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ABSTRACT: To investigate the relation between testicular transferrin and insulin-like growth factor-1 (IGF-1) secreted by Sertoli cells and the differentiation of germ cells in the rat, testosterone and/or purified FSH was administered to rats medically hypophysectomized by an LH-RH agonist. Spermatogenesis was quantitatively analyzed and concentrations of intratesticular transferrin and IGF-1 were measured by radioimmunoassays. The last step of spermatogenesis was quantitatively restored by combined administration of testosterone and purified FSH. Intratesticular IGF-1 concentrations were significantly increased by combined administration of testosterone and purified FSH. From these observations, it is surmised that IGF-1 may have a stimulatory effect on the last step of spermatogenesis.
Archives of Andrology 07/2009; 33(3):169-77. · 0.89 Impact Factor
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ABSTRACT: We evaluated whether ejaculatory dysfunction induced with a selective alpha1A-blocker influenced orgasm. Fifteen healthy male volunteers took silodosin or a placebo in a randomized, double-blind crossover design. We investigated the ejaculatory volume before and after administration of the agents. After each ejaculation, participants self-reported the answers to an original questionnaire, which was about discomfort on ejaculation, orgasm and satisfaction with the discomforting ejaculation. All participants on silodosin had a complete lack of seminal emission and expulsion. All participants felt orgasm in spite of a complete lack of seminal emission. Of the 15, 12 (80%) who had a somewhat uncomfortable feeling during orgasm were dissatisfied with this feeling, although 9 of the 12 reported that its degree was mild. Orgasm is preserved regardless of the loss of seminal emission with silodosin administration. Although most participants reported mild discomfort during orgasm, they were greatly dissatisfied with the loss of seminal emission.
International journal of impotence research 07/2009; 21(5):306-10. · 2.73 Impact Factor
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ABSTRACT: We aimed to confirm the reliability of the Japanese version of the Aging Males' Symptoms rating scale (JPN-AMS) and its applicability in patients with testosterone deficiency syndrome (TDS)-like symptoms, comparing it for young, middle-aged and elderly Japanese men. The study included 93 patients with TDS-like symptoms, 39 men younger than 30 years old, and 125 normal men 40 years old and older, who agreed to respond to a self-administered questionnaire using the JPN-AMS. Testing-retesting was done to confirm the reliability of the questionnaire, with a 2-week interval between tests. The total AMS score and three domain scores were clearly higher in patients with TDS-like symptoms than in young men and in normal males, respectively. The test-retest analysis showed good reliability and internal consistency for the JPN-AMS. The JPN-AMS can be reliably used for measuring health-related quality of life of aging Japanese males.
International journal of impotence research 07/2008; 20(6):544-8. · 2.73 Impact Factor
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ABSTRACT: To investigate the expression of p62 in various prostatic tissues, and to demonstrate different immunohistochemical patterns of p62 expression in distinct pathological entities of the prostate. The p62 sequestosome 1 (SQSTM1) gene product is a multifunctional protein with ubiquitous expression in normal adult tissue.
Overexpression of p62 was detected in prostate cancer cell lines and tissues by reverse transcriptase-polymerase chain reaction. Immunohistochemical staining for p62 was performed on 73 cases of paraffin-embedded prostatic tissue. p62 was negative or weakly positive only in the nucleus (pattern N) of prostatic gland epithelium in nine normal and hyperplastic prostate specimens, whilst most cancerous tissue showed intense, uniform staining for p62 in the cytoplasm (pattern C). Of the prostate cancer specimens, 91% showed positive pattern C immunoreactivity. Of the cases with high-grade prostatic intraepithelial neoplasia (PIN) around cancer, 77% showed pattern C. However, in specimens from the patients without prostate cancer PIN displayed pattern C in only 32% of cases. Western blot analysis showed that all cancer cell lines expressed p62 in the cytoplasm but there was little nuclear expression.
Cytosolic overexpression of p62 is a novel immunohistochemical characteristic in prostatic adenocarcinoma and high-grade PIN, suggesting that p62 might be a novel marker for prostatic malignancy.
