급성 요폐 및 하부요로증상의 소양인(少陽人) 육미지황탕가감방(六味地黃湯加減方) 치험 1례

조승완,오지연,김원영,임은철,이여경,홍승효,김동영,Jo, Seung-Wan,Oh, Ji-Yeon,Kim, Won-Young,Lim, Eun-Chul,Lee, Yeo-Gyeong,Hong, Seung-Hyo,Kim, Dong-Young 사상체질의학회 2020 사상체질의학회지 Vol.32 No.2

We report 1 case about Yukmijihwang-tanggagambang that was considered by Sasang constitution that was used for an elderly Soyangin patient with acute urinary retention, lower urinary tract symptoms and other symptoms. We treated an elderly Soyangin patient who suffered from acute urinary retention, lower urinary tract symptoms and other symptoms, who had history of benign prostatic hyperplasia. We considered his Sasang constitution and prescribed Yukmijihwnag-tanggagambang mainly. The improvement of his symptoms were evaluated by presence of symptoms, times of urination and visual analogue scale. After treatment that was been Yukmijihwang-tanggagambang mainly, patient's symptoms were disappeared or improved. And there was not any adverse effect. This study shows that using Yukmijihwang-tanggagambang that was considered by Sasang constitution can be effective treatment for an elderly Soyangin patient's acute urinary retention, lower urinary tract symptoms and other symptoms.

뇌병변 환자에서 배뇨 장애가 삶의 질에 미치는 영향-다기관 전향적 역학적 연구-

조강희,이혜진,지성주,최은석,이호,이기훈,복수경,박노경,황선홍 대한재활의학회 2010 Annals of Rehabilitation Medicine Vol.34 No.2

Objective: To asses the prevalence of urinary difficulty and the relationship of urinary difficulty and type of brain lesion from multicenter prospective epidemiologic study. Method: 394 patients including outpatients and inpatients who visited from multicenter department of rehabilitation medicine from January 2008 to June 2008 were evaluated. Study based on international prostate symptom score (IPSS) and Quality of life (QoL) score were assessed, and the correlation between the two indexes was analyzed. Results: 140 patients (35.5%) complained urinary difficulty as patient's main symptom, while IPSS score was 13.7 showing above moderate symptom at 77.5%. For patients complained urinary difficulty, the average of quality of life score was 3.1. Among stroke, 37% of infarction and 34% of hemorrhage complained urinary difficulty while 40% of traumatic brain injury did. Patients with ACA infarction reported urinary difficulty most frequently. Nocturia (71%), frequency (53.3%), incomplete emptying (30%) were the most frequent symptoms. Sixty-six patients (46%) complaining urinary difficulty were taking medications and anticholinergics were most widely used (75%). Scores of IPSS and QoL according to type and site of brain lesion didn’t show meaningful difference while QoL score correlated significantly with IPSS score (p<0.05). Conclusion: Among all the brain lesion patients, 35.5% complained urinary difficulty while IPSS and QoL score according to type and site of brain lesion didn’t show meaningful difference. Urinary difficulty affects the life quality of brain lesion patients. (J Korean Acad Rehab Med 2010; 34: 115-119) Objective: To asses the prevalence of urinary difficulty and the relationship of urinary difficulty and type of brain lesion from multicenter prospective epidemiologic study. Method: 394 patients including outpatients and inpatients who visited from multicenter department of rehabilitation medicine from January 2008 to June 2008 were evaluated. Study based on international prostate symptom score (IPSS) and Quality of life (QoL) score were assessed, and the correlation between the two indexes was analyzed. Results: 140 patients (35.5%) complained urinary difficulty as patient's main symptom, while IPSS score was 13.7 showing above moderate symptom at 77.5%. For patients complained urinary difficulty, the average of quality of life score was 3.1. Among stroke, 37% of infarction and 34% of hemorrhage complained urinary difficulty while 40% of traumatic brain injury did. Patients with ACA infarction reported urinary difficulty most frequently. Nocturia (71%), frequency (53.3%), incomplete emptying (30%) were the most frequent symptoms. Sixty-six patients (46%) complaining urinary difficulty were taking medications and anticholinergics were most widely used (75%). Scores of IPSS and QoL according to type and site of brain lesion didn’t show meaningful difference while QoL score correlated significantly with IPSS score (p<0.05). Conclusion: Among all the brain lesion patients, 35.5% complained urinary difficulty while IPSS and QoL score according to type and site of brain lesion didn’t show meaningful difference. Urinary difficulty affects the life quality of brain lesion patients. (J Korean Acad Rehab Med 2010; 34: 115-119)

