Seung Il Jung

Correlation of metabolic syndrome with urinary stone composition

To determine the correlation between metabolic syndrome and the distribution of stone components in patients with urolithiasis.

Impact of diabetes mellitus on recurrence and progression in patients with non-muscle invasive bladder carcinoma: A retrospective cohort study

Objective:  The aim of the present study was to investigate the relationship between diabetes mellitus (DM) and tumor features in patients with non‐muscle invasive bladder cancer (NMIBC).

Testicular catch up growth: the impact of orchiopexy age.

OBJECTIVE To compare the long-term follow-up growth of congenital, unilaterally palpable, undescended testes after orchiopexy according to age at the time of surgery. The optimal age for surgical treatment remains controversial. MATERIALS AND METHODS A total of 86 patients (108 testes) between the ages of 1 and 9 years underwent orchiopexy. Patients were divided according to age at the time of surgery: group I, <2 years (n = 43); group II, 2 ≤ age < 5 years (n = 35); and group III, ≥5 years (n = 30). The boys were then followed for more than 2 years after surgery. Ultrasonography was used for determination of testicular volume. Testicular volume percentage was compared by the equation of (operated testis volume/normal testis volume × 100%). RESULTS Testicular location was the inguinal canal in 92 (85.2%) and lower to the external inguinal ring in 16 (14.8%). Only group I, which received orchiopexy within two years from birth, showed significant recovery of testicular volume at follow-up (P <.05), compared with groups II and III. CONCLUSIONS Orchiopexy performed at less than 2 years from birth was a significant factor for recovery of delayed cryptorchid testicular growth. This result suggests that early orchiopexy improves subsequent testicular catch-up growth.

Impact of Nocturia on Health-Related Quality of Life and Medical Outcomes Study Sleep Score in Men

Purpose To evaluate the impact of nocturia on health-related quality of life and sleep in men. Methods From January 2008 to December 2008, 284 patients with lower urinary tract symptoms were selected for this study. The participants completed a series of questionnaires on health-related quality of life (the overactive bladder questionnaire, or OAB-q), the Medical Outcomes Study (MOS) sleep scale, and the frequency volume chart. Results The patient population had a mean age of 60.0±13.4 years (range, 40 to 79 years). The mean duration of symptoms was 28.8±34.6 months. The mean number of voiding episodes per night was measured as follows: 88 patients (31.0%) reported no nocturia, 60 patients (21.1%) reported 2>voids/night ≥1, 56 patients (19.7%) reported 3>voids/night ≥2, and 80 patients (28.2%) reported ≥3 voids/night. The mean number of nocturia episodes increased with age (P=0.001), and the number of nocturia episodes was significantly associated with the OAB-q symptom score (P=0.001) and symptom bother (P=0.001). Among the categories of the MOS sleep scale, sleep index I (P=0.020), sleep disturbance (P=0.010), adequacy of sleep (P=0.005), and somnolence (P=0.041) were significantly associated with an increased number of nocturia episodes. Conclusions The number of nocturia episodes increased with age in men. Nocturia appeared to be associated with further negative effects on sleep quality, health-related quality of life, and symptom bother.

Use of the NMP22 BladderChek test in the diagnosis and follow-up of urothelial cancer: a cross-sectional study.

OBJECTIVES To investigate the efficacy of the nuclear matrix protein (NMP) 22 BladderChek test (NMP22BC) in the detection and follow-up of urothelial carcinoma. MATERIAL AND METHODS A total of 1021 patients who underwent the NMP22BC, cytology, and cystoscopy, were studied. We divided the patients into 2 groups: group I consisted of 597 patients who were being followed up for previous urothelial carcinoma, and group II consisted of 424 patients with hematuria. The sensitivity and specificity of the NMP22BC, cytology, and the combination (NMP22BC + cytology) were compared. RESULTS Of the 1021 patients, 131 were diagnosed with urothelial cancer. The overall sensitivities for the NMP22BC, cytology, and the combination were 32.1%, 38.2%, and 52.7%, respectively. In group I, the sensitivity of the NMP22BC was lower than the sensitivity of cytology (22.58% vs 35.5%); there was no difference between the sensitivity of the NMP22BC and that of cytology in group II (40.58% vs 40.58%). For the combination, the sensitivity was greater than that of either test alone in both groups (46.77% and 57.97% in groups I and II, respectively). The sensitivity of the NMP22BC was greater than that of cytology (22.6% vs 13.2%) for low-grade bladder cancer. CONCLUSIONS The NMP22BC has lower sensitivity than cytology. However, the sensitivity of NMP22BC in low-grade tumors was higher than that of cytology. Therefore, when the NMP22BC is combined with cytology, the sensitivity for detecting urothelial carcinoma is increased, which implies that this combination may be useful in the screening and follow-up of urothelial carcinoma.