Histopathology 02/2006; 48(2):157-61. · 3.08 Impact Factor
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ABSTRACT: Since it has been widely recognised that renal cell carcinoma is refractory to standard therapies such as chemotherapy and radiotherapy, a new modality of treatment is needed. One of the potential alternative therapies for renal cell carcinoma may be inhibition of angiogenesis. In this study, we analysed the inhibitory effects of several potential agents on expression of angiogenic factors such as vascular endothelial growth factor and basic fibroblast growth factor, which are the main mediators in angiogenesis of renal cell carcinoma. We used medroxyprogesterone acetate, interferon-alpha, interferon-gamma, minocycline hydrochrolide and genistein, which are known to be antiangiogeneic. Northern blot analyses revealed that, among the five agents examined, genistein had a strong inhibitory effect on expression of vascular endothelial growth factor mRNA and basic fibroblast growth factor mRNA. Medroxyprogesterone acetate and interferon-alpha did not significantly decrease the level of either vascular endothelial growth factor mRNA or basic fibroblast growth factor mRNA. Interferon-gamma and minocycline had mild inhibitory effects on vascular endothelial growth factor mRNA and basic fibroblast growth factor mRNA expression. Genistein also inhibited both vascular endothelial growth factor mRNA and basic fibroblast growth factor mRNA expression after treatment with epidermal growth factor and hypoxia. These findings suggest that one of the mechanisms of the inhibition of angiogenesis by genistein is suppression of the expression of the angiogenic factors vascular endothelial growth factor and basic fibroblast growth factor in renal cell carcinoma.
British Journal of Cancer 04/2002; 86(5):768-73. · 5.04 Impact Factor
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ABSTRACT: Between June 1997 and September 1999, we performed transurethral unroofing (TUUR) in three patients with hematospermia that recurred repeatedly for one year or more. Patient 1 (48 years old) and Patient 2 (59 years old) were diagnosed as having müllerian duct cysts that communicated with the left ejaculatory duct, and Patient 3 (36 years old) as an ejaculatory duct obstruction with the right ejaculatory duct dilation. A mixture of water-soluble contrast medium and indigocarmine blue dye was injected into the cysts and the ejaculatory duct cavity after incision of the vas deferens in Patients 1 and 3, and by cyst puncture under transrectal ultrasound (TRUS) guidance in Patient 2. Then the urethra was incised between the bladder neck and the verumontanum using a Collins' hot knife electrode, and spouting of the dye from the incision was judged to indicate successful unroofing. In Patient 2, safe and simple TUUR was possible by identifying the cyst location and its distance from the knife electrode under TRUS guidance. Hematospermia resolved after surgery in all three patients and there has been no recurrence for 1.3-3.5 years (mean: 2.6 years). Thus, TUUR was effective for treating chronic hematospermia caused by müllerian duct cyst and ejaculatory duct obstruction. For safe and reliable performance of this treatment, TRUS guidance and injection of the dye into the cyst and ejaculatory duct cavity can be recommended.
Hinyokika kiyo. Acta urologica Japonica 01/2002; 47(12):839-42.
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ABSTRACT: To elucidate the risk factors for a second or third intravesical recurrence in patients with superficial bladder cancer.
Of 84 consecutive patients newly diagnosed as having superficial bladder cancer in Sapporo Medical University Hospital, 30 patients who had at least one recurrent superficial bladder cancer and were followed up for more than 3 years were included in this study. Multivariate analysis by Cox's proportional hazards model was used to determine which clinical and pathologic variables significantly affected the second and third recurrences. Stepwise regression analysis was used to determine which clinical and pathologic variables significantly affected multiple recurrences of bladder cancer.
The 1, 2, and 5-year recurrence-free rates as determined by the Kaplan-Meier method were 66.1%, 43.8%, and 29.8% for a second recurrence and 67.4%, 61.8%, and 39.2% for a third recurrence, respectively. Multivariate analysis revealed that only the interval between the initial transurethral resection of the bladder cancer and the first recurrence was a significant and independent factor affecting the second recurrence. In the study of the third recurrence, the interval between the first and second recurrences was the only definite risk factor for the third one. When multiple recurrences were considered, stepwise regression analysis revealed that a time of 6 months or less from the initial transurethral resection until the first recurrence was a significant factor that affected the total frequency of bladder cancer recurrence (R(2) = 0.220, P = 0.0078).
