Search

Purpose: Advances in the diagnosis and treatment of prostate cancer have increased the patients’ stress level and decreased the quality of life. A variety of instruments are currently available to evaluate patients with prostate cancer. However, only a few tools are available to assess Korean patients, and therefore we demonstrated a linguistic validation of Korean Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP).Methods: EPIC-CP was translated into Korean and the linguistic validation was evaluated. The evaluation process includes permission for translation, forward translation, reconciliation, backward translation, cognitive debriefing, and proofreading. Two bilingual translators independently translated the original questionnaire, discussed the feasibility and naturalness of initial translation, followed by revision to the reconciled version. Another translator then performed a backward translation into English. Ten patients with prostate cancer completed the translated questionnaire and performed cognitive debriefing.Results: The original EPIC-CP was translated into 2 Korean versions. The different wording in both versions and the ordinary words in the initial translations were changed considering the nuances and meanings of medical terms. During the backward translation, the panels made slight changes to clarify the meaning and nuances of the translated questionnaire. During cognitive debriefing, 10 patients answered the questionnaire and offered their opinions regarding comprehensibility and naturalness. Most patients agreed that the translation was comprehensible in general.Conclusions: Our study provides a successful linguistic validation of the EPIC-CP questionnaire. The translation is a helpful diagnostic tool to ensure the quality of life of patients with prostate cancer attending crowded clinics.

To examine the diagnostic performance of Vesical Imaging-Reporting and Data System (VIRADS) and to find a quantitative indicator for predicting muscle layer invasion of bladder cancer. 3-T MRI of 82 patients performed before transurethral resection of bladder tumors or radical cystectomy between July 2018 and June 2019 were retrospectively analyzed. For one index lesion of each patient, two radiologists independently assigned VIRADS score and measured tumor-wall interface (contact length between tumor and bladder wall) on T2-weighted, diffusion-weighted, and dynamic contrast-enhanced MRI. Inter-reader agreement was assessed, and logistic regression analysis was performed to find indicators of muscle layer invasion. Comparison of indicators’ diagnostic performance was done with receiver operating characteristic (ROC) curve and generalized linear model analyses. Optimal cutoff point was determined by the Youden index J. Inter-reader agreement was at least substantial for VIRADS categorization (κ 0.77–0.81), and almost perfect for tumor-wall interface (intraclass correlation coefficient 0.88–0.90). Tumor-wall interface (odds ratio [OR] 1.90–2.00) and VIRADS score (OR 8.59–8.89) were independently associated with muscle layer invasion (p ≤ 0.02). For VIRADS, area under the ROC curve (AUROC) was 0.94, and the accuracy was 0.93 at score 3, the optimal threshold for predicting muscle layer invasion. Depending on the MRI sequence, tumor-wall interface showed AUROCs of 0.90–0.92 and accuracy of 0.84–0.90 at suggested thresholds (3 ± 0.3 cm). Tumor-wall interface showed insignificant differences in accuracy compared with VIRADS (p > 0.10), except as measured on diffusion-weighted images (p = 0.01). VIRADS is a good predictor of muscle layer invasion. As an independent quantitative indicator, tumor-wall interface may complement VIRADS to enhance prediction. • Vesical Imaging-Reporting and Data System (VIRADS) is a promising predictor of muscle invasion of bladder cancer with good reproducibility, as suggested by previous studies. • VIRADS score and the tumor-wall interface (curvilinear contact length between the tumor and the bladder wall) are independent predictors of muscle layer invasion. • As an easy-to-use quantitative indicator, tumor-wall interface is expected to be used as an indicator complementary to VIRADS, a qualitative indicator.

Background We investigated prevalence of familial and hereditary prostate cancer (PCa) in Asian population, and compared clinical characteristics between familial and sporadic disease. Methods Pedigrees of 1102 patients who were treated for PCa were prospectively acquired. Clinical and pathologic characteristics and biochemical recurrence (BCR)-free survival were compared between familial PCa and sporadic PCa in patients who underwent radical prostatectomy (RP; n = 751). Results The prevalence of familial, first-degree familial, and hereditary PCa was found to be 8.4%, 6.7%, and 0.9%, respectively; similar result was obtained in patients who underwent RP (8.4%, 6.4%, and 0.9%). Patients with familial PCa were significantly younger than those with sporadic PCa (63.3 vs 65.6 years; P = .015). However, preoperative variables (prostate-specific antigen, clinical stage, biopsy Gleason score [GS], and percentage of positive biopsy cores) and postoperative variables (surgical GS, upgrading rate, pathologic stage, and percentage of tumor volume) did not correlate with family history (P range: .114-.982). Kaplan-Meier analysis of 5-year BCR-free survival revealed no significant difference between sporadic (82.7%), familial (89.4%; P = .594), and first-degree familial (87.1%; P = .774) PCa. Analysis of p53, Bcl-2, Ki67, and other immunohistochemistry biomarkers revealed that only increasing p53 expression and first-degree familial PCa approached significance (P = .059). Conclusion The prevalence of familial PCa was somewhat lower in the Asian population than in other ethnic groups. Clinical and pathologic variables and selected histologic biomarker abnormalities were not significantly different in patients with and without a family history of PCa. BCR-free survival following RP was also unaffected by family history.

Background: Tick-borne diseases (TBDs) can be fatal to humans as well as to animals causing severe economic losses globally to livestock industries. Many countries conduct regular surveill...

To investigate the association between pelvic floor muscle strength and erectile function in a prospectively collected observational cohort. 270 male volunteers were prospectively collected and grouped by International Index of Erectile Function-5 (IIEF-5) scores. Pelvic floor muscle strength was compared. Patients with obvious neurologic deficits, abnormal pelvic bones, history of pelvic radiation therapy, prostatectomy, or urinary incontinence were excluded. We analyzed 247 patients with mean (± standard deviation, SD) age of 62.8 (± 10.1) years. Mean (± SD) maximal and average strength were 2.0 (± 1.5) and 1.1 (± 0.8) kgf, respectively. Mean (± SD) endurance and IIEF-5 scores were 7.2 (± 2.6) seconds and 13.3 (± 7.9), respectively. Patients with IIEF-5 scores ≤ 12 tended to be older, with a higher occurrence of hypertension and lower body mass index. Age [odds ratio (OR) 1.08, 95% confidence interval (CI) 1.04–1.12, p p = 0.003) were independent predictors for IIEF-5 scores ≤ 12 in multivariate regression analysis. Patients with erectile dysfunction were older and showed lower pelvic floor muscle maximal strength. Future prospective trials needed for using physiotherapy are required to verify our results.

