尿路結石的處理方法有許多種，包括現在普遍使用的體外震波碎石術(ESWL)、內視鏡手術及傳統開刀手術。對於巨大的腎結石或腎盂輸尿管交接處的結石，單用體外震波碎石術，往往無法一次完全擊碎，並且擊碎後常引起碎小結石阻塞輸尿管使病情愈趨複雜，這種情況最適合進行經皮腎造瘻截石手術(PCNL)

，將大部分的結石直接取出，若有殘餘結石，再配合體外震波碎石術，才可以獲得最好的效果。雖然與PCNL同時發展的體外震波碎石術在1984年後已大幅降低PCNL的臨床應用，PCNL在治療尿路結石上仍有其無可取代的地位，是治療尿路結石的重要方法。

PCNL於1976年由Fernstrom與Johannson完成首例，到1980年早期已是一趨近成熟的手術。傳統的手術方式是讓病患趴臥在手術檯上，胸腹部以枕頭墊高，使側腹得以向上突起，由X光透視結石的位置，在背部做腎臟穿刺。首先以穿刺針穿刺，經皮膚、腎臟皮質，通到腎盞內，先留置一條.035或.038的導線，再沿著導線以擴張管(Fascial dilator)將此腎臟通道擴張至24~30F，接著放置安氏套管(Amplatz sheath)當工作通道，方便腎臟鏡進出腎臟，將腎結石以水電波導線(electrohydraulic probe)、超音波碎石棒(ultrasonic lithotriptor)或震動碎石棒(lithoclast)擊碎，再以取石鉗(Forceps or basket)取出。手術結束前通常會在輸尿管及腎臟通道分別留置一條輸尿管導管及一條腎造瘻管，身體外表只有一個一公分左右的傷口。術後48小時拔除腎造瘻管即可準備出院，腎造瘻管拔除後遺留下的傷口會暫時滲尿，但24小時內通常會自行癒合。這種手術方式住院時間約在五天以內，比腎臟半切取石手術的方法輕鬆，而且對腎臟極少傷害。

  

但是這種傳統的PCNL方式，具有先天上的重大缺點。１.病人需變換姿勢成趴臥，若搬動不小心，容易意外造成關節扭傷，且浪費手術時間。２.病人趴臥，對呼吸、血液循環都有不利的影響︰麻醉方面比較危險，而且頭常需側向一邊，容易妨礙腦部血液循環。３.病人趴臥，由背部做腎臟穿刺，經由腰背肌肉時，不只手術當中的器械操作較不靈活，結石碎塊較不易清除乾淨，也較容易流血。４.因解剖位置的關係，腎臟通道的角度通常有較大的仰角，手術的醫師常需站立完成手術，若手術時間長，體力的損耗也大。５.以放射線X光透視定位，增加醫師及病人輻射曝露的機會，其效應往往是數年後才發現，有可能導致皮膚發紅、毛髮脫落、白內障、不孕、體內血液細胞的變化，甚至癌化或基因突變。６.手術後有些病人會抱怨胸部趴臥處不適。

近來我們在這項手術有極具突破性的發展：改採用平躺姿勢、超音波定位的方法來進行手術。以平躺姿勢進行手術可以避免上述趴臥姿勢的缺點，麻醉中可維持良好的呼吸及血液循環，麻醉照護也很理想，病人手術中較安全舒適；腎臟穿刺位置避開腰背肌肉，手術當中的器械操作較靈活，流血相對也較少；且因解剖位置的關係，腎臟通道的位置不超過後腋線(posterior axillary line)，角度較水平或幾乎水平，醫師可坐著利用內視鏡連接教學電視系統輕鬆完成手術；而在結石定位採用超音波技術，可以保護病人、醫護人員免受輻射的危害；且超音波機器輕巧靈活，操作簡便，遠非笨重繁複的X光透視設備所可比擬。病人一生或只接受一、二次類似手術，但醫護人員一生則可能為千百位病患手術，累積的輻射劑量不容小覷。雖有各種防護措施，包括穿鉛衣、戴鉛眼鏡，但總是無法如太空人一般全身武裝，因此使用超音波技術做此項手術，將是未來趨勢，雖然在美國多採用X光透視定位，但在歐洲則是超音波定位較普遍。

 

這種平躺姿勢的手術方式於1990年首度由Valdivia報告，1998年報告累積557例、採用X光透視定位的手術成績，其手術效果良好，併發症的機率沒有增加，並且沒有一般醫師所擔心的腸穿孔併發症。以往採用趴臥姿勢，一大理由即根源於此，擔心平躺姿勢較有腸穿孔的危險；反而是曾有二篇醫學報告分別提出四百例及一千例趴臥姿態的手術成績，各有一例及二例大腸穿孔的併發症。我們自1998年12月即改採用平躺姿勢，結合超音波定位技術，至2003年12月累積完成315例手術，腎結石有294例(93.3%)，大的阻塞性上端輸尿管結石有21例(6.7%)。其中178位男性(60.3%)、117位女性(39.7%)，共295位病患，年齡從26到88歲，平均52.6歲。右側結石142例 (45.1%)，左側結石173例 (54.9%)；需進行第二次PCNL的有6位男性、14位女性，共20位病患(6.8%)。結石大小從 35到3603 mm²不等, 平均660 mm²。手術時間由65到290分鐘，平均156分鐘；結石廓清率0-100%不等，平均82%。有4例(1.3%)因腎臟通道消失不見而手術失敗。失血量 50到1000 ml，平均225 ml；有61例(19.4%)需輸血PRBC 2-4單位。45位高危險群病患，術後沒有因心肺血管併發症需住加護病房照顧；沒有重大併發症包括動靜脈瘻管或失血過多需要接受動脈栓塞或開刀手術止血；同時也沒有腸穿孔、氣胸或水胸等其它重大併發症。

 

 

此項手術技巧，不只針對大的腎結石或輸尿管結石，其它如腎水腫、腎盂輸尿管狹窄或腎臟腫瘤等疾病，配合新近推出的軟式腎臟鏡及軟式輸尿管鏡，在泌尿系統疾病的診斷與治療上都有更寬廣的應用及非凡的價值。甚至有小至一公分左右的腎結石，位於腎盞憩室內，經數次體外震波碎石術擊碎，但仍無法排出結石的病患，亦經由此方法而順利完成手術。因此，這種結合平躺姿勢，應用超音波定位技術的經皮腎造瘻截石手術，可減少病人翻身的麻煩及危險，節省寶貴的手術時間，避免腸穿孔等重大併發症，減少輻射曝露，手術傷口小、效果佳、恢復快，是一種極為安全及方便的手術方式，預料未來伴隨相關診斷與治療儀器的推陳出新，這種手術技巧將有更大的應用空間。

參考文獻

1.      Lehman T, Bagley D: Reversed lithotomy: modified prone position for simultaneous nephroscopic and ureteroscopic procedures in women. Urology 1988; 32: 529.

2.      Segura JW: Percutaneous management. In: Walsh PC et al, eds. Campbell’s Urology. Philadelphia, W. B. Saunders, 1998, p2183.

3.      Netto NR, Lemos GC, Fiuza JL: Colon perforation following percutaneous nephrolithomy. Urology 1988; 32: 223.

4.      Segura JW, Patterson DE, Leroy AJ, et al: Percutaneous removal of kidney stones: review of 1000 cases. J Urol 1985; 134: 1077.

5.      Reddy PK, Hulbert JC, Lange PH, et al: Percutaneous removal of renal and ureteral calculi: experience with 400 cases. J Urol 1985; 134: 662.

6.      Valdiva UJG, Valer J, Villarroya S, et al: Why is percutaneous nephroscopy still performed with patient prone? J Endourol 1990; 4: 269.

7.      Valdiva UJG, Gerhold JV, Lopex JAL, et al: Technique and complications of percutaneous nephroscopy: experience with 557 patients in the supine position. J Urol 1998; 160: 1975.

8.      Lowe FC, Auster M, Beck TJ, et al: Monitoring radiation exposure to medical personnel during percutaneous nephrolithotomy. Urology 1986; 28: 221.