The results of our study indicate that patients will have the potential for frequent recurrences if they have the disease with recurrence after a short interval. This result may contribute to the selection of patients with superficial bladder cancer to receive aggressive adjuvant treatments to prevent frequent recurrences.
Urology 01/2002; 58(6):935-9. · 2.43 Impact Factor
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ABSTRACT: We determined whether prostate volume (PV), maximum flow rate (Qmax), residual urine (RU) and the International Prostate Symptom Score (I-PSS) predicted bladder outlet obstruction in patients having lower urinary tract symptoms (LUTSs). The study consisted of 114 patients aged 50 years or older with LUTSs who had scores of 8 or more on the I-PSS and 2 or more for the quality of life index. All patients received transrectal ultrasonography for estimation of PV and pressure-flow study (PFS). When PFS showed an obstruction grade of 2 or more in Schäfer's p/Q diagram, the result was defined as bladder outlet obstruction. When we examined which criteria indicated that 90% of patients had bladder outlet obstruction (positive predictive value: 90%), we found that PV of 35 ml or more, Qmax of 8 ml/sec or less, RU of 110 ml or more, and I-PSS of 30 or more did so. Fifty-nine percent of patients met at least one of these criteria. The results suggested that 59% of patients with LUTSs had bladder outlet obstruction with a 90% positive predictive value based on the value of PV, Qmax, RU or I-PSS.
Hinyokika kiyo. Acta urologica Japonica 01/2002; 47(12):843-7.
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S Takahashi,
T Hirose,
T Satoh,
R Kato,
S I Hisasue,
S Takagi,
T Shimizu,
Y Kunishima,
M Matsukawa,
N Itoh, T Tsukamoto
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ABSTRACT: This study aimed to evaluate the efficacy and safety of oral antibacterial treatment with fluoroquinilone for acute uncomplicated pyelonephritis Thirteen female patients with acute uncomplicated pyelonephritis were treated with oral fluoroquinilone (ciprofloxacin; CPFX). They received 200 mg of the drug three times a day while febrile (3-5 days). Once they become afebrile, the same dose of the drug, given twice a day, was given for another 9-11 days. The mean duration of the course of CPFX was 14 days. Symptoms were evaluated, and laboratory examinations, including urine culture and measurement of the minimal inhibitory concentration (MIC) of CPFX were conducted before treatment, and 3, 7, 14, 21, and/or 28 days after the initiation of the treatment. Of the 13 patients, only 5 needed to be hospitalized, and the period of hospitalization was only a few days. On the 14th day after the commencement of treatment, bacteriologic and clinical cure rates were 100%. Escherichia coli was the most common uropathogen, being isolated from the urine of 8 patients. No clinical relapse of the disease was found during a follow-up period of up to 4 weeks. The patients tolerated the drug well without developing any serious adverse effects. Oral antimicrobial chemotherapy with fluoroquinolone, given on an outpatient or short-term hospitalization basis, achieved satisfactory bacteriological and clinical outcomes in the treatment of acute uncomplicated pyelonephritis. This treatment regimen is indicated for patients with this disease who are not in a serious condition with complications such as shock.
Journal of Infection and Chemotherapy 01/2002; 7(4):255-7. · 1.80 Impact Factor
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ABSTRACT: The goal of this study was to evaluate the correlation between increments of penile tumescence and penile rigidity measured by the erectometer and the RigiScan, respectively.
Nocturnal penile tumescence (NPT) was measured in 25 volunteers (mean age, 49.5 years). The erectometer and the RigiScan were used simultaneously for a total of 47 nights. We studied the correlation between maximum penile circumferential changes determined by the erectometer and penile rigidity patterns measured by the RigiScan.
Maximum circumferential changes during NPT measured by the erectometer were well correlated to those determined by the RigiScan (correlation coefficient, 0.719). In addition, penile circumferential changes measured by the erectometer corresponded well to the penile rigidity pattern determined by the RigiScan (P=0.0001). Specifically, maximum penile circumferential changes of more than 30 mm and less than 10 mm had 70% positive predictive value and 100% negative predictive value for predicting the normal rigidity pattern, respectively.
