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Chronic prostatitis in Korea:a nationwide postal survey of practicing urologists in 2004

Asian Journal of Andrology 2005年第4期7卷 427-432,页

作者： Ja-Hyeon Ku Jae-Seung Paick soo-woong kim Department of Urology Seoul National University College of MedicineSeoul 110-744Korea

Aim： To examine the diagnosis and treatment of chronic prostatitis by means of a nationwide postal survey of practicing urologists in 2004. Methods： A random sample of 850 Korean urologists from the Korean Urological Association Registry of Physicians were asked to complete a questionnaire that explored practicing characteristics, attitudes and diagnostic and treatment strategies in the management of chronic prostatitis. Results： Of the 850 questionnaires sent, 302 were returned （response rate 35.5 %） and 275 were induced in the final analysis. More than 50 % believed in a multifactorial etiology for chronic prostatitis and 52 % considered chronic abacterial prostatitis to be bacterial in nature. For routine diagnostic assessment, the most commonly used tests were reported to be urinalysis （95.3 %）, analysis of expressed prostatic secretions （89.5 %） and digital rectal examination （81.1%）. Only a few urologists use specific lower urinary tract cultures. Symptom assessment according to the National Institute of Health-Chronic Prostatitis Symptom Index was less frequently used （12.7 %）. First choices for therapy included antibiotics （96.4 %）, alpha-blockers （71.6 %） and sitz baths （70.5 %）. If unsuccessful, urologists frequently continued to prescribe a second course of either alpha-blockers （69.5 %） or antibiotics （57.8 %）. Conclusion： These data provide a picture of current practice regarding the management of chronic prostatitis in Korea. The diagnostic and treatment practices for prostatitis do not follow standard textbook algorithms. Further studies are needed to elucidate the etiology and pathogenesis of chronic prostatitis and to establish guidelines for its diagnosis and treatment.

关键词： prostatitis chronic pelvic pain syndrome questionnaire diagnosis treatment

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Treatment satisfaction after I year high-power potassiumtitanyl-phosphate photoselective vaporization of the prostate

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Asian Journal of Andrology 2010年第5期12卷 728-734页

作者： Ja Hyeon Ku Min Chul Cho Hyeong Seok kim Jae-Seung Paick soo woong kim Department of Urology Seoul National University Hospital Seoul 100-744 Korea

To investigate the factors that influence treatment satisfaction after high-power potassium-titanyl-phosphate （KTP） laser vaporization of the prostate, we compared the characteristics between patients who were satisfied and those who were not satisfied. In all, 97 patients aged between 53-82 years （median age 67 years） underwent high-power KTP laser vaporization of the prostate for lower urinary tract symptoms due to benign prostatic hyperplasia. At 12 months postoperatively, 60 patients were satisfied with the treatment, whereas 37 were dissatisfied. Although there were no differences in International Prostate Symptom Score （IPSS） values at baseline, the satisfied group scored better in total IPSS at 1, 3, 6, and 12 months postoperatively （P 〈 0.05）. At baseline, the maximum flow rate （Qmax） was lower in the dissatisfied group and remained low throughout the follow-up period, with the exception of 1 month postoperatively （P 〈 0.05）, compared with the satisfied group. There were no differences in other objective data between the two groups, including post-void residual and the number of voids based on the frequency-volume charts. In a multivariate model, a higher bladder contractility index was associated with a greater likelihood of treatment satisfaction 12 months after high-power KTP laser vaporization （odds ratio 1.024, 95% confidence interval 1.001-1.048, P 〈 0.05）. Patients who were not satisfied following the surgery had a smaller improvement in subjective symptoms and Qmax. In addition, our findings suggest that the relative risk of treatment dissatisfaction following high-power KTP laser vaporization was increased in patients with weak detrusor contractility.