INTRODUCTION AND OBJECTIVE:DA8010 is a novel muscarinic M3 receptor antagonist. Prior preclinical studies have verified that DA8010 has high binding affinity for human muscarinic M3 receptor and si...

Purpose In recent years, the importance of patient satisfaction and quality of life—referred to as patient-related outcomes— has been emphasized, in addition to the evaluation of symptoms and severity through questionnaires. However, the questionnaires that can be applied to Korean patients with neurogenic bladder are limited. Therefore, the current study linguistically validated the Intermittent Self-Catheterization Questionnaire (ISC-Q) as an instrument to evaluate the quality of life of Korean patients with neurogenic bladder who regularly perform clean intermittent catheterization (CIC). Methods The validation process included permission for translation, forward translations, reconciliation, backward translation, cognitive debriefing, and proofreading. Two bilingual translators independently translated the original version of the ISC-Q into Korean and then combined the initial translations. A third bilingual translator performed a backward translation of the reconciled version into English. Five Korean-speaking patients with neurogenic bladder carried out the cognitive debriefing. Results During the forward translation process, the 24 questions of the ISC-Q were translated into 2 Korean versions. The terms used in each version were adjusted from the original version to use more conceptually equivalent expressions in Korean. During the backward translation process, several changes were involving substitutions of meaning. In the cognitive debriefing process, 5 patients were asked to complete the questionnaire. All patients agreed that the questionnaire explained their situation well. Conclusions This study presents a successful linguistic validation of the Korean version of the ISC-Q, which could be a useful tool for evaluating treatment satisfaction in patients with neurogenic bladder performing CIC regularly.

Aims To evaluate the efficacy and safety of mirabegron in males with overactive bladder (OAB) symptoms. Methods In total, 464 males with OAB symptoms were enrolled from 14 institutes and were sorted into either the mirabegron 50 mg (n = 310) or placebo (n = 154) groups. The change in (i) the mean number of 24-h micturition episodes; (ii) OAB Symptom Scale (OABSS); and (iii) International Prostate Symptom Score (IPSS) from baseline to 12 weeks of treatment were compared between the two groups. Safety assessments included treatment-emergent adverse events, blood pressure, pulse rate, postvoid residual volume, and maximum urinary flow rate. After 12 weeks, the study was extended for 14 additional weeks by administering mirabegron 50 mg to both groups. Results The reduction in the mean number of 24-h micturition episodes from baseline to 12 weeks of treatment was similar between the two groups. However, significantly greater changes from baseline to 12 weeks were observed in total OABSS, OABSS urgency incontinence score (Q4), IPSS storage subscore (Q2 + Q4 + Q7), and IPSS urgency score (Q4) in the mirabegron group (P = 0.01 for all). According to the extended study, the changes of all efficacy variables from baseline to 26 weeks were similar between both groups. The safety assessment results were also similar between the two groups at 12 and 26 weeks. Conclusion A daily 50 mg dose of mirabegron for 12 weeks reduced OAB symptoms in men, and no significant adverse events compared to the placebo group were noted.

Purpose To identify the prevalence of detrusor overactivity with impaired contractility (DOIC) in the community-dwelling elderly and explore whether it is from a single or two independent bladder dysfunctions. Materials and Methods Based on a 10-year urodynamic database of the SEOUL Study Group, elderly patients who met inclusion criteria were selected. Bladder sensation, capacity, and compliance were designated as evaluation elements for storage function, and free maximal flow rate (Qmax) and post void residual volume, detrusor pressure at maximal flow (PdetQmax), and bladder voiding efficiency for voiding function. Results The prevalence rate of DOIC was 18.8% and 5.5% among 2,571 men and 688 women, respectively, and increased significantly with age. In men, patients with DOIC showed no differences in storage parameters and significantly lower free Qmax and PdetQmax among voiding parameters, compared to those with detrusor overactivity (DO) only. Compared to men with detrusor underactivity (DU) only, those with DOIC had worse parameters in the majority of storage and voiding functions. In women, most of the storage and voiding functions were worse in patients with DOIC than in those with DO only. On the other hand, women with DU showed lower PdetQmax and worse voiding functions than those with DOIC, although some parameters did not reach statistical significance. Conclusions It seems that DOIC is developed from a coincidental combination of two independent DO and DU in men. In contrast, DOIC is likely to be an intermediate step during the process of progression from DO to DU in women., Graphical Abstract

Aims This study aimed to investigate the efficacy and safety of mirabegron for Parkinsonism patients with overactive bladder (OAB) symptoms in a randomized, placebo-controlled, multicenter study. Materials and methods Inclusion criteria are Parkinsonism with OAB symptoms for 4 weeks or more, OAB symptom score (OABSS) questionnaire scores greater than 2, and OABSS urgency question scores greater than 1. After a 2-week wash-out period, the patients were randomized into placebo and mirabegron groups at visit 2. Visit 3 was performed after 4 weeks of medication. Mirabegron was prescribed to the two groups for the rest of the study period at visit 4. Result The mean age was 68.1 ± 8.1 years and 72 males and 64 females were included. A total of 136 patients were screened, 117 patients were randomized, and 25 patients dropped out. The OABSS scores were significantly different between the two groups at Weeks 4 and 8. The OABSS scores became the same in the two groups at Week 12 (visit 5). The postvoid residual urine volume showed a mild increase to 64 ml in the mirabegron group compared to the placebo group at visit 4. Adverse events occurred in 27 patients (23.1%). The degree was mild in 26 cases (78.8%), moderate in five (15.2%), and severe in two (6.1%). Only 13 cases (39.4%) showed medication-related adverse events. Acute urinary retention occurred in a single case. The treatment satisfaction questionnaires showed no significant differences between the two groups. Conclusion Mirabegron was effective in treating OAB symptoms in patients with Parkinsonism with acceptable adverse events.

Parkinson's disease (PD) is a multisystemic disorder characterized by various non-motor symptoms (NMS) in addition to motor dysfunction. NMS include sleep, ocular, olfactory, throat, cardiovascular, gastrointestinal, genitourinary, or musculoskeletal disorders. A range of NMS, particularly hyposmia, sleep disturbances, constipation, and depression, can even appear prior to the motor symptoms of PD. Because NMS can affect multiple organs and result in major disabilities, the recognition and multidisciplinary and collaborative management of NMS by physicians is essential for patients with PD. Therefore, the aim of this review article is to provide an overview of the organs that are affected by NMS in PD together with a brief review of pathophysiology and treatment options., Graphical Abstract

INTRODUCTION AND OBJECTIVE:We aimed to evaluate the prognostic value of seminal vesicle invasion (SVI) on preoperative multiparametric MRI (mpMRI) in pathological T3b prostate cancer (PCa).METHODS:...