Penile circumferential changes measured by the erectometer were well correlated to penile rigidity measured by the RigiScan, particularly when the increments were larger than 30 mm or less than 10 mm. These results suggested that the erectometer was a useful tool to estimate the penile rigidity patterns of the RigiScan.
International Journal of Urology 12/2001; 8(11):594-8. · 1.75 Impact Factor
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ABSTRACT: To provide evidence that a pathological process in spermatogonial proliferation and apoptosis may participate in developing hypospermatogenesis of infertile men.
Case-controlled retrospective analysis.
University-based male infertility clinic.
Thirty-four patients with idiopathic hypospermatogenesis.
Collecting blood samples for measurement of hormones and performing testicular biopsy for assessment of spermatogenesis.
The expression of proliferating cell nuclear antigen (PCNA) of spermatogonia and the frequency of apoptosis of spermatogonia demonstrated by the in situ DNA 3'-end-labeling method were investigated to determine the degree of cell degeneration.
We could classify 34 infertile patients into four subgroups according to spermatogonial proliferation and differentiation. No significant difference in the expression of PCNA was demonstrated between these four groups and the control group. In all groups, the balance of spermatogonial proliferation (PCNA-positive rate) to apoptosis was significantly lower than that of the control group.
It was demonstrated that accelerated apoptosis, rather than proliferative dysfunction in the mitotic phase, may induce the decreased number of spermatogonia in hypospermatogenesis. These findings suggest that disorders of the control and regulation of apoptosis may participate in the pathogenesis of idiopathic hypospermatogenesis.
Fertility and Sterility 12/2001; 76(5):901-7. · 3.56 Impact Factor
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ABSTRACT: The natural history and growth rate of renal cell carcinoma (RCC) have not yet been determined. The growth rates of primary lesions in incidentally found RCC were compared with those of metastatic lesions.
Sixteen patients who did not receive immediate surgical treatment for renal solid masses that were later proven to be RCC were reviewed retrospectively. All primary lesions of the 16 patients were found incidentally. For comparison, metastatic lesions were evaluated in another 16 patients with RCC. Of these, 11 underwent surgical treatment for the primary lesions.
The growth rates of primary and metastatic lesions of RCC varied. They ranged from 0.10 to 1.35 cm/year for primary lesions and from 0.08 to 7.87 cm/year for metastatic lesions. The growth rate of primary lesions of incidentally found RCC was lower than that of metastatic lesions (P = 0.0159). The initial tumor diameter and pathological grade did not affect the growth rate of the primary lesion of incidentally found RCC. However, a close correlation was found between the growth rate of metastatic lesions and the pathological grade of the primary lesion in patients with metastasis.
The growth rate of incidentally found RCC varied. Some patients with the disease may be candidates for 'watchful waiting' when an immediate surgical treatment is not indicated, but they should be selected with great caution.
International Journal of Urology 10/2001; 8(9):473-7. · 1.75 Impact Factor
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Y Kumamoto, T Tsukamoto,
M Ogihara,
K Ishibashi,
T Hirose,
M Matsukawa,
S Takahashi,
Y Kunishima,
S Shigeta,
H Yoshida, [......],
K Monden,
J Igari,
T Oguri,
S Kohno,
Y Miyazaki,
T Yamaguchi,
K Matsumoto,
K Izumikawa,
F Kashitani,
C Mochida
