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여성 복압성요실금 환자에서 한국어판 King's Health Questionnaire 설문지의 타당도 및 신뢰도에 관한 정신측정학적 특성
오승준,이규성,박원희,노준,강위창,김준철,이정구,김덕윤,이지열,백재승,정병수,민권식,정희창,손환철,정정윤,주명수,김홍식,윤종민,김영호 대한배뇨장애요실금학회 2005 International Neurourology Journal Vol.9 No.2
Purpose: The purpose of this study is to evaluate the psychometric properties of the Korean version of the King's Health Questionnaire (KHQ) in patients with stress urinary incontinence. Materials and Methods: Multicenter prospective study was undertaken in 106 patients with stress urinary incontince. Psychometric properties including discriminant validity, convergent validity were evaluated and the Cronbach's alpha coefficients were calculated. Test-retest analysis was performed and the sensitivity to clinical change before and after treatment was also evaluated. Results: The psychometric properties and clinical validity of the KHQ Korean version were confirmed in 106 study population. The KHQ's good reliability was evidenced by Cronbach's alpha coefficients of >0.60, indicating to change in patients' perception of bladder condition in all domains.Conclusion: Our analyses confirm excellent psychometric properties for the Korean version of KHQ, which appears to provide a valid and reliable instrument for clinical usages in Korea. (J. Korean Continence Society 2005;9:115-123)
Comparison of Efficacy of Different Surgical Techniques for Benign Prostatic Obstruction
유지웅,정병창,전성수,이성원,이규성 대한배뇨장애요실금학회 2021 International Neurourology Journal Vol.25 No.3
Purpose: We compared success rates of 3 surgical techniques (holmium laser enucleation of the prostate [HoLEP], transurethral resection of the prostate [TURP], and photoselective laser vaporization prostatectomy [PVP]) for treatment of benign prostatic obstruction (BPO). We aimed to identify preoperative clinical variables and urodynamic parameters that predict surgical success. Methods: A total of 483 patients who underwent surgical treatment for BPO at Samsung Medical Center between 2006 and 2017 were retrospectively analyzed; of these 361, 81, and 41 patients underwent HoLEP, TURP, and PVP, respectively. Prostate- specific antigen, prostate volume, urodynamic parameters, and International Prostate Symptom Score (IPSS)/quality of life (QoL) index were evaluated preoperatively; uroflowmetry, postvoid residual urine, and IPSS/QoL index were measured 6 months postoperatively. Surgical success was defined based on IPSS, maximum flow rate, and QoL index and predictive factors were identified using multiple logistic regression analyses. Results: Success rates of HoLEP, TURP, and PVP were 67.6%, 65.4%, and 34.1%, respectively, and the HoLEP and TURP groups were not significantly different. Regression analysis revealed prostate volume ≥50 mL and bladder outlet obstruction index (BOOI) ≥40 to be independent factors predicting HoLEP success. Only high preoperative QoL could predict the success of TURP, whereas other urodynamic parameters remained unrelated. Conclusions: Patients treated with HoLEP and TURP displayed equivalent efficacies, but PVP was relatively less efficient than both. Preoperative variables of prostate volume ≥50 mL and BOOI ≥40 were independent predictive factors for the success of HoLEP but not of TURP.
주성호,이동기,이준호,백민기,정병창,전성수,이규성,한덕현 대한비뇨의학회 2011 Investigative and Clinical Urology Vol.52 No.9
Purpose: Despite a recent surge in the performance of laparoendoscopic single-site surgery (LESS), concerns remain about performing LESS pyeloplasty (LESS-P) because of the technical difficulty in suturing. We report our techniques and initial experiences with LESS-P using additional needlescopic instruments and compare the results with conventional laparoscopic pyeloplasty (CL-P). Materials and Methods: Nine patients undergoing LESS-P were matched 2:1 with regard to age and side of surgery to a previous cohort of 18 patients who underwent CL-P. In both groups, the operating procedures were performed equally except for the number of access points. In the LESS-P group, we made a single 2 cm incision at the umbilicus and used a homemade port. We also used additional 2 mm needlescopic instruments at the subcostal area to facilitate suturing and the ureteral stenting. Results: The preoperative characteristics were comparable in both groups. Postoperatively, no significant differences were noted between the LESS-P and CL-P cases in regard to length of stay, estimated blood loss, analgesics required, and complications. But, LESS-P was associated with a shorter operative time (252.2 vs. 309.7 minutes, p=0.044) and less pain on postoperative day one (numeric rating scale 3.7 vs. 5.6, p=0.024). The success rate was 94% with CL-P (median, 23 months) and 100% with LESS-P (median, 14 months). Conclusions: Our initial experiences suggest that LESS-P is a feasible and safe procedure. The use of additional 2 mm instruments can help to overcome the difficulties associated with LESS surgery.
