Hwancheol Son

The Prevalence and Risk Factors of Female Sexual Dysfunction in Young Korean Women: An Internet‐Based Survey

INTRODUCTION In Korea, although male sexual problems have been relatively well addressed, few surveys have been conducted on female sexual dysfunction (FSD) in the general population. In the present study, we investigated the prevalence and identified the risk factors of sexual dysfunction in young Korean women. AIM To evaluate the prevalence and to identify the risk factors of FSD in young Korean women. METHODS A total of 47,000 women were initially approached. All received an e-mail requesting that they participate in a Web-based survey. The participants were asked to complete a questionnaire requesting detailed medical and sexual histories, which included the questions contained in the Korean version of the Female Sexual Function Index questionnaire. MAIN OUTCOME MEASURES The prevalence of FSD in young Korean women in the different age groups and risk factors for developing FSD. RESULTS A total of 504 women of average age 28.5 years (18-52 years) were evaluated during this survey. Setting the cutoff score for FSD using a receiver operating characteristic curve of our data as 25.0 points, 43.1% of women under 40 years old reported FSD. FSD was detected as a desire problem in 44.0% of women, an arousal problem in 49.0%, a lubrication problem in 37.0%, an orgasm problem in 32.0%, a satisfaction problem in 37.0%, and a pain problem in 34.6%. Risk factors for FSD as determined by logistic regression analysis were increasing age, a low frequency of sex, depression, a sexually abused history, and voiding dysfunction. CONCLUSIONS The prevalence of FSD in Korean young women was common and comparable to those reported worldwide.

Self‐Reported Premature Ejaculation Prevalence and Characteristics in Korean Young Males: Community‐Based Data From an Internet Survey

Premature ejaculation (PE) is suspected to be the most prevalent male sexual complaint, and the prevalence of PE is considerably high also in the younger generation. We investigated the PE prevalence based on the Diagnostic and Statistical Manual of Mental Disorders (4th ed text revision; DSM-IV-TR) definition and the risk factors of PE in Korean young men via Internet survey. Subjects (n = 3980) aged from 20 to 59, who performed sexual intercourse more than once a month during the past 6 months were asked to participate in this study. Participants were asked to complete a questionnaire that consisted of questions on general, medical, and sexual history related to ejaculation. A total of 600 subjects were included in this study. PE prevalence was found to be 18.3%. Prevalences were not significantly different across age groups, after excluding subjects with erectile dysfunction (ED). Educational level, marital status and duration, average income, sexual orientation, smoking, alcohol consumption, and circumcision status showed no difference in the PE and non-PE groups. Partners perceived satisfaction rates were 45.0% in the PE group and 63.9% in the non-PE group. Significant differences were found between the PE and non-PE groups in terms of ED, obesity, and depression prevalence. However, multiple logistic regression analysis revealed that the significant risk factors of PE were age and the frequency of conversations with partners about sexual intercourse. This Internet-based study is limited because participants probably represent a selected population of Internet users with non-representative educational and socioeconomic profiles. This study is the first to report the prevalence of both self-reported PE and PE on the basis of the DSM-IV-TR definition in the Korean population. This study demonstrates that PE in Korea is as prevalent as it is in European countries and the United States.

Modified vaporization-resection for photoselective vaporization of the prostate using a GreenLight high-performance system 120-W Laser: the Seoul technique.

OBJECTIVES The most popular technique of photoselective vaporization of the prostate (PVP) for benign prostatic hyperplasia (BPH) involves vaporization only. We developed a modified vaporization-resection technique that consists of vaporizing a prostate along outlined margins and retrieving the wedge-shaped prostate tissue. We report the operative procedure and clinical outcomes of our technique with the GreenLight high performance system (HPS). METHODS A total of 104 patients with a prostate volume greater than 40 mL who underwent PVP were included in this retrospective study. Forty patients were treated with the vaporization-only technique (Group non-S) and 64 patients with the Seoul technique (group S). The clinical outcomes were assessed at 1, 3, 6, and 12 months postoperatively using the International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximum flow rate (Q(max.)), and postvoid residual urine volume (PVR). RESULTS The Q(max.), PVR, IPSS, and QoL scores improved significantly from 1 to 12 months after the PVP compared with the baseline in both groups (P <.05). In the S group, the volume reduction of the prostate per operative time, lasing time, and laser energy were significantly smaller than in the non-S group (P <.05). In general, the overall complication rates were low in the 2 groups. Two patients were found to have prostate cancer on pathology. CONCLUSIONS The Seoul technique for PVP showed good short-term efficacy and safety for the treatment of BPH. With this technique, we can conserve on the operative time, lasing time, and energy, and obtain prostatic tissue for pathologic evaluation.

