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The purpose of this study was to investigate whether postoperative cystography findings can predict early and long-term recovery from incontinence after radical prostatectomy (RP), compared with the other cystography parameters.I retrospectively reviewed 118 patients who underwent robot-assisted RP (RARP) for localized prostate cancer at single institution between January 2016 and April 2021. One hundred and seven patients were included in the study. Postoperative cystography was routinely performed 7 days after surgery. The bladder neck to pubic symphysis ratio, vesicourethral angle, and bladder neck anteroposterior length (BNAP) ratio (the bladder neck-posterior margin distances divided by the anteroposterior lengths) were evaluated. Continence was defined as cessation of pad use. The association between these variables and urinary incontinence was also analyzed.The urinary incontinence recovery rates 1, 3, 6, and 12 months after RARP were 43.92%, 66.35%, 87.85%, and 97.19%, respectively. Multivariate logistic regression analysis demonstrated that a lower BNAP ratio and wider vesicourethral angle were significantly associated with continence restoration at 1, 3, and 6 months after surgery. In addition, in terms of days of pad usage, lower BNAP ratio, wider vesicourethral angle, and bladder neck preservation were significantly associated with recovery from urinary incontinence within 12 months as assessed by Cox proportional hazard analysis.This study demonstrated that vesicourethral angle and BNAP ratio were independent predictors of early recovery from post-prostatectomy incontinence. I suggest that both the sagittal and coronal views of postoperative cystography help anticipate early continence restoration after RARP.

Ureterosciatic hernia is extremely rare. In ureteral herniation, ureter prolapses occur through either the greater or lesser sciatic foramen. Atrophy of the piriformis muscle, hip joint diseases, and defects in the parietal pelvic fascia are predisposing factors for the development of ureterosciatic hernia. Most symptomatic patients have been treated surgically, with conservative treatment reserved only for asymptomatic patients. To the best of our knowledge, long-term follow-up outcomes after ureterosciatic hernia management are sparse. In this paper, we report the case of a 68-year-old woman who presented with colicky left abdominal pain. After computed tomography (CT) scan and anterograde pyelography, she was diagnosed ureterosciatic hernia with obstructive uropathy. We performed ureteral balloon dilatation and double-J ureteral stent placement. After this minimally invasive procedure, CT scan demonstrated that the left ureter had returned to its normal anatomical position without looping into the sciatic foramen. The patient remained asymptomatic with no adverse events 7 years after the minimally invasive procedures. This brief report describes ureterosciatic hernia successfully managed with minimally invasive procedures with long-term follow-up outcomes.

INTRODUCTION AND OBJECTIVE:Urethral stricture is one of the postoperative complications after transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH) and urethral dila...

INTRODUCTION AND OBJECTIVE:Erectile dysfunction (ED) is a common problem whose relation to cardiovascular diseases has been scientifically proven, but it has not been studied sufficiently in patien...

Numerous biomarkers and risk tables can be used to predict recurrence or progression of patients with primary or recurrent non-muscle invasive bladder cancer (NMIBC) receiving Bacillus Calmette-Guerin (BCG). However, few are suitable for BCG-unresponsive disease (i.e., recurrence or progression after BCG treatment). Therefore, identification of a novel marker that allows accurate prediction of prognosis, particularly risk of recurrence, is critically important in clinical practice. In the current study, gene ontology and gene set enrichment analyses of microarray datasets (GSE13507, n = 47) revealed that differentially expressed genes in recurred NMIBC patients after BCG treatment were associated with virus and ribosomal pathways. Among the core-enrichment genes, the expression of RPL9, a putative tumor suppressor, was lower in recurred NMIBC patients after BCG therapy than in patients without recurrence (P = 0.033) from the E-MTAT-4321 European cohort (n = 84). Data from The Cancer Genome Atlas (n = 406) showed that bladder cancer patients with higher RPL9 expression had a longer overall survival probability than patients with lower RPL9 expression (P = 0.011). Moreover, we used the latest digital PCR platform to examine 59 NMIBC patients and identified downregulation of RPL9 in patients with recurrence after BCG therapy (P = 0.031). The Kaplan-Meier survival estimator showed that NMIBC patients with higher expression of RPL9 had longer recurrence-free survival (log-rank test, P = 0.015). Therefore, we conclude that RPL9 expression is a prospective predictor of recurrence after BCG therapy in NMIBC patients.