한국 농촌 지역 여성에 있어서 복압성요실금과 방광 자극 증상에 관한 역학 조사

주명수,정태규,이재원,김홍식,정상욱,박종연,박태한 大韓泌尿器科學會 1999 Korean Journal of Urology Vol.40 No.9

남성 뇌졸중 환자의 배뇨증상과 요정체 및 삶의 질

황은숙 중앙대학교 의과대학 간호학과 간호과학연구소 2011 중앙간호논문집 Vol.15 No.-

This study was done to examine the relationship beetween urinary symptom, urinary retention and quality of life in male patients hospitalized due to stroke. A cross-sectional descriptive correlational study was conducted in the C university hospital. Data were collected between April 1 and July 30, 2008 from 91 male stroke patients. the questionnaire included general items as well as items related to disease characteristics, a quality of life scale (Stroke-Specific Quality of Life, SS-QOL), and the international prostate symptom score (IPSS) for voiding symptoms. Urinary retention was measured using portable ultrasound scanning (CUBE scan, Biocon-500l 371458). The average age of the participants was 60.6 years old. Of the 91 participants, 75.9% had experienced their first stroke and 56% were diagnosed as having suffered cerebral infarction. Most of the participants (67%) were paralyzed on either one or both sides. The mean scores for the quality of life and urinary symptoms were 2.85±.85 and 14.71, respectively. Urinary urgency and nocturia were the most common symptoms. 67.1% of participants had moderate or severe urinary symptoms and 28.6% had urinary retention. Quality of life was negatively correlated with urinary symptom (r=-.870, p=.000_ and urinary retention (r=-.759, p=.000) and urinary retention (r=-.759, p=.000). Urinary symptom was positively correlated with urinary retention (r=.745, p=.000). The findings suggest that the efforts of nurses to recognize and manage the urinary symptoms and urinary retention of patients as early as possible will promote a better quality of life in hospitalized stroke patients.

지역사회 성인남성에서의 하부요로증상 및 전립선비대증 의료이용과 사회경제적 요인의 관련성

김한해,공경애,이훈재,윤하나,이보은,문옥륜,박혜숙,Kim, Han-Hae,Kong, Kyoung-Ae,Lee, Hun-Jae,Yoon, Ha-Na,Lee, Bo-Eun,Moon, Ok-Ryun,Park, Hye-Sook 대한예방의학회 2006 예방의학회지 Vol.39 No.2

Objectives : We wanted to evaluate the medical underutilization for benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) among Korean elderly men and we wanted to determine their associated factors. Methods : This study was conducted on 239 men with LUTS and 116 men with BPH who were compatible with the diagnostic criteria from a total of 641 participants. These participants were over 50 years old and they were randomly chosen in a community-based study for estimating the prevalence of BPH. Using a self-reported questionnaire, we surveyed the sociodemographics, health status, quality of life, lower urinary tract symptoms, medical utilization and reasons for not seeking treatment. Results : Only 27.6% of the men with LUTS and 31.0% of the men with BPH reported having visited a doctor for urinary symptoms. The reasons for not visiting a doctor were, in order of responses from the group with LUTS: 'considered the symptoms as a part of the normal ageing process', 'not enough time to visit a doctor', 'financial difficulty' and 'the symptoms were not severe or bothersome'. Regarding BPH, the responses were the same as those of the group with LUTS however, 'financial difficulty' placed second. Among the men with experience of visiting a doctor for urinary symptoms, 33.3% of those with LUTS and 28.1% of those with BPH were not treated. The most common reason in both groups was 'the symptoms were not severe to be treated'. On a multiple logistic regression analysis, the larger size household (odds ratio (OR) 3.03, 95% confidence interval (CI)=1.40-6.54) and an unsatisfactory quality of life related with urinary symptoms (OR 2.98, 95% CI=1.23-7.21) were associated with medical utilization in the group of LUTS. For BPH, the current employment status was related with the medical utilization (OR 2.80, 95% CI=1.10-7.11), in addition to the larger size household (OR 3.24, 95% CI=1.14-9.21). Conclusions : Many men with urinary symptoms do not visit a doctor. This medical underutilization for people with LUTS and BPH may be associated with economic status in Korea.