(本文登載於2004年台北市醫師公會會刊第48卷)

近年國人生活水準條件改善及飲食習慣的改變，動物性蛋白質攝入增加，不僅使血液中尿酸值過高的人愈來愈多，而且高尿酸血症發病年齡也有明顯往下降的趨勢。尿酸是普林(purine)的代謝產物，體內的普林三分之二來自身體的新陳代謝，另外三分之一則來自飲食，當食物越豐盛，山珍海味滿桌時，吃下去的普林也愈多，當過多的普林代謝成尿酸時，血中的尿酸值自然也隨之上升。 …

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急性腎盂腎炎（Acute Pyelonephritis）

作者：謝政興

急性腎盂腎炎(APN)是最常見的上泌尿道感染，為腎臟實質及腎盂因細菌感染而產生的急性發炎，通常發生在單側，但有時兩側都受到感染。

臨床症狀：通常病患會發燒、畏寒、單側或雙側腰部疼痛，膿尿及菌尿(即所謂的臨床三特徵clinical triad ) …

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作者：謝政興

尿路感染是泛指人體泌尿道受到微生物的感染，而其中的細菌感染是最常見的，如感染到膀胱就是膀胱炎。

臨床症狀：隨著感染程度的不同, 造成的症狀也不一樣。通常病患會有頻尿、急尿、解尿疼痛、灼熱感、下腹痠痛、尿液混濁、甚至血尿或尿道口排出分泌物等症狀，但不會發燒。有些尿路感染的病患完全沒有任何症狀,尿液檢查卻發現尿液中有細菌，稱為無症狀菌尿症。 …

膀胱炎閱讀全文 »

作者：謝政興醫學日新月異，伴隨著疾病的診斷工具也不斷創新。在種種的醫學影像系統當中，超音波儀器檢查是公認最方便且不具侵襲性的優良診斷輔助利器，利用超音波的一些物理特性，在身體器官中穿透、反射及衰減程度的不同來達到造影的目的。一般人可以聽到的聲波，大約在兩萬赫芝以下，大於兩萬赫芝人耳就不太可能聽到了，這種超越可聽音波頻率的音波，我們稱之為超音波。超音波的頻率,在醫學上的使用，依據其使用的功能，而有不同的頻率，一般在醫療上所使用的頻率大約為1到10MHz之間。音波在不同的傳播介質，有不同的傳播速度，在人體的軟組織當中，因為其組合成份相近，所以傳播的速度大約是1540mm/sec；但在肺泡及骨組織中，傳播的速度不同，而有相當程度的偏差，所以超音波掃描並不適用掃描這兩種組織。超音波探頭的功能為接收及發出音波訊號，所以在探頭上就必須要有一些設計，不同頻率的超音波探頭，符合不同使用目的的需求。

本院先進的B-K Medical超音波掃描系統，除具備一般超音波的基本功能外，更擁有多頻率、多層面經直腸超音波掃描探頭、獨特設計之經直腸穿刺導引裝置、腹部穿刺引流導引裝置、探頭上遙控按鍵方便掃描等特色，而其超音波掃描探頭皆可浸泡於消毒液(Cidex)中，避免因穿刺組織或器官造成的病人感染問題。主機則具備泌尿科專用計算測量功能(Urology Calculations Module),可以測量包括腎臟(Kidney)、睪丸(Testis)、攝護腺(Prostate)、膀胱(Bladder)、陰莖(Penis)等泌尿系統器官及組織之大小、截面積、體積，換算PSA density..等，更可以獲取泌尿系統器官及組織病灶的進一步相關資訊，並儲存於報告中及列印。

泌尿科經直腸超音波掃描探頭，以橫切面、縱切面及其他旋轉切面之多層面掃描方式，選擇6/7.5/10 MHz三種頻率，針對攝護腺內各個區域(如過渡區Transition zone、中央區Central zone、周圍區Peripheral zone)，及儲精囊(Seminal vesicles)、射精管(Ejaculatory ducts)、膀胱頸(Bladder neck)、直腸(Rectum)、尿道(Urethra)等，作完整而精確的掃描。對於常見的良性攝護腺肥大(BPH)可以做為治療前後的參考；尤其對於攝護腺癌及儲精囊腫瘤的診斷及侵襲程度的分期評估，非常重要，即使小到1cm的腫瘤都可診斷，可完整觀察攝護腺之整體影像，且影像不受腸壁皺摺影響，故影像清晰。而配合超音波穿刺定位 (puncture line)，可以導引穿刺針(Puncture needle) 至適當位置取樣，對於攝護腺、儲精囊各個部位之病灶，皆可毫無死角的做病理切片，提升取樣的精準度，增加檢驗準確度。

腹部掃描探頭也是多頻率之掃描探頭，符合人體工學之設計，。可針對不同體型之病患選擇3.5/4.3/5.0MHz三種頻率掃描包括腎臟、膀胱在內的腹部器官，以獲得清晰的影像，對於腎臟結石、腫瘤、腎水腫、腎囊腫、膀胱腫瘤、尿滯留、殘尿量之診斷及評估，有正面及時效上之臨床意義；且由於探頭體積小，易於操作。而其他腹部器官掃描，藉由不同頻率選擇，對於肝臟、脾臟、胰臟等腹部器官，皆可做即時的一般腹部超音波掃描。對於有懷疑之病灶，可經由此種超音波定位取樣探頭，確定其病灶位置及病灶的超音波特性，作準確之穿刺取樣。執行器官穿刺(例如腎臟或膀胱)時，藉由超音波Puncture line定位導引Puncture needle 至適當位置，可增加其準確性，尤其在執行腎臟內視鏡手術(包含腎臟引流)時，為不可或缺之輔助裝置，更可提高手術成功率，相對的降低手術併發症。

Small part超音波探頭利用超高頻率，可掃描陰囊(Scrotum)及陰莖(Penis)等較小及淺層組織之病灶，對於相關疾病具有診斷上的價值，如睪丸腫瘤、睪丸血腫、睪丸扭轉、睪丸膿瘍、睪丸外傷、睪丸血管梗塞、睪丸炎、睪丸囊腫、副睪丸炎、副睪丸。囊腫、精液囊腫、副睪丸扭轉、陰囊積水、陰囊疝氣、陰囊血腫、陰囊腫瘤、精索靜脈曲張、陰莖腫塊、陰莖外傷、血腫、膿瘍等，均適用作為優秀的輔助診斷工具；同時可應用於男性性功能障礙的檢查。

本院泌尿科門診配備超音波儀器，可增加診斷率，進而提升門診效率，對於醫師及病患都極其方便，可迅速進行更進一步的處置。也可於門診同時完成疑似攝護腺癌病患的經直腸超音波病理切片檢查，增加攝護腺癌的檢出率，以安排進一步的治療。於開刀房中，泌尿科超音波機器輔助手術的進行，如腎臟造瘻術(PCN)、經皮腎造瘻結石取石術(PCNL)即可運用，是極現代化的手術。因此超音波儀器已成為醫師診療的左右手；當然，最重要的控制關鍵仍在於人，需熟練超音波的相關操作及判讀，才能賦與超音波儀器新的生命力，超越其本身的價值。

(本文登載於康寧醫訊)

進入千禧年,台灣已正式面臨高齡化社會的問題,老年人的健康愈發受重視,良性攝護腺肥大與勃起功能障礙(俗稱陽萎)是相當常見的老人疾病。良性攝護腺肥大常引發頻尿、夜尿、尿流細小等症狀,造成生活上的極大的困擾﹔不巧的是,許多老年人更有陽萎的問題,影響性生活品質,人生從此彩色變黑白,僅能感嘆歲月的無情,徒增感傷。

根據統計資料顯示,50歲以上的男性約有75%的人會有良性攝護腺肥大, 四十歲以上的男性中﹐50%的人有不同程度勃起功能障礙的困擾,尤其年齡愈高,發生的比率愈大。因此這兩種疾病在老年族群的高發生率常令人聯想之間有無相互關係,但是很少證據顯示兩者有明顯的關聯性。在最近的研究報告中,陽萎與年齡有顯著的相關,但與攝護腺的體積大小及最大尿流速率則無明顯的相關;然而當攝護腺的體積及最大尿流速率這兩個參數與年齡做相關分析時,均顯示有顯著的相關;亦即良性攝護腺肥大與陽萎沒有直接的相關性,但均與年齡有顯著的相關性。這兩種疾病的關係只顯示一個事實,就是兩者有類似的姓別及年齡分佈。

然而,治療良性攝護腺肥大的外科手術可能造成陽萎,成為術後的併發症。傳統的經尿道攝護腺切除手術(TURP)造成陽萎,報告的比率由4%到40%不等, 一般相信較接近4%,其原因可能是術中為了止血在攝護腺的底部側面應用太多電燒,傷害到勃起的神經。新的治療方法如ND-YAG雷射,發生陽萎的比率約3.2%,逆行性射精有12.0%﹔Transurethral microwave thermotherapy (TUMT) 發生射精功能障礙的比率有11%,但沒有陽萎的報告﹔Radiofrequency transurethral needle ablation (TUNA), High intensity focus ultrasound (HIFU) 也沒有陽萎的報告.但治療良性攝護腺肥大的效果尚經不起時間的考驗,曾有報告43%接受HIFU的病患,4年內仍需接受TURP﹔另外針對藥物治療無效且無法接受手術的病患,可考慮放置尿道支撐物將被攝護腺阻塞的尿道撐開,曾有報告20例成功放置尿道支撐物的病患,4例因拔除尿管而重新恢復性生活。但勃起功能障礙有多種不同的病因,包括器質性及心因性的病因,藥物的 副作用也是病因之一,加上病患對於性能力認知上的差異,很難獲得有效的數據進行分析陽萎的正確發生率。

