Seung Ki Min

Cut-off Value of Testes Volume in Young Adults and Correlation Among Testes Volume, Body Mass Index, Hormonal Level, and Seminal Profiles

OBJECTIVESnTo set a population-based cut-off value of normal adult and to determine correlations of testicular volume with body mass index (BMI), seminal profiles, and hormone levels. Testicular volume is an index of male fertility but cut-off values of normal adult has not been reported.nnnMETHODSnDuring 54 months from January 2004, 1139 normal young men, 19-27 years old in military service were enrolled. Testicular volumes were measured by ultrasonometry. Height, body weight, and BMI were measured and semen analysis and hormone assay (follicle-stimulating hormone [FSH], luteinizing hormone [LH], and testosterone) were performed.nnnRESULTSnThe mean age was 23.52+/-2.74. The mean testicular volume was 18.37+/-3.62 cm3 in left, and 18.13+/-3.85 cm3 in right. The mean body weight was 67.4+/-7.91 kg, the mean height was 176.2+/-6.64 cm, and mean BMI was 22.49+/-2.02 kg/m2. Testicular volumes had significant but weak correlations with height, body weight, and BMI. The semen analyses showed a mean pH of 7.63+/-0.74, volume of 2.49+/-1.12 mL, count of 68.63+/-13.62x10(6), motility of 69.93%+/-10.28%, and morphology of 68.62%+/-7.48%. Sperm counts and motility had positive correlations with testicular volume. The mean hormonal levels of FSH, LH, and testosterone were 7.31+/-2.42 mIU/mL, 7.81+/-2.49 mIU/mL, and 6.23+/-1.69 ng/mL, respectively. Testicular volume was negatively correlated with FSH and LH and positively with testosterone.nnnCONCLUSIONSnIn this population-based study, we conclude that the cut-off testicular volume in normal young adults is around 18 mL and that testicular volume is positively correlated with height, body weight, BMI, semen profile, and testosterone, and negatively correlated with FSH and LH.

Gonadotropin-Releasing Hormone (GnRH) and GnRH Receptor in Bladder Cancer Epithelia and GnRH Effect on Bladder Cancer Cell Proliferation

Introduction: Gonadotropin-releasing hormone (GnRH) is the pivotal hormone in the hypothalamopituitary gonadal axis. Recently, localization of extrahypothalamic GnRHs and GnRH receptors has been made in several organs but not in the bladder. We studied the extrahypothalamic GnRH and GnRH receptor in bladder cancer epithelia, and the role of GnRH on bladder cancer cell proliferation. Material and Methods: Normal human bladder mucosa, human transitional bladder cancer tissue, and 4 bladder cancer cell lines were used. For culture media, normal or charcoal-stripped serum with exogenous GnRH of different concentrations (0, 10–3, 10–5, and 10–7M) were supplemented. For detection of GnRH and the GnRH receptor and its mRNAs, RNase protection assay, in situ hybridization, and immunocytochemistry were performed. Cellular proliferation was measured by hemocytometer and the cell cycle by flow cytometer. Results: GnRH and GnRH receptor mRNA expression were detected in all cancer cell lines and human bladder cancer tissues. GnRH and GnRH receptors were localized in bladder cancer epithelial cells, but the density was not even. There were no significant differences (p > 0.05) in proliferation, and no significant change (p > 0.05) in cell cycle with GnRH supplements compared to controls. Conclusion: The bladder epithelia produce GnRH and the GnRH receptor in both normal and malignant tissues, but GnRH does not induce proliferation or cell cycle change of bladder cancer cells.

Relationship between Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia and Metabolic Syndrome in Korean Men

Purpose To investigate any associations between lower urinary tract symptoms (LUTS)/benign prostate hyperplasia (BPH) and metabolic syndrome (MetS). Materials and Methods In all, 1,224 male police officers in their 50s who had participated in health examinations were included. LUTS/BPH was assessed by serum prostate-specific antigen, International Prostate Symptom Score (IPSS), transrectal ultrasonography, maximum urinary flow rate (Q max), and postvoid residual urine volume (PVR). In addition, testosterone was also examined. The MetS was defined using NCEP-ATP III guidelines. We used the multiple linear regression test and logistic regression analyses to examine the relationships. Results MetS was diagnosed in 29.0% of participants. There was no significant difference in the percentage of cases of BPH (IPSS >7, Q max <15 ml/sec, and prostate gland volume ≥ 20 ml) (14.2% in the non-MetS group vs. 17.2 in the MetS group; p value=0.178). The total IPSS score and the Q max were not significantly different. The prostate volume and PVR were significantly greater in the subjects with MetS. After adjusting for age and testosterone, the presence of MetS was not associated with BPH (multivariate odds ratio, 1.122; 95% confidence interval, 0.593~2.120). Additionally, MetS was not related to IPSS (Beta, -0.189; p value=0.819), prostate volume (Beta, 0.815; p value=0.285), Q max (Beta, -0.827; p value=0.393), or PVR (Beta, 0.506; p value=0.837). Conclusions According to our results, the MetS was not clearly correlated with LUTS/BPH in Korean men in their 50s.