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ABSTRACT: The bacteria (Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, Klebsiella spp. and Pseudomonas aeruginosa) isolated from patients diagnosed as having urinary tract infections (UTIs) in 9 institutions in Japan were supplied between the period of August 1999 to July 2000. Then, the susceptibilities of these bacteria to various antimicrobial agents were examined and the results were compared with those obtained between 1991 and 1998. Comparison was made by classifying strains isolated from patients into those with uncomplicated UTIs and those with complicated UTIs (including with or without indwelling catheter). About E. faecalis, increase of low sensitive strains noted in the former year showed a decreasing tendency, however, one strain each with MIC of 4 micrograms/ml to vancomycin (VCM) was detected in patients with both uncomplicated and complicated UTIs. As for S. aureus, many sensitive strains to cephems, imipenem (IPM) and VCM were noted, and each MIC50 was better than that in the former years. S. aureus strains showing low susceptibility to arbekacin (ABK) were detected in patients with complicated UTIs in this year as well as in the former year, and one strain each with MIC of 16 micrograms/ml and 32 micrograms/ml was detected. Susceptibilities of E. coli were effective to all drugs except for penicillins and minocycline (MINO). Decrease of low sensitive strains was also noted in all drugs except for quinolones. Each MIC90 of ciprofloxacin (CPFX) and sparfloxacin (SPFX) in patients with complicated UTIs against E. coli was 3 degrees classes lower than that in patients with uncomplicated UTIs. As for Klebsiella pneumoniae, decrease of low sensitive strains to cephems was noted in patients with uncomplicated UTIs in 1998. In 1999, low sensitive strains decreased also in patients with complicated UTIs, and few were detected. Susceptibilities of K. pneumoniae to quinolones were effective as compared with those in the former years with the MIC80s of 0.125 microgram/ml or below without detection of low sensitive strains. One low sensitive strain of K. pneumoniae with MIC of 8 micrograms/ml was detected for gentamicin (GM). Susceptibilities of P. aeruginosa to carbapenems were notable. The MIC90 of meropenem (MEPM) and IPM was 4 micrograms/ml each which was 2 degrees better than that in 1998. Resistant P. aeruginosa strains to other drugs except for monobactams decreased in 1999.
The Japanese journal of antibiotics 07/2001; 54(6):231-322.
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Y Kumamoto, T Tsukamoto,
K Watanabe,
Y Kobayashi,
T Hirose,
M Matsukawa,
H Uchida,
S Takahashi,
Y Kunishima,
S Matsuda, [......],
M Nishikawa,
S Kohno,
Y Miyazaki,
K Izumikawa,
T Yamaguchi,
C Mochida,
T Oka,
M Kitamura,
Y Takano,
Y Matsuoka
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ABSTRACT: The bacterial strains isolated from patients diagnosed as having urinary tract infections (UTIs) in 9 institutions in Japan were supplied between the period of August 1999 to July 2000. Then, the susceptibilities of them to many kinds of antimicrobial agents were investigated. The number of them were 499 strains. The breakdown of these strains was Gram-positive bacteria as 31.3% and Gram-negative bacteria as 68.7%. Susceptibilities of these bacteria to antimicrobial agents were as follows; vancomycin (VCM), ampicillin (ABPC) and imipenem (IPM) showed strong activities against Enterococcus faecalis. The increase of low-susceptible strains which was noticed in the former year showed a slight recovery in this year. VCM showed a strong activity against MRSA preventing growth of all strains with 1 microgram/ml. In addition, the activity of arbekacin (ABK) was also strong with the MIC90 of 2 micrograms/ml against MRSA. However, MSSA and MRSA showing low susceptibilities were detected in one strain each (MIC: 16 micrograms/ml and 32 micrograms/ml, respectively). Carbapenems showed high activities against Citrobacter freundii and Escherichia coli. Meropenem (MEPM) prevented growth of all strains within 0.125 microgram/ml. Quinolone resistant E. coli decreased in this year compared with those in the last year, that percentage was less than 5%. Almost all drugs showed strong activities against Klebsiella pneumoniae and Proteus mirabilis. MEPM and carumonam (CRMN) prevented growth of all strains within 0.125 microgram/ml. On the other hand, one strain of K. pneumoniae showing resistance to cefaclor (CCL) and one strain of P. mirabilis showing low susceptibility to most of cephems were detected. Against Pseudomonas aeruginosa, almost drugs were not so active. The MIC90s of carbapenems were 8 micrograms/ml and those of all other drugs were more than 16 micrograms/ml.
The Japanese journal of antibiotics 06/2001; 54(5):185-216.