內科療法也可能造成陽萎,荷爾蒙製劑如Finasteride連續服用約三個月之後會使攝護腺萎縮約30% 而達到治療的目的,但是由於其抗男性荷爾蒙的作用,可能會影響病患的性功能及射精功能障礙,報告產生陽萎的比率小於5%﹔此外這類的藥物在停止服用之後,攝護腺還是會變大。甲型阻斷劑( α-blocker )則較不會有此副作用,報告產生陽萎的比率小於1%。這些患者中有許多人同時合併有高血壓及糖尿病,高血壓的病理生理機轉原就易導致血管硬化及陽萎,而抗高血壓藥物中Thiazide diuretics及Beta-blockers較會引起陽萎,此時服用α-blocker較能避免陽萎的副作用﹔而且治療陽萎的同時,服用α-blocker似有加成的效果,其作用機轉源於血管擴張及抑制交感神經的活性,例如曾有報告Doxazosin可改善良性攝護腺肥大患者的性功能,另外對於同時有糖尿病的患者,也可改善胰島素的敏感度,對於良性攝護腺肥大患者,是一個有利的選擇藥物。總之,老年人常常不只有單一疾病,因此在治療上需瞻前顧後,讓病患得到最佳的治療利益及最少的副作用。

(本文登載於2003年台灣男性學醫學會會訊)

攝護腺又稱為前列腺，是男性泌尿生殖系統特有的器官(女性沒有攝護腺)，為一胡桃形的腺體，位於膀胱正下方出口處，包圍著尿道，正常成年人攝護腺的重量約20±6公克，長度約1.5英吋。攝護腺會分泌攝護腺液，是精液的重要成份。

但因攝護腺隨年齡慢慢增大，有些人因尿道阻塞，造成攝護腺肥大的相關症狀。高齡化社會中，老年人的健康問題愈受重視，超過50歲、有排尿問題的男性，大部份原因是良性攝護腺肥大；而活到80歲的男性有20%到30%需接受手術治療。

但〝良性攝護腺肥大〞只是一般的俗稱，正確的名稱應為〝良性攝護腺增生〞，是男性最常見的一種良性腫瘤，但與攝護腺癌並沒有直接關係。

攝護腺肥大發生率：

西方人比東方人多，以膚色而言，在黑人中更普遍。男性在青春期之前，攝護腺大小幾乎沒有變化。但是到青春期時，攝護腺快速生長，每年約生長1.6公克；而在30歲以後，每年約只生長0.4公克。在30歲左右，少數人就開始有良性攝護腺增生；50到60歲間，約有50%會有良性攝護腺增生；90到100歲，約有90%會有良性攝護腺增生。一項研究發現，良性攝護腺增生可能有部份的遺傳性：65歲以前就有很大的攝護腺增生的人，他們的男親戚在一生中需要接受攝護腺增生切除手術的機會是其他人的4倍，他們的兄弟則增加6倍的危險性。

攝護腺肥大發生原因：

良性攝護腺增生的原因可能與年齡增加及男性荷爾蒙變化有關。隨年齡增加，細胞對於男性荷爾蒙的感受性也增加；同時可能因喪失生物性的抑制機轉，使細胞的死亡率下降，終造成攝護腺細胞增生。另外，女性荷爾蒙(Estrogen)會誘導男性荷爾蒙受體的表現增加，加上男性荷爾蒙(Androgen)的持續刺激，兩者的協同作用逐漸導致良性攝護腺增生。

攝護腺肥大臨床症狀：

可區分成直接尿道阻塞及膀胱內間接變化所引起的症狀。

直接尿道阻塞引起的症狀包括

1. 開始解尿時不好解，需用力才解的出來。
2. 解尿斷斷續續，遲緩無力。
3. 解完尿時還滴滴答答。

膀胱內間接變化所引起的症狀包括

1. 突然間尿急，有時還沒到廁所就憋不住了。
2. 頻尿，小便次數增加。
3. 夜尿，半夜常起床解尿。
4. 餘尿感，解完了仍然感覺沒有尿完。

如果合併膀胱發炎或膀胱結石，會有小便灼熱及疼痛的症狀。

少數人也可能尿中帶血(血尿)。

攝護腺肥大臨床評估：

目前使用最廣泛的是美國泌尿科醫學會（AUA）所設計、世界衛生組織認可的國際攝護腺症狀分數(IPSS)評分表來評估症狀的嚴重程度，由病人自己打分數，以分數的高低來決定治療的方向。每一個問題都有五個選項來表示患者症狀的嚴重性，總分35分，完全沒有症狀是0分；8分以下是輕度；8到20分是中度；21分以上則是重度。

國際攝護腺症狀分數 (IPSS)評分表	從 來 沒 有	很 少 有	偶 爾 有	約 半 數 有	時 常 有	每 次 都 有	症狀 評 分
IPSS1. 排尿不乾淨(餘尿感)當您解完小便,是否感覺尿液仍未解完?	0	1	2	3	4	5
IPSS2. 頻尿(小便次數增多) 當您解完小便,是否不到兩小時又想再解?	0	1	2	3	4	5
IPSS3. 小便斷斷續續 您小便斷斷續續,解解停停?	0	1	2	3	4	5
IPSS4. 小便急迫感 您想解小便時,是否來不及到廁所就解出來?	0	1	2	3	4	5
IPSS5. 小便無力 您是否發現小便變細變弱?	0	1	2	3	4	5
IPSS6. 小便困難 您小便時,是否要肚子用力才解得出來?	0	1	2	3	4	5
IPSS7. 夜尿症 從您上床睡覺直到早上睡醒前,您要起床小便幾次?	0	1	2	3	4	5
總分

除了症狀評估之外，與良性攝護腺增生的相關檢查，包括尿液檢查、肛門內指診、尿液流速測定、抽血檢查攝護腺特異抗原(PSA)、經直腸攝護腺超音波檢查、膀胱鏡檢查或靜脈注射尿路攝影檢查等。檢查是依實際病情需要安排，並不一定全部要做。

攝護腺肥大何時需要治療？

攝護腺增生的病程很難預測。有些人的症狀維持穩定許多年，甚至有1/3的人逐漸改善。一項新近的研究指出，輕微的攝護腺肥大病患，73%在三年半內排尿症狀沒有惡化。解尿無力、尿柱變細、及餘尿感是最後決定要治療的重要因素；雖然頻繁的夜尿是的最討厭的症狀之一，但是不一定需要因此接受治療。所以，治療與否要考慮症狀厲害的程度、泌尿道傷害的程度及病患整體的健康情形。如果尿道阻塞症狀惡化而未治療，可能的併發症包括：膀胱壁變厚、膀胱不穩定及容量變小，餘尿導致發炎感染或膀胱結石，膀胱內壓力增大並傳導至腎臟傷害腎臟功能。

攝護腺肥大何時考慮手術治療？

有以下情形，常需治療，尤其是手術治療

1. 膀胱無法完全排空，導致腎臟傷害。
2. 急性尿滯留後，完全無法排尿。
3. 因膀胱尿漲或膀胱變敏感，導致尿失禁。
4. 膀胱結石。
5. 餘尿導致發炎感染。
6. 反覆發生厲害的血尿。
7. 症狀嚴重困擾病人，降低生活品質。

攝護腺肥大治療方法：

1. 觀察與等待
   症狀輕微，沒造成生活上的困擾，半年至一年門診定期追蹤即可。避免服用鎮靜劑或治感冒鼻塞的藥物。
2. 藥物治療
   有30%到60%的人可改善症狀，但無法預測誰吃了效果好或哪一種藥最有效。治療藥物大致分為兩種，甲型交感神經阻斷劑及男性荷爾蒙抑制劑。

A: 甲型交感神經阻斷劑 (α-blocker):

這類藥物原先是用來治療高血壓，可降低血管壁的張力並放鬆攝護腺內的平滑肌，緩解攝護腺肥大導致排尿不順暢的症狀，效果迅速。所以同時有高血壓及攝護腺肥大症狀的病患是最理想的治療藥物。常用的包括Hytrin, Doxaben, Harnalidge等。可能的副作用有姿態性低血壓、頭暈、頭痛、倦怠無力、鼻塞、口乾、失眠等，在調整劑量後，這些副作用通常會減輕或消失。另外，有冠狀動脈心臟疾病的人也可能產生心絞痛，必須小心使用。這類藥物基本上是症狀治療，並不能使攝護腺縮小或不見，所以必需長期服用；但依筆者經驗，也有服用一段時間，症狀減輕而逐漸停藥的。

B: 男性荷爾蒙抑制劑 (5α-reductase inhibitor):

攝護腺肥大和男性荷爾蒙的作用有關，所以抑制男性荷爾蒙作用的藥物就被用來治療攝護腺肥大，而這些藥物在連續服用六個月之後會使攝護腺萎縮約30%，效果較慢；這類藥物適合較大的攝護腺增生(>40公克)病患，使攝護腺體積減小的效果最好。可能的副作用有性慾減低、性功能障礙、降低射精量、男性女乳症等，但通常停止服藥副作用就消失。因PSA值會下降50%，可能會影響攝護腺癌的早期發現；此外這類的藥物在停止服用之後，攝護腺又會變大回來，所以必需長期服用。

自然藥物療法（phytotherapy）是利用植物或其粹取物來治療攝護腺增生，例如：Saw Palmetto, African Pygeum, Serenoa repens (sago palm), hypoxis rooperi (South African star grass) 等，目前以歐洲最為流行，因未經完整的醫學驗證過程，有效程度仍存疑；但是通常沒什麼大的副作用，對於有輕度或中度症狀、又不想服用一般藥物的病患，是另一項選擇。

