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Purpose: This study was conducted to compare the accuracy of bi-parametric magnetic resonance imaging (bpMRI) with high b-value (b=1,000 s/mm2, b1000) diffusion-weighted imaging (DWI) to that of bpMRI with ultra-high b-value (b=1,800 s/mm2, b1800) DWI to detect clinically significant prostate cancer (csPCa). Materials and Methods: A total of 408 patients with suspected PCa were evaluated by bpMRI prior to biopsy. One reader retrospectively reviewed all images for confirmation of Prostate Imaging–Reporting and Data System (PI-RADS) score. Cognitive magnetic resonance/ultrasound fusion target biopsy was done for all visible lesions (PI-RADS 3–5). Systematic biopsy was done for all cases. The csPCa detection rates were compared according to the bpMRI protocol (with/without b1800 DWI) or PI-RADS score. The accuracy of PI-RADS score was estimated using receiver operating characteristics curve. The signal intensity (SI) ratio (visible lesion/surrounding background) was evaluated. Results: Among 164 men confirmed having PCa, 102 had csPCa (Gleason score≥7). Proportions of PI-RADS score 1–2/3/4/5 without b1800 DWI (n=133) and with b1800 DWI (n=275) were 19.5%/57.9%/15.8%/6.8% and 21.1%/48.7%/22.2%/8.0%, respectively. csPCa detection rates with/without b1800 DWI were 27.6%/19.5% (p=0.048), respectively. Areas under the curve of PI-RADS grading with/without b1800 DWI for csPCa detection were 0.885 and 0.705, respectively. The SI ratio in b1800 DWI was higher than that in b1000 DWI (p

Purpose: We evaluated the clinical and therapeutic characteristics of adult cryptorchidism, which have been difficult to establish, given the small number of patients presenting to outpatient clinics. Materials and Methods: A retrospective study of 20 adult patients with cryptorchid testis was performed. We analyzed their palpation of testis, location, surgical method, marital status, number of children, histologic findings, and semen analysis. Results: In 17 cases with unilateral cryptorchidism, the mean age at surgery was 31.1±12.5 years. Fourteen patients had a palpable, small cryptorchid testis. The location of the testis, as verified, was inguinal in 14, prepubic in 2, and intra-abdominal in 1, respectively. We performed orchiopexy in 14 out of 15 patients who sought to have this procedure. Four among 6 married patients had children. Testis biopsy was performed in 12 patients, and all showed abnormal histologic findings. Three among 4 patients, performed semen analysis, showed abnormal findings. In three cases of bilateral cryptorchidism, the mean age at surgery was 35.7±12.5 years. All of these patients had palpated cryptorchid testes in the inguinal area and sought to have a bilateral orchiopexy. Two patients have been married but had no children. All showed abnormal findings in both testis biopsy and semen analysis. No testicular neoplasm was detected during the duration of follow-up. Conclusions: Most adult patients with cryptorchidism preferred orchiopexy to orchiectomy. However, most of patients showed abnormal histology of the testis and semen analysis. Therefore, orchiopexy with regular scrotal examination may be considered a suitable treatment options for adult cryptorchidism.

Purpose: We analyzed factors associated with early recovery of continence after laparoscopic radical prostatectomy. Materials and Methods: Among 467 patients treated with laparoscopic radical prostatectomy for localized prostate cancer between 2007 and 2012, 249 patients who underwent a preoperative urodynamic study were enrolled. The patients’ age, prostate volume, preoperative serum prostate-specific antigen (PSA), Gleason score, pathologic stage, and preoperative urodynamic parameters were recorded. The preoperative membranous and prostatic urethral length on magnetic resonance image, nerve sparing technique, and type of surgical procedure (extrafascial and intrafascial) were analyzed. Patients were considered to have early recovery of continence when they needed no pad in 3 months or less after surgery. Results: Ninety-two patients were in the early recovery group and 157 were in the late recovery group. The membranous urethral lengths were 12.06±2.56 and 11.81±2.87 mm, and prostatic urethral lengths were 36.39±6.15 and 37.45±7.55 mm in each group, respectively. The membranous-posterior urethral length ratios were 0.25±0.06 and 0.24±0.06, and prostatic-posterior urethral length ratios were 0.75±0.06 and 0.76±0.06, respectively. In and of themselves, the membranous and prostatic urethral lengths were not associated with recovery duration however, the membranous-total and prostatic-total urethral length ratios were related (p=0.024 and 0.024, respectively). None of the urodynamic parameters correlated with continence recovery time. In the multivariate analysis, the type of surgical procedure (odds ratio [OR], 7.032; 95% confidence interval [CI], 2.660 to 18.590; p＜0.001) and membranous urethral length (OR, 0.845; 95% CI, 0.766 to 0.931; p=0.001) were significantly related to early recovery of continence. Conclusions: The current intrafascial surgical procedure is the most important factor affecting early recovery of continence after laparoscopic radical prostatectomy.