Introduction:This study is to investigate the efficacy and safety of mirabegron for parkinsonism patients with overactive bladder (OAB) symptoms in a randomized, placebo-controlled, multicenter stu...

Clean intermittent catheterization (CIC) is one of the core elements of neurogenic bladder management in the patients with spinal cord injury and is effective and safe to maintain low intra-bladder pressure and achieve urinary continence. Until now, the most notable development in urinary catheter products for CIC is the introduction of hydrophilic coating. Fortunately, in Korea, the national medical insurance has recently covered the cost for urinary catheters in this patient group. The purpose of this review is to summarize the history of CIC and the recent development of urinary catheter products. From our review, we would like to suggest a way of thinking that is the way forward for the future to improve the implementation of CIC with minimal morbidity.

It has not been clearly proved in real practice whether early rehabilitation with phosphodiesterase type 5 inhibitors starting immediately after radical prostatectomy improves erectile function recovery more effectively than delayed treatment with the same regimen. We performed a prospective randomized trial to identify this.Patients with prostate cancer and an IIEF-5 (International Index of Erectile Function-5) preoperative score of 17 or greater were randomly assigned to receive sildenafil 100 mg regularly twice per week for 3 months immediately after urethral catheter removal as the early group or only 3 months after nerve sparing robot-assisted laparoscopic radical prostatectomy as the delayed group. The study primary end point was the full erectile function recovery rate, defined as an IIEF-5 score of 17 or greater, during the 12 months.Of the 120 randomized patients the proportion who achieved full recovery was significantly higher during the 12 months in the early group than in the delayed group (β = 0.356, p0.001, generalized estimating equation). After 9 months postoperatively the proportion of patients who achieved full recovery steadily increased to 41.4% at 12 months in the early group while patients in the delayed group showed no further improvement. Thus, full recovery was achieved in only 17.7% of patients at 12 months. Only early sildenafil treatment independently improved full recovery at 12 months (HR 2.943, p = 0.034).Our trial provides clinical data to suggest that earlier rehabilitation with phosphodiesterase type 5 inhibitors can contribute to the recovery of erectile function after radical prostatectomy in the clinical setting.

Purpose To compare the clinical efficacy of anticholinergics for managing diabetes mellitus-associated overactive bladder (DM OAB) versus idiopathic overactive bladder (OAB) in Korean women. Methods We conducted a multicenter, prospective, parallel-group, open-label, 12-week study. Women (20–65 years old) with OAB symptoms for over 3 months were assigned to the DM OAB and idiopathic OAB groups. Changes in the Overactive Bladder Symptom Score (OABSS), urgency, urinary urgency incontinence, nocturia, daytime frequency according to a voiding diary, uroflowmetry, and postvoid residual urine volume (PVR) at the first visit (V1), week 4 (V2), and week 12 (V3) were compared. Results No significant difference was found between the baseline patient characteristics of the DM OAB and idiopathic OAB groups. Treatment with solifenacin was associated with improvements in urgency, urinary urgency incontinence, nocturia, frequency according to a voiding diary, and the total OABSS between V1 and V2 and between V1 and V3. Moreover, a significant improvement in urgency and urge incontinence was found between V2 and V3 in the DM OAB group. However, no significant changes were found in any other parameters. There were no significant differences between the DM OAB group and the idiopathic OAB group except for urgency and urge incontinence at V2 (3.71 vs. 2.28 and 0.47 vs. 0.32, respectively). Conclusions The patients who received solifenacin demonstrated improved urgency, urinary urgency incontinence, nocturia, frequency according to a voiding diary, and total OABSS. Management with solifenacin was equally effective for both DM-related OAB and idiopathic OAB.

Parkinson's disease (PD) is the second most common neurodegenerative disorder. Although its major manifestation is motor symptoms, resulting from the loss of dopaminergic neurons in the substantia nigra, psychiatric symptoms, such as depression, anxiety, hallucination, delusion, apathy and anhedonia, impulsive and compulsive behaviors, and cognitive dysfunction, may also manifest in most patients with PD. Given that the quality of life — and the need for institutionalization — is so highly dependent on the psychiatric well-being of patients with PD, psychiatric symptoms are of high clinical significance. We reviewed the prevalence, risk factors, pathophysiology, and treatment of psychiatric symptoms to get a better understanding of PD for improved management., Graphical Abstract

Background The significance of focal positive margins (FPMs) after radical prostatectomy (RP) is unclear. Our objective was to investigate the prognostic value of FPMs in patients undergoing RP. Materials and Methods The data were analyzed retrospectively for 1733 patients with clinically localized prostate cancer who had undergone RP at our institution from December 2003 to March 2014 without neoadjuvant or adjuvant therapy. Positive surgical margins were characterized as FPMs (≤ 3 mm long) or non-FPMs (> 3 mm long). Multivariate analysis of the clinicopathologic factors, including FPMs, was performed with respect to biochemical recurrence (BCR)-free survival. Results Of the 1733 patients, 1260 (72.7%) had negative margins, 114 (6.6%) had a FPM, 218 (12.6%) had a nonfocal single positive margin (NFSPM), and 141 (8.1%) had nonfocal multiple positive margins (NFMPMs). Of the patients with pathologic T2 prostate cancer, 1065 (84.3%) had negative margins, 62 (4.9%) had 1 FPM, 104 (8.2%) had 1 NFSPM, and 33 (2.6%) had NFMPMs. The 5-year BCR-free survival for patients with negative margins and FPMs was 90% and 83.4%, respectively. On multivariate analysis, the presence of a FPM was not a significant prognostic factor for BCR-free survival in all the patients or in the patients with pathologic T2 disease (P = .458 and P = .512, respectively). Conclusions FPMs after RP do not significantly affect BCR-free survival in patients with prostate cancer.