3. 經尿道攝護腺刮除手術 (Transurethral Resection of Prostate（TURP）)
傳統的經尿道攝護腺刮除手術，是將切除式內視鏡(resectoscope)伸入尿道，身體沒有任何傷口(如做胃鏡，)，圓弧形的電刀隱藏在內視鏡內，一起由尿道進入，具有切割和止血的功能，如打通隧道一樣，手術就是將攝護腺一片一片地刮除，僅刮除攝護腺內部良性腫瘤部分，仍保留小部份的正常攝護腺組織及包膜，這是目前公認最好、最快改善攝護腺肥大症狀的方法。這種手術方式與因攝護腺癌症所施行的根除性攝護腺切除手術不同，因為根除性攝護腺切除手術需切除全部的攝護腺組織，包括包膜。接受經尿道攝護腺刮除手術後，93%有重度症狀的病患可獲得顯著的改善，80%有中度症狀的病患可獲得顯著的改善；但是手術不一定能完全改善所有的症狀，例如阻塞的症狀改善、小便順暢了；可是膀胱功能異常所導致的頻尿或夜尿症狀仍可能持續或減輕一些，不一定能像年輕時一樣一覺到天亮。可能的併發症比例一般不高，包括膀胱頸狹窄(2.7%)、尿道狹窄(2.5%)、陽萎(5-10%)、尿失禁(0.7-1.4%)、逆行性射精(術後恢復性生活時，精液逆流至膀胱，沒有精液射出，等解小便時再一起解出，這種現象不會影響性功能，對身體也無害，不會影響健康)(50%)等，死亡率很低，約0.1%。

4. 其他相關手術治療方式
如攝護腺過大或無法經尿道內視鏡刮除者，可考慮剖腹式的攝護腺切除手術。有些病患因本身身體條件不適合接受經尿道攝護腺刮除手術時，可以考慮選擇其他的相關手術治療方法。治療方式很多，但基本原理就是利用微波(Transurethral Microwave Thermotherapy (TUMT))、超音波(High Intensity Focused Ultrasound (HIFU))、雷達波(Transurethral Needle Ablation (TUNA))、雷射(Transurethral Laser-inducedProstatectomy (TULIP); Visual Laser Ablation of Prostate (VLAP); Interstitial Laser Coaguation (ILC))等產生能量，集中到肥大的攝護腺上使之壞死、萎縮，達到正常排尿的目的。另有經尿道攝護腺切開手術、經膀胱鏡攝護腺絕對酒精注射法及放置尿道支撐物將被攝護腺阻塞的尿道撐聞。不同方式各有優缺點，但無論如何，經尿道攝護腺刮除手術仍是一致公認的黃金標準(gold standard)，是最好、最徹底的手術治療方式。

經尿道攝護腺刮除手術前注意事項：

1. 平時有吃阿斯匹靈(Aspirin)等抗凝血劑，手術前最好先停藥7天。
2. 術前有泌尿道感染，最好先控制到一定程度，至少沒有發燒。

經尿道攝護腺刮除手術後注意事項：

1. 據統計，6%病患術後需輸血彌補術中的出血。
2. 手術多採半身麻醉，術後必須平躺及禁食8小時，以免有脊椎性頭痛(spinal headache)的後遺症。
3. 術後需在尿道內留置一條導尿管1-3天，會刺激膀胱和直腸，有下腹部脹痛、想解大便或小便的感覺，平均需住院五天。
4. 導尿管拔除後，可能會有暫時性輕微血尿、尿急感、頻尿、解尿疼痛、解尿後滴尿等情形，通常會慢慢改善，也可口服藥物緩解症狀。
5. 有些病患術前評估膀胱收縮功能不良，術中會另外放置恥骨上膀胱造瘻管，以方便術後導尿管拔除後，可以訓練膀胱正常解尿。
6. 常見的立即性併發症如出血、尿路感染等，有時會拖到術後一個月；膀胱收縮功能不良、切除的攝護腺碎片未完全洗出或血塊堵塞，可能無法解尿。可能的其他併發症有經尿道攝護腺刮除症候群(TUR syndrome)，因血鈉太低，有頭暈等情形；另因攝護腺肥大病人多為年老患者，雖然手術本身甚為安全，仍有可能發生心肌梗塞、肺炎、肺部血塊栓塞、腦中風等意外，但發生機率很低，術後可以做呼吸運動(Breathing exercises)、床上腿部運動、早日下床活動等方法來預防。
7. 出院後小便如持續有鮮血的顏色、發燒或解尿困難，應即返診治療；如尿液是暗紅色或咖啡色，表示是舊的血塊溶解，此時多喝開水，把舊血塊解出即可。
8. 多喝開水，每天保持尿量在2000CC以上，預防小便太濃，減少發炎的機會。
9. 術後一個月內應避免騎腳踏車、摩托車、跑步等較劇烈運動；不要蹲太久及避免上下樓梯；暫時不要有性生活；多吃蔬菜水果使大便保持鬆軟，解大便時不要太用力；勿提重物；洗澡不要溫水坐浴等，以預防術後產生厲害的血尿。

如何保健?

1. 避免憋尿。
2. 可有正常的性生活，不需禁慾。
3. 睡前避免飲用含利尿成份的飲料，如咖啡、茶或啤洒。
4. 白天開水可多喝，但晚飯後少喝開水或吃含水份多的東西，減少夜尿的次數。
5. 避免服用鎮靜劑或治感冒鼻塞的藥物。
6. 若有發燒、解尿疼痛或解不出尿的情形，應立即就醫。

攝護腺肥大的治療方式日新月異，唯有經過泌尿科醫師仔細的評估，才能尋找最適合的治療模式。

陰囊水腫通常簡單區分為先天性(小兒、開放型)陰囊水腫及後天性(成人、封閉型)陰囊水腫。

先天性(小兒、開放型)陰囊水腫

小兒陰囊水腫是小兒常見的外科疾病，與小兒的間接型腹股溝疝氣(又稱鼠蹊部疝氣或脫腸)的病因相似，症狀及處理方式也相似。

發生率及原因：

文獻報告足月產的嬰兒，6%有陰囊水腫，但大部分會在一歲內消失（腹膜鞘狀突逐漸關閉），所以新生兒的陰囊水腫可以等到一歲後再決定是否手術；疝氣的發生率，足月產的嬰兒約1-5%。早產兒因發育未成熟即出生，陰囊水腫及疝氣發生率都相對較高。但是這兩種疾病並沒有特定的遺傳模式。

小孩在胚胎發育過程中有一管狀突出的腹膜[腹膜鞘狀突(processus vaginalis)]，由腹腔延伸到腹壁並走在精索(男生)的旁邊，出生後不久這管道應該會自然關閉(閉鎖)起來；若這管道關閉不全，便形成一條連通腹腔和陰囊的通道，形成突起的疝氣囊袋，常造成陰囊腫大；如果未閉鎖的通道只延伸到腹股溝(鼠蹊)，則陰囊不一定變大。嚴重的閉鎖不全會使腹腔內的器官如腸子或網膜等藉由這個通道進入疝氣囊袋，造成腹壁突出，甚至進到陰囊引起陰囊腫大，這就是間接型腹股溝疝氣；輕度的關閉不全，若只有腹腔內的腹水能通過，腹水便循此管道聚積在最低點的囊袋內，形成陰囊水腫。女性也是相同原理，同樣可能有疝氣或水腫。

症狀：

出生時就可發現腹股溝處有一個鼓起或陰囊腫大，但也可能出生後數天、數月甚至數年才出現。因為腹膜鞘狀突的管道是通的，站立或腹部用力，如哭鬧、運動、解便、咳嗽時，陰囊會變大，平躺臥床休息或睡覺後往往自行變小或消失。

診斷：

可讓小孩站立、咳嗽或吹氣球，腹部用力時檢查陰囊是否變大，若不明顯則讓小孩平躺，以手指觸摸腹股溝，因有疝氣囊袋存在，會有如絲質布料相摩擦的感覺。另可用「燈光照明法」，將手電筒抵住陰囊皮膚照射，可見陰囊水腫會透光。超音波可以輔助診斷，可看到陰囊有積水；有些合併疝氣，可發現腹股溝甚至陰囊內有網膜或腸子存在。

治療：

如果診斷是腹股溝疝氣必須及早手術，因為有可能腸子或其他腹部內容物卡在疝氣囊袋內造成壞死。但陰囊水腫大部分可在週歲內消失(腹膜鞘狀突逐漸關閉)，所以可等到一歲後，若沒有消失再考慮手術，但在觀察期間，應注意是否合併有疝氣。手術方法類似疝氣手術，傷口位於腹股溝處，做疝氣囊袋高位結紮，將這個管狀通道綁紮起來，並去除疝氣囊袋即可，鮮少復發。一般而言，術後當天或隔天就可返家，傷口不需換藥或拆線，一星期後門診追蹤即可。