Use of NTrap® during Ureteroscopic Lithotripsy for Upper Ureteral Stones

Purpose This study aimed to determine the value of the NTrap® (Cook Urological INC, USA), which was designed to block the upward movement of stones during ureteroscopic lithotripsy. Materials and Methods We reviewed the data of 144 patients who underwent ureteroscopic lithotripsy for an upper ureteral stone from June 2006 to May 2010. Sixty-eight patients who underwent ureteroscopic lithotripsy without the use of the NTrap® were assigned to Group I and 76 patients who underwent ureteroscopic lithotripsy with the NTrap® were assigned to Group II. The size of the stones, operation time, success rate, and pre- and postoperative complications were compared retrospectively between the two groups. Results The mean age of the patients (Group I: 35.8 years; Group II: 32.6 years) and the sex ratios were not significantly different between the two groups. The mean size of the stones was 6.9 mm and 7.4 mm, which also was not significantly different between the two groups. The mean operation time was 82.7 minutes and 78.7 minutes. The operation time was shorter in Group II, but the difference was not significant. The success rate of stone removal was 89.7% and 98.7% in Groups I and II, respectively; Group II showed a significantly higher success rate. Two cases of ureteral perforation and one case of ureteral avulsion occurred in Group I, and one case of ureteral perforation occurred in Group II. Conclusions NTrap®, which is an instrument used to assist during ureteroscopic lithotripsy, can be considered to be an effective tool that blocks the upward movement of the stone and aids in safe stone removal.

Associations of Ultrasonographic Features with Scrotal Pain after Vasectomy

Purpose Scrotal discomfort is a recognized complication of vasectomy, but the natural history and incidence of this problem are uncertain. The typical ultrasonographic changes after a vasectomy primarily include epididymal thickening and epididymal tubular ectasia with diminished blood flow in the epididymis. We prospectively studied the differences in the ultrasonographic features of the testis and epididymis between patients with and those without scrotal discomfort after vasectomy. Materials and Methods We prospectively assessed pain scores in 178 men who underwent outpatient bilateral no-scalpel vasectomy at our institution between January 2009 and December 2010. At 2 months after vasectomy, we evaluated the postoperative scrotal pain questionnaire and scrotal ultrasonographic features for patients who returned for semen analysis. On the basis of the scrotal information, we investigated the potential relationships between scrotal pain or discomfort and scrotal ultrasonographic features of both testes and epididymides. Results The average age of the 114 men was 36.3 years (range, 29 to 53 years). group 1 (n=23), which reported scrotal pain or discomfort, showed no significant mean differences in the maximal diameter of the head of the epididymis when compared with group 2 (n=91), who had no scrotal pain or discomfort. Also, the width of the body of the epididymis between the two groups showed no significant differences. Conclusions There were no significant differences in ultrasonographic features according to the presence of chronic scrotal discomfort after vasectomy. Therefore, causes of scrotal pain other than obstruction may need to be considered after vasectomy.

Relationship of Estimated Glomerular Filtration Rate With Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia Measures in Middle-aged Men With Moderate to Severe Lower Urinary Tract Symptoms

OBJECTIVEnTo evaluate the relationship of the glomerular filtration rate (GFR) and lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia measures in middle-aged men.nnnMETHODSnA total of 1400 male police officers with moderate and severe LUTS (international prostate symptoms score [IPSS] >7) and aged 40-59 years who had participated in a health examination were included. LUTS/benign prostatic hyperplasia was measured with IPSS, transrectal ultrasonography, uroflowmetry, and postvoid residual urine volume. We estimated the GFR using the Chronic Kidney Disease Epidemiology Collaboration equation. Spearman correlation tests and multiple linear regression tests were used to evaluate the relationship.nnnRESULTSnThe median age was 50.0 years, and the median GFR was 85.3 mL/min/1.73 m(2). The GFR showed a significant positive correlation with the maximal flow rate (Qmax; r = .112; P <.001). However, there was no significant correlation of GFR with IPSS (r = -.018; P = .493), total prostate volume (r = -.032; P = .237), and postvoid residual (r = -.066; P = .051). After adjusting for age, body mass index (BMI), and metabolic syndrome, only Qmax showed a positive correlation with GFR (beta = .114; P = .003).nnnCONCLUSIONnQmax demonstrated a significant correlation with GFR in middle-aged men with moderate to severe LUTS in this study. Our data suggest that improved clinical attention is required for patients with LUTS and a low Qmax.