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Sensation of the bladder trigone and bladder neck induced by traction of an indwelling balloon catheter with a spring balance and cystometry was evaluated in 393 males and 106 females. Male patients with an average age of 56.9 +/- 15.9 (mean +/- standard deviation) years old (range 17 to 88 years) were divided into 7 groups as follows: 19 patients without any micturitional disturbance, uregency and chronic prostatitis (11 patients), benign prostate hypertrophy (BPH) (131 patients), cervical or thoracic cord compression disorders (67 patients), lumbar vertebral disorders (114 patients), other peripheral nerve disorders associated with diabetes mellitus, post operative status of rectum cancer and others (27 patients) and brain diseases (24 patients). Female patients with an average age of 55.2 +/- 15.5 years old (range 17 to 88 years) were divided into 6 groups as follows: 24 patients without any neurological problems, urgency (7 patients), cervical or thoracic cord compression disorders (11 patients), lumbar vertebral disorders (37 patients), other peripheral nerve disorders (18 patients) and brain diseases (9 patients). The observed sensation, first desire to void (FDV) and maximum cystometric capacity (MCC) were evaluated statistically in relation to clinical factors (e.g. disease group, generation and patterns of cystometrogram). The correlation between the sensation and FDV or MCC in these patients were assessed by linear regression analysis. Sensation of normal males was 334.2 +/- 159.7 g on the average and correlated well with FDV (r = 0.88, y = 375x - 189.4). Sensation of normal females was 373.3 +/- 199.5 g on the average. However, there was no correlation (r = 0.35) between sensation and FDV in females. In males, the means of sensation obtained in patients with other peripheral nerve disorders (557.3 +/- 314.5 g) was significantly larger than the means of normal subjects (p less than 0.001), and patients with uregency and chronic prostatitis (236.4 +/- 148.3 g, p less than 0.01), BPH (424.1 +/- 215.6 g, p less than 0.001), cervical or thoracic cord compression disorders (349.0 +/- 229.5 g p less than 0.001), lumbar vertebral disorders (349.7 +/- 201.7 g, p less than 0.001) or brain diseases (490.6 +/- 305.0 g, p less than 0.05). Furthermore, the differences in the means of sensation between BPH and lumbar vertebral disorders (p less than 0.05) or brain diseases (p less than 0.05) were statistically significant.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Relationship between bladder trigone and bladder neck induced by traction of an indwelling balloon catheter with a spring balance and parameters of cystometrogram]. 137 57

The objective causes of sexual impotency include chronic prostatitis arising from bacterial infection (1/3 of patients have sexual disturbances), congestive prostatitis (owing to sexual hyperstimulation treated with temporary blockage of testosterone), and hemorrhoids. Diabetes, advances tuberculosis, neurological and psychological diseases also negatively impact sexual potency as does alcoholism. The increase of dopamine and the decrease of serotonin stimulate, while the reverse of these reduce sexual activity. Endocrine medicines, drugs that affect the central nervous system, antihypertension drugs, anticoagulants, vincristine, cimetidine, and clofibrate generally lower the libido. Methods to be avoided because of a negative effect on sexual life include coitus interruptus. The intolerance of sensitivity to the sperm of the partner also complicates the sexual life of a couple. Sexual disorders without apparent cause include the lack of harmony, attention, and education about sexual matters. Other disorders can be caused by rape (only 25% of rapists are caught and punished), as 50% of female victims have psychological sequelae with a sexual tone; venereophobia; repulsive cutaneous symptoms; emotional taste; fear of inability to complete the sexual act; timidity or excessive shyness with anxiety about intimacy; and lack of emotional attraction to the partner. Eventually, the lack of a satisfactory sexual life has an effect on the integrity of conjugal life, as it is frequently the cause of divorce.
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PMID:[Sexual problems in dermatovenereology consultations]. 182 15

We have experienced a case of Fournier's gangrene which progressed rapidly after prostatic massage. The patient was a 70-year-old man who had poorly controlled diabetes mellitus, hemorrhoid, urethral stricture and benign prostatic hyperplasia. He visited an urologist complaining of pollakisuria and miction pain. Under the diagnosis of prostatitis, prostatic massage was performed. From that night, he developed a high grade fever. Simultaneously, redness, swelling and pain of the scrotum progressed rapidly, and 11 days later, he was admitted to our hospital. An X-ray examination revealed subcutaneous gas formation in the scrotum. Immediately, incision and drainage with extensive debridement of necrotic tissue were performed combined with chemotherapy using broad spectrum antibiotics and insulin therapy. About 3 months later, the gangrene and the wound were healed with granulation and scarring. Cultures of the pus and the necrotic tissue from the scrotum were positive for Bacteroides fragilis and several aerobes including Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterococcus and Staphylococcus epidermidis. The case proved to be non-clostridial gas gangrene.
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PMID:[A case of Fournier's gangrene: was it triggered by prostatic massage?]. 223 20

A case of granulomatous prostatitis due to Cryptococcus neoformans is reported. The patient, who had a history of diabetes mellitus and chronic active hepatitis, had symptoms of prostatic hypertrophy. Tissue obtained from surgery showed granulomatous prostatitis, and a cryptococcal organism was identified by special stains. Postoperative cultures grew Cryptococcus neoformans, and the patient was treated successfully with surgery and a short course of amphotericin B. After nine months of follow-up, there is no evidence of systemic infection.
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PMID:Cryptococcal prostatitis. 700 77