後天性(成人、封閉型)陰囊水腫

成人陰囊水腫與小兒的陰囊水腫病因不同，症狀及處理方式也不一樣。
原因：成人的陰囊水腫，其陰囊內的積液並非來自腹膜鞘狀突，而是因陰囊外傷、睪丸炎或副睪丸炎，睪丸鞘膜內滲液太多而形成水腫；睪丸腫瘤10%會先合併有反應性的陰囊水腫；淋巴循環受阻，也會造成陰囊淋巴水腫，常見在血絲蟲病(Filariasis)和精索靜脈曲張手術後(7%)。另有一種特殊的原因是腹壓太大，如肝硬化合併嚴重腹水，將原已閉鎖的腹膜鞘狀突重新打開，腹水進入陰囊造成陰囊腫大。

症狀：

陰囊腫大，有時會有陰囊下墜感。若有急性睪丸炎或副睪丸炎，則有陰囊疼痛症狀；發炎緩解後，陰囊腫大程度會改善。

診斷：

由陰囊外觀或以手觸摸可發現陰囊腫大，檢查時腹部用力不會改變陰囊大小，平躺臥床休息也不會變小或消失。以燈光照明法，將手電筒抵住陰囊皮膚照射，可見陰囊水腫會透光。超音波可以輔助診斷，看到陰囊積水。

治療：

成人的陰囊水腫多是後天性的，因為不是鞘狀突通道造成，將水囊打開即可，傷口位於陰囊處。一般而言，術後當天或隔天就可返家，傷口不需拆線，一星期後門診追蹤即可。對於腹壓太大造成的陰囊水腫，需等腹水減少、腹壓控制好再考慮手術。另有免開刀的陰囊水腫抽吸法，雖可立即見效，但可能引起出血或發炎，且容易再發，最好的方法還是手術。

攝護腺炎是臨床上常見的男性泌尿系統疾病，好發於成年男性，青春期前極少發生，盛行率約5-8%。年紀大的男性常會因攝護腺肥大而有頻尿、夜尿、小便不順等症狀；而攝護腺炎卻偏好年輕、中年男仕，尤其慢性攝護腺炎症狀反覆不易治癒，令人不勝其擾。長久下來病人就會變得焦慮、失眠、倦怠，進而影響到工作。 …

攝護腺炎閱讀全文 »

作者: 許耕榕 謝政興

火鳥傳奇 — 談電刀的誘惑 

往墾丁國家公園的屏鵝公路上，除了沿岸的旖旎風光，另外讓人印象深刻的就是路邊斷續出現的野味串燒 – 烤伯勞鳥。雖然伯勞鳥是保育類動物，但許多民眾為了養家糊口，也只好潦落去，在汗水(不用加鹽巴)、醬料、爐火的烘烤下，出現一隻隻晶瑩剔透、美味可口的烤小鳥(但偶爾失了一個神，就燒起來變成一隻火鳥)；購買的民眾則虎視瞻瞻盯著小鳥看，挑剔這個部位烤的太焦、那個部位沒烤熟。在這攤販的小天地裏，顧客與老闆彷彿在共同創作一件完美的藝術品；令人感覺興味的不是那人的專注，卻是那鳥的苦悶。身體各部位的外科手術都會遇到流血或需要處理血管的情況，使用電刀、以電燒來切割或燒灼組織，是普遍且理所當然的原則。電燒使血管的組織燒焦、萎縮、凝結，以達到止血的效果；但是大的血管使用電燒較難止血，則用絲線綁紮，所以電燒在手術中的應用相當廣泛。但是小鳥生病需接受外科手術時，不管是破壞性的手術(如包皮環切手術治療包皮過長引起的包皮炎)、或重建性的手術(如陰莖彎曲矯正、陰莖靜脈截除手術治療陰莖靜脈滲漏導致的陽萎)，應用電刀燒灼處理血管時，容易使小鳥得「內傷」，運氣不好的也會得「外傷」。此話從何說起？

陰莖主要是由兩支陰莖海綿體、一支尿道海綿體(內含尿道)及位於前端的龜頭所構成。圍繞在兩支陰莖海綿體外面的是堅韌且富彈性的白膜；陰莖海綿體內並不是一個單純的大空腔，而是類似會吸水的海綿、由眾多蜂窩狀的小空腔(海綿竇)所構成，海綿竇的腔壁中有許多平滑肌細胞，陰莖未勃起時，海綿竇是塌塌扁扁的。正常的小鳥抬頭時，陰莖動脈擴張，海綿竇腔壁中的平滑肌放鬆造成海綿竇腔室擴張，大量血液經由陰莖動脈流入陰莖海綿體內的海綿竇腔室中，造成整個陰莖海綿體內充血(就如同海綿吸飽水般膨脹)；此時白膜下的小靜脈被擠壓在海綿竇壁和白膜之間而被壓扁關閉，穿過白膜的釋出靜脈則完全被阻斷，讓血液不會流出陰莖海綿體，因而保持陰莖勃起；好比充氣後的輪胎，小鳥才有高踞枝頭的神氣。當小鳥要休息時，陰莖動脈收縮，海綿竇腔壁中的平滑肌細胞也收縮，陰莖海綿體內的血流減少；海綿竇中的血液經由與海綿竇連通的小靜脈(釋出靜脈)，流經較大的陰莖靜脈，再回到體內循環系統，勃起就消退了(參考文獻1)。

陰莖海綿竇與陰莖靜脈的相關結構好比是一串葡萄中、葡萄(海綿竇)與葡萄枝(小靜脈)的關係。手術中電燒這類中等大小管腔的釋出靜脈，止血效果立竿見影，可惜電流將傳導到陰莖海綿體內鄰接的海綿竇，海綿竇腔壁中的平滑肌細胞將受傷或死亡，導致海綿體內局部的纖維化(結疤)；這情形好似由葡萄串的梗部通高壓電，電流傳導到放射狀分布的各個葡萄，此時葡萄(海綿竇)已萎縮成葡萄乾，要勃起時，這部份的海綿竇腔室無法擴張，海綿體內充血不完全，理所當然，勃起功能頹廢得令人「恨鐵不成鋼」。因此，依使用電燒的強度及範圍，產生不同程度的內傷，勃起硬度可能由「微軟」變「疲軟」，甚至變成不折不扣的「倒爺」。同時，由於小鳥的體積不大，電燒也可能傷害到緊鄰的陰莖背動脈、神經或包皮組織，產生麻木感或包皮局部缺血壞死等外傷。另外，許多醫學文獻報告都指出，使用電燒時，局部組織遭到破壞，這塊燒焦的地方，對細菌的抵抗力下降，傷口較易發炎感染。小鳥面對內傷加外傷的困境，即使有傾國傾城的佳人，也只能獨悵然而涕下了。

人類陰莖生理上每分鐘2毫升的血流就夠用，但在性行為時可達30倍，亦即每分鐘60毫升的血流，所以不論任何手術，格外容易出血；陰莖靜脈數目多、既細小、又繁雜，在不使用電燒的前提下，如何止血呢？不妨先在實驗室老鼠身上熟練操作血管的顯微手術要領及技巧。

引起陽萎的一個關鍵因素就是陰莖靜脈滲漏，當血液經由陰莖動脈流入陰莖海綿體後，陰莖海綿體內充血，但無法壓迫住陰莖靜脈系統，血液很快流出陰莖海綿體，此時需手術將滲漏的陰莖靜脈截除或綁紮，手術過程中須仔細綁紮的靜脈端有76-125處之多(參考文獻2,3)。如果用電燒使陰莖靜脈組織燒焦、凝結，雖可讓海綿體內的血液不會由陰莖靜脈滲漏，大幅縮短手術時間；但陰莖海綿體也可能因電流傷害而導致海綿體纖維化，亦即電燒本身就是造就陽萎的因素，正所謂「收之桑隅(靜脈不滲漏)，失之東隅(陰莖不勃起)」。

這種新見解在我們刊登於美國男性學醫學雜誌(Journal of Andrology)的論文中(參考文獻4)，有特別的敘述。當然，小鳥手術有許多種，電燒並非不行，但應避免副作用，尤其陰莖海綿體對於電燒的敏感度高於全身其他器官，這個課題值得醫界共同深入探討。此時，腦際倏忽響起以前熟悉的一首歌「燃燒吧火鳥」，歌詞依稀是「如果你是一隻火鳥，我願是那一根火苗，把你燃燒，把你燃燒—」，心底不禁一陣哆嗦—-!!

(本文登載於93年6月24日聯合報)

參考文獻

1. Hsu GL, Hsieh CH (謝政興), Wen HS, Hsu WL, Wu CH, Fong TH, Chen SC, Tseng GF. Anatomy of the human penis: the relationship of the architecture between skeletal and smooth muscles (人類陰莖解剖構造：骨骼肌和平滑肌之間的結構關係). Journal of Andrology. 25:426-431, 2004.
2. Hsu GL, Hsieh CH (謝政興), Wen HS, Chiang HS. Penile venous anatomy: application to surgery for erectile disturbance (陰莖靜脈解剖構造：在勃起功能障礙手術中的應用). Asian Journal of Andrology. 4(1):61-66, 2002.
3. Hsu GL, Hsieh CH (謝政興), Wen HS, Chen YC, Chen SC, Mok MS. Penile venous anatomy: an additional description and its clinical implication (陰莖靜脈解剖構造：附加描述及其臨床意涵). Journal of Andrology. 24(6):921-927, 2003.
4. Hsu GL, Hsieh CH (謝政興), Wen HS, Hsu WL, Chen YC, Chen RM, Chen SC, Hsieh JT. The effect of electrocoagulation on the sinusoids in the human penis (電燒對於人類陰莖海綿體的影響). Journal of Andrology. 25(6):954-9, 2004.