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Y Kumamoto, T Tsukamoto,
T Hirose,
M Matsukawa,
S Takahashi,
Y Kunishima,
M Fujime,
K Fujita,
M Ogihara,
K Ishibashi, [......],
S Matsuda,
S Sato,
T Furuhama,
H Kumon,
K Monden,
K Izumikawa,
T Yamaguchi,
C Mochida,
S Kohno,
Y Miyazaki
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ABSTRACT: Five-hundred forty four bacterial strains isolated from 412 patients diagnosed as having urinary tract infections (UTIs) in 9 institutions in Japan were supplied between the period of August 1999 to July 2000. Then, the clinical background of patients were investigated such as sex, age and type of infections, infections and kind of bacteria, frequency of isolation of bacteria by age and infections, bacteria and infections by timing of administration of antibiotics, and bacteria and infections by surgical procedures. About the relationship between age and sex of patients and type of infections, the number of male patients aged less than 50 years was few, and complicated UTIs without indwelling catheter was the most frequent. In females, the number of patients aged less than 20 years was few. Complicated UTIs without indwelling catheter was the most frequent among female patients aged between 40 to 59 years, in other age groups, uncomplicated UTIs was most frequent. As for type of infections and kind of bacteria, Escherichia coli decreased when the infections became complicated, and Pseudomonas aeruginosa and Enterococcus faecalis increased when the infection became complicated. Considering this result by age of patients, isolation frequency of E. coli was gradually decreased with aging in patients aged more than 20 years with uncomplicated UTIs or complicated UTIs without indwelling catheter. The isolation frequencies of E. faecalis and Staphylococcus aureus were gradually increased with aging in complicated UTIs without indwelling catheter. In patients with complicated UTIs with indwelling catheter, there was no difference between age group, and P. aeruginosa and E. faecalis were frequently isolated. As for type of causative organisms in UTIs before and after the administration of antibiotics, the isolation of bacteria was remarkably decreased after administration in patients with uncomplicated UTIs and complicated UTIs without indwelling catheter. E. coli decreased after administration of antibiotics, and P. aeruginosa and E. faecalis increased after administration in patients with all infections. As for type of causative organisms in UTIs and surgical procedures, E. coli were more frequently isolated in patients with uncomplicated UTIs when surgical procedures were experienced. Also, Klebsiella spp. and E. faecalis were more frequently isolated in patients with surgical procedures. However, in complicated UTIs, type of causative organisms had no relationship with surgical procedures.
The Japanese journal of antibiotics 06/2001; 54(5):217-29.
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ABSTRACT: Surgical site infection (SSI) remains an important cause of morbidity among hospitalized patients. We reviewed 421 patients who underwent open urological operations between January 1993 and December 1997 in our institute. Group I consisted of 259 patients who received uncontrolled antimicrobial prophylaxis (AMP) between 1993 and 1995. Group II consisted of 162 patients who received controlled AMP between 1996 and 1997. In group II, penicillins or first to second-generation cephalosporins was used and the duration of use for these agents regulated according to the wound class of each operation. The operations with clean wounds showed the lowest rate of SSI in both groups; the operations with contaminated wounds showed the highest rate of SSI (32.0% in group I and 33.3% in group II). There was no significant difference in the total rates of SSI between the two groups (P=0.216). The most frequently isolated bacterial species was methicillin-resistant Staphylococcus aureus (MRSA), isolated in 73.3% of the cases in group I and in 93.3% in group II. There was no significant difference in the incidence of MRSA isolation between the two groups (P=0.114). The controlled AMP could not lower the incidence of MRSA-induced SSIs. In SSI patients, 22.7% of group I and 35.7% in group II, had MRSA bacteriuria before operation. The prohibition of third-generation cephalosporins and shorter duration of AMP did not reduce the incidence of SSI induced by MRSA because MRSA was not the emerging microorganism but rather a resident in the urological ward. On the other hand, the total incidence of SSI did not increase after regulation of AMP. This finding suggests that older antibacterial agents can prevent infection, except those caused by resistant microorganisms such as MRSA. The effective counter-measure for the prevention of MRSA-induced SSI is needed.
International Journal of Antimicrobial Agents 05/2001; 17(4):327-9, discussion 329-30. · 4.13 Impact Factor
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ABSTRACT: The recovery of sexual function (erectile function and frequency of sexual intercourse) over time after nerve-sparing radical prostatectomy or cystoprostatectomy was evaluated.
Forty-nine consecutive patients with clinically localized prostate cancer and muscle-invasive bladder cancer were treated with radical prostatectomy and radical cystoprostatectomy with a nerve-sparing procedure. Erectile function was evaluated by the circumferential change of the penis during nocturnal penile tumescence (NPT value) with an erectometer before and after surgery. Erectile function and the frequency of sexual intercourse were also evaluated with a self-administered questionnaire before and after surgery. Multivariate analysis by Cox's proportional hazards model was used to evaluate the factor(s) that affected the recovery of erectile function and sexual intercourse.
