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Aim: The aim of this study was to evaluate the clinical characteristics of uric acid urolithiasis and how the presentation differs between urolithiasis of the upper urinary tract (UUT) compared with urolithiasis of the bladder. We attempted to evaluate the importance of local vs. systemic factors in the formation of bladder uric acid stones. Patients and Methods: The medical records of 77 consecutive patients with uric acid urolithiasis from January 2004 to December 2006 were reviewed retrospectively. In all patients, histories were recorded, and physical examinations, renal function tests and urine analysis were done. The features of the treated stones were recorded, and the chemical composition was analyzed by computed Fourier transform infrared spectrophotometry. Results: Among 77 patients with uric acid stones, 66 were male and 11 were female (ratio of 7.6:1). Mean age was 59.50 ± 10.46 years. Of the stones, 55 (71.4%) were located in the UUT (UUT group) and 22 (28.6%) in the bladder (bladder group). Multiple presentations of urolithiasis at diagnosis were found in 56 (72.7%) patients. The mean values of serum creatinine and uric acid were 148.28 ± 70.69 and 443.33 ± 95.91 μmol/l, respectively. Mean body mass index (BMI) was 26.78 ± 2.90, and 72.7% of patients were overweight or obese. Mean urinary pH was 5.39. No significant differences existed between the 2 groups in regard to gender, BMI, urinary pH, stone nature, or presence of hypertension, gout, and/or urinary tract infections. In the bladder group, the incidence of benign prostate hyperplasia was significantly increased, and the incidence of diabetes mellitus was significantly lower, as were levels of serum uric acid and creatinine. Conclusions: Uric acid urolithiasis was predominant in men in this study. These patients tended to be obese or overweight, with multiple stone presentations and low urinary pH. Furthermore, the bladder uric acid stone group had significantly lower levels of serum creatinine and uric acid, and lower percentages of diabetes mellitus but higher incidences of benign prostate hyperplasia in comparison with the UUT group. The local factor seems more important than the systemic factor in the formation of bladder uric acid stone.

Purpose: Evidence is accumulating indicating that chronic inflammation plays an important role in prostate cancer. We investigated the potential prognostic roles of IL-6, IL-8 and IL-10 polymorphisms in clinical localized prostate cancer after radical prostatectomy. Materials and Methods: A total of 116 clinically localized prostate cancer patients undergoing curative radical prostatectomy were included in this study. The IL-6, IL-8 and IL-10 polymorphisms were determined by the TaqMan real-time PCR method. Their prognostic significance on prostate-specific antigen (PSA) recurrence was assessed using Kaplan-Meier analysis and Cox regression model. Results: The IL-6 polymorphism (rs2066992) T/G and G/G genotype cases were associated with a higher percentage of preoperative PSA levels of ≥10 ng/ml; higher risk of positive surgical margin, and higher risk of extraprostatic extension compared to the T/T genotype. The IL-10 polymorphism (rs1800871) A/A genotype was associated with a higher risk of PSA recurrence compared with the A/G + G/G genotypes and significantly poorer PSA-free survival (log-rank test, p = 0.019). After considering other covariates in a Cox proportional hazard model, the IL-10A/A genotype and high Gleason score (8–10) were still independent predictors of poor PSA-free survival. Conclusion: Our results suggest that the IL-10 polymorphism may be a prognostic factor for PSA recurrence after radical prostatectomy.

Aim: The CDKN1B (p27) V109G polymorphism has been suggested to confer the risk of advanced prostate cancer in Caucasian males. However, its prevalence in Asian populations has never been reported. The aim of this study was to determine the CDKN1B V109G polymorphism frequency in the low incidence Taiwanese population and investigate its potential role on prostate cancer susceptibility and disease progression. Methods: A hospital-based case-control study was conducted, which enrolled a total of 190 prostate cancer patients and 292 age-matched male controls. PCR-RFLP was used to determine the CDKN1B V109G polymorphism. The association between CDKN1B V109G and prostate cancer risk and clinicopathologic variables was analyzed. Results: The variant CDKN1B G allele frequency in Taiwanese males appears to be low (2.1%). Overall, there was no significant association between CDKN1B V109G polymorphism and prostate cancer risk. Similarly, no significant findings were found when further stratified by different age groups, disease stages, and pathological grades. In terms of disease outcome, the CDKN1B V109G genotypes were not associated with either hormone response status after hormone therapy (p = 0.730) or with prostate-specific antigen recurrence for clinically localized prostate cancer patients who receive radical prostatectomy (p = 0.536). Conclusions: There was a low prevalence of CDKN1B V109G polymorphism in Taiwanese compared to Caucasian males. Hence, it may not be an appropriate biomarker of prostate cancer among the Taiwanese population. Further large-scale studies are needed to clarify the role of CDKN1B V109G polymorphism on prostate cancer risk.

Aim: To determine efficacy and clinical predictors of stone fragmentation when using slow-rate shock wave lithotripsy (SWL). Patients and Methods: In total, 116 patients with radiopaque urinary tract stones were randomized into two groups: 57 patients were treated with SWL at 90 shocks/min, and 59 patients were treated with SWL at 120 shocks/min. The efficacy of SWL was evaluated within 1 month after treatment. Patient characteristics, features of stones, and SWL conditions were reviewed. Success rates relating to individual parameters were assessed by using chi-square and Student t tests. All factors were further entered into multivariate logistic regression analysis. Results: There were no statistically significant differences between the two groups with regard to age, sex, site and size of the stones, renal function, and total number of shock waves. In univariate analysis, the success rate was significantly related to shock wave frequency (p = 0.023), length and width of the stones (p < 0.001), total number of shock waves (p = 0.047), and age (p = 0.049). In multivariate analysis, however, only shock wave rate and stone length remained statistically significant (p = 0.021 and p = 0.046, respectively). The overall success rate was significantly higher in the group treated with 90 shocks/min (p = 0.02). However, this higher success rate was statistically significant only in patients with a stone length ≧10 mm (50.0 vs. 18.5%, p = 0.019). Conclusion: SWL at 90 shocks/min yielded better outcomes than SWL at 120 shocks/min, particularly in patients with stone lengths ≧10 mm.

Introduction: This study was conducted to evaluate the relationship between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) in aging males of Taiwan. Patients and Methods: A free health screening for aging males (≧45 years old) was conducted in Kaohsiung Medical University Chung-Ho Memorial Hospital in August 2004. LUTS and ED were assessed by validated symptom scales: the International Prostate Symptom Score (IPSS) and the International Index of Erectile Function-5 (IIEF-5). The subjects also completed a health and demographics questionnaire and underwent detailed physical examination, serum prostate-specific antigen level determination, and transrectal ultrasonography. Results: The final study population consisted of 141 patients with a mean age of 59.8 years. The severity of LUTS and ED increased with age. After controlling for comorbidities, age (p < 0.001) and IPSS score (p < 0.001) were significantly associated with the IIEF-5 score. Furthermore, men with moderate to high IPSS scores were more likely to have ED as compared with those with mild symptoms after age adjustment (age-adjusted odds ratio 3.27, p = 0.002). Conclusions: ED and LUTS are highly prevalent in our study population, and this prevalence increases with age. ED is significantly associated with the severity of LUTS after controlling for age and comorbidities. These results highlight the clinical importance of evaluating LUTS in patients with ED and the need to consider sexual issues in the management of patients with benign prostatic hyperplasia.