凡是長形、會膨脹、具穿透力的物體，都可能被認為是男性性器官(小弟弟)的表徵，例如石柱、樹幹、鰻魚、加農砲等，常被用來比喻甚至當成祟拜的對象。許多人恨鐵不成鋼，幻想著自己的小弟弟也能有如此這般的偉大堅挺，於是求助許多方法，包括推拿、坐禪、吐納等，甚至折磨小弟弟的”九九神功”，在陰莖上吊掛重物，希望把小弟弟快點「拉拔長大」、有「凍久」的效果 …

小弟弟的迷思閱讀全文 »

『我的手是上天賜予的，祂要經過我的手治療你的病，祂要治好你幾分就會治好你幾分；上天的決定是什麼，我也不知道。讓我們一起祈禱吧！』，有位醫師在手術前這樣告訴病患。帶著些許揶揄卻也顯露出真誠，正說明人類對於疾病的挑戰，能力尚有許多不足之處，因此對於疾病的治療，需常滿懷敬畏之心。

泌尿醫學近年拜高科技醫療設備的創新與發展有長足的進步，但大眾對於〝下半身的醫學〞仍有諸多隱諱與誤解，因此我們建構這個專業的泌尿醫學網站，嘗試以現代醫學的觀點來闡釋可能發生在我們生活周遭人群的相關疾病；藉由清楚的疾病分類讓需要的人輕易的找到所需資訊。當然，一個優良的網站並非一蹴可幾，須顧及專業但不詰屈聱牙，深入卻又淺顯易懂，尤其秉持寧缺勿濫的最高精神，務必使內容充實精確，………，真的不容易！

最後只能說：『我的能力是上天賜予的，祂要經過我的網站傳播泌尿醫學資訊，祂要讓人了解幾分就會讓人了解幾分；上天的決定是什麼，我也不知道。讓我們一起祈禱吧！』

10.Hsu GL, Wen HS, Hsieh CH (謝政興), Liu LJ, Chen YC. Traumatic glans deformity: reconstruction of distal ligamentous structure (外傷性龜頭畸形：重建遠端韌帶結構). Journal of Urology. 166:1390, 2001.

11.Hsu GL, Wen HS, Hsieh CH (謝政興), Chen YC, Liu LJ, Chiang HS. Disturbance of erection-related veins in the human penis (人類陰莖勃起相關靜脈的分佈). New Taipei Journal of Medicine. 3:245-252, 2001.

12.Yang SSD, Hsieh CH (謝政興), Chen YT, Chen SC. Normal size of the urethral meatus in uncircumcised boys (未割包皮男孩尿道口徑的正常大小). Journal of the Urological Association ROC. 12:20-23, 2001.

13.Yang SS, Chen SC, Hsieh CH (謝政興), Chen YT. Reoperative Snodgrass procedure (Snodgrass再次手術方法). Journal of Urology. 166(6):2342-2345, 2001.

14.Wong WY, Chen YT, Yang SSD, Hsieh CH (謝政興), Wang CC. Experience with managing renal trauma (腎臟外傷處理經驗). Journal of the Urological Association ROC. 12:171-175, 2001.

15.Liao CH, Chen YT, Hsieh CH (謝政興), Yang SSD, Wang CC, Tsai SS. Multiple-session percutaneous sclerotherapy with alcohol is a safe and effective treatment for symptomatic simple renal cysts (多療程經皮酒精硬化療法對於有症狀的單純性腎囊腫是一種安全有效的治療方式). Journal of the Urological Association ROC. 13:103-107, 2002.

16.Chen SC, Yang SS, Hsieh CH (謝政興), Wang CC, Chen YT. One-stage correction of proximal hypospadias and penoscrotal transposition (單一階段手術矯正近端尿道下裂合併陰莖陰囊轉位). Journal of the Formosan Medical Association. 101(1):48-51, 2002.

17.Hsu GL, Hsieh CH (謝政興), Wen HS, Chen YC, Liu LJ, Kang TJ, Yang SD, Chiang HS. Penile enhancement: an outpatient technique (陰莖增大：門診手術技巧). European Journal of Medical Sexology. 11(39):6-10, 2002.

18.Hsu GL, Hsieh CH (謝政興), Wen HS, Chiang HS. Penile venous anatomy: application to surgery for erectile disturbance (陰莖靜脈解剖構造：在勃起功能障礙手術中的應用). Asian Journal of Andrology. 4(1):61-66, 2002.

19.Hsu GL, Hsieh CH (謝政興), Wen HS. Curvature correction in patients with tunical rupture: a necessary adjunct to repair (陰莖白膜破裂患者的彎曲矯正：修補破裂的必要輔助方法). Journal of Urology. 167:1381-1383, 2002.

20.Chen YT, Chen J, Wong WY, Yang SS, Hsieh CH (謝政興), Wang CC. Is ureteral stenting necessary after uncomplicated ureteroscopic lithotripsy? A prospective, randomized controlled trial (非複雜性輸尿管鏡碎石手術後是否需要置入輸尿管導管？一項前瞻性隨機對照試驗). Journal of Urology. 167(5):1977-1980, 2002.

21.Yang SS, Wang CC, Hsieh CH (謝政興), Chen YT. Alpha1-adrenergic blockers in young men with primary bladder neck obstruction (使用α1-腎上腺素阻斷劑治療原發性膀胱頸阻塞的年輕男性). Journal of Urology. 168(2):571-574, 2002.

22.Hsu GL, Hsieh CH (謝政興), Wen HS, Hsieh JT, Chiang HS. Outpatient surgery for penile venous patch with the patient under local anesthesia (局部麻醉門診手術：陰莖靜脈皮瓣補綴手術矯正陰莖彎曲). Journal of Andrology. 24(1):35-39, 2003.

23.Hsu GL, Hsieh CH (謝政興), Wen HS, Chen YC, Chen SC, Mok MS. Penile venous anatomy: an additional description and its clinical implication (陰莖靜脈解剖構造：附加描述及其臨床意涵). Journal of Andrology. 24(6):921-927, 2003.

24.Chen YT, Yang SS, Hsieh CH (謝政興), Wang CC. Hand port-site metastasis of renal-cell carcinoma following hand-assisted laparoscopic radical nephrectomy: case report (手輔式腹腔鏡根治性腎臟切除術後腎細胞癌的手部端口轉移：病例報告). Journal of Endourology. 17(9):771-775, 2003.

25.Hsu GL, Hsieh CH (謝政興), Wen HS, Hsu WL, Wu CH, Fong TH, Chen SC, Tseng GF. Anatomy of the human penis: the relationship of the architecture between skeletal and smooth muscles (人類陰莖解剖構造：骨骼肌和平滑肌之間的結構關係). Journal of Andrology. 25:426-431, 2004.

26.Hsu GL, Hsieh CH (謝政興), Wen HS, Chen SC, Chen YC, Liu LJ, Mok MS, Wu CH. Outpatient penile implantation with the patient under a novel method of crural block (以新的陰莖腳局部麻醉方法施行陰莖植入門診手術). International Journal of Andrology. 27:147-151, 2004.

27.Hsu GL, Hsieh CH (謝政興), Wen HS, Hsu WL, Chen YC, Chen RM, Chen SC, Hsieh JT. The effect of electrocoagulation on the sinusoids in the human penis (電燒對於人類陰莖海綿體的影響). Journal of Andrology. 25(6):954-959, 2004.

28.Chen SC, Hsieh CH (謝政興), Hsu GL, Wang CJ, Wen HS, Ling PY, Huang HM, Tseng GF. The progression of the penile vein: could it be recurrent (陰莖靜脈的進展：陰莖靜脈是否會復發)? Journal of Andrology. 26(1):53-60, 2005.

29.Hsieh CH (謝政興), Wang CJ, Hsu GL, Chen SC, Ling PY, Wang T, Fong TH, Tseng GF. Penile veins play a pivotal role in erection: the hemodynamic evidence (陰莖靜脈在勃起中扮演關鍵角色：血液動力學上的證據). International Journal of Andrology. 28(2):88-92, 2005.

30.Hsu GL, Lin CW, Hsieh CH (謝政興), Hsieh JT, Chen SC, Kuo TF, Ling PY, Huang HM, Wang CJ, Tseng GF. Distal ligament in human glans: a comparative study of penile architecture (人類龜頭遠端韌帶：一項比較研究陰莖結構). Journal of Andrology. 26(5):624-28, 2005.

