Jae Min Chung

Prevalence and Associated Factors of Overactive Bladder in Korean Children 5-13 Years Old: A Nationwide Multicenter Study

OBJECTIVES To estimate the prevalence of overactive bladder (OAB) in Korean children, 5-13 years of age, and to assess the associated factors for OAB. METHODS A randomly selected cross-section study was conducted in 26 kindergartens and 27 elementary schools nationwide in Korea. A total of 19 240 children were included; a parent was asked to complete the questionnaires, which included items about OAB and voiding and defecating habits. OAB was defined as urgency with or without urge incontinence, usually with increased daytime frequency and nocturia (International Childrens Continence Society, 2006). Its prevalence and associated factors were also investigated. RESULTS The response rate for the questionnaires was 85.84%. The overall prevalence of OAB was 16.59%. The prevalence of OAB decreased with age from 22.99% to 12.16% (P = .0001). The overall incidence of wet and dry OAB was 26.97% and 73.03%, respectively. Compared with normal children, those with OAB had a greater prevalence of nocturnal enuresis, constipation, fecal incontinence, urinary tract infection, delayed bladder control, and poor toilet facilities (P < .05). The incidence of increased daytime frequency and urge incontinence was 3.69% and 2.31% (P = .009) and 26.97% and 14.78% (P = .0001) in OAB and non-OAB children, respectively. The corresponding prevalence decreased with age from 5.04% to 3.06% and from 45.74% to 18.50% in OAB children (P = .0001). CONCLUSIONS The overall prevalence of OAB in Korean children, 5-13 years of age, was 16.59% and decreased with age. Nocturnal enuresis, constipation, fecal incontinence, history of urinary tract infection, delayed bladder control, and poor toilet facilities might be factors associated with the development of OAB.

An Epidemiologic Study of Voiding and Bowel Habits in Korean Children: A Nationwide Multicenter Study

OBJECTIVES To evaluate the prevalence of abnormal voiding and bowel habits in healthy children, and to identify possible relationships between personal and familial factors and voiding and/or bowel habits. METHODS A randomly selected cross-sectional study was conducted in 19,240 children (5-13 years old) nationwide in the Republic of Korea. Parents were asked to complete questionnaires, which included items about nocturnal enuresis, daytime dysfunctional voiding symptoms (DVSs), and abnormal bowel habits (ABHs). Rates and associated factors were investigated. RESULTS The overall rates of DVS, ABH, and of both were 46.4%, 31.3%, and 18.4%, respectively, and nocturnal enuresis was reported in 919 (5.6%). Daytime dysfunctional voiding symptoms were as follows: increased voiding frequency in 419 (2.5%), decreased voiding frequency in 720 (4.4%), urgency in 2740 (16.6%), daytime incontinence in 1854 (11.2%), urge incontinence in 2775 (16.8%), and holding maneuvers or postponed voiding in 3888 (23.5%). ABHs were as follows: constipation by frequency in 1103 (6.7%), constipation by the Bristol scale in 1941 (11.8%), fecal incontinence in 1293 (7.8%), and difficult or painful defecation in 2609 (15.8%). Delayed stool control, history of urinary tract infection, and a double-income family were positively associated with DVS or ABH or both. Furthermore, fathers with a low level of education and a low income were found to be associated with higher risk of ABH or DVS or both. CONCLUSIONS Delayed stool control, a history of urinary tract infection, a low paternal level of education, a double-income family, and a lower family income had a negative effect on voiding or bowel habits in children.

Retroperitoneal Bronchogenic Cyst Presenting as Adrenal Tumor in Adult Successfully Treated With Retroperitoneal Laparoscopic Surgery

A bronchogenic cyst in the retroperitoneum is rare in adults. A 41-year-old woman presented with an incidental left retroperitoneal mass that was suspicious for an adrenal tumor. Retroperitoneal laparoscopic excision and complete resection were performed. The pathologic examination confirmed a bronchogenic cyst in the retroperitoneum. We present the case with review of the relevant published data.

Malignant Inflammatory Myofibroblastic Tumor of the Bladder with Rapid Progression

A 71-year-old man was referred for painless hematuria and a bladder tumor. Cystoscopy and computed tomography revealed a 3-cm oval nodular mass on the left lateral side of the bladder. The patient underwent a complete transurethral resection of the lesion and histology showed a proliferation of atypical spindle cells with inflammation consistent with a myofibroblastic tumor. After 4 and 7 months, follow-up cystoscopy demonstrated nodular mass lesions and transurethral resection of bladder tumor was done, which showed chronic cystitis and a recurred myofibroblastic tumor, respectively. Five months later, multiple lymph node, bone, and soft tissue metastases were found by positron emission tomography. The patient was treated first with palliative chemotherapy, including doxorubicin and cisplatin. After that, radiologic studies showed disease progression but the patient refused further treatment and died 6 months later.