근치적 전립선절제술 후 배뇨증상의 변화: 초기 연구

최향식,임창민,김선옥,김명기,권동득,류수방 대한비뇨의학회 2008 Investigative and Clinical Urology Vol.49 No.8

Purpose: The primary objective of this study was to evaluate the impact of radical retropubic prostatectomy(RRP) on lower urinary tract symptoms(LUTS) in patients with clinically localized prostate cancer. Materials and Methods: Between 2000 and 2006, 82 men with clinically localized prostate cancer underwent RRP. The International Prostate Symptom Score(IPSS) and the IPSS quality of life(QoL) score, and uroflowmetry were administered both prior to and 1 year after RRP. Results: The overall mean total IPSS, maximal flow rate, and postvoid residual volume did not change over time after RRP. Prior to and after RRP, the mean maximal flow rate and residual urine changed from 17.6ml/sec to 17.9ml/sec(p=0.566) and 16.9ml to 15.8ml(p=0.777), respectively. Total IPSS also changed after RRP, from 12.8 to 12.5(p=0.731). The reduction of the IPSS was more prominent in patients with severe symptoms(IPSS≥20), whereas in those with moderate symptoms(8≤IPSS<20), the score did not change significantly after RRP. Furthermore, in those patients with no or mild symptoms(IPSS<8), the score increased after RRP. Conclusions: RRP was not shown to improve uroflowmetric parameters, including maximal flow rate, postvoid residual urine, and IPSS, in cases of moderate LUTS. However, RRP may exert a beneficial effect in those patients with severe LUTS, and may also have adverse effects on some individuals with no or mild symptoms. We believe that these results might be utilized when counseling patients about treatment options for localized prostate cancer. Purpose: The primary objective of this study was to evaluate the impact of radical retropubic prostatectomy(RRP) on lower urinary tract symptoms(LUTS) in patients with clinically localized prostate cancer. Materials and Methods: Between 2000 and 2006, 82 men with clinically localized prostate cancer underwent RRP. The International Prostate Symptom Score(IPSS) and the IPSS quality of life(QoL) score, and uroflowmetry were administered both prior to and 1 year after RRP. Results: The overall mean total IPSS, maximal flow rate, and postvoid residual volume did not change over time after RRP. Prior to and after RRP, the mean maximal flow rate and residual urine changed from 17.6ml/sec to 17.9ml/sec(p=0.566) and 16.9ml to 15.8ml(p=0.777), respectively. Total IPSS also changed after RRP, from 12.8 to 12.5(p=0.731). The reduction of the IPSS was more prominent in patients with severe symptoms(IPSS≥20), whereas in those with moderate symptoms(8≤IPSS<20), the score did not change significantly after RRP. Furthermore, in those patients with no or mild symptoms(IPSS<8), the score increased after RRP. Conclusions: RRP was not shown to improve uroflowmetric parameters, including maximal flow rate, postvoid residual urine, and IPSS, in cases of moderate LUTS. However, RRP may exert a beneficial effect in those patients with severe LUTS, and may also have adverse effects on some individuals with no or mild symptoms. We believe that these results might be utilized when counseling patients about treatment options for localized prostate cancer.

The Urinary Tract Microbiome in Male Genitourinary Diseases: Focusing on Benign Prostate Hyperplasia and Lower Urinary Tract Symptoms

김명수,정승일 대한배뇨장애요실금학회 2021 International Neurourology Journal Vol.25 No.1

The human body is sterile during gestation; however, but during and after birth, the entire body surface becomes host to an enormous variety of microorganisms. Urine in the urinary tract was once considered sterile based on the lack of cultured microorganisms. Many recent studies have revealed evidence of microorganisms in human urine in the absence of clinical infection. Sequencing methods and analytical techniques are rapidly evolving to improve the ability to detect bacterial DNA and living bacteria and to understand the microbiota of the urinary tract. In women, fascinating evidence associates urinary tract microbiota with lower urinary tract symptoms. However, in men, the relevance of urinary tract microbiota in low urinary tract symptoms and prostate disease has not been established. In this review, we highlight a recent study that increases our ability to understand the urinary tract microbiota in men with lower urinary tract symptoms.

