Young Hwan Ji

A Double-Blind Crossover Study Evaluating the Efficacy of Korean Red Ginseng in Patients With Erectile Dysfunction: A Preliminary Report

PURPOSE We investigated the efficacy of Korean red ginseng for erectile dysfunction using the International Index of Erectile Function, RigiScan (UroHealth Systems, Laguna Niguel, California), hormonal levels and penile duplex ultrasonography with audiovisual sexual stimulation. MATERIALS AND METHODS A total of 45 patients with clinically diagnosed erectile dysfunction were enrolled in a double-blind, placebo controlled, crossover study (8 weeks on treatment, 2 weeks of washout and 8 weeks on treatment) in which the effects of Korean red ginseng and a vehicle placebo were compared using multiple variables. The ginseng dose was 900 mg. 3 times daily. RESULTS Mean International Index of Erectile Function scores were significantly higher in patients treated with Korean red ginseng than in those who received placebo (baseline 28.0 +/- 16.7 and 38.1 +/- 16.6 versus 30.9 +/- 15.7, p <0.01). Scores on questions 3 (penetration) and 4 (maintenance) were significantly higher in the ginseng than in the placebo group (p <0.01). In response to the global efficacy question 60% of the patients answered that Korean red ginseng improved erection (p <0.01). Among other variables penile tip rigidity on RigiScan showed significant improvement for ginseng versus placebo. CONCLUSIONS Our data show that Korean red ginseng can be as effective alternative for treating male erectile dysfunction.

Change in Penile Length in Children: Preliminary Study

Purpose Studies of penile length in children have been rarely conducted. In Korea, great improvements in height and weight have been observed because of economic development over the past 25 years. We investigated the current status of penile length in Korean children and compared the results with those of a previous Korean study conducted in 1987. Materials and Methods The subjects in this study were 233 boys aged 1 to 158 months, each of whom had been brought to outpatient clinics between April and October 2011. Penile length was measured according to the stretched penile length (SPL) technique; testicular size was measured (in ml) by using orchidometry. A comparison of penile lengths between the current study and the 1987 study was made by using Students t-test. Results SPL increased significantly by 0.7 to 1.1 cm in most age groups (p<0.05). Current anthropometric measures of Korean children such as height, body weight, and testicular size have increased compared with those from 1987. Conclusions Penile length has increased significantly over the last quarter century. Therefore, it is suggested that novel reference values for penile length in prepubertal Korean children be determined in studies with a larger community-based population in order to diagnose and treat size-related penile disorders.

Clinical characteristics and surgical outcomes in adolescents and adults with varicocele.

Purpose To compare clinical characteristics and surgical results in adolescents and adults with varicocele. Materials and Methods We retrospectively analyzed the characteristics of 93 patients, 34 adolescents (mean age, 14.4±2.1 years) and 59 adults (mean age, 30.4±12.4 years), who underwent surgical repair of varicocele between 2006 and 2009. Median follow-up time in all patients was 18.7 months. The most bothersome symptoms, bilaterality, grades, surgical methods, artery-sparing rates, operation times, semen analysis, success rates, and recurrence-free period were compared between the two groups. Results The overall success rate of surgical repair was 92.5%. The most bothersome symptoms were scrotal mass, pain, and hypotrophy in adolescents and pain, scrotal mass, infertility, and hypotrophy in adults (p=0.008). There were no significant between-group differences in bilaterality, grades, surgical methods, operation times, pre- or postoperative semen analyses, success rates, or recurrence-free periods. Patients who underwent artery-sparing surgery had higher recurrence rates than did those who underwent surgery that did not spare arteries. In adults, semen density increased significantly after surgery, from 35.6 million/ml to 49.6 million/ml (p=0.046). Conclusions There were no significant differences in clinical characteristics or surgical results between adolescents and adults with varicocele, except for the most bothersome symptoms. Semen density increased after surgery in both groups.

Solitary Penile Neurofibroma with Erectile Dysfunction

Neurofibromas of the penis, although very rare, are often associated with neurofibromatosis type 1. Primary solitary neurofibromas of the penis are extremely rare. We describe a 37-year-old man with a solitary neurofibroma in the dorsum of the penis. The patient reported difficulty with sexual intercourse owing to a penile mass and erectile dysfunction. After surgical excision of the neurofibroma, he had no pain and a normal sensation of the penile glans, and his erectile dysfunction improved. At the present time, 26 months after surgery, there has been no evidence of tumor recurrence.

Giant ureteral polyps causing proximal ureter obstruction: emphasis on the surgical method and ureteroscopy ☆

We describe here the case of a 13-year-old boy who had right flank pain for 3 months. An intravenous pyelogram showed filling defects in the right upper part of the ureter as well as hydronephrosis. Because the diseased part of the ureter was about 5 cm in length and we wished to avoid short ureter after surgery, we performed a minimal segmental resection of the ureter including the entire stalk. Perioperative ureteroscopic examination showed another polyp 3 cm below the primary polyp, which was also removed. End-to-end ureteral anastomosis was performed without mobilization of the kidney. Frozen and formal microscopic examination showed that these polyps were fibroepithelial.

483 PROGNOSTIC VALUE OF BODY MASS INDEX IN BLADDER CANCER PATIENTS RECEIVED RADICAL CYSTECTOMY

comes of patients undergoing radical cystectomy with and without prior pelvic radiation. METHODS: A retrospective review of patients who underwent RC at our institution since 2000 was performed. Patients were stratified into two groups, those having received pelvic radiation prior to surgery (RPS) and an age/stage-matched control group without prior pelvic irradiation. Complications within 90 days of surgery were assigned a Clavien classification. RESULTS: 515 RCs were performed over the decade, of which 50 (9.7%) patients had received prior pelvic radiation. These 50 patients were compared to 50 age/stage-matched controls. There were no demographic differences between the two groups (Table 1). There was no significant difference in preoperative T stage, with the majority of each group having T2 disease (60.0% vs. 61.2%, p 0.274). The RPS group, however, had a significantly higher requirement for transfusion, at a rate of 79% compared with 45% in the controls (p 0.001). Postoperative complications as classified by the Clavien system did not differ between the groups, with a rate of 86% in the RPS group vs. 81.6% in the controls (p 0.777) (Table 2). Final pathology revealed a trend towards a higher rate of T4 lesions in the RPS group (31.3% vs 16.3%), but this value was not statistically significant (p 0.08). Rates of progression to metastatic disease were equivalent (57.1% vs. 55.8%, p 1). There was no significant difference in overall survival rates (1061 and 737 days, p 0.89) at a median follow up of 19.6 and 23.9 months. CONCLUSIONS: The majority of patients have a complication after RC using the Clavien system. Prior pelvic radiation did not appear to significantly increase intraoperative or postoperative complication rates using the Clavien classification system. Blood transfusion rate was higher in the radiated group.