The recovery rates of erectile function were 49% at 3 years and 79% at 5 years. For recovery of sexual intercourse the rates were 36% at 3 years and 57% at 5 years. Multivariate analysis revealed that the preoperative NPT value was the only independent factor which significantly affected the recovery of erectile function. The age at surgery was a significant factor for recovery of sexual intercourse.
Nerve-sparing operations can often, but not always, provide preservation or recovery of erectile function for patients who receive radical prostatectomy or cystoprostatectomy. Recovery of erectile function depends upon the preoperative NPT value and recovery of sexual intercourse depends upon the age of the patient.
International Journal of Urology 05/2001; 8(4):158-64. · 1.75 Impact Factor
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ABSTRACT: OBJECTIVE
Sz: To study the clinical and urodynamic effects of oral distigmine bromide (distigmine) by using pressure-flow studies in patients who were persistently poor voiders after transurethral resection of the prostate.
The study included 14 poor voiders after transurethral resection of the prostate who were 50 years old or older. Their poor voiding conditions were characterized by a mean International Prostate Symptom Score of 18.9 or a mean quality-of-life index of 4.6 and a mean maximum flow rate of 8.9 mL/s. All patients underwent symptomatic and urodynamic investigations before and after 4 weeks of daily treatment with 15 mg oral distigmine.
In the baseline pressure-flow studies, all patients had weak detrusor contractility as demonstrated by Schäfer's diagram and the maximum Watts factor but did not have bladder outlet obstruction. They had symptomatic improvements after oral distigmine treatment, with the International Prostate Symptom Score reduced to a mean of less than 10 and the quality-of-life index reduced to a mean of less than 3. In the urodynamic investigations, the maximum flow rate improved significantly to a mean of more than 12 mL/s in parallel with a significant increase in the maximum Watts factor. Detrusor contractility according to Schäfer's diagram also tended to improve after oral distigmine treatment. However, no significant changes were found in any of the parameters of bladder outlet obstruction.
Poor voiders after transurethral resection of the prostate who have weak detrusor contractility without bladder outlet obstruction may benefit clinically from treatment with distigmine because of its efficacy in increasing detrusor contractility without enhancing bladder outlet obstruction.
Urology 03/2001; 57(2):270-4. · 2.43 Impact Factor
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ABSTRACT: A polymerase chain reaction (PCR) method for the detection of Chlamydia trachomatis has been developed and is now available in the clinical setting. However, one of the major problems with this method is possible false-positive detection posttreatment. Nonviable C. trachomatis was established by in-vitro exposure to an antimicrobial agent, and we tried to detect the nonviable cells (NVCs) of C. trachomatis by PCR with variant primer sets. C. trachomatis strains (D/UW-3/Cx) were cultured in a medium containing the antimicrobial agent, at 8 x MIC (minimal inhibitory concentration) 15 to 20 h postinfection. Amplicor and two sets of PCR primers were used to detect the DNA of NVCs. Serial passages of NVCs were done five times. All samples were positive on Amplicor, and all except the fourth passage were positive for the two sets of primers. Although the PCR test appears to be valuable, NVCs may possibly be detected by this method, and this may be clinically responsible for the false detection of C. trachomatis after appropriate antimicrobial chemotherapy.
Journal of Infection and Chemotherapy 01/2001; 6(4):211-5. · 1.80 Impact Factor
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ABSTRACT: Because sildenafil (Viagra) is scheduled to be clinically available in the near future, urologists in Japan must prepare for changes in the treatment of erectile dysfunction. The drug will surely influence our current clinical style of diagnosis and treatment of the dysfunction. We herein discuss this issue, referring to favorable and unfavorable effects that will be brought about by the drug. We also propose several future studies that we should do, including those on testosterone replacement therapy. We present results of our experiment using testosterone replacement therapy in aged rats and speculate about the mechanism by which the hormone replacement works in the sex center of the brain.
World Journal of Surgery 11/2000; 24(10):1180-2. · 2.36 Impact Factor