关键词： benign prostatic hyperplasia potassium-titanyl-phosphate prostate satisfaction vaporization

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Second to fourth digit ratio： a predictor of adult penile ength

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Asian Journal of Andrology 2011年第5期13卷 710-714页

作者： In Ho Choi Khae Hawn kim Han Jung Sang Jin Yoon soo woong kim Tae Beom kim Department of Urology Gachon University Gil Hospital Incheon Korea Department of Urology Seoul National University College of Medicine Seoul Korea

The second to fourth digit ratio （2D：4D） has been proposed as a putative biomarker for prenatal testosterone and covaries with the sensitivity of the androgen receptor （AR）. Both prenatal testosterone and the AR play a central role in penile growth. In this study, we investigated the relationship between digit ratio and penile length. Korean men who were hospitalized for urological surgery at a single tertiary academic centre were examined in this study, and 144 men aged 20 years or older who gave informed consent were prospectively enrolled. Right-hand second- and fourth-digit lengths were measured by a single investigator prior to measurement of penile length. Under anaesthesia, flaccid and stretched penile lengths were measured by another investigator who did not measure nor have any the information regarding the digit lengths. Univariate and multivariate analysis using linear regression models showed that only height was a significant predictive factor for flaccid penile length （univariate analysis： r=0. 185, P=-0.026; multivariate analysis： r=-0.172, P=0.038） and that only digit ratio was a significant predictive factor for stretched penile length （univariate analysis： r=-0.216, P=0.009; multivariate analysis： r=-0.201, P=0.024; stretched penile length=-9.201 xdigit ratio ＋ 20.577）. Based on this evidence, we suggest that the digit ratio can predict adult penile size and that the effects of prenatal testosterone may in part explain the differences in adult penile length.

关键词： digit ratio flaccid penile length stretched penile length

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The effects of androgen on penile reflex, erectile response to electrical stimulation and penile NOS activity in the rat

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Asian Journal of Andrology 1999年第4期1卷 169-174页

作者： Seong Il Seo soo woong kim Jae-Seung Paick Department of Urology Seoul National University College of Medicine Seoul 110-744 KoreaDepartment of Urology Seoul National University College of Medicine Seoul 110-744 KoreaDepartment of Urology Seoul National University College of Medicine Seoul 110-744 Korea

Aim: To investigate the effects of androgen on penile erection through the reflex arc and penile corpus cavernosum,and study the respective roles of testosterone (T) and dihydrotestosterone (DHT) in penile erection in rats. Methods:Male Sprague-Dawley rats were castrated and implanted with silastic brand silicone tube containing T or DHT, with orwithout daily injections of a 5α-reductase inhibitor, MK-434. The penile reflex, erectile response to electrical stimula-tion (ES) of the cavernous nerves and penile nitric-oxide synthase (NOS) activity were observed under varying andro-genic status. Results: Penile reflex erection in the rat was, on the whole, related to serum T levels though the numberof glans engorgements was not. The number of cups and flips was significantly decreased by castration, and restoredto the control level by T supplementation. Erectile response to ES and NOS activity in penile tissue was also related toserum T level. T administered together with a 5α-reductase inhibitor no longer restored the number of reflex erection,erectile responses to ES and NOS activity in the corpus cavernosum. Conclusion: Androgen influenced the penile re-flex arc, corpus cavernosum, and the perineal striated muscles. In reflex erection, erectile response to ES and penileNOS activity in the rat, T seems to be first converted to DHT, the more active androgen modality. (Asian J Androl1999 Dec; 1: 169-174)

关键词： androgens penile erection reflex electric stimulation nitric-oxide synthase

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Role of Jun amino-terminal kinase （JNK） in apoptosis of cavernosal tissue during acute phase after cavernosal nerve injury

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Asian Journal of Andrology 2018年第1期20卷 50-55页

作者： Won Hoon Song Hwancheol Son soo woong kim Jae-Seung Paick Min Chul Cho Department of Urology Seoul National University College of Medicine Seou103080 Korea Department of Urology Seoul National University Boramae Medical Center Seeu107061 Korea