Purpose We compared bladder and urethral functions following radical prostatectomy (RP) between men with and without urinary incontinence (UI), using a large-scale database from SNU-experts-of-urodynamics-leading (SEOUL) Study Group. Materials and Methods Since July 2004, we have prospectively collected data on urodynamics from 303 patients with lower urinary tract symptoms (LUTS) following RP at three affiliated hospitals of SEOUL Study Group. After excluding 35 patients with neurogenic abnormality, pelvic irradiation after surgery, or a history of surgery on the lower urinary tract, 268 men were evaluated. We compared the urodynamic findings between men who had LUTS with UI (postprostatectomy incontinence [PPI] group) and those who had LUTS without UI (non-PPI group). Results The mean age at an urodynamic study was 68.2 years. Overall, a reduced bladder compliance (≤20 mL/cmH2O) was shown in 27.2% of patients; and 31.3% patients had idiopathic detrusor overactivity. The patients in the PPI group were older (p=0.001) at an urodynamic study and had a lower maximum urethral closure pressure (MUCP) (p

We evaluated whether the prostate-specific antigen (PSA) mass or free PSA (fPSA) mass (i.e., absolute amount of total circulating PSA or fPSA protein, respectively), versus serum PSA or fPSA concentration, improves the accuracy of predicting the total prostate volume (TPV) in relation to obesity. Among men whose multicore (≥12) transrectal prostate biopsy was negative, 586 who had a PSA of ≤10 ng ml−1 and underwent the fPSA test prior to biopsy were enrolled. The PSA mass or fPSA mass (μ g) was calculated by multiplying the serum level by plasma volume. At each TPV cut-off point (30 ml, 40 ml, and 50 ml), the areas under the receiver operating characteristics curve (AUCs) of each variable were compared in obesity-based subgroups. AUCs of fPSA and fPSA mass for predicting TPV were significantly larger than those for PSA and PSA mass by 8.7%–12.1% at all cut-off points. Subgroup analyses based on obesity showed that, although PSA mass and fPSA mass enhanced accuracy by 4% (P = 0.031) and 1.8% (P = 0.003), respectively, for determining TPVs of ≥30 ml and ≥50 ml in obese and overweight men, they did not improve the accuracy in most other combinations of the degrees of obesity with TPV cut-off points. Thus, compared with serum PSA or fPSA, the absolute amount of PSA or fPSA protein mass improved the accuracy of predicting TPV in obese men very minimally and only for certain TPV cut-off points. Hence, these indicators may not provide clinically meaningful improvement in predicting TPV in obese men.

Jung Ki Jo,1 Sung Kyu Hong,2 Seok-Soo Byun,2 Sang Eun Lee,2 Seong Jin Jeong2 1Department of Urology, Hanyang University Seoul Hospital, Seoul, Korea; 2Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea Objective: The efficacy of additional cores from cancer-suspicious lesions by transrectal ultrasound (TRUS) for the detection of prostate cancer (PCa) was assessed. Materials and methods: Data were collected from 4144 men who underwent systematic 12-core biopsy with no cancer-suspicious lesions (Group A: 3256 cases) or 13- or more-core (systematic 12 core + additional cores) biopsy with cancer-suspicious lesions (Group B: 888 cases) on TRUS-guided biopsy. The effect of additional biopsy cores on the cancer detection rate was investigated. Results: PCa was detected in 1006 (30.9%) cases in Group A and 485 (54.6%) cases in Group B (p < 0.001). In 370/485 (76.3%) patients in Group B, cancer was detected from the additional cores from TRUS suspicious lesions. Logistic regression analysis showed that the number of biopsy cores was the most significant factor for cancer detection (hazards ratio: 2.6 [2.221–3.043], p < 0.001]. Additional core biopsies did not increase the detection rate of index tumors (p&nbsp

Detrusor underactivity (DU) or underactive bladder is a common cause of lower urinary tract symptoms (LUTS), but it is still poorly understood and underresearched. Although there has been a proposed definition by International Continence Society in 2002, no widely accepted diagnostic criteria have been established for this entity in clinical practice. Therefore, it has been rare to identify community-based researches on the epidemiology of DU until now. Only certain studies have reported the prevalence of DU in community-dwelling cohorts with significant LUTS using arbitrary urodynamic criteria for DU and these investigations have indicated that DU accounts for 25%-48% and 12%-24% of elderly men and women, respectively. However, these prevalence data based on the urodynamic definition apparently are limited in their extrapolation to the general population. Despite the clinical ambiguity of DU, its clinical effects on quality of life are quite significant, especially in the elderly population. An overall and proper comprehension of epidemiologic studies of DU may be crucial for better insight into DU, relevant decision making, and a more reasonable allocation of health resources. Therefore, researchers should find clues to the solution for the clinical diagnosis of this specific condition of LUTS from contemporary epidemiologic studies and try to develop a possible definition of 'clinical' DU from further studies.

Aims Progressive supranuclear palsy (PSP) can present urinary symptoms, similar to other parkinsonian disorders. We investigated the urodynamic parameters of PSP and compared them with those of idiopathic Parkinson's disease (IPD) and multiple system atrophy (MSA) METHODS: We retrospectively analyzed the urodynamic data in patients diagnosed with parkinsonian disorders (PSP, IPD, and MSA) presenting urinary symptoms. Clinical data, including onset age, duration, and severity, as well as treatment status of parkinsonian disorders and urinary symptoms were collected. Results A total of 131 patients (10 with PSP, 79 with IPD, and 42 with MSA) were included. The mean age and disease onset age of PSP patients were similar to those of IPD patients, but older than those of MSA patients. The disease duration until the onset of urinary symptoms in PSP patients was similar to that in MSA patients, but shorter than that in IPD patients. According to the urodynamic study, storage phase dysfunctions in PSP patients were similar to those in IPD or MSA patients. However, according to a pressure-flow study, PSP patients showed higher rates of voiding failure, as well as lower maximum flow rate, higher post-void residual volume, and higher proportions of impaired detrusor contraction than IPD patients, but rather similar to MSA patients. Conclusions Urinary dysfunctions in PSP patients were as extensive as those with MSA, and were more severe than those with IPD, especially in the voiding phase. This may reflect the extensive degenerative process of neural structure in PSP patients.

Purpose We evaluated whether preoperative erectile function is associated with pathologic features in the patients who underwent radical prostatectomy (RP). Materials and Methods We reviewed medical records of 1,743 men who underwent RP from November 2003 through May 2012. Of these, 50 patients who had prior hormone therapy and 272 patients who had lacking data of International Index of Erectile Function-5 (IIEF-5) were excluded. Men whose IIEF-5 was in the lower 25 percentile were assigned as Low Erectile Function group and the others were assigned as Control group. We compared pathologic features using univariable and multivariable logistic regression analysis between two groups. Results A total of 1,421 patients were included in the analysis. Patients’ age was 65.8 ± 6.7 years and prostate-specific antigen (PSA) was 12.8±16.1 ng/mL. Median and low 25 percentile of IIEF-5 were 14 and 8, respectively. Low Erectile Function group (IIEF-5