Background and objectiveTo investigate the usefulness of digital rectal examination (DRE), a cost-effective and simple way to mea-sure prostate volume versus transrectal ultrasound (TRUS), and the gold standard method for measuring prostate volume. Material and methodsFrom 2018 to 2019, a total of 580 patients who underwent DRE and TRUS for the initial evaluation of benign prostatic hyperplasia (BPH) were included in this study. DRE was performed twice at two appointments by a single urologist, and TRUS was performed once by a single radiologist. The patients were divided into seven groups according to TRUS-estimated prostate volume (A, 80 cc). We investigated the agreement between the TRUS and DRE measurements. ResultsThere was a high percent agreement of DRE and TRUS in groups B–D (84.6, 84.1, and 79.1%, respectively). The highest over- and underestimations of prostate volume on DRE were 23.1 and 79.5% in groups A and G, respectively. In the Bland–Altman plot, the mean difference between TRUS and DRE in group A–D was closer to zero-line than that in groups E–G. The variability in differences between TRUS and DRE in groups A, B, and C was lower than that in groups D, E, F, and G. ConclusionDRE was accurate in measuring the prostate volume of 30~49 cc. We suggested that DRE remains a simple and cost-effective method for measuring prostate volume.

INTRODUCTION AND OBJECTIVES:Ejaculation frequency, including sexual intercourse, nocturnal emissions, and masturbation, affect the development of prostate disease, such as benign prostatic hyperpla...

Benign prostatic hyperplasia (BPH) is most commonly observed in men of advancing age. Patients with BPH may experience urinary symptoms. For moderate lower urinary tract symptoms (LUTS), pharmacotherapy is recommended, but many patients have symptom progression and require additional surgical intervention such as transurethral resection of prostate (TURP) or prostatectomy. However, these procedures are still associated with significant perioperative morbidity. As a result, treatment-related complications have led to the development of new technologies for the management of BPH.

Objective : The purpose of this study was to investigate the synergistic effect of Angelicae gigantis Radix (AG) and Lycii fructus (LF) ethanol extracts on skin-whitening effects. Method : LFAG extracts were prepared by extracting with 80% ethanol. The efficacy of LFAG was judged by measurement of cell viability, tyrosinase activity, melanin production, tyrosinase and microphthalmiaassociated transcription factor (MITF) expression in B16F10 murine melanoma cells by lipopolysaccharides (LPS) treatment . Results : Each extract (LF or AG) inhibited the tyrosinase activity in a dose-dependent manner. The co-treatment of LFAG extracts (25 μg/mL LF plus 25 μg/mL AG) markedly suppressed the LPS-induced cellular tyrosine activity, melanin production, tyrosinase and MMP-1 expression in B16F10 murine melanoma cells. These suppressive effects were synergistically increased by their combination.

We have developed a numerical model for a remote ICP(inductively coupled plasma) system in 2D and 3D with gas distribution configurations and confirmed it by plasma diagnostics. The ICP source has a Cu tube antenna wound along a quartz tube driven by a variable frequency rf power source( MHz) for fast tuning without resort to motor driven variable capacitors. We investigated what conditions should be met to make the plasma remotely localized within the quartz tube region without charged particles' diffusing down to a substrate which is 300 mm below the source, using the numerical model. OES(optical emission spectroscopy), Langmuir probe measurements, and thermocouple measurement were used to verify it. To maintain ion current density at the substrate less than 0.1 , two requirements were found to be necessary; higher gas pressure than 100 mTorr and smaller rf power than 1 kW for Ar.

sion. There was a higher decompression rate at teaching versus nonteaching hospitals (81% vs 77% p 0.01), large versus small hospitals (81% vs 73% p 0.01) and urban versus rural hospitals (79% vs 73% p 0.04). These factors all remained independently associated with a higher likelihood of surgical decompression in multivariable analysis (Table 1). Other covariates associated with a higher likelihood of decompression included private insurance, female gender and midwest or northeast region. Black race was associated with decreased odds of undergoing decompression. CONCLUSIONS: Hospital factors including teaching status, large bedsize and urban location are independently associated with higher rates of surgical decompression among inpatients with sepsis and ureteral calculi. Possible explanations for these findings include variation in access to resources and subspecialist care. Further research is necessary to explain these differences to ensure optimal treatment across the health care system by improving access to these lifesaving interventions where decompression rates are lowest.

Purpose Transrectal ultrasound (TRUS)-guided prostate biopsy is the most useful technique for the diagnosis of prostate cancer; however, many patients describe the procedure as uncomfortable and painful. We investigated the effect of the patient's position on pain scales during TRUS-guided prostate biopsy. Materials and Methods Between July 2012 and June 2013, a total of 128 consecutive patients who underwent TRUS-guided prostate biopsy were included in this study. Seventy patients underwent the procedure in the lithotomy position performed by a urologist and the other patients (n=58) underwent the procedure in the left lateral decubitus (LLD) position performed by a radiologist. Pain was assessed by using visual analogue scale (VAS) scores from 0 to 10. Using a linear regression model, we analyzed the correlation between pain scale score and clinical variables with a focus on patient position. Results No significant differences related to age, body mass index, prostate volume, prostate-specific antigen (PSA), hematuria, pyuria, International Prostate Symptom Score, or the cancer detection rate were observed between the lithotomy and the LLD groups. In the correlation analysis, VAS score showed a significant correlation with diabetes mellitus, PSA level, and lithotomy position (p