The present study aimed to identify which mitogen-activated protein kinase （p38 or Jun amino-terminal kinase [JNK]） was involved in cavernosal apoptosis during the acute phase after cavernosal nerve crush injury （CNCI） in rats to ameliorate apoptosis of cavernosal tissue, such as smooth muscle （SM）. A total of twenty 10-week-old male Sprague-Dawley rats were divided equally into two groups： sham surgery （S） and CNCI （I）. The I group approximated the clinical situation of men undergoing radical prostatectomy using two 60-second compressions of both CNs with a microsurgical vascular clamp. At 2-week postinjury, erectile response was assessed using electrostimulation. Penile tissues were harvested for immunohistochemistry analysis of alpha-SM actin （（x-SMA）, western blot analysis, and double immunofluorescence analysis of （x-SMA and phosphorylated p38 or JNK, as well as double immunofluorescent of TUNEL and phosphorylated p38 or JNK. At 2-week postinjury, the I group had a significantly lower intracavernous pressure （ICP）/mean arterial pressure （MAP） and a lower area under the curve （AUC）/MAP than the S group. The I group also exhibited decreased immunohistochemical staining of α-SMA, an increase in the number of SM cells positive for phosphorylated JNK, an increased number of apoptotic cells positive for phosphorylated JNK, and increased JNK phosphorylation compared with the S group. However, there was no significant difference in p38 phosphorylation expression or the number of SM cells positive for phosphorylated p38 between the two groups. In conclusion, our data suggest that JNK, not p38, is involved in cavernosal apoptosis during the acute phase after partial CN damage.

关键词： apoptosis erectile dysfunction Jun amino-terminal kinase mitogen-activated protein kinases p38 penis prostatectomy

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Reasons for discontinuation of sildenafil citrate after successful restoration of erectile function

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Asian Journal of Andrology 2004年第2期6卷 117-120页

作者： Hwancheol Son Kwanjin Park soo-woong kim Jae-Seung Paick Department of Urology Seoul National University College of Medicine Seoul Korea and Department of Urology Seoul Municipal Boramae Hospital Seoul 110-744 Korea

Aim: To investigate the reasons for discontinuations of sildenafil after the successful restoration of erectile function. Methods: One hundred fifty six patients, whose scores of erectile function domain of the 15-item International Index of Erectile Function (IIEF) increased to 26 or more after sildenafil medication, were included in this study. Six-months after the first sildenafil prescription, compliance to medication and the reason for discontinuity were reviewed by chart or surveyed by telephone. Results: Fifty-four (34.6%) of the 156 successfully treated patients discontinued sildenafil medication. The r easons for discontinuance were shortcomings in the partners' or patients' emotional readiness for the restoration of sexual life after long-term abstinence (37.0%), fear of possible side effects (18.5 %), recovery of spontaneous erection (14.8 %), postponement of ED treatment because of co morbid disease treatment (11.1%), unwillingness to accept drug-dependent erection (7.4%), high drug cost (3.7%), unacceptability of planned sexual activity (3.7%) and lack of sexual interesi (3.7%). Conclusion: The reasons for discontinuing sildenafil medication were primarily emotional or relationship-oriented, which indicates that simple recovery of a rigid erection is insufficient to restore sexual activity. More education about the effects of drug and the counseling of both partners is recommended to promote the successful recovery of sexual activity.

关键词： sildenafil erectile dysfunction drop-out discontinuation

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Potentiation of apomorphine effect on sildenafil-induced penile erection in conscious rabbits

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Asian Journal of Andrology 2004年第3期6卷 205-209页

作者： Jae-Young Park Hwancheol Son soo woong kim Jae-Seung Paick Department of Urology Seoul National University College of MedicineSeoulKoreaDepartment of UrologySeoul Municipal Boramae HospitalSeoulKoreaDepartment of UrologySeoul National University College of MedicineSeoulKoreaDepartment of UrologySeoul National University College of MedicineSeoulKorea

Aim: To investigate a possible potentiation effect of apomorphine (APO) on sildenafil-induced penile erection in the conscious rabbit. Methods: Erection of male New Zealand White rabbits (3.5-4.0 kg, n=12) was assessed by measuring the length of the uncovered penile mucosa and the duration of erection before and after intravenous administration of agents. After injection of APO (0, 0.05, 0.1 and 0.4 mg/kg), sildenafil was administered intravenously in a dose-response manner (0.5, 1 and 5 mg/kg). In additional experiments, the effect of increasing doses of sildenafil in combination with APO on systemic blood pressure was evaluated. Results: Systemic administration of sildenafil induced a dose-dependent increase in the penile length. Intravenous injection of APO alone did not produce any change in the penile length, while significantly enhanced the penile erection induced by sildenafil. The co-administration of 0.1 mg/kg of APO and 1 mg/kg of sildenafil was found to be the most effective combination in producing penile erection. Intravenous administration of sildenafil caused a concentration-dependent decrease in systemic blood pressure, but no additional decrease was observed with co-administration of APO. Conclusion: APO enhances the penile erection induced by sildenafil in the conscious rabbit without causing an additional decrease in blood pressure.