Safety and Efficacy of Once Daily Administration of 50 mg Mirodenafil in Patients with Erectile Dysfunction: a Multicenter, Double-Blind, Placebo Controlled Trial

PURPOSE We evaluated the improvement in erectile dysfunction and lower urinary tract symptoms as well as the safety of once daily administration of 50 mg mirodenafil in men with erectile dysfunction. MATERIALS AND METHODS A total of 226 patients visited for treatment of erectile dysfunction and were recruited for the study. Of these men 180 met the study inclusion criteria after completing a 2-week screening period (visit [V]1). The patients were randomly allocated into 2 groups. Group 1 (90 patients) received 50 mg mirodenafil once daily and group 2 (90 patients) received a placebo daily. Blood pressure, heart rate, IIEF-5 (5-item version of the International Index of Erectile Function), and SEP (Sexual Encounter Profile) questions 2 and 3 were assessed at 4 (V2), 8 (V3) and 12 weeks after the start of treatment (V4). I-PSS (International Prostate Symptom Score), maximal flow rate and post-void residual volume were also assessed for the evaluation of lower urinary tract symptoms. RESULTS Of the 180 patients 71 in group 1 and 63 in group 2 completed the 12-week clinical trial. IIEF-5 and I-PSS significantly improved in group 1 (p <0.001 for both). Facial flushing was the most common adverse effect, followed by headaches. Notably there were no statistically significant differences in either of the variables related to the cardiovascular system. CONCLUSIONS Once daily administration of 50 mg mirodenafil was efficacious and safe for the treatment of erectile dysfunction and lower urinary tract symptoms.

A Prospective Korean Multicenter Study for Infectious Complications in Patients Undergoing Prostate Surgery: Risk Factors and Efficacy of Antibiotic Prophylaxis

This multicenter study was undertaken to determine the efficacy of antibiotic prophylaxis and identify the risk factors for infectious complications after prostate surgery in Korean patients. A total of 424 patients who underwent surgery of the prostate were reviewed. All patients underwent urinalysis and urine culture preoperatively and postoperatively. Efficacy of antibiotic prophylaxis and risk factors for infectious complications were investigated. Infectious complications were observed in 34.9% of all patients. Factors independently associated with infectious complications were diabetes mellitus (adjusted OR, 1.99; 95% CI, 1.09-3.65, P=0.025) and operation time (adjusted OR, 1.08; 95% CI, 1.03-1.13, P=0.004). Clinicians should be aware of the high risk of infectious complications in patients with diabetes and those who undergo a prolonged operation time. Neither the type nor duration of prophylactic antibiotics resulted in differences in infectious complications. Graphical Abstract

Squamous Cell Carcinoma of the Suprapubic Cystostomy Tract With Bladder Involvement

Herein we report a case of a squamous cell carcinoma of a well-healed suprapubic cystostomy tract scar involving the bladder mucosa in a 56-year-old man. He presented with a spontaneous suprapubic urinary leak from a suprapubic cystostomy tract scar. He had a history of urethral stricture and failed urethroplasty. Preoperative cystoscopy suggested a bladder mass. Transurethral biopsy of the bladder mass revealed a squamous cell carcinoma confined to the suprapubic cystostomy tract involving the bladder mucosa. The patient died 6 months after the start of radiation therapy after lung metastasis and pneumonia.

Evaluation of maximum voided volume in Korean children by use of a 48-h frequency volume chart.

Study Type – Diagnostic (validating cohort)

Erratum: Efficacy and Tolerability of Anticholinergics in Korean Children with Overactive Bladder: A Multicenter Retrospective Study

[This corrects the article on p. 1550 in vol. 29, PMID: 25408588.].

Effects of prolyl 4-hydroxylase inhibitor on bladder function, bladder hypertrophy and collagen subtypes in a rat model with partial bladder outlet obstruction.

OBJECTIVE To investigate the effects of prolyl 4-hydroxylase (P4H) inhibitor on the bladder in rats with partial bladder outlet obstruction. METHODS Forty-five female Sprague-Dawley rats were divided into 3 groups; partial bladder outlet obstruction with P4H inhibitor 20 mg/kg (groups A1, A2, and A4, each n = 5), partial bladder outlet obstruction with normal saline (groups B1, B2, and B4, each n = 5), and normal control (groups C1, C2, and C4, each n = 5). After partial bladder outlet obstruction for 1, 2, and 4 weeks in the groups A and B, respectively, the inhibitor or normal saline were administered orally at the indicated dosage once a day for 2 weeks. After either 3, 4, or 6 weeks, the bladders were removed after cystometry. RESULTS The pressure and volume parameters from the cystometry and the muscle thickness from the Masson trichrome staining of groups A and B increased significantly compared to those in group C (P < .05), and those in group A were significantly lower than those of group B (P < .05). Based on immunohistochemical staining and reverse transcription-polymerase chain reaction, P4H expression in groups A and B was increased compared with that in group C. Furthermore, P4H expression showed a larger decrease in group A compared to that in group B. Collagens I and III protein expressions increased with partial bladder outlet obstruction in comparison with that of group C, and expression in group A was marginally decreased compared with expression in group B. CONCLUSION Our data suggest that the P4H inhibitor may improve bladder function and reduce the bladder fibrosis caused by partial bladder outlet obstruction.