Introduction: To investigate differences in urodynamic parameters between two groups: Parkinson's disease (PD) and multiple system atrophy (MSA) patients. Methods: A retrospective study was performed in patients with PD and MSA who presented to three referral centers between 2005 and 2012. Patients referred to the urology department for lower urinary tract symptoms underwent urodynamic studies. Patients with other rare or ambiguous subtypes of PPS, urinary tract infection, urinary stones, or other neurogenic conditions were excluded from the analysis. Results: A total of 581 consecutive patients (359 men and 222 women) were analyzed. The mean patient age was 69.2 (SD, 9.3) years. Among these patients, 390 (64.3%) had PD, and 191 (31.5%) had MSA. Patients with MSA showed a statistically significantly decreased maximal flow rate and increased post-void residual urine volume compared with patients with PD (P range

Objective To provide detailed characteristics of asymptomatic microscopic hematuria, as well as to identify the significant predictors of detecting underlying diseases of asymptomatic microscopic hematuria, by evaluating a large Korean population. Methods We obtained data from healthy adults over the age of 20 years who underwent the health-screening program from 2005 to 2010 at Seoul National University Bundang Hospital, resulting in 56 632 participants included in the analysis. Patients who had microscopic hematuria (five red blood cells/high-power field) were referred to a urological outpatient clinic for further urological evaluation. An underlying disease of asymptomatic microscopic hematuria was predefined as a urinary stone, renal mass, urothelial cancer or other relevant lesions. Results At the initial urinalysis, 6.2% (3517/56 632) were diagnosed with asymptomatic microscopic hematuria. Of these, 1619 participants underwent repeat urinalysis within 1 year after screening, and 911 (56.3%) participants were detected with microscopic hematuria again. We identified 131 lesions (3.7%) as underlying diseases for asymptomatic microscopic hematuria, with urinary stone as the most common cause. Just six lesions were malignant: three renal cell carcinomas and three bladder cancers. Male sex and diabetes mellitus were significant predictors for detection of underlying diseases of asymptomatic microscopic hematuria. Conclusions Herein we report the largest screening case series of asymptomatic microscopic hematuria including approximately 60 000 asymptomatic participants studied at a single institution. These findings provide clinical practice information for the management of asymptomatic microscopic hematuria in adults.

Purpose: Differentiating significant cancer from insignificant cancer is a major challenge in active surveillance (AS) for prostate cancer. We evaluated whether the apparent diffusion coefficient (ADC) grade from 3-T diffusion-weighted magnetic resonance imaging (DW-MRI) is useful to exclude men with unfavorable pathological features from men meeting current AS eligibility criteria. Methods: Among patients who underwent radical prostatectomy, 117 potential AS candidates defined according to 2013 European Association of Urology guidelines who had undergone preoperative 3-T DW-MRI were included. A blinded uro-radiologist graded the level of suspicion from the ADC map using the Likert scale from 1 to 5. The rate of unfavorable pathological features was evaluated according to ADC grade. Unfavorable pathological features were defined as non–organ-confined disease or pathological Gleason score ≥ 7 (4+3). The associations between unfavorable pathological features and clinical variables including ADC grade ( > 3 vs. ≤ 3) were evaluated using logistic regression analysis. Results: The rates of unfavorable pathological features were 0.0% (0/14), 2.9% (1/34), 5.4% (2/37), 25.0% (6/24), and 37.5% (3/8) from grades 1 to 5 (P = 0.002). The predictive accuracy was as high as 0.804. The rates were significantly different between low ( ≤ 3, 3.5%) and high ( > 3, 28.1%, P < 0.001) grades. The sensitivity, specificity, and positive and negative predictive values were 75.0%, 78.1%, 28.1%, and 96.5%. ADC grade (odds ratio [OR], 10.696; 95% confidence interval [CI], 2.675–42.773) was significantly associated with unfavorable pathological features, even after adjusting for other variables (OR, 11.274; 95% CI, 2.622–48.471). Conclusions: ADC grade from 3-T DW-MRI is useful to predict men with unfavorable pathologic features from AS candidates.

Objectives To evaluate the efficacy of targeted therapy after complete resection of metastatic lesions in patients with metastatic renal cell carcinoma. Methods We retrospectively reviewed the medical records of 53 patients with metastatic renal cell carcinoma who underwent complete surgical resection of metastatic lesions between January 2006 and December 2012. Immediate postoperative targeted therapy was given to a subgroup of patients. Progression-free survival and cancer-specific survival were assessed. Results All patients underwent curative surgery for a primary tumor. A total of 13 patients (24.5%) had metastatic disease at initial diagnosis, and 49 (92.5%) had single-organ involvement at the time of first metastasis. None of the patients met the poor-risk criteria. Of the 19 patients who received immediate postoperative targeted therapy, five (26.3%) experienced relapse. Of the 34 patients who did not receive immediate postoperative targeted therapy, 27 (79.4%) experienced disease recurrence. Targeted therapy was restarted in 30 patients (93.8%) after relapse with excellent disease control rates (complete response: 3.3%, partial response: 36.7%, stable disease: 46.7%). Immediate postoperative targeted therapy was associated with better median progression-free survival (not reached vs 20.0 months; P = 0.017), but not better cancer-specific survival. Conclusions Postoperative targeted therapy after complete metastasectomy seems to be associated with better progression-free survival in patients with metastatic renal cell carcinoma, but not with cancer-specific survival.

Purpose To compare several contemporary urodynamic criteria for diagnosing detrusor underactivity (DU) and estimate how well they coincide with each other. Materials and methods From our prospective urodynamic database we identified nonneurogenic lower urinary tract symptoms (LUTS) patients older than 60 years between 2003 and 2014. Patients were reclassified based on four and three contemporary criteria for DU among men and women. Each criterion was compared with the others using the McNemar test. Results Urodynamic data of 4,372 patients (3,357 men and 1,015 women) were analyzed. In men, the prevalence of DU was estimated to be 56%, 17%, 5%, and 10% based on bladder contractility index, Abrams-Griffith number, maximal detrusor pressure at maximal flow rate (PdetQmax) 30, and bladder voiding efficiency (BVE) criteria. In women, 14.9%, 9.6%, and 6.4% of patients were classified as having DU based on maximal flow rate/postvoid residual (Qmax/PVR), PdetQmax 30, and BVE criteria. For individual subjects, all 4 criteria for men were significantly different from each other, while PdetQmax 30 and BVE criteria for women did not differ significantly (p=0.065). Additionally, BVE criterion for men and PdetQmax 30 and BVE criteria for women could distinguish the differences of patient age, free Qmax and free PVR between patient with and without DU. Conclusions Each urodynamic criterion for men does not coincide with each other in the diagnosis of DU within individual subjects. On the other hand, PdetQmax 30 criteria and BVE criteria for women could be appropriately applied to clinical practice when diagnosing DU in women with LUTS.

