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Hsiao-Jen Chung

Publications and source records attributed to Hsiao-Jen Chung.

10 recordsLinked to original sources

Lymphangioma of male exogenital organs.

Lymphangioma manifesting in the genitourinary tract is an uncommon disease. Cystic lymphangioma is a congenital lymphatic hamartoma known as lymphatic malformation. Herein we report 2 cases of lymphangioma of male exogenital organs. After complete excision of the tumor and subsequent follow-up for 6 months, both of them were free of recurrence. Ultrasonography and computed tomography scans are very useful in the differential diagnosis of this cystic disease.

Adult↗

Upper quadrant access for urologic laparoscopy.

Initial access into the peritoneum and establishing pneumoperitoneum are required for laparoscopy. Various techniques have been described to achieve insufflation and place trocars. We describe our method of initial entry into the upper quadrant and subsequent incorporation of this site as a working port during upper urinary tract laparoscopy. This is an easy and safe means of entering the peritoneum, even after prior surgery, and provides a functional trocar for retraction and dissection.

Humans↗

Chyluria--experience of Taipei Veterans General Hospital.

BACKGROUND: Chyluria is caused by rupturing of lymphatic varices into the pyelocaliceal system. Although Chyluria is rare in western countries, it is not uncommon in Asia. We would like to present the experience of diagnosis, evaluation and treatment of chyluria in Taipei Veterans General Hospital. METHODS: From 1973 to 1999, a total of 30 patients with chyluria were reviewed. All had the chief complaint of milky white urine passage. They were investigated by multiple workup modalities including computed tomography, intravenous urography, lymphangiography, and cystoscopy. Fifteen cases received 1% silver nitrate instillation and 4 cases underwent nephrolysis either as primary or salvage treatment. RESULTS: Lymphangiography was performed in 24 of the 30 cases and responsible causes of chyluria were noted in 21. They were followed up for at least 12 months in 9 patients treated by intrarenal pelvic instillation of silver nitrate and 3 by nephrolysis, respectively. Recurrence was found in 1 patient (11.1%) receiving silver nitrate only and no significant adverse effect was noted. CONCLUSIONS: Lymphangiography is the most powerful diagnostic tool. Intrarenal silver nitrate instillation is a safe and effective management of chyluria.

Adult↗

Long-term efficacy and safety of sildenafil for patients with erectile dysfunction.

BACKGROUND: To investigate the long-term efficacy and safety of sildenafil for patients with erectile dysfunction (ED). METHODS: Between March 1999 and February 2001, a total of 3168 patients visited Taipei Veterans General Hospital for prescription of sildenafil. The follow-up period was 1-3 years. A questionnaire was designed for evaluation of efficacy and safety of sildenafil via telephone survey. RESULTS: Of the 3168 patients, 1414 were interviewed by telephone. Data from telephone questionnaires were successfully obtained in 1074 cases. Achievement of the first penile erection after sildenafil was reported in 58.8% of our patients. The distribution of the first doses was 0.6%, 8.5%, 81.9% and 90% for 12.5 mg, 25 mg, 50 mg and 100 mg, respectively. After administration of sildenafil, 72.1% men had successful intercourses "sometimes" or "always achieving vaginal penetration", and 72.3% had "slight difficulty" or "no difficulty" in maintaining of sexual intercourses. The "sometimes/most times/always" satisfaction accounted 63.9% and 62.8%, respectively for patients and partners. The global assessment of penile erection was improved in 58.6% of the patients. The sexual confidence of the patients was moderate, high and very high in 72.4% of the patients. Of the 434 patients who failed first penile erections, 400 (92.2%) were related to improper administration of sildenafil. Discontinuation of sildenafil in the last 3 months before telephone survey was found in 852 patients (80.2%). The causes of discontinuation were loss of efficacy in 51.6% of patients, lack of sexual desire in 8.8%, and chronic diseases in 8.2%. Spontaneous erection without sildenafil was claimed in 21.5% of the patients (most times in 9.5% and always in 12.0%). The rate of adverse events after taking sildenafil were 16.6%, and the most common adverse event was facial flushing (9.2%). CONCLUSIONS: The results of this study demonstrated that the efficacy of sildenafil was similar to the previous clinical trials. The adverse events after sildenafil were mild and tolerable. Recovery of complete or partial spontaneous erection was noted in some patients (21.5% in our study) after long-term usage of sildenafil.