关键词： penile erection sildenafil apomorphine conscious rabbit combination therapy

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Patient-reported ejaculatory function and satisfaction in men with lower urinary tract symptoms/benign prostatic hyperplasia

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Asian Journal of Andrology 2018年第1期20卷 69-74页

作者： Min Chul Cho Jung Kwon kim Sang Hoon Song Sung Yong Cho Sang Wook Lee soo woong kim Jae-Seung Paick Department of Urology Seoul National University Boramae Medical Center Seou107061 Korea Department of Urology Seoul National University College of Medicine Seoul 03080 Korea Department of Urology Asan Medical Center Seou105505 Korea Department of Urology Kangwon National University College of Medicine Chuncheon 24289 Korea

This study aimed to investigate perceived ejaculatory function/satisfaction before treatment for lower urinary tract symptoms （LUTS）/benign prostatic hyperplasia （BPH） and to identify associations between specific categories of ejaculatory dysfunctions （EjDs） and LUTS. A total of 1574 treatment-naive men with LUTS/BPH were included in this study. All patients underwent routine evaluation for LUTS/BPH including the International Index of Erectile Function and a 5-item questionnaire developed to assess ejaculatory volume/force/pain/satisfaction/latency time. Patients who had sexual intercourse over the past 4 weeks were classified as sexually active group. A total of 783 patients were categorized as sexually active group. Decreased ejaculatory volume and force were reported by 53.4% and 55.7% of 783 sexually active men, respectively, There was a strong correlation between ejaculatory volume and force. Ejaculatory pain/discomfort, premature ejaculation （PE）, and delayed ejaculation （DE） were reported in 41,0%, 16.3%, and 41.4% of the patients, respectively. Over 40.0% of men without decreased ejaculation volume/force were satisfied with ejaculatory function, whereas approximately 6.0% of men with decreased volume/force were satisfied with ejaculatory function. About 30.0% of men with decreased volume/force had orgasmic dysfunction, while approximately 10.0% of men without decreased volume/force did. Decreased ejaculatory volume or force was associated with LUTS severity after adjusting for other influential factors including testosterone level, erectile function, and prostate size on ultrasonography, but PE or DE or ejaculatory pain/discomfort was not. In conclusion, a considerable portion of men with LUTS/BPH appear to have a variety of EjDs. Ejaculatory volume/force and satisfaction/orgasm do not always appear to be concordant. Ejaculatory volume or force is independently associated with LUTS severity, whereas PE or DE or ejaculatory pain/discomfort is not.

关键词： dysfunction ejaculation lower urinary tract symptoms (LUTS) satisfaction

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The effects of single versus combined therapy using LIM-kinase 2 inhibitor and type 5 phosphodiesterase inhibitor on erectile function in a rat model of cavernous nerve injury-induced erectile dysfunction

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Asian Journal of Andrology 2019年第5期21卷 493-500页

作者： Min Chui Cho Junghoon Lee Juhyun Park Sohee Oh Ji Sun Chai Hwancheol Son Jae-Seung Paick soo woong kim Department of Urology Seoul National University College of MedicineSMG-SNU Boramae Medical CenterSeoul 07061Korea Department of Urology Seoul National University College of MedicineSeoul National University HospitalSeoul 03080Korea Department of Biostatistics Seoul National University College of MedicineSMG-SNU Boramae Medical CenterSeoul 07061Korea

