2 weeks after treatment. The Benefit, Satisfaction, and Willingness to continue questionnaire showed no significant difference in patient satisfaction between the groups. Although the solifenacin group showed increased post-void residual volume compared with the placebo group, there was no statistically significant difference. Conclusions: Storage symptoms measured using OABSS tended to decrease after medication with solifenacin in the early period after PVP. Therefore, we suggest that anticholinergics have a potential role in improving storage symptoms after PVP.

The Anti-Inflammatory Effects of a New Herbal Formula (WSY-1075) in a Nonbacterial Prostatitis Rat Model

윤병일,배웅진,김수진,김효신,하유신,손동완,황성연,김세웅 대한남성과학회 2013 The World Journal of Men's Health Vol.31 No.2

Purpose: The aim of this study was to investigate the anti-inflammatory effects of a new herbal formula (WSY-1075) in a nonbacterial prostatitis rat model.Materials and Methods: Prostatitis was induced in male Wistar rats (n=32) by treatment with 17 beta-estradiol and dihydrotestosterone for 4 weeks. After the induction of prostatitis, the rats were randomly divided into one of four treatment groups: control (n=8), ciprofloxacin (n=8), WSY-1075 (100 mg/kg) (n=8), and WSY-1075 (400 mg/kg) (n=8). After 4 weeks of treatment, the prostatic proinflammatory cytokine (tumor necrosis factor-α, interleukin [IL]-6, and IL-8) levels and histological findings were noted.Results: The ciprofloxacin and WSY-1075 treatment groups showed significantly decreased proinflammatory cytokine levels compared with the control group. Histologically, treatment with ciprofloxacin and WSY-1075 significantly suppressed the severity of prostatitis lesions compared with those in the control group. No differences in the proinflammatory cytokine levels or histologic findings were observed with the dose dependent treatment of WSY-1075.Conclusions: The new herbal formula, WSY-1075, showed effective anti-inflammatory activities in the prostate and may be useful for the clinical treatment of nonbacterial prostatitis. Our findings suggest that WSY-1075 has a beneficial effect on the prevention and treatment of nonbacterial prostatitis.

The Effect of Anthocyanin on the Prostate in an Andropause Animal Model: Rapid Prostatic Cell Death by Apoptosis Is Partially Prevented by Anthocyanin Supplementation

장훈,배웅진,김수진,육성모,한동석,하유신,황성연,윤신희,Zhiping Wang,김세웅 대한남성과학회 2013 The World Journal of Men's Health Vol.31 No.3

Purpose: To evaluate the anti-apoptotic effect of the antioxidant reaction of anthocyanin on the prostate in an andropause animal model.Materials and Methods: Sprague-Dawley rats were divided into three groups (n=12 in each): control (Group I), andropause (Group II), andropause treated with anthocyanin (Group III). For induction of andropause, Group II and III underwent bilateral orchiectomy. Group III was treated with daily oral anthocyanin (160 mg/kg) for 8 weeks. After 8 weeks, the rats were sacrificed and their blood and prostates were examined pathohistologically and evaluated for oxidative stress and apoptosis. Oxidative stress was assessed by the activity of superoxide dismutase (SOD) and apoptosis in the prostate was identified by terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick end-labelling assay.Results: Group II showed markedly increased activity of SOD in serum over that observed in Group I, whereas the rats in Group III showed reduced oxidative stress compared to Group II. Despite no significant differences in prostate weight between Group II and III (p=0.078), the apoptotic index was significantly greater in Group II than Group I, and was significantly lesser in Group III than Group II.Conclusions: We suggest that the oxidative stress caused by low testosterone may be another inducer of apoptosis, and this apoptosis may partly contribute to the overall apoptosis of the prostate in the andropause animal model. Therefore, anthocyanin supplementation may contribute to preventing excessively rapid cell death by apoptosis in the prostate in an animal model of andropause.

Development of an Improved Animal Model of Overactive Bladder: Transperineal Ligation versus Transperitoneal Ligation in Male Rats

김우현,배웅진,박중우,최진봉,김수진,조혁진,하유신,홍성후,이지열,황성연,김세웅 대한남성과학회 2016 The World Journal of Men's Health Vol.34 No.2

Purpose: We compared a transperineal ligation model and a transperitoneal ligation model in male rats to determine which animal model of overactive bladder (OAB) was more useful based on cystometrography, estimations of oxidative stress, and measurements of pro-inflammatory cytokine levels.Materials and Methods: Male rats were randomly divided into three groups (n=15 in each): the control group, the transperineal ligation group, and the transperitoneal ligation group. Four weeks after the ligation procedure, cystometrography was performed and oxidative stress, pro-inflammatory cytokine levels, and histologic changes were evaluated. Oxidative stress was assessed by measuring 8-hydroxy-20-deoxyguanosine and superoxide dismutase, and pro-inflammatory cytokine activity was investigated by measuring levels of interleukin (IL)-6, IL-8, and tumor necrosis factor-α.Results: The transperineal model led to results similar to those observed for the transperitoneal model, namely (1) increased voiding frequency and reductions in the non-voiding contraction interval and the maximal vesical pressure, (2) increased levels of oxidative stress markers, (3) increased pro-inflammatory cytokine levels, and (4) fibrotic changes in the bladder tissue.Conclusions: We suggest that the transperineal procedure can be used as an alternative OAB model in male rats.