Adult↗

Experience of surgical treatment of peyronie's disease with deep dorsal venous patch graft in Taiwanese men.

BACKGROUND: Using venous graft to repair the defect of tunica cavernosal plaque incision has been a mainstay of surgical intervention for Peyronie's disease. The greater saphenous vein is generally believed to be the graft of choice. However, the increased discomfort as well as the chance of morbidity in harvesting saphenous vein is occasionally reported. The other alternative for donor vein graft is from the deep dorsal vein of the penis. The major concern in using the deep dorsal vein is its lack of thickness and its limitation in the size to cover the defect. This study is to assess the feasibility of the deep dorsal vein graft in repairing the defect after plaque incision for Peyronie's disease in Taiwanese men. METHODS: Twenty-four men of Peyronie's disease were included from 1992 to 2001 in our institution. The mean age was 56.3 years (range 51-70). All patients underwent tunica plaque incision and deep dorsal vein patch grafting. The mean followup was 2.6 years (range 1-8). Penile straightness, potency status and possible complications after this procedure were evaluated during the followup. RESULTS: The location of the plaque(s) was at left lateral penile shaft for 10 patients, right lateral for 6, ventral for 5 and dorsal for 3. The mean curvature angle was 45 degrees (range 35 degrees - 75 degrees). The penis became straight in 23 out of 24 (96%) of the patients after the operation, while the other one had a residual curvature about 20 degrees. Twenty-three patients (96%) remained similar potency as in preoperative status. The other one had less rigidity but can still accomplish successful intercourse. Three patients experienced sensation change at the glans, and it recovered gradually within 8 months. They were all satisfied with the operation. CONCLUSIONS: Deep dorsal vein patch harvested from patients' own penis had a satisfied outcome from a Taiwanese cohort. For smaller Peyronie's defect, especially in Asian men, deep dorsal vein patch is a graft of choice.

Aged↗

Antiandrogen-associated hepatotoxicity in the management of advanced prostate cancer.

BACKGROUND: Antiandrogens available for patients with advanced prostate cancer are reported to cause hepatotoxicity. The aim of this study is to investigate the antiandrogen-associated hepatotoxicity in patients with advanced prostate cancer. METHODS: By retrospective charts review, 229 patients (47-89 years old) with advanced prostate cancer treated by total androgen blockade (TAB) with bilateral orchiectomy or LHRH (luteinizing hormone-releasing hormone) analogues plus antiandrogen, or antiandrogen-radiotherapy were enrolled in this study. There were 124 patients taking flutamide 750 mg daily and 105 patients taking cyproterone acetate (CPA) 150 mg daily. Hepatotoxicity defined by the International Consensus Meeting in 1990 and Food and Drug Administration, USA was used to evaluate the hepatotoxicity (including serious hepatotoxicity). RESULTS: There was a higher occurrence of hepatotoxicity in patients taking flutamide (15.3%) than taking CPA (9.5%) (p = 0.034). The occurrence of serious hepatotoxicity of flutamide and CPA was 4.8% (6/124) and 3.8% (4/105), respectively. The mean latency period of hepatotoxicity for CPA was 4.8 +/- 2.0 months for flutamide and 5.8 +/- 1.9 months for CPA, respectively. The 2 groups made no significant difference of liver enzyme (mean maximal alanine aminotransaminase (ALT) and aspartate aminotransaminase (AST) = 284.2 +/- 99.3/300.6 +/- 58.5 U/L versus 341.8 +/- 67.1/301.6 +/- 80.5 U/L). All of the 19 patients (100%) and 9 of 10 patients (90%) with flutamide and CPA-induced hepatotoxicity got self-resolution after discontinuation of the antiandrogens. The average time of self-resolution is 4.5 +/- 3.1 months and 6.3 +/- 4.7 months for flutamide and CPA, respectively. Five patients of flutamide-induced and 2 patients of CPA-induced hepatotoxicity got resolution after changing to other antiandrogen. CONCLUSIONS: Flutamide and CPA appear to cause hepatotoxic effects in some patients. Discontinuation of the antiandrogens seems to be the resolution of hepatotoxicity. A change to other antiandrogen may be the alternative strategy to the antiandrogen-induced hepatotoxicity. The results of this study suggest that all patients received flutamide and CPA should be monitored carefully for signs and symptoms referable to hepatic injury to prevent the development of serious hepatic dysfunction.

Aged↗