A 41-year-old Japanese male with uncontrolled diabetes mellitus and alcoholic liver dysfunction developed melioidosis after his business trip to Indonesia and Singapore in 1988. His disease started with spiked fever on the following day after extraction of a tooth, and a liver abscess developed, followed by abscesses in the spleen and in the subphrenic space. In spite of splenectomy and intensive antimicrobial treatments for three months, he developed parotitis, prostatitis, and abscess of the right submandibular gland at 5 to 16-month interval. Pseudomonas pseudomallei was isolated from the blood and pus from each abscess. The lung was not involved. At present, he has returned to work, with continued intravenous instillation of imipenem/cilastatin.
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PMID:Chronic melioidosis: a report of the first case in Japan. 846

Erectile impotence may be of neuropathic, vascular, psychogenic and hormonal origin or may be caused by their combination. This impotence occurs in up to 10% of sexually active men. The injection of prostaglandin E1 (PGE1) into the penile cavernous bodies results in venous occlusion warranting maximal erection. Edex (PGE1) was given to 23 patients aged 43-68 years (mean age 58.9 years) suffering from impotence as a result of prostatic cancer (5 cases), postprostatic adenomectomy condition (8 cases), chronic prostatitis (4 cases), diabetes mellitus (4 cases), chronic alcoholism (1 case), spinal trauma (1 patient). The dose (from 5 to 20 micrograms) was adjusted individually. Good, satisfactory and poor effects were achieved in 86.2, 13.0 and 4.3% of the patients, respectively. In prostatic cancer males on hormone therapy and after adenomectomy the effect was obtained in 76.9% (in 10 of 13 males). An old age is not a contraindication for intracavernous injections of Edex.
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PMID:[The intracavernous injection of Edex (prostaglandin E1) in the treatment of erectile impotence in persons in older age groups]. 903 6

Correlation interrelations between indices for SMF (sexual formula male proper) were studied together with values for testosterone in blood serum and testosterone-estradiol relations in 63 male subjects presenting with sexual problems of various genesis. No correlation was established between blood serum testosterone levels or testosterone-estradiol relations as well as between SMF indices characterizing the state of libido and erection both in cases of psychogenic sexual dysfunction and in those precipitated by prepubertal hypogonadism, insulin-dependent diabetes mellitus, and chronic prostatitis. It is only in those cases of the above-mentioned dysfunction related to chronic prostatitis that there exists a positive correlation between testosterone-estradiol ratio and SMF index characterizing ejaculation.
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PMID:[The significance of the androgen-estrogen ratios in the clinical picture of sexual disorders in men]. 1087 75

This article presents and evaluates the symptoms, presentation, diagnosis, and treatment of men with interstitial cystitis (IC). A retrospective chart review and an interview of all men in our practice diagnosed with IC since 1990 was performed. The patients' presenting symptoms, physical findings, clinical evaluation, and responses to therapy were reviewed. A total of 52 men were identified during the study who met the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) criteria for diagnosis of IC. The most common referral diagnosis was prostatitis with the most common predominant symptoms being suprapubic pain with urinary frequency and dysuria. A significant number of male patients also developed sexual dysfunction. All patients met the NIDDK criteria for a diagnosis of IC. Multiple therapies were used for the treatment of these patients over the study period. Five patients were initially treated with dimethyl sulfoxide (DMSO) as a sole agent; however, all intravesically treated patients eventually failed this form of therapy. A total of 37 of 52 patients were treated with multidrug oral therapy. Findings showed that 80% of patients achieved >75% improvement in their symptomology at 6 months of follow-up with a durable response at 1 year. IC in men is probably underdiagnosed and is most commonly misdiagnosed as prostatitis. The patient's presentation is analogous to that in the female population allowing for gender differences. The patients responded well to multidrug oral therapy.
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PMID:Observations on the presentation, diagnosis, and treatment of interstitial cystitis in men. 1137 46

Very few epidemiologic studies of interstitial cystitis (IC) have been published over the past 5 years. One population-based study focused only on women and suggested that the prevalence of the IC symptom complex in the United States is much higher than previously reported. Future epidemiologic studies of IC must overcome major obstacles to obtain more accurate population-based estimates. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) criteria used to assist in identifying patients with IC have proven to be cumbersome and too restrictive. Other obstacles include (1) the relative infrequency of the condition; (2) the long duration between development of symptoms and diagnosis; and (3) the perception that the disorder occurs predominantly in white women. Evidence suggests men with the IC symptom complex are often misdiagnosed by physicians and identified as having chronic prostatitis (also called the chronic pelvic pain syndrome) or benign prostatic hyperplasia. Children who present with the IC symptom complex are often thought to have voiding dysfunction. We propose that the more inclusive, less restrictive term chronic pelvic pain of the bladder (CPPB) be used in future epidemiologic studies of persons with the characteristic IC symptoms of urinary frequency, urgency, and pain. Early studies of chronic pelvic pain in general suggest that it is most common in women, of unknown etiology, and, in many patients, is associated with urinary bladder symptoms. It is necessary to develop case definitions for CPPB to accurately identify those patients with symptoms currently identified as IC.
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PMID:The epidemiology of interstitial cystitis: is it time to expand our definition? 1137 56

A short version of the UTI Guidelines elaborated by the Urinary Tract Infection Working Group of the Health Care Office of the European Association of Urology is presented. The topics include classification, diagnosis, treatment and follow-up of uncomplicated UTI, UTI in children, UTI in diabetes mellitus, renal insufficiency, renal transplant recipients and immunosuppression, complicated UTI due to urological disorders, sepsis syndrome, urosepsis, urethritis, prostatitis, epididymitis, orchitis and principles of perioperative prophylaxis in urology.
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PMID:EAU guidelines for the management of urinary and male genital tract infections. Urinary Tract Infection (UTI) Working Group of the Health Care Office (HCO) of the European Association of Urology (EAU). 1175 70


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