Is a Decreased Serum Testosterone Level a Risk Factor for Prostate Cancer? A Cohort Study of Korean Men

Purpose To investigate patients who had transrectal ultrasonography (TRUS)-guided prostate biopsy to define the role of the serum testosterone level in predicting prostate cancer risk and its association with a high Gleason score. Materials and Methods A total of 568 patients who underwent prostate biopsy were entered in this study. We divided the patients into two groups according to serum testosterone level (median level, 3.85 ng/ml): the high-testosterone group (n=285) and the low-testosterone group (n=283). Multivariate regression analysis was used to define the effect of age, prostate volume, serum prostate-specific antigen (PSA) level and PSA density, and serum testosterone level on the risk of prostate cancer and a high Gleason score. Results Baseline characteristics did not differ significantly between the two groups. Compared with the high-testosterone group, the low-testosterone group had a significantly higher prostate cancer incidence (38.9% vs. 29.5%, p=0.018). Factors associated with an increased risk of prostate cancer were increased age (odds ratio [OR]=1.08, 95% confidence interval [CI]=1.25-3.16, p=0.001), a high serum PSA level (OR=3.35, 95% CI=2.63-4.25, p=0.001), a low prostate volume (OR=0.183, 95% CI=0.11-0.30, p=0.001), and a low serum testosterone level (OR=1.99, 95% CI=1.25-3.16, p=0.001). Among these, only the serum PSA level was a strong predictor of high-grade prostate cancer (Gleason score ≥7) (OR=2.19, 95% CI=1.57-2.95, p=0.001). Conclusions Patients with lower levels of serum testosterone had a higher risk of prostate cancer than did patients with high serum testosterone. Even though a lower serum testosterone level was a predictor of prostate cancer risk, it was not associated with an increased risk of high-grade prostate cancer.

Usefulness of liquid-based preparation in urine cytology

Objective:  ThinPrep (TP), a liquid‐based cytological and non‐invasive technique to confirm the diagnosis of bladder cancer, is reported to be a better screening test than the conventional cytospin method. This study compared the new MonoPrep2 (MP), a liquid‐based cytological technique, with TP for diagnosing bladder cancer.

Predictors of Intravesical Recurrence After Radical Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma: An Inflammation-Based Prognostic Score

Purpose Systemic inflammatory responses, which are defined in terms of the Glasgow prognostic score (GPS), have been reported to be independent predictors of unfavorable outcomes in various human cancers. We assessed the utility of the GPS as a predictor of intravesical recurrence after radical nephroureterectomy (RNU) in upper urinary tract carcinoma (UTUC). Materials and Methods We collected data for 147 UTUC patients with no previous history of bladder cancer who underwent RNU from 2004 to 2012. Associations between perioperative clinicopathological variables and intravesical recurrence were analyzed by using univariate and multivariate Cox regression models. Results Overall, 71 of 147 patients (48%) developed intravesical recurrence, including 21 patients (30%) diagnosed with synchronous bladder tumor. In the univariate analysis, performance status, diabetes mellitus (DM), serum albumin, C-reactive protein, GPS, and synchronous bladder tumor were associated with intravesical recurrence. In the multivariate analysis, performance status (hazard ratio [HR], 2.33; 95% confidence interval [CI], 1.41-3.85; p=0.001), DM (HR, 2.04; 95% CI, 1.21-3.41; p=0.007), cortical thinning (HR, 2.01; 95% CI, 1.08-3.71; p=0.026), and GPS (score of 1: HR, 6.86; 95% CI, 3.69-12.7; p=0.001; score of 2: HR, 5.96; 95% CI, 3.10-11.4; p=0.001) were independent predictors of intravesical recurrence. Conclusions Our results suggest that the GPS as well as performance status, DM, and cortical thinning are associated with intravesical recurrence after RNU. Thus, more careful follow-up, coupled with postoperative intravesical therapy to avoid bladder recurrence, should be considered in these patients.

Men with Hypertension are More Likely to Have Severe Lower Urinary Tract Symptoms and Large Prostate Volume.

Patients with lower urinary tract symptoms (LUTS) have a higher prevalence of cardiovascular disease. We evaluated the correlation between LUTS and cardiovascular risk factors in men presenting with benign prostatic hyperplasia (BPH).

Delayed Diagnosis of an Intraurethral Foreign Body Causing Urosepsis and Penile Necrosis

Cases of self-inserted foreign bodies in the male urethra and urinary bladder are unusual. In most cases, the type of foreign body can be identified by taking a history or from radiological findings; sometimes, however, it is difficult to identify the foreign body because of decreased mental capacity of the patient or unknown radiological characteristics of the foreign body. We experienced a chronic alcoholic patient with septicemia and penile necrosis in whom a fragment of mirror glass had passed through the urethra into the bladder. The glass, 2 cm in length and 0.7 cm in diameter, was detected by cystoscopy and was removed by using a resectosope.