Purpose: To evaluate whether the risk of prostate cancer was different according to the pattern of fluctuation in prostate-specific antigen (PSA) levels in patients undergoing repeat transrectal ultrasound-guided prostate biopsy (TRUS-Bx). Methods: From March 2003 to December 2012, 492 patients underwent repeat TRUS-Bx. The patients were stratified into 3 groups based on the PSA fluctuation pattern: group 1 (continuous elevation of PSA, n=169), group 2 (PSA fluctuation with PSA velocity [PSAV]≥1.0 ng/mL/yr, n=123), and group 3 (PSA fluctuation with PSAV

Purpose: A major limitation of performing hemiablative focal therapy (FT) for prostate cancer (PCa) is the possibility of accompanying significant cancer in the contralateral side of the prostate that is missed on prostate biopsy. We attempted to verify whether clinical and biopsy-related parameters can be used to predict the absence of significant cancer in the prostate lobe. Methods: We assumed that hemiablative FT could be performed in patients with low-risk PCa, with unilateral tumors as assessed by transrectal ultrasound-guided biopsy. We evaluated 214 patients who had undergone radical prostatectomy (RP) and fulfilled the eligibility criteria. Seemingly preserved lobes, defined by the absence of cancer on biopsy, were classified as lobes with no cancer (LNC), lobes with insignificant cancer (LIC), and lobes with significant cancer (LSC) according to RP pathology. Cases with an estimated tumor volume of

Objective To investigate potential predictors of biochemical recurrence (BCR) in patients with localized prostate cancer with negative surgical resection margin (SRM). Materials and Methods Data from 582 consecutive patients diagnosed with localized prostate cancer with negative SRM who underwent only radical prostatectomy between November 2003 and April 2010 were reviewed. Pathologic prostate-specific antigen (PSA) mass ratio was defined as total circulating PSA protein per surgical prostate volume. Cox regression models tested the association between clinicopathologic variables and BCR-free survival. Results Mean age at surgery was 64.9 ± 6.9 years and mean PSA was 8.3 ± 4.4 ng/mL. The mean follow-up period was 40.7 ± 7.9 months. Pathologic stage was T2a in 113 of 582 patients (19.3%), T2b in 4 of 582 (0.7%), and T2c in 465 of 582 (79.9%). Surgical Gleason score was ≤6 in 215 of 582 patients (37.0%), 7 in 342 of 582 (58.8%), and ≥8 in 25 of 582 (4.3%). Mean pathologic prostate volume and pathologic PSA mass ratio were 42.4 ± 15.8 mL (14.6-176.0 mL) and 0.48 ± 0.37 μg/mL (0.03-2.62 μg/mL), respectively. Five-year BCR-free survival rate was 90.9%. PSA, surgical Gleason score, and pathologic PSA mass ratio were significantly associated with BCR-free survival in univariate analysis. In multivariate analysis, surgical Gleason score (P

Few studies have analyzed factors that influence longitudinal changes in patient-perceived satisfaction during the recovery period following robot-assisted radical prostatectomy (RARP) for prostate cancer. We investigated variables that were associated with patient-perceived satisfaction after RARP using the expanded prostate cancer index composite (EPIC) survey.Of 175 men who underwent RARP between 2010 and 2011, 140 men completed the EPIC questionnaire preoperatively and 3, 6 and 12 months postoperatively. On the basis of the EPIC question no. 32 (item number 80), patients were divided into four groups according to the pattern of satisfaction change at postoperative 3 and 12 months: satisfied to satisfied (group 1); satisfied to dissatisfied (group 2); dissatisfied to satisfied (group 3); and dissatisfied to dissatisfied (group 4). Longitudinal changes in EPIC scores over time in each group and differences in EPIC scores of each domain subscale between groups at each follow-up were analyzed. A linear mixed model with generalized estimating equation approach was used to identify independent factors that influence overall satisfaction among repeated measures from same patients.On the basis of the pattern of satisfaction change, groups 1, 2, 3 and 4 had 103 (74.3%), 21 (15.0%), 11 (7.9%) and 5 (2.9%) patients, respectively. The factor that was associated with overall satisfaction was urinary bother (UB) (β=0.283, 95% confidence interval (0.024, 0.543 ); P=0.033) adjusted for other factors under consideration.UB was the independent factor influencing patient-perceived satisfaction after RARP. During post-RARP follow-up, physician should have the optimal management for the patient's UB.

Few studies have been conducted on the serial evaluation of predictors for recovery of urinary continence (RC) after radical prostatectomy (RP) among same cohort. We developed and validated nomograms to predict immediate (≤1), early (≤3), and late (≤12 months) RC from a contemporary series and compared each nomogram with regard to the significance of predictors for RC. Among consecutive men who received robot-assisted or open retropubic RP between 2004 and 2011, 872 (74.7 %) and 296 (25.3 %) were randomly assigned to subcohorts for the development of nomograms and for the split-sample external validation. The final multivariate model was selected based on the stepwise procedure, and the regression coefficient-based nomograms were developed based on final models. Age at surgery, membranous urethral length (MUL), and robot-assisted RP were significant for RC at 1, 3, and 12 months. Saving the neurovascular bundle (NVB) and prostate volume were significant only for RC at 12 months. Odds ratios for age and MUL were constant over time, whereas the odds ratio for robot-assisted surgery decreased over time. Each developed nomogram was reasonably well fitted to the ideal line of the calibration plot. The split-sample external validation of nomograms indicated 63, 65, 71 % accuracy for each RC time point. We developed nomograms for RC at each time point after RP and validated adequately. Saving the NVB and prostate volume may affect only late RC after RP. In contrast, age, MUL, and robot-assisted surgery seem to be consistently associated with immediate, early, and late RC.

The Overactive Bladder Symptom Score (OABSS) is comprised of 4 items with a single total score for quantification of OAB symptoms and has been reported as sensitive to treatment-related changes. The aim of this study was to assess the psychometric properties of the Korean version in patients with OAB symptoms. Two prospective trials were conducted at two teaching hospitals. The Part I study evaluated the internal consistency and test–retest reliability among 42 enrolled patients, and the Part II trial assessed the construct validity and anticholinergic responsiveness in 50 enrolled patients and 50 controls. Internal consistency was found acceptable, with Cronbach’s α of 0.73 for total OABSS score. From a 2-week test–retest, Spearman’s rho of each item ranged from 0.53 to 0.82, and the intraclass correlation coefficient of the total score was 0.80, showing the high stability. Acceptable discriminant validity was demonstrated, with substantially different correlations of OABSS scores with an International Prostate Symptom Score-storage and voiding score sum, and significant differences between patients and controls. Convergent validity was acceptable, with moderate correlations between each OABSS item and the corresponding 3-day frequency–volume chart variables. The Korean version was found considerably responsive to symptom changes following 12-week solifenacin treatment, as judged by moderate or large effect sizes, standardized response means, and the Guyatt Responsiveness Index. With good psychometric properties and responsiveness, the Korean version of the OABSS may offer researchers and clinicians a valid and reliable measure for the assessment of OAB symptoms in the Korean population.

