Joon-Sung Kim

Initial combined treatment with anticholinergics and α-blockers for men with lower urinary tract symptoms related to BPH and overactive bladder: a prospective, randomized, multi-center, double-blind, placebo-controlled study.

We aimed to evaluate the efficacy and safety of combination treatment using anticholinergics with α-blocker for initial treatment of both overactive bladder (OAB) and other lower urinary tract symptoms (LUTS), secondary to BPH. A 12-week, randomized, double-blind, placebo-controlled trial was conducted at four urology clinics in Korea, involving men, aged 50 years or older, with LUTS related to BPH and OAB. A total of 176 patients were randomly assigned to receive doxazosin (4u2009mg) plus placebo or doxazosin (4u2009mg) plus tolterodine SR (4u2009mg), once a day for 12 weeks. Changes from baseline in total International Prostate Symptom Score (IPSS), bladder diary variables, patient perception of bladder condition (PPBC), uroflowmetry, postvoid residual volume and IPSS subscores (voiding and storage) were analyzed. Of the 176 enrolled patients, 91 had doxazosin gastrointestinal therapeutic system (GITS) and placebo, and 85 had combined medication with doxazosin GITS and tolterodine SR. Compared with the doxazosin plus placebo group, the doxazosin plus tolterodine group showed significant reductions in IPSS storage subscore and improvement in the quality of life item, urgency episodes, as well as in micturition frequency at weeks 4 and 12. However, it failed to improve PPBC at week 4 as well as at week 12. Earlier intervention with anticholinergics plus α-blocker was tolerated well, including the questions about urinary retention (n=1) and dry mouth (n=2). Initial combination treatment of anticholinergics plus α-blocker showed positive results for men with LUTS related to BPH and OAB symptoms and did not increase the risk of urinary retention.

Twelve-month medication persistence in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia

This study aimed to assess patients baseline characteristics and provider factors influencing the continuation of medication for 12 months in patients who were newly diagnosed with benign prostatic hyperplasia (BPH).

How Safe and Effective Is Routine Left Hand-Assisted Laparoscopic Donor Nephrectomy With Multiple Renal Arteries? A High-Volume, Single-Center Experience

BACKGROUNDnWe investigated the safety and effectiveness of routine harvest of the left kidney for renal transplantation regardless of the presence of multiple renal arteries to obtain the longer renal vein.nnnPATIENTS AND METHODSnBetween February 2000 and July 2008, 325 patients underwent left hand-assisted laparoscopic living donor nephrectomy. The true renal arterial anatomy as evaluated intraoperatively was compared with the renal arterial anatomy by computed tomography (CT). We compared the results for the patients with a single renal artery (group I) with the patients with multiple renal arteries (group II) in terms of the donor and recipient outcomes.nnnRESULTSnMultiple renal arteries in left kidney were identified in 86 patients (26.5%). Thirty-seven CTs (11.4%) were in discord with the renal arterial anatomy evaluated intraoperatively. There was no difference in age, gender, body mass index, estimated blood loss, complication rate, or length of hospital stay between the 2 groups in the donor. Although the warm ischemic time and the operation time were significantly longer in group II (P = .008 and .001), overall graft survival was similar between the groups.nnnCONCLUSIONnRoutine harvest of the left kidney can be performed safely and effectively for the donor and recipient, even in the presence of multiple renal arteries.

Rate and associated factors of solifenacin add-on after tamsulosin monotherapy in men with voiding and storage lower urinary tract symptoms

To explore the rate of add‐on therapy with solifenacin in men with voiding and storage lower urinary tract symptoms (LUTS) after tamsulosin monotherapy and to explore predictive factors for starting solifenacin add‐on therapy.

Patient‐reported goal achievement after antimuscarinic treatment in patients with overactive bladder symptoms

Aim:u2002 Standardised traditional outcome measures may fail to address factors that are important to patients and address irrelevant factors. Aim of this study was to assess patient‐reported goals and goal achievement (GA) in the antimuscarinic treatment for overactive bladder (OAB) patients.

Cervical Meningomyelitis After Lumbar Epidural Steroid Injection

Epidural steroid injections (ESI) are a common treatment for back pain management. ESI-related complications have increased with the growing number of procedures. We report a case of cervical meningomyelitis followed by multiple lumbar ESI. A 60-year-old male with diabetes mellitus presented to our hospital with severe neck pain. He had a history of multiple lumbar injections from a local pain clinic. After admission, high fever and elevated inflammatory values were detected. L-spine magnetic resonance imaging (MRI) revealed hematoma in the S1 epidural space. Antibiotic treatment began under the diagnosis of a lumbar epidural abscess. Despite the treatment, he started to complain of weakness in both lower extremities. Three days later, the weakness progressed to both upper extremities. C-spine MRI revealed cervical leptomeningeal enhancement in the medulla oblongata and cervical spinal cord. Removal of the epidural abscess was performed, but there was no neurological improvement.

A randomised, prospective double-blind, propiverine-controlled trial of imidafenacin in patients with overactive bladder

To assess the efficacy and safety of imidafenacin compared with propiverine for treatment of overactive bladder (OAB) in Korean patients.

Development of Korean Academy of Medical Sciences Guideline Rating the Physical Impairment: Lower Extremities

Lower Extremities Committee of Korean Academy of Medical Sciences Guideline for Impairment Rating develops new guidelines which are based on McBride method, American Medical Association Guides, Disability evaluation by The Korean Orthopaedic Association, The Korean Neurosurgery Society, and Korean Academy of Rehabilitation Medicine. The committee analyzed and discussed to create an ideal method practical in Korea. Our committee endeavors to develop new methods which are easy to use, but are suitable for professional use and also independent from the examinees intentions. The lower extremities are evaluated on the basis of anatomic change, functional change, and diagnosis based evaluation. Nine methods are used to assess the lower extremities. Anatomic assessment includes leg length discrepancy, ankylosis, amputation, skin loss, peripheral nerve injury, and vascular disease. In functional assessment, range of motion and muscle strength are included. Diagnosis-based assessments are used to evaluate impairment caused by specific fractures, deformities, ligament instability, meniscectomies, post-traumatic arthritis, fusion of the foot, and lower extremity joint replacements.

The impact of depression and somatic symptoms on treatment outcomes in patients with chronic prostatitis/chronic pelvic pain syndrome: a preliminary study in a naturalistic treatment setting.

The aim of this study was to evaluate the impact of depression and somatic symptoms on treatment outcomes in Korean male patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) attending a routine clinical practice.

Persistence with solifenacin add‐on therapy in men with benign prostate obstruction and residual symptoms of overactive bladder after tamsulosin monotherapy

In spite of the reported efficacy and safety of antimuscarinics in men with OAB (overactive bladder) and BPO (benign prostatic obstruction), many patients do not persist with the treatment. We aimed to evaluate persistence and the reasons for the discontinuation of solifenacin add‐on therapy in men with residual symptoms of OAB after tamsulosin monotherapy for BPO in a real clinical environment.