Treatment for Chronic Prostatitis/ Chronic Pelvic Pain Syndrome: Levofloxacin, Doxazosin and Their Combination

Introduction: We performed a prospective, randomized study to examine the efficacies of levofloxacin and doxazosin alone and as a combination therapy in patients with National Institutes of Health (NIH) category III chronic prostatitis/chronic pelvic pain syndrome. Patients and Methods: Men with a NIH diagnosis of category III chronic prostatitis/chronic pelvic pain syndrome and who had experienced pelvic pain for more than 3 months during the last 6 months were enrolled. All patients underwent treatment for 6 weeks. The patients were assessed at baseline and after 2 and 6 weeks by using the NIH Chronic Prostatitis Symptom Index. Eighty-one men (average age 40.1 years) were randomized to either the levofloxacin group (n = 26), the doxazosin group (n = 26), or the combination group (n = 29). Results: The average baseline NIH Chronic Prostatitis Symptom Index total scores were 22.6, 22.4, and 24.1, respectively. At 6 weeks, the total scores were 11.2 (response rate 50.3%), 17.7 (response rate 21.1%), and 13.1 (response rate 45.6%), respectively. The levofloxacin group showed a higher response rate than the doxazosin group, not at 2 weeks but at 6 weeks (p < 0.001). Conclusions: For a 6-week short-term treatment levofloxacin is more effective than doxazosin for chronic prostatitis/chronic pelvic pain syndrome. In addition, levofloxacin monotherapy was also more effective when compared with the combination therapy.

Relationship between Premature Ejaculation and Depression in Korean Males

INTRODUCTION The psychological impacts of premature ejaculation (PE), which include guilt, anxiety, and distress, have been well established in Western countries. However, in Asia, although a substantial number of epidemiological studies have surveyed the prevalence of PE, researchers have not thoroughly investigated the relationship between PE and depression, or have defined PE properly. AIM We studied the association between PE and depression and other psychological disturbances, in a Korean cohort by applying an appropriate definition for PE and validated outcome measures of depression. METHODS.  A total of 956 males (≥20 years) were initially approached via an Internet survey company. Participants were asked to complete a questionnaire requesting detailed medical and sexual histories, which included questions from the Erectile Function Domain score in the International Index of Erectile Function (IIEF-EF) and the Beck Depression Inventory (BDI). The prevalence of PE was evaluated using two different definitions-self-assessed PE and presumed PE. Presumed PE was defined as a short ejaculation time (an estimated intravaginal ejaculatory latency time ≤5 minutes), an inability to control ejaculation, and the presence of distress resulting from PE. MAIN OUTCOME MEASURES Ejaculation-related questionnaire, the IIEF-EF, and BDI. RESULTS A total of 334 men were evaluated. The prevalence of PE was 10.5% according to the Presumed PE definition, whereas by self-assessment, it was 25.4%. Self-assessed PE patients suffered from various psychological problems, such as depression, low self-esteem, bother, and low sexual satisfaction. Even after excluding erectile dysfunction (ED) subjects, a significant relationship was found between self-assessed PE and depression. Moreover, after further classification of the Self-assessed PE group, we found that subjects included in this group, but not in the Presumed PE group, suffered more from psychological burden than any other members of the cohort. CONCLUSION Korean men with subjective perceptions of PE are prone to various psychological problems, which include depression.

Current Laser Treatments for Benign Prostatic Hyperplasia

The latest technical improvements in the surgical armamentarium are remarkable. In particular, advancements in the urologic field are so exceptional that we could observe the flare-up of robot-assisted laparoscopic radical prostatectomy for prostate cancer and laser prostatectomy for benign prostatic hyperplasia (BPH). Photoselective vaporization of the prostate (PVP) and holmium laser prostatectomy are the most generalized options for laser surgery of BPH, and both modalities have shown good postoperative results. In comparison to transurethral prostatectomy (TURP), they showed similar efficacy and a much lower complication rate in randomized prospective clinical trials. Even in cases of large prostates, laser prostatectomy showed comparable efficacy and safety profiles compared to open prostatectomy. From a technical point of view, PVP is considered to be an easier technique for the urologist to master. Furthermore, patients can be safely followed up in an outpatient clinic. Holmium laser enucleation of the prostate (HoLEP) mimics open prostatectomy because the adenomatous tissue is peeled off the surgical capsule in both procedures. Therefore, HoLEP shows notable volume reduction of the prostate similar to open prostatectomy with fewer blood transfusions, shorter hospital stay, and cost reduction regardless of prostate size. Outcomes of laser prostatectomy for BPH are encouraging but sometimes are unbalanced because safety and feasibility studies were reported mainly for PVP, whereas long-term data are mostly available for HoLEP. We need longer-term randomized clinical data to identify the reoperation rate of PVP and to determine which procedure is the ideal alternative to TURP and open prostatectomy for each patient.

