Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
Objectives: Although plication of the tunica albuginea with nonabsorbable sutures is an effective method in correcting congenital penile curvature (CPC), suture-related complications may happen. We investigated the long-term outcome and patient satisfaction of a modified tunical plication technique using absorbable sutures.
Materials and methods: From January 1999 to July 2005, 114 consecutive patients with CPC treated with a modified tunical plication technique by a single surgeon were retrospectively reviewed. With the modified corporeal plication technique, two, interrupted, U-shaped sutures with 2-zero polyglactin were applied to create bumps on the tunica albuginea. The long-term outcome and patient satisfaction were assessed by a post hoc questionnaire interview.
Results: Among the 114 patients, complete straightness of the penis was achieved in 65 (57%) patients, and 33 (29%) patients reported a 15-degree or less residual or recurrent curvature at 6 mo postoperatively. Although 32 (28%) patients experienced suture failure (median time: 38.5 d), only half of them had a residual or recurrent curvature greater than 15 degrees. Younger patients (<24 yr) had a higher chance of suture failure than elder patients ( p = 0.03). Among the 103 patients completing the questionnaire, no palpable suture knots, suture granuloma, erectile discomfort, or erectile dysfunction was reported (median follow-up time: 41.5 mo). Eighty-three (81.5%) patients were either very or moderately satisfied with the surgical outcome.
Conclusions: The modified technique using double, interrupted, U-shaped sutures and absorbable suture material is a simple and effective method for treating CPC. Suture-related complications rarely happen. The long-term outcome is satisfactory, and most patients are pleased with the procedure.
男性學論文獎基礎組
Nutrition and Cancer, 58(1), 93–106
Brain Derived Metastatic Prostate Cancer DU-145 Cells are Effectively Inhibited in Vitro by Guava (Psidium gujava L.) Leaf Extracts
Kuan-Chou Chen, Chiu-Lan Hsieh, Chiung-Chi Peng, Hsiu-Mei Hsieh-Li,Han-Sun Chiang, Kuan-Dar Huang, and Robert Y. Peng
The aqueous extract of Psidium guajava L. (PE) inhibited the cancer cell DU-145 in a dose-and time-dependent manner. At 1.0 mg/mL, PE reduced the viability of PCa DU145 (the androgen independent PCa cells) to 36.1 and 3.59%, respectively after 48 h and 72 h of incubations. The absolute cell viability suppressing capability (VSC)AC could reach 262.5 cells-mL-h/mg on exposure to PE for 72 h, corresponding to the safe ranges, i.e. the percent viability suppressing rates (PVSR) of 2.72 and 2.41 folds for DU-145 comparing to PZ-HPV-7 cells when treated with PE at 0.5 and 1.0 mg/mL respectively for 72 h. In addition, the colony forming capability of DU-145 cells was apparently lowered. The suppressing rates of which reached 8.09 and 5.96 colony/mg/day for D-145 and PZ-HPV-7 cells, respectively within the concentration range of PE at 0.1.0.25 mg/mL. Cell cycle arrests at G0/G1 phase in both cells were observed by TUNEL assay and flow cytometric analysis, yet more prominently evident in DU-145. In addition, suppression of the matrix metalloproteinases MMP-2 and MMP-9, and the upregulation of active caspase-3 at 0.10 to 1.0 mg/mL in DU-145 were also effected in a dose-dependent manner by PE at 0.25 to 1.0 mg/mL, implicating a potent anti-metastasis power of PE. Conclusively, we ascribe the anticancer activity of PE to its extraordinarily high polyphenolic (165.61 ± 10.39 mg/g) and flavonoid (82.85 ± 0.22 mg/g) contents. Furthermore, PE might be useful for treatment of brain derived metastatic cancers such as DU-145, acting simultaneously as both a chemopreventive and a chemotherapeutic.
輝瑞論文獎臨床組
International Journal of Impotence Research (2007)19,69-75
Association among Hypogonadism, Quality of Life and Erectile Dysfunction in Middle-aged and Aged Male in Taiwan TIS Hwang 1,2,3, H-C Lo 4, T-F Tsai 1 and H-Y Chiou 4
1Division of Urology, Department of Surgery, Shin Kong WHS Memorial Hospital, Taipei, Taiwan
2Department of Urology, Taipei Medical University, Taipei, Taiwan;
3Department of Urology, School of Medicine, Fu Jen Catholic University, Taipei, Taiwan
4School of Public Health, Taipei Medical University, Taipei, Taiwan
The association between hypogonadism, quality of life (QoL), and erectile dysfunction (ED) among the middle-aged and aged male in Taiwan is evaluated. A total of 680 study subjects aged ≧ 40 years old were recruited from Northern (n=276), Middle (n=238), and Southern (n=202) Taiwan, respectively. ED was diagnosed by score of International Index of Erectile Function (IIEF-5). Taiwan version questionnaire for QoL includes domain 1 (physical domain), domain 2 (psychological domain), domain 3 (social relationship domain), and domain 4 (environmental domain) was used to measure QoL. Blood hormones, including FSH, LH, Prolactin, SHBG, total testosterone (TT), calculated free testosterone (cFT), and bioavailable testosterone (Bio-T), were determined, Logistic regression analysis was used to estimate crude and multivariate-adjusted odds ratio of risk factors and its 95% confidence interval. A significantly inverse association between concentration of serum cFT and Bio-T, and severity of ED was observed. Scores of QoL of Domain 1-4 were significantly decreased with the increament of severity of ED. Significant correlations were found between IIEF scores and four domains of QoL, respectively. After adjustment for age, cFT and Bio-T, study subjects with ED (IIEF≦21) would have significantly high risk of low level of QoL in four domains. In conclusion, a significant association between low levels of serum calculated cFT, Bio-T, and severity of ED was found. In addition, abnormal erectile function significantly associated with low level of QoL in four domains.