The prevalence of lower urinary tract symptoms in population aged 40 years or over, in South Korea

유탁근,이규성,Budiwan Sumarsono,김성태,김현정,이현철,김수화 대한비뇨의학회 2018 Investigative and Clinical Urology Vol.59 No.3

Purpose: Lower urinary tract symptoms (LUTS) can be distressing and socially isolating, and the economic impact can be substantial. Further data to characterize the epidemiology and effects of LUTS in South Korea would be beneficial. Materials and Methods: In an international, internet-based survey, the prevalence and impact of LUTS was evaluated in adults aged ≥40 years. Questions related to International Continence Society (ICS) symptom definitions and the bother associated with each symptom. The international prostate symptom score (IPSS) and the overactive bladder symptom score (OABSS) were assessed. Results: Of the 2,080 participants from South Korea, 1,090 (52.4%) were women and 740 (35.6%) were aged ≥60 years. The prevalence of LUTS according to ICS criteria was 68.2% (men, 70.6%; women, 66.0%). LUTS prevalence increased significantly with age (p=0.01 in men and women). Storage symptoms only were reported in 16.2% of men and 30.5% of women, making this the most common ICS symptom group overall. Individual symptoms with the highest prevalence in the overall population were nocturia, frequency, and weak stream (36%, 30%, and 29%, respectively). IPSS results showed that 40.1% of participants had at least moderate symptoms. The prevalence of OABSS-defined overactive bladder was 19.7% (men, 19.5%; women, 19.9%). Fourteen percent of individuals with any LUTS visited healthcare professionals regarding urinary symptoms. Conclusions: LUTS affect the majority of adults aged ≥40 years in South Korea. The low percentage of individuals with LUTS consulting healthcare professionals regarding urinary symptoms indicates a need to improve rates of diagnosis and treatment.

하부요로증상을 가진 남성 환자에서 요내 신경성장인자 및 전환성장인자 베타 1의 변화

김준철,전수분,김두배,이홍우,박용현,황태곤 大韓泌尿器科學會 2002 Korean Journal of Urology Vol.43 No.7

Men With Severe Lower Urinary Tract Symptoms Are at Increased Risk of Depression

정원식,최홍용,남지원,김신아,최보율,문홍상,김규식 대한배뇨장애요실금학회 2015 International Neurourology Journal Vol.19 No.4

Purpose: Lower urinary tract symptoms (LUTS) comprise a set of common, bothersome symptoms in middle-aged and elderly men. Recent research suggests that depressive symptoms may influence the symptoms of benign prostatic hyperplasia (BPH). We performed a community-based cross-sectional study to evaluate the correlation between LUTS and depression. Methods: The survey was conducted in a rural community during four periods in August 2009, 2010, 2011, and 2012. Two validated questionnaires were used to examine LUTS and depressive symptoms. These included the International Prostate Symptom Score/quality of life (IPSS/QoL) and the Korean version of the Center for Epidemiological Studies-Depression scale (CES-D-K). Patients were categorized in the depressive symptom group if their CES-D-K score was >16 points. Results: A total of 711 men were included in this study. Thirty-five participants (4.92%) were found to have depressive symptoms. There was a positive correlation between depressive symptoms and LUTS severity (P<0.001). As compared to the mild LUTS group, the odds ratio (OR) of depression was 2.868 (95% confidence interval [CI], 1.293–6.362; P for trend<0.001) in the moderate LUTS group, and 4.133 (95% CI, 1.510–11.313; P for trend<0.001) in the severe LUTS group. In a model considering multiple variables such as age, education level, smoking, and exercise, the OR in the moderate LUTS group was 2.534 (1.125–5.708, 95% CI, P for trend=0.005), while that in the severe LUTS group was 3.910 (95% CI, 5.708–11.154; P for trend=0.005). In addition, depression was related to voiding symptoms. Conclusions: Men with severe LUTS are at higher risk of depression than those with less severe urinary symptoms. The severity of voiding symptoms worsens depression. More aggressive urological diagnosis and treatment is needed in patients with severe LUTS, due to the impact on depressive symptoms and QoL.