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Purpose: The study of lower urinary tact symptoms (LUTS) in women is rare except urinary incontinence, and there were even no diagnostic or therapeutic guidelines for female bladder outlet obstruction. The objective of this study was to determine the efficacy of tamsulosin 0.2 mg/day single therapy for the female patients with LUTS. Materials and Methods: A total 71 patients were evaluable. Tamsulosin 0.2 mg/day was administered orally in a nonblind design for 8 weeks. The efficacy parameters were International Prostate Symptom Score (IPSS), quality of life (QOL) score, frequency in daytime and night, maximal flow rate (Qmax), post-void residual urine volume (PVR), and changes in blood pressure and pulse rates. Changes in parameters between baseline and 8 weeks were assessed using Student’s paired t-test. Results: Statistically significant changes in the total, obstructive and irritative IPSS, QOL score, daytime and night time frequency, Qmax and PVR were observed at week 8. Adverse events included dizziness in 2 patients and increased nocturia in 1 patient. There were no withdrawals resulting from adverse events. There were significant differences in systolic blood pressure, but did not cause significant hypotension events. Conclusion: Treatment with tamsulosin 0.2 mg/day in female patients with LUTS was effective and well tolerated in improving LUTS and QOL. (J. Korean Continence Society 2006;10:140-146)
Wernicke’s encephalopathy (WE) is a neurological disorder induced by a dietary vitamin B1 (thiamine) deficiency which is characterized by encephalopathy, gait ataxia, and variant ocular motor dysfunction. In addition to these classical signs of WE, a loss of the horizontal vestibulo-ocular reflex (VOR) is being reported as the major underdiagnosed symptoms in WE. In this retrospective single center study, we report four cases of WE initially presented with impaired horizontal VOR in addition to the classical clinical presentations, and imaging and neurotological laboratory findings were described.
Purpose: To investigate the ability of serum prostate specific antigen(PSA) as an estimator of the prostate volume in patients with symptomatic benign prostatic hyperplasia(BPH) according to their decade of life. Materials and Methods: Between January 1997 and May 2003, 3,192 patients presented at our clinic due to lower urinary tract symptoms. Of these 1,922 were confirmed as BPH and enrolled in this study. Patients with prostate cancer and conditions other than BPH at the baseline were excluded. Receiver operating characteristic(ROC) curves were constructed to evaluate the diagnostic ability of serum PSA to estimate the threshold prostate volume and select the optimal PSA cut-off values. Results: The ROC curve analyses revealed the serum PSA to be a good estimator of the prostate volume, with areas under the ROC curves of 0.785, 0.846 and 0.856 for prostate volume cut-off points of 30, 40 and 50ml, respectively. The optimal serum PSA cut-off values for all age groups, irrespective of age, were 1.5ng/ml for the detection of a prostate volume >30ml and 2.0ng/ml for a prostate volume >40ml. Conclusions: Serum PSA can be used to estimate the prostate volume. Since the treatment outcome or risk of complications depends on the prostate volume, the estimated prostate volume is useful in therapeutic decision making in the absence of a reliable direct measurement of the prostate volume.
Purpose: The objective of this study was to investigate the efficacy of the International Prostate Symptom Score(IPSS) and various parameters obtained from transrectal ultrasonography(TRUS) as predictors of the onset of acute urinary retention in patients with symptomatic benign prostatic hyperplasia(BPH). Materials and Methods: From January 1997 to December 2003, 1,765 patients with symptomatic BPH were enrolled in this study, but not all patients had had previous BPH treatment. Of the 1,765 patients, 323 presented with acute urinary retention. A TRUS examination was performed to calculate the total prostate volume(TPV), transition zone volume(TZV), transition zone index(TZI=TZ volume/TP volume) and elongation ratio(ER=maximal anteroposterior diameter/transverse diameter). Statistical comparisons of the retention(n=323) and non-retention groups(n=1,442) were performed using the Mann-Whitney test, and receiver operating characteristic(ROC) curves of the independent risk factor were obtained to compare the usefulness of various indices. Results: There were significant differences in the age, TPV, TZV, TZI and ER between the retention and non-retention groups, but no significant differences in the IPSS. The most effective cutoff value was a 15ml TZV. The area under the curves were 0.887(TZV), 0.884(TZI), 0.857(TPV) and 0.736(ER). Conclusions: The TZV is the most useful predictor of the onset of acute urinary retention in patients with symptomatic BPH, with the TZI can also be a useful predictor. The TZV and TZI may be useful parameters when deciding the method of treatment.