31.Wen HS, Hsieh CH (謝政興), Hsu GL, Kao YC, Ling PY, Huang HM, Wang CJ, Einhorn EF. The synergism of penile venous surgery and oral sildenafil in treating patients with erectile dysfunction (陰莖靜脈截除手術與口服威而剛治療勃起功能障礙的協同作用). International Journal of Andrology. 28(5):297-303, 2005.

32.Hsu GL, Ling PY, Hsieh CH (謝政興), Wang CJ, Chen CW, Wen HS, Huang HM, Einhorn EF, Tseng GF. Outpatient varicocelectomy performed under local anesthesia (局部麻醉門診手術：精索靜脈曲張截除手術). Asian Journal of Andrology. 7(4):439-444, 2005.

47.Hsu GL, Hsieh CH (謝政興), Wen HS. Erection related venous distribution in human penis. Annual Meeting of the Association of Andrology, ROC, 2001.

48.Hsu GL, Hsieh CH (謝政興), Wen HS. Reconstruction for traumatic glans deformity: a case report. Annual Meeting of the Association of Andrology, ROC, 2001.

49.Tsai YC, Chen YT, Hsieh CH (謝政興), Yang SSD. Transurethral resection of prostate in male older than 85 years. Annual Meeting of the Association of Andrology, ROC, 2001.

50.Huang JHE, Chen YT, Yang SSD, Hsieh CH (謝政興), Wang CC. Experience of managing large impacted upper ureteral stones by ureteroscopy. Annual Meeting of the Surgical Association, ROC, 2001.

51.Wang CC, Yang SSD, Chen YT, Hsieh CH (謝政興). Female bladder outlet obstruction: ECK hospital experiences. Annual Meeting of the Surgical Association, ROC, 2001.

52.Wang CC, Yang SSD, Hsieh CH (謝政興), Chen YT. Low maximum flow rate in men less than 50 years old. Annual Meeting of the Surgical Association, ROC, 2001.

53.Wang CC, Hsieh CH (謝政興), Chen YT, Yang SSD. The volume of the prostate measured by 2-D and 3-D transrectal ultrasonography. Annual Meeting of the Surgical Association, ROC, 2001.

54.Huang JHE, Chen YT, Yang SSD, Hsieh CH (謝政興), Wang CC, Chen J. Is ureteral stenting necessary in uncomplicated ureteroscopic lithotripsy ? Annual Meeting of the American Urological Association, Aneiham, CA, 2001.

55.Hsieh CH (謝政興), Hsu GL, Wen HS, Chen YC, Liu LJ. Penile enhancement: an outpatient technique. The 15th World Congress of Sexology, Paris, France, 2001.

56.Hsieh CH (謝政興), Hsu GL, Wen HS, Chen YC, Liu LJ. Erection related venous distribution in human penis. The 15th World Congress of Sexology, Paris, France, 2001.

57.Hsieh CH (謝政興), Hsu GL, Wen HS, Chen YC, Liu LJ, Kang TJ. Penile enhancement: an outpatient technique. Annual Meeting of the Urological Association, ROC, 2001.

58.Wen HS, Hsu GL, Hsieh CH (謝政興), Chen YC, Liu LJ, Kang TJ. Erection related venous distribution in human penis. Annual Meeting of the Urological Association, ROC, 2001.

59.Chen YT, Wang CC, Hsieh CH (謝政興), Yang SSD. Management of renal trauma with vicryl mesh repair and nephrectomy. Annual Meeting of the Urological Association, ROC, 2001.

60.Tsai SS, Chen YT, Yang SSD, Hsieh CH (謝政興), Wang CC. The treatment of renal cyst – our three year experience. Annual Meeting of the Urological Association, ROC, 2001.

61.Chen YT, Wang CC, Hsieh CH (謝政興), Yang SSD. Application of flexible ureterorenoscopy for upper urinary tract problems. Annual Meeting of the Urological Association, ROC, 2001.

62.Wu CC, Yang SSD, Wang CC, Hsieh CH (謝政興), Chen YT. Comparison of two steroid hormone in treating boys with phimosis: a randomized prospective study. Annual Meeting of the Urological Association, ROC, 2001.

63.Chen YT, Yang SSD, Wang CC, Hsieh CH (謝政興). Laparoscopic radical cystoprostatectomy-initial experience. Annual Meeting of the Urological Association, ROC, 2001.

64.Chen YT, Lin CH, Wang CC, Hsieh CH (謝政興), Yang SSD. Femoral nerve neuropathy after retropubic radical prostatectomy: a case report. Annual Meeting of the Urological Association, ROC, 2001.

65.Yang SSD, Tsai YC, Chen SC, Chen YT, Hsieh CH (謝政興), Wang CC. The efficacy and safety of alpha-1 blockers in the treatment of enuresis associated with low peak flow rate. Annual Meeting of the Urological Association, ROC, 2001.

66.Wang CC, Yang SSD, Chen YT, Hsieh CH (謝政興). Management of bladder neck dysfunction. Annual Meeting of the Urological Association, ROC, 2001.

67.Yang SSD, Liao CH, Chen YT, Hsieh CH (謝政興), Wang CC. Biofeedback relaxation (BFR) for patients with pelvic floor overactivity (PFO): preliminary experience in En-Chu-Kong hospital. Annual Meeting of the Urological Association, ROC, 2001.

68.Chen YT, Yang SSD, Wang CC, Hsieh CH (謝政興). Is ureteral stenting necessary after uncomplicated ureteroscopic lithotripsy:a prospective randomized controlled trial. Annual Meeting of the Urological Association, ROC, 2001.

69.Hsieh CH (謝政興), Tsai YC, Chen YT, Wang CC, Yang SSD. PCN-L for calyceal diverticular stone under ultrasonographic guidance with patients in modified supine position. Annual Meeting of the Urological Association, ROC, 2001.

70.Wu CC, Chen YT, Hsieh CH (謝政興), Wang CC, Yang SSD. Management of bladder calculi:clinical experience in En-Chu-Kong hospital. Annual Meeting of the Urological Association, ROC, 2001.

71.Wong MY, Chen YT, Yang SSD, Hsieh CH (謝政興), Wang CC. Management large impacted upper ureteral stones by ureteroscopy. Annual Meeting of the Urological Association, ROC, 2001.

72.Hsieh CH (謝政興), Hsu GL, Wen HS, Chen YC, Liu LJ, Kang TJ. Penile enhancement for implant patients: outpatient vein-ligated technique. The 8th Biennial Asia Pacific Meeting on Impotence, APSIR, Phuket, Thailand, 2001.

73.Hsu GL, Hsieh CH (謝政興), Wen HS, Chen YC, Liu LJ, Kang TJ. Erection related venous distribution in human penis. The 8th Biennial Asia Pacific Meeting on Impotence, APSIR, Phuket, Thailand, 2001.

74.Hsu GL, Hsieh CH (謝政興), Wen HS, Chen YC, Liu LJ, Kang TJ. The necessity of curvature correction in patients with tunical rupture. The 8th Biennial Asia Pacific Meeting on Impotence, APSIR, Phuket, Thailand, 2001.

75.Chen YT, Yang SSD, Wang CC, Hsieh CH (謝政興). Laparoscopic radical cystoprostatectomy-initial experience. Annual Meeting of the Urological Association, ROC, 2001.

76.Chen YT, Yang SSD, Wang CC, Hsieh CH (謝政興). Laparoscopic radical cystotectomy and radical prostatectomy. The 3th Symposium of the Minimally Invasive Surgery, Taiwan, 2001.

77.Chen YT, Wong WY, Yang SSD, Hsieh CH (謝政興), Wang CC. Is ureteral stentng necessary after uncomplicated ureteroscopic lithotripsy-a prospective randomized controlled trial. The 17th Basic Research Symposium and the 19th World Congress on Endourology and SWL. Bangkok, Thailand, 2001.

78.Chen YT, Yang SSD, Hsieh CH (謝政興), Wong WY. Management of large upper ureteral stones by ureteroscopic electrohydraulict lithotripsy. The 17th Basic Research Symposium and the 19th World Congress on Endourology and SWL. Bangkok, Thailand, 2001.

79.Chen YT, Yang SSD, Hsieh CH (謝政興), Wang CC. Simultaneous antegrade and reterograde endoscopic management of ureteral stricture. The 17th Basic Research Symposium and the 19th World Congress on Endourology and SWL. Bangkok, Thailand, 2001.

80.Chen YT, Chunghsin Y, Hsieh CH (謝政興), Yang SSD, Guangdar J. Management of ureteric calculi during pregnancy by ureteroscopy and electrohydraulic lithotripsy. The 17th Basic Research Symposium and the 19th World Congress on Endourology and SWL. Bangkok, Thailand, 2001.

81.Hsieh CH (謝政興), Hsu GL, Wen HS, Chen JS, Kang TJ, Chiang HS. Outpatient surgery of penile implant with the patient under local anesthesia. The 17th General Scientific Meeting of the Association of Andrology, ROC, P49, Taipei, 2002.

82.Hsu GL, Hsieh CH (謝政興), Wen HS, Chen JS, Kang TJ, Chiang HS. Penile anatomy: implication for erectile surgery. The 17th General Scientific Meeting of the Association of Andrology, ROC, P50, 2002.

