PurposeTo evaluate the clinical factors that impact ureteral stent-related lower urinary tract symptoms (LUTS) after ureteroscopic ureterolithotomy, including the stent position and medication.Materials and MethodsFifty-three patients who underwent ureteroscopic ureterolithotomy with indwelling a stent were distributed into three groups. On demand analgesics were given to the group 1 (n=18). Daily tamsulosin 0.2 mg was added for group 2 (n=15) and daily tamsulosin 0.2 mg and tolterodine 4 mg was added for group 3 (n=20). The patients were also subclassified into appropriate or inappropriate group according to stent position. All the patients completed a visual analogue scale (VAS) and International Prostate Symptom Score (IPSS) on the 1st and 7th postoperative days. The VAS and IPSS were analyzed according to the medication groups and the stent position.ResultsIn the appropriate stent potion group, only the storage symptom scores of groups 2 and 3 on the 1st postoperative day were significantly lower than those of the group 1 (p=0.001). This medication effect on LUTS was not observed in the inappropriate stent position group. In this group, total IPSS (p=0.015) and storage symptom scores (p=0.002) were higher than in the appropriate stent position group on the 7th postoperative day.ConclusionsCorrect placement of the stent was more important than medication for lessening stent-related storage symptoms.

Introduction There is partial evidence to support the use of phophodiesterase-5 inhibitor (PDE5-I) for the treatment of premature ejaculation (PE). Aim We compared on-demand dosing of dapoxetine alone and combined with mirodenafil in subjects with lifelong PE and without erectile dysfunction (ED). Methods Our prospective, randomized, double-blind, placebo-controlled, multicenter trial enrolled 118 subjects with lifelong PE without ED. PE was diagnosed using D  iagnostic and S  tatistical M  anual of M  ental D  isorders, fourth edition, text revision. Patients were divided into two groups: dapoxetine 30 mg plus placebo (group A, n = 56) and dapoxetine 30 mg plus mirodenafil 50 mg (group B, n = 62). Main Outcome Measures During 12 weeks, intravaginal ejaculatory latency time (IELT) and the time from foreplay to beginning intercourse (FTIT) with a stopwatch, and Premature Ejaculation Profile (PEP) were measured. Overall sexual act time (OSAT; sum of FTIT and IELT) was calculated. Any treatment-emergent adverse events (TEAEs) were also recorded. Results Over 12 weeks, IELT, OSAT, and PEP index score significantly improved in group B compared with group A (increased geometric mean IELT in group A and B = 3.6 and 6.1 minutes, P = 0.026; increased geometric mean OSAT in group A and B = 5.5 and 9.9 minutes, P = 0.012; increased median PEP index score in group A and B = 1.0 and 1.3, P = 0.046). However, there was no significant difference between two groups with respect to improvement of FTIT (P = 0.147). TEAEs did not differ between groups (all P > 0.05), and there was no serious adverse event in any subjects. Conclusions Low dose of dapoxetine combined with mirodenafil showed better results in terms of IELT, OSAT, and PEP index score, and similar TEAEs, compared with that of dapoxetine only. Our results support the suggestion that the PDE5-Is have a potential role in the treatment of PE without ED.

We evaluated the clinical efficacy and safety of administering udenafil (5-[2-propyloxy-5-(1-methyl-2-pyrollidinylethylamidosulphonyl)phenyl]-1-methyl-3-propyl-1,6-dihydro-7H-pyrazolo(4,3-d)-pyrimidin-7-one) in patients with comorbid benign prostatic hyperplasia (BPH) and erectile dysfunction (ED). One hundred and twenty patients who had been undergoing stable a-blocker therapy for BPH were enrolled in this trial and they were administered 100 mg udenafil for 8 weeks.Changes in blood pressure (BP), heart rate (HR), the international prostatic symptom score (IPSS) and the international index of ED (IIEF-5) were evaluated every 4 weeks. At end point, there was no significant change in BP and HR, whereas the lower urinary tract symptoms (LUTS) and ED improved significantly compared with baseline (IPSS 14.3-11.5, IIEF-5 11.95-18.32, Po0.05). Most patients were tolerant to the treatment and there was no evidence of additional side effects related to coadministration. The coadministration of udenafil and an a-blocker in patients with comorbid BPH and ED was safe and gave significant improvements in both LUTS and ED.

PurposeTo identify potential predictive factors of incidental prostate cancer (IPca) in patients considering tissue-ablation treatment for benign prostatic hyperplasia (BPH).Materials and MethodsFrom the 11 centers, 1,613 men who underwent transurethral resection of the prostate (TURP) or open prostatectomy were included. Before surgery, prostate biopsy was performed in all patients with prostate-specific antigen (PSA) ≥4.0 ng/ml or with abnormal digital rectal examination (DRE) findings. The patients with prostate cancer preoperatively or with PSA >20 ng/ml were excluded. As predictive factors of IPca, age, body mass index, PSA, DRE, and transrectal ultrasonography (TRUS) findings, including total prostate volume (TPV), transition zone volume (TZV), and the presence of hypoechoic lesions, were reviewed. PSA density (PSAD) and PSAD in the transition zone (PSAD-TZV) were calculated.ResultsIPca was diagnosed in 78 patients (4.8%). DRE findings, PSA, and TZV were independent predictive factors in the multivariate analysis. In the receiver operating characteristic curve analysis of PSA, PSAD, and PSAD-TZV, the area under the curve (AUC) was the largest for PSAD-TZV (AUC, 0.685).ConclusionsIPca was detected in 4.8% of the population studied. In addition to DRE findings, the combination of TZV and PSA can be useful predictive factors of IPca in patients considering tissue-ablation treatment as well as TURP.

We analyzed the effects of obesity on lower urinary tract symptoms (LUTSs) in Korean benign prostatic hyperplasia (BPH) patients. This is a multicenter, cross-sectional, prospective study conducted in four centers in Korea. A total of 602 men with LUTSs secondary to BPH were included. BPH/LUTSs cases were men aged >/= 40 years with international prostate symptom scores (IPSS) > or = 8 points. Height, weight and waist circumference were measured. Among the 602 patients, 156 patients had a waist circumference above 90 cm, representing central obesity, and 215 patients had a body mass index above 25 kg m(-2). Waist circumference was positively correlated with prostate volume (P = 0.034). Men with waist circumference > 90 cm experienced a 1.36-fold increased risk of severe LUTSs (95% CI 0.82-2.41) compared with men with waist circumference < or = 90 cm. Prostate volume was positively correlated with urgency and nocturia in men with central obesity. In this population of Korean men diagnosed with BPH, central obesity rather than overall obesity seems to be the more important predictor of LUTSs correlated with BPH.

Once daily administration of 50 mg mirodenafil was efficacious and safe for the treatment of erectile dysfunction and lower urinary tract symptoms.

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Long-term treatment with silodosin and propiverine significantly improved not only subjective symptoms but also storage function and bladder outlet obstruction in the BPE patients with OAB. The CT more effectively improved the subjective symptoms, QOL, and storage function than a1-blocker MT in the long term.