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Edward D Kim

Publications and source records attributed to Edward D Kim.

8 recordsLinked to original sources

The use of baseline clinical measures to predict those at risk for progression of benign prostatic hyperplasia.

Although histologic changes of benign prostatic hyperplasia (BPH) begin in men when they are in their thirties, symptomatic BPH characterized by lower urinary tract symptoms (LUTS) typically do not develop for several decades. Progression of BPH may lead to significant voiding symptoms, acute urinary retention, and the need for prostate surgery. However, developing LUTS is not inevitable for men with histologic evidence of BPH. The ability to predict those men who are at risk for BPH progression is increasingly important because of recent evidence provided by the Medical Therapy of Prostate Symptoms study. This landmark study demonstrated that 5alpha-reductase inhibitors, alone or in combination with selective alpha-blockers, can delay or prevent the progression of BPH. In addition, the most important and consistent predictive factors for BPH progression are baseline prostate-specific antigen and prostate volume. Integration of these clinical parameters into clinical practice is influencing the decision regarding which men should observe or initiate treatment. This article highlights recent studies regarding the use of baseline clinical parameters on predicting BPH progression.

5-alpha Reductase Inhibitors↗

Seminal vesicle cyst presenting as rectal obstruction.

We report an unusual case of a pelvic mass arising from the seminal vesicle. A 45-year-old man presented with difficulty voiding and difficult bowel movements. Computed tomography demonstrated a large 14 x 10 x 15-cm cystic pelvic mass displacing the bladder anteriorly and the rectum posteriorly. Magnetic resonance imaging confirmed that this lesion appeared to be originating from the right seminal vesicle. On surgical exploration of the abdomen, a large cystic lesion in the posterior retroperitoneum was identified and removed. The patient improved, with restoration of normal bowel function.

Adult↗

Subjective and objective analysis of the prevalence of Peyronie's disease in a population of men presenting for prostate cancer screening.

PURPOSE: In this study we defined the prevalence of Peyronie's disease in a cohort of men being screened for prostate cancer in the United States. The association between Peyronie's disease, and medical comorbidities and patient self-reported erectile dysfunction was also defined. MATERIALS AND METHODS: A total of 534 men presenting to 1 of 3 prostate cancer screening centers provided a complete medical history, underwent physical examination performed in all by a urologist and completed the Sexual Health Inventory for Men (SHIM) questionnaire. This population was chosen because of the access to a large number of subjects combined with the fact that subjects were not presenting with a specific urological complaint. The diagnosis of Peyronie's disease was based on a palpable penile plaque. Data were assessed using univariate analysis, multivariate logistic regression and Pearson chi-square analysis. RESULTS: A total of 48 patients were found to have a palpable penile plaque on physical examination for a prevalence rate of 8.9%. The mean age of men with Peyronie's disease was 68.2 years compared to a mean of 61.8 years in men without Peyronie's disease (p <0.0001). On univariate analysis hypertension (p = 0.02) and diabetes (p = 0.007) were present with significantly increased frequency in patients with Peyronie's disease. Patients diagnosed with Peyronie's disease had significantly lower values for responses to each of the 5 questions on the SHIM survey. An increase in age and decrease in total SHIM score remained significantly associated with a greater probability of Peyronie's disease on multivariate analysis. CONCLUSIONS: We found the prevalence of Peyronie's disease to be greater than in most previously reported series. We also noted a significant association between Peyronie's disease aging, hypertension, diabetes and self-reported erectile dysfunction.

Adult↗

Ethanol injection for the treatment of benign prostatic hyperplasia.

Recent studies examining the benefit of prostatic ethanol injection for symptomatic benign prostatic hyperplasia (BPH) have demonstrated significant postsurgical improvements (after 1 to 3 months) in BPH parameters such as symptom score, flow rate, and postvoid residual. Transperineal and transurethral injection routes have been reported to be safe and well-tolerated in men. Animal and human studies demonstrate that this treatment has a direct necrotic effect on prostatic tissue with negligible systemic absorption. Although this technique demonstrates promise as a minimally invasive treatment for BPH, further study of a large series of men is clearly required to define its benefit.

Animals↗

Treatment of a complete lower urinary tract obstruction secondary to an expandable foam sealant.

We present a unique case of an iatrogenic complete lower urinary tract obstruction with an expandable foam sealant. A 41-year-old man presented in urinary retention 36 hours after self-injecting his urethra with the foam sealant, which could be palpated throughout his entire urethra. The sealant was removed from the distal urethra in numerous fragments with a hemostat and cystoscopically. A perfect mold of the bladder and prostatic urethra were removed by suprapubic cystotomy. Cystoscopy 2 months later demonstrated a mild bulbar urethral stricture, but normal bladder mucosa. The cystoscopy at 6 months was normal.

Adult↗

Apoptosis: its importance in spermatogenic dysfunction.

Apoptosis, spontaneous programmed cell death, has recently generated great interest in several areas of investigation, including infertility. Selective sperm cell death also seems to be a component of normal spermatogenesis. A better understanding of this process may lead to the development of new strategies to treat intrinsic testicular failure.

Apoptosis↗