김태선,고광진,신승제,유현수,송완,성현환,한덕현,정병창,서성일,전성수,이규성,이성원,이현무,최한용,전황균 대한비뇨의학회 2015 Investigative and Clinical Urology Vol.56 No.12
Purpose: To investigate the differences in the cancer detection rate and pathological findings on a second prostate biopsy according to benign diagnosis, high-grade prostatic intraepithelial neoplasia (HGPIN), and atypical small acinar proliferation (ASAP) on first biopsy. Materials and Methods: We retrospectively reviewed the records of 1,323 patients who underwent a second prostate biopsy between March 1995 and November 2012. We divided the patients into three groups according to the pathologic findings on the first biopsy (benign diagnosis, HGPIN, and ASAP). We compared the cancer detection rate and Gleason scores on second biopsy and the unfavorable disease rate after radical prostatectomy among the three groups. Results: A total of 214 patients (16.2%) were diagnosed with prostate cancer on a second biopsy. The rate of cancer detection was 14.6% in the benign diagnosis group, 22.1% in the HGPIN group, and 32.1% in the ASAP group, respectively (p<0.001). When patients were divided into subgroups according to the number of positive cores, the rate of cancer detection was 16.7%, 30.5%, 31.0%, and 36.4% in patients with a single core of HGPIN, more than one core of HGPIN, a single core of ASAP, and more than one core of ASAP, respectively. There were no significant differences in Gleason scores on second biopsy (p=0.324) or in the unfavorable disease rate after radical prostatectomy among the three groups (benign diagnosis vs. HGPIN, p=0.857, and benign diagnosis vs. ASAP, p=0.957, respectively). Conclusions: Patients with multiple cores of HGPIN or any core number of ASAP on a first biopsy had a significantly higher cancer detection rate on a second biopsy. Repeat biopsy should be considered and not be delayed in those patients.
이영숙,한덕현,임수현,김태헌,주명수,서주태,이정주,정병수,이정구,이규성 대한배뇨장애요실금학회 2010 International Neurourology Journal Vol.14 No.1
Purpose: To evaluate the efficacy and safety of the tension-free placement of a monofilament polypropylene mesh for the repair of an anterior vaginal wall prolapse (AVWP). Materials and Methods: Women aged ≥ 30 years with an AVWP stage of II or greater were included. Forty-nine women underwent trans-vaginal repair using a GynemeshTM PS. Forty-six women who had symptomatic stress urinary incontinence received a midurethral sling (MUS). At the 12-month follow-up, evaluations were made for changes in the Pelvic Organ Prolapse Quantification (POP-Q) stage and Pelvic Floor Distress Inventory. Cure was defined as a POP-Q stage of 0 and improvement as a stage of I. Complications were also evaluated. Results: The cure rate was 71.4%, and the improvement rate was 18.4%. Obstructive/discomfort, irritative, and stress subscale scores of the Urinary Distress Inventory anterior and posterior subscale scores of the POP Distress Inventory and the obstructive subscale score of the Colo-Rectal-Anal Distress Inventory were significantly improved. Thirty-two of the 46 women (69.6%) who received MUS procedures reported no leakage after surgery. Complications were 2 cases of increased intraoperative bleeding and 1 case of vaginal erosion. Conclusions: Trans-vaginal repair using a GynemeshTM PS is a feasible and effective procedure for the treatment of AVWP with no significant complications.