We aimed to determine whether combination of LIM-kinase 2 inhibitor(LIMK2i)and phosphodiesterase type-5 inhibitor(PDE5i)could restore erectile function through suppressing cavernous fibrosis and improving caver nous apoptosis in a rat model of cavernous nerve crush injury(CNCI).Seventy 12-week-old Sprague-Dawley rats were equally distributed into five groups as follows:(1)sham surgery(Group S),(2)CNCI(Group I),(3)CNCI treated with daily intraperitoneal administration of 10.0 mg kg^-1 LIMK2i(Group I+L),(4)daily oral administration of 20.0 mg kg-1 udenafil,PDE5i(Group I+U),and(5)combined administration of 10.0 mg kg^-1 LIMK2i and 20.0 mg kg^-1 udenafil(Group I+L+U).Rats in Groups I+L,I+U,and I+L+U were treated with respective regimens for 2 weeks after *** 2 weeks after surgery,erectile response was assessed using *** tissues were processed for histological studies and western *** I showed lower intracavernous pressure(ICP)/mean arterial pressure(MAP),lower area under the curve(AUC)/MAP,decreased immunohistochemical staining for alpha-smooth muscle(SM)actin,higher apoptotic index,lower SM/collagen ratio,increased phospho-LIMK2-positive fibroblasts,decreased protein kinase B/endothelial nitric oxide synthase(Akt/eNOS)phosphorylation,increased LIMK2/cofilin phosphorylation,and increased protein expression of fibronectin,compared to Group *** all three treatment groups,erectile responses,protein expression of fibronectin,and SM/collagen ratio were *** I+L+U showed greater improvement in erectile response than Group I+*** content and apoptotic index in Groups I+U and I+L+U were improved compared to those in Group ***,Group I+L did not show a significant improvement in SM content or apoptotic *** number of phospho-LIMK2-positive fibroblasts was normalized in Groups I+L and I+L+U,but not in Group I+***/eNOS phosphorylation was improved in Groups I+U and I+L+U,but not in Group I+***2/cofilin phosphorylation was i

关键词： apoptosis erectile dysfunction fibrosis LIM kinase phosphodiesterase

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Role of inhibiting LIM-kinase2 in improving erectile function through suppression of corporal fibrosis in a rat model of cavernous nerve injury

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Asian Journal of Andrology 2018年第4期20卷 372-378页

作者： Juhyun Park Sung Yong Cho Kwanjin Park Ji Sun Chai Hwancheol Son soo woong kim Jae-Seung Paick Min Chul Cho Department of Urology Seoul National University College of Medicine SMG-SNU Boramae Medical Center Seoul 03080 Korea Department of Urology Seoul Nationa University College of Medicine Seoul National University Hospital Seoul 07061 Korea

We evaluated whether LIM-kinase 2 inhibitor （LIMK2i） could improve erectile function by suppressing corporal fibrosis through the normalization of the Rho-associated coiled-coil protein kinase 1 （ROCK1）/LIMK2/Cofilin pathway in a rat model of cavernous nerve crush injury （CNCl）. Sixty 11-week-old male Sprague-Dawley rats were divided equally into five groups： sham surgery （S）, CNCl （I）, and CNCl treated with low-dose （L）, medium-dose （M）, and high-dose （H） LIMK2i. The L, M, and H groups were treated with a daily intraperitoneal injection of LIMK2i （2.5, 5.0, and 10.0 mg kg-1 body weight, respectively） for 1 week after surgery. The erectile response was assessed using electrostimulation at 1 week, postoperatively. Penile tissues were processed for Masson＇s trichrome staining, double immunofluorescence, and Western blot assay. Erectile responses in the H group improved compared with the I group, while the M group showed only partial improvement. A significantly decreased smooth muscle/collagen ratio and an increased content of fibroblasts positive for phospho-/IMK2 were noted in the I group. The M and H groups revealed significant improvements in histological alterations and the dysregulated LIMK2/Cofilin pathway, except for LIMK2 phosphorylation in the M group. The inhibition of LIMK2 did not affect the ROCK1 protein expression. The content of fibroblasts positive for phospho-LIMK2 in the H group returned to the level found in the S group, whereas it did not in the M group. However, the L group did not exhibit such improvements. Our data suggest that the inhibition of LIMK2, particularly with administration of 10.0 mg kg^-1 body weight LIMK2i, can improve corporal fibrosis and erectile function by normalizing the LIMK2/Cofilin pathway.

关键词： erectile dysfunction fibrosis LIM kinase penis prostatectomy

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