What's known on the subject? and What does the study add? As most urologist known, obesity significantly lowers serum PSA levels. So there is some concern about delayed diagnosis of prostate cancer in obese men. In the present study, we found that the accuracy level of PSA for detecting prostate cancer was not significantly different between different obesity levels. A well-designed study adjusting for several factors, e.g. diet, exercise, medication and comorbidity, which may possibly compensate for the associated effects on PSA levels, is needed for confirmation of the present findings. Objective To investigate prostate-specific antigen (PSA) accuracy in detecting prostate cancer according to body mass index (BMI) in Asian men with a PSA level of

To identify the perioperative and oncological impact of different intervals between biopsy and robot-assisted laparoscopic radical prostatectomy (RALP) for localized prostate cancer. All consecutive patients with localized prostate cancer who underwent RALP with primary curative intent in January 2008–July 2014 in a large tertiary hospital were enrolled in this retrospective cohort study. The patients were divided into groups according to whether the biopsy–RALP interval was ≤2, ≤4, ≤6, or >6 weeks. Estimated blood loss and operating room time were surrogates for surgical difficulty. Surgical margin status and continence at the 1 year were surrogates for surgical efficacy. Biochemical recurrence (BCR) was defined as two consecutive postoperative prostate serum antigen values of ≥0.2 ng/ml. Of the 1446 enrolled patients, the biopsy–RALP interval was ≤2, ≤4, ≤6, and >6 weeks in 145 (10 %), 728 (50.3 %), 1124 (77.7 %), and 322 (22.3 %) patients, respectively. The >6 week group had a significantly longer mean operation time than the ≤2, ≤4, and ≤6 week groups. The groups did not differ significantly in terms of estimated blood loss or surgical margin status. Kaplan–Meier analysis showed that interval did not significantly affect postoperative BCR-free survival. Multivariable Cox proportional hazards model analysis showed that interval duration was not an independent predictor of BCR (≤2 vs. >2 weeks, HR = 0.859, p = 0.474; ≤4 vs. >4 weeks, HR = 1.029, p = 0.842; ≤6 vs. >6 weeks, HR = 0.84, p = 0.368). Performing RALP within 2, 4, or 6 weeks of biopsy does not appear to adversely influence surgical difficulty or efficacy or oncological outcomes.

INTRODUCTION AND OBJECTIVES: Angiogenesis is known to play a major role in the pathogenesis of bladder cancer. Bosutinib is an orally bioavailable dual Src/Abl tyrosin kinase inhibitor (TKI). Nintedanib and vatalanib are TKI that inhibits the vascular endothelial growth factor receptor (VEGFR) and the platelet-derived growth factor receptor (PDGFR), has been demonstrated to exert anti-tumor effects. However, the molecular mechanisms underlying its effects on bladder cancer remain unknown. We examined anti-tumor effects of bosutinib, nintedanib, and vatalanib in human bladder cancer cells (T24, cisplatinresistant-T24R2). METHODS: Bladder cancer cells were treated with bosutinib, nintedanib, and vatalanib and cancer cell proliferation was determined using the cell counting kit-8 (CCK-8) assay and clonogenic assay. Cell cycle and apoptosis rate were measured by flow cytometry. Apoptosisand cell cycle-related protein expression was analyzed by Western blot assays. RESULTS: Bladder cancer cell proliferation and colony formation was significantly reduced by bosutinib and vatalanib treatment in a dose-dependent manner. Bosutinib, nintedanib, and vatalanib induced apoptosis and cell cycle arrest at G1 phase. Expression of apoptosis related proteins (caspase-3, -8, -9, PARP, cytochrome c, bad, and bax) was elevated by bosutinib, nintedanib, and vatalanib treatment. CONCLUSIONS: In conclusion, new TKI (bosutinib, nintedanib, and vatalanib) showed anticancer effect in bladder cancer cells through induce apoptosis and cell cycle arrest. These data suggest that bosutinib, nintedanib, and vatalanib may be a novel therapeutic approach in the bladder cancer.

Objectives: To evaluate the clinical prognosis of incontinence and to determine the predictors for further recovery of urinary continence in patients not achieving urinary continence within 1 year after radical prostatectomy. Methods: A total of 708 patients were evaluated regarding urinary continence status at 1 year after surgery from a prospectively maintained radical prostatectomy database. Of these, 73 (10.3%) did not recover urinary continence within 1 year after surgery. For these patients, incontinence status and the number of pads for urinary control were assessed serially. Results: In 708 patients, factors associated with the recovery of urinary continence within 1 year after radical prostatectomy were membranous urethral length, prostatic apex shape and patient age. Among 73 patients with urinary incontinence, 41 (56.2%) achieved urinary continence with a mean time of 15.4 months subsequent to the first year after radical prostatectomy (baseline). A younger age at surgery (P = 0.027) and one pad being required (vs≥2 pads) at baseline (P = 0.046) were identified as independent factors for achievement of urinary continence within a further 2 years. Only the number of pads was a significant factor for further recovery of urinary continence in the longer follow up (hazard ratio 0.36, P = 0.029). Conclusion: Compared with factors related to the prostate or membranous urethra, patient age and severity of incontinence at 1 year after radical prostatectomy are more strongly related to the recovery of urinary continence later than 1 year after surgery. These findings might help to decide whether a definite treatment is required for persistent incontinence beyond 1 year after radical prostatectomy.