120W GreenLight High Performance System Laser for Benign Prostate Hyperplasia: 68 Patients With 3-Year Follow-up and Analysis of Predictors of Response

OBJECTIVE To investigate 3-year postoperative results of photoselective vaporization of the prostate using the 120W GreenLight High Performance System photoselective vaporization of the prostate (HPS-PVP) for treating benign prostate hyperplasia (BPH) >30 mL. METHODS Records of 68 of 85 men who underwent HPS-PVP and were followed up for 3 years were analyzed retrospectively. Patients were older than 50 years with prostate volume >30 mL, International Prostate Symptom Score (IPSS) ≥8, maximum flow rate (Q(max.)) <15 mL/s, and bladder outlet obstruction (BOO) index ≥20. Parameters, including IPSS and Q(max.), were measured at baseline and 6, 12, 24, and 36 months postoperatively. Patients who improved by at least 30% from baseline IPSS scores were considered responders, and logistic regression analysis was done to determine predictors of response. RESULTS Mean age, prostate volume, IPSS, Q(max.), and operative time were 71.6 ± 7.3 years, 50.0 ± 17.0 mL, 21.7 ± 7.9, 8.7 ± 3.1 mL/s, and 60.6 ± 31.9 minutes, respectively. Six months postoperatively, 50 (73.5%) patients responded with respect to IPSS score, and 40 (58.8%) maintained improvements at 3 years postoperatively. Analysis at 3-year follow-up showed that for IPSS ≥19, the higher the IPSS the greater the functional bladder capacity (FBC) and the lower the frequency of nocturia; and for BOO index ≥40, the higher the BOO index the better the response. CONCLUSION HPS-PVP is a safe and effective procedure for treating BPH, having demonstrated that 60% of patients maintained efficacy at 3 years postoperatively. Baseline IPSS, FBC, nocturia, BOO index, and bladder contractility index were valuable for predicting response to surgery.

Effect of a 'centralized intensive education system' for clean intermittent self-catheterization in patients with voiding dysfunction who start catheterization for the first time

Background:  This study evaluated the effects of a ‘centralized intensive education system’ (CIES) in terms of acquiring a proper clean intermittent self‐catheterization (CISC) technique by patients with voiding dysfunction.

Effects of light on secondary metabolism and fungal development of Fusarium graminearum.

The objectives of this study were (i) to characterize white‐collar (WC) orthologues of the filamentous fungus Fusarium graminearum, (ii) to investigate light‐responsive phenotypes by the deletion of Fgwc‐1 and Fgwc‐2 genes and (iii) to examine the roles of those genes in constant light and darkness in relation to secondary metabolite synthesis and development.

National-wide data on the treatment of BPH in Korea

The healthcare system in Korea provides coverage to all the people who are residing in Korea, so the data of the Korea healthcare system are national-wide and relatively accurate. We obtained the recent 5-year data (2004–2008) on the treatment of BPH from the national health insurance system. We tried to determine the trends or changes of BPH treatments in Korea. Over 3.8 million men visited clinics and were prescribed one or more BPH medications, and more than 44 000 men underwent surgical treatment during 2004–2008. Compared with the year 2004, two times the patients were prescribed BPH medications in 2008. With respect to the surgical treatment, the number of cases was increased 1.6 times in 2006 compared with the previous years. The most commonly used surgical option was TURP before 2006, but laser therapy was carried out as much as TURP in 2006 and in the following years. The relative risk of laser therapy in the 50 s is 1.53 (95% CI is 1.47–1.59). In conclusion, our national-wide data for the Korean BPH patients show that these patients’ medical treatment increased during the 5 years from 2004 to 2008. Laser treatment had increased and it might replace TURP in several years.