Objectives: To develop and evaluate nomograms to predict the pathological stage of clinically localized prostate cancer after radical prostatectomy in Korean men. Methods: We reviewed the medical records of 2041 patients who had clinical stages T1c–T3a prostate cancer and were treated solely with radical prostatectomy at two hospitals. Logistic regressions were carried out to predict organ-confined disease, extraprostatic extension, seminal vesicle invasion, and lymph node metastasis using preoperative variables and resulting nomograms. Internal validations were assessed using the area under the receiver operating characteristic curve and calibration plot, and then external validations were carried out on 129 patients from another hospital. Head-to-head comparisons with 2007 Partin tables and Cancer of the Prostate Risk Assessment score were carried out using the area under the curve and decision curve analysis. Results: The significant predictors for organ-confined disease and extraprostatic extension were clinical stage, prostate-specific antigen, Gleason score and a percent positive core of biopsy. Significant predictors for seminal vesicle invasion were prostate-specific antigen, Gleason score and percent positive core, and those for lymph node metastasis were prostate-specific antigen and percent positive core. The area under the curve of established nomograms for organ-confined disease, extraprostatic extension, seminal vesicle invasion and lymph node metastasis were 0.809, 0.804, 0.889 and 0.838, respectively. The nomograms were well calibrated and externally validated. These nomograms showed significantly higher accuracies and net benefits than two Western tools in Korean men. Conclusion: This is the first study to have developed and fully validated nomograms to predict the pathological stage of prostate cancer in an Asian population. These nomograms might be more accurate and useful for Korean men than other predictive models developed using Western populations.

BACKGROUND To assess whether the severity of lower urinary tract symptoms (LUTS) is associated with the risk of prostate cancer (PCa) detection via a multi (≥12)-core prostate biopsy. METHODS From January 2004 to May 2011, 3,107 patients underwent transrectal ultrasound (TRUS) prostate biopsies due to elevated PSA levels ranging between 3 and 20 ng/ml or abnormal digital rectal exams (DREs). Multivariate logistic analysis was used to assess the potential association of LUTS and PCa detection via biopsy. The predictive accuracy of the multivariate model was assessed based on the receiver operating characteristics-derived area under the curve. RESULTS The median International Prostate Symptom Score (IPSS) was 11, and the mean PSA was 6.81 ng/ml. Of the total subjects, PCa was detected from biopsy in 931 (30.0%) patients. In a comparison of 1,465 patients with IPSS ≥11 and 1,642 patients with IPSS

Aims The significance of preoperative urodynamic studies in women with a “clinically-defined pure stress urinary incontinence (SUI) symptom” has been debated in recent years. We evaluated changes of reliability of pure SUI symptoms for prediction of pure urodynamic SUI (USUI) when the assessment of post-void residual (PVR) volume and a stress test, designated as the initial standard evaluation in the NICE and AUA guidelines, were added to the process for the diagnosis of pure SUI symptoms. Methods We reviewed records of 1,019 women aged 30–80 who underwent urodynamic study for incontinence. Criteria for pure SUI symptoms were defined as absence of overactive bladder symptoms and voiding difficulties based on a frequency–volume chart and AUA Symptom Index. We then added assessment of PVR volume and a stress test to the process for clinical diagnosis. Results Of subjects, 211 (20.7%) could be classified as having a pure SUI symptom. Of these, only 167 (79.1%) had pure USUI and 33 (15.7%) had detrusor overactivity. Eight (3.8%) had detrusor underactivity/bladder outlet obstruction. Sensitivity and specificity of pure SUI symptoms for pure USUI were 28.6% and 89.9%. Addition of assessment of PVR volume and a stress test resulted in an increase of predictive accuracy of only 3.6%. Conclusions As one-fifth of women with pure SUI symptoms exhibit the pathophysiologies that could affect the surgical outcomes despite additional use of PVR assessment and a stress test in the clinical diagnostic process, urodynamic evaluation is considered necessary before anti-incontinence surgery in this population. Neurourol. Urodynam. 31:508–512, 2012. © 2012 Wiley Periodicals, Inc.

To investigate the impact of preoperative anemia (PA) on oncologic outcomes among patients who underwent radical cystectomy (RC) for bladder cancer. We reviewed the records of 200 patients undergoing RC between October 2003 and December 2014. Patients were categorized according to PA status. We performed multivariable Cox regression analyses to assess the impact of PA on oncological outcomes. Among 200 patients, 81 patients (40.5 %) had PA according to definition of the WHO classification. Fifty-two (26 %) of 200, 12 (6 %) of 200 and 61 (30.5 %) of 200 patients experienced the disease recurrence (DR), cancer-specific mortality (CSM) and all-cause mortality (ACM), respectively. In Kaplan–Meier analysis, the non-PA group showed a significantly higher 5-year DR-free survival than PA group (log-rank test: p = 0.018). The non-PA group showed a similar pattern of CSM and ACM (p = 0.004 and p = 0.037, respectively). In multivariable Cox proportional hazards analysis, PA was significantly associated with DR (HR 1.86, 95 % CI, p = 0.04) and ACM (HR 2.13, 95 % CI, p = 0.006) after adjusting other factors. The preoperative anemic bladder cancer patients who underwent RC had worse oncological outcomes than non-anemic bladder cancer patients.

We investigated the prognostic significance of percentage of tumour involvement (PTI) according to the clinicopathological features of prostate cancer among patients who underwent radical prostatectomy (RP). A retrospective study of 534 patients who underwent RP between September 2003 and March 2008 without any neoadjuvant or adjuvant therapy was performed. The associations of PTI with various clinicopathological features and biochemical recurrence-free survival were examined via uni- and multivariate analyses. The predictive accuracy of the multivariate model was assessed with a receiver operating characteristics-derived area under the curve. PTI was demonstrated to be significantly associated with preoperative prostate-specific antigen (PSA) level (P=0.001), pathological Gleason score (P

PURPOSE The overactive bladder symptom score (OABSS) consists of 4 questions regarding OAB symptoms. The aim of this study was to develop Korean version of the OABSS from the original Japanese version, with subsequent linguistic validation. METHODS Between February and May 2008, the translation and linguistic validation process was performed as follows: a forward translation, reconciliation, backward translation, cognitive debriefing, and final proofreading. RESULTS A forward translation from the original version of the OABSS to the Korean language was carried out by 2 native Korean speakers, who were also fluent in Japanese. Reconciliation was made after review of both translations by a panel consisting of both translators and one of the authors. Another bilingual translator who had never seen the original version of the OABSS carried out a translation of the reconciled version back into Japanese, and the original and backward-translated versions were subsequently compared. After discussion of all discrepancies between both versions by the panel, a second Korean version was produced. During cognitive debriefing, 5 outpatients with OAB reported that each question of the Korean version was significant and appropriate for their symptoms. However, 2 patients said that some parts of the questions or instructions were not clear or were not easy to understand. According to the cognitive debriefing, some words and phrases were revised into more understandable expressions. CONCLUSIONS A Korean version of the OABSS was developed and linguistic validation was performed. Further studies are needed to assess the reproducibility and validity of the questionnaire in Korean populations.