83.Chen JS, Hsu GL, Hsieh CH (謝政興), Wen HS, Kang TJ, Chiang HS. Sildenafil in patient with poor responsiveness to penile venous stripping surgery. The 17th General Scientific Meeting of the Association of Andrology, ROC, P57, 2002.

84.Hsieh CH (謝政興), Hsu GL, Wen HS, Kang TJ, Chen JS, Chiang HS. Outpatient surgery for penile venous patch with the patient under local anesthesia. The 24th Congress of the Urological Association, ROC, F7, 2002.

85.Hsu GL, Hsieh CH (謝政興), Wen HS, Kang TJ, Chen JS, Chiang HS. Penile venous surgery: shall it be abandoned? The 24th Congress of the Urological Association, ROC, F6, 2002.

86.Hsu GL, Hsieh CH (謝政興), Wen HS, Kang TJ, Chen JS, Chiang HS. Penile venous anatomy: application for erectile surgery. International Journal of Impotence Research. 14(Suppl 3), S112, Montreal, Canada, 2002.

87.Hsieh CH (謝政興), Hsu GL, Wen HS, Chen JS, Kang TJ, Chiang HS. Outpatient surgery of penile implant with the patient under local anesthesia. International Journal of Impotence Research. 14(Suppl 3), S34, Montreal, Canada, 2002.

88.Hsu GL, Hsieh CH (謝政興), Wen HS, Kang TJ, Chen JS, Chiang HS. The evolution of the penile vein: could it be recurrent? International Journal of Impotence Research. 14(Suppl 3), S115, Montreal, Canada, 2002.

89.Hsu GL, Hsieh CH (謝政興), Wen HS, Chen SC, Tsai TC. The evolution of the penile vein: could it be recurrent? XXXIII World Congress of the International College of Surgeons in conjunction with 2002 Annual Meeting of ICS, Taiwan section, P351, 2002.

90.Hsu GL, Chen SC, Hsieh CH (謝政興), Wen HS, Tsai TC. Penile venous surgery: shall it be abandoned? XXXIII World Congress of the International College of Surgeons in conjunction with 2002 Annual Meeting of ICS, Taiwan section, P351, 2002.

91.Hsu GL, Hsieh CH (謝政興), Wen HS, Hsieh JT, Chiang HS. Outpatient surgery for penile venous patch with the patient under local anesthesia. XXXIII World Congress of the International College of Surgeons in conjunction with 2002 Annual Meeting of ICS, Taiwan section, P352, 2002.

92.Hsu GL, Hsieh CH (謝政興), Wen HS, Hsu WL, Chiu SY, Tsai SS. A guidline to the quantity of grafting for penile curvature cirrection. XXXIII World Congress of the International College of Surgeons in conjunction with 2002 Annual Meeting of ICS, Taiwan section, P352, 2002.

93.Hsu GL, Hsieh CH (謝政興), Wen HS, Chiu SY, Chen RM. The effect of electrocoagulation on the sinusoids of the human penis. XXXIII World Congress of the International College of Surgeons in conjunction with 2002 Annual Meeting of ICS, Taiwan section, P353, 2002.

94.Hsu GL, Hsieh CH (謝政興), Wen HS, Kang TJ, Tsai TC. Outpatient surgery of penile implant with the patient under local anesthesia. XXXIII World Congress of the International College of Surgeons in conjunction with 2002 Annual Meeting of ICS, Taiwan section, P353, 2002.

95.Hsu GL, Wen HS, Chen CW, Hsieh CH (謝政興), Tsai TC. Enhancement of oral sildenafil to penile venous surgery. XXXIII World Congress of the International College of Surgeons in conjunction with 2002 Annual Meeting of ICS, Taiwan section, P354, 2002.

96.Hsieh CH (謝政興), Hsu GL, Wen HS, Chen SC, Tsai TC. Penile venous surgery for impotence: shall it be abandoned? The 19th General Scientific Meeting of the Taiwanese Association of Andrology, P58, 2003.

97.Hsieh CH (謝政興), Hsu GL, Wen HS, Chen SC, Tsai TC. Penile venous surgery for impotence: shall it be abandoned? 海峽兩岸男性老化研討會. E7, Taipei, Taiwan, 2003.

98.Hsieh CH (謝政興), Hsu GL, Wen HS, Hsu WL, Chiu, Chen RM. The effect of electrocoagulation on the sinusoids in the human penis. The 2nd Asian ISSAM Meeting on the Aging Male, P2-06, Taipei, Taiwan, 2003.

99.Hsu GL, Hsieh CH (謝政興), Wen HS, Hsu WL, Chiu SY, Chen SC. A guideline to the quantity of grafting for penile curvature correction. The 2nd Asian ISSAM Meeting on the Aging Male, P2-07, Taipei, Taiwan, 2003.

100.Hsu GL, Hsieh CH (謝政興), Wen HS, Chen SC, Tsai TC. The evolution of the penile vein: could it be recurrent? The 18th Congress of the Taiwan Surgical Association, ROC, Abstract book, P156, 2003.

101.Hsieh CH (謝政興), Hsu GL, Wen HS, Chiu SY, Chen RM. The effect of electrocoagulation on the sinusoids in the human penis. The 18th Congress of the Taiwan Surgical Association, ROC, Abstract book, P197, 2003.

102.Chen YC, Hsu GL, Hsieh CH (謝政興), Wen HS, Lin MY, Chen SC. Penile venous surgery for impotence: should it be abandoned? The 21st General Scientific Meeting of the Taiwanese Association of Andrology, P82, 2004.

103.Hsieh CH (謝政興), Hsu GL, Wen HS, Lin MY, Chen YC, Chen SC. Progression of the penile vein: could it be recurrent? The 21st General Scientific Meeting of the Taiwanese Association of Andrology, P83, 2004.

104.Hsieh CH (謝政興), Hsu GL, Wen HS, Lin MY, Chen YC, Chen SC. The evolution of mammals’ penis: an anatomical evidence. The 21st General Scientific Meeting of the Taiwanese Association of Andrology, P57, 2004.

105.Hsu GL, Hsieh CH (謝政興), Wen HS, Lin MY, Chen YC, Chen SC. Anatomy of the human penis: the relationship of the architecture between skeletal and smooth muscles. The 21st General Scientific Meeting of the Taiwanese Association of Andrology, P56, 2004.

106.Lin MY, Hsu GL, Hsieh CH (謝政興), Wen HS, Chen YC, Chen SC. Testicular ptosis: a new recognition and its management. The 21st General Scientific Meeting of the Taiwanese Association of Andrology, P76, 2004.

107.Lin MY, Hsu GL, Hsieh CH (謝政興), Wen HS, Chen YC, Chen SC. The electrocoagulation effect on penile sinusoids. The 21st General Scientific Meeting of the Taiwanese Association of Andrology, P53, 2004.

108.Wen HS, Hsu GL, Hsieh CH (謝政興), Lin MY, Chen YC, Chen SC. Guidelines for determining the amount of grafting required for correction of penile curvature. The 21st General Scientific Meeting of the Taiwanese Association of Andrology, P52, 2004.

109.Wen HS, Hsu GL, Hsieh CH (謝政興), Lin MY, Chen YC, Chen SC. Outpatient penile implantation with the patient under a novel method of crural block. The 21st General Scientific Meeting of the Taiwanese Association of Andrology, P81, 2004.

110.Hsieh CH (謝政興), Wen HS, Hsu GL, Chen SC, Liu LJ, Chen YC. Testicular ptosis: a new recognition and its management. The 19th Congress of the Taiwan Surgical Association, ROC, Abstract book, P193, 2004.

111.Hsieh CH (謝政興), Wen HS, Hsu GL, Chen SC, Chen YC, Liu LJ. Anatomy of glans penis: a comparative study. The 19th Congress of the Taiwan Surgical Association, ROC, Abstract book, P164, 2004.

112.Hsieh CH (謝政興), Lee WC, Lee CL, Hsu WH. Giant bladder diverticulum. The 19th Congress of the Taiwan Surgical Association, ROC, Abstract book, P195, 2004.

113.Hsieh CH (謝政興), Hsu GL, Wen HS, Lin MY, Chen SC. Progression of the penile vein: could it be recurrent? The 29th Annual Meeting of American Society of Andrology, Abstract book, P60, Baltimore, 2004.

114.Hsieh CH (謝政興), Hsu GL, Wen HS, Lin MY, Chen YC, Chen SC. Anatomy of glans penis: a comparative study. The 29th Annual Meeting of American Society of Andrology, Abstract book, P94, Baltimore, 2004.

115.Hsu GL, Hsieh CH (謝政興), Wen HS, Lin MY, Fong TH. Anatomy of the human penis: the relationship of the architecture between skeletal and smooth muscles. The 29th Annual Meeting of American Society of Andrology, Abstract book, P60, Baltimore, 2004.

116.Hsu GL, Hsieh CH (謝政興), Wen HS, Lin MY, Chen SC. Penile venous surgery for impotence: should it be abandoned? The 29th Annual Meeting of American Society of Andrology, Abstract book, P95, Baltimore, 2004.

117.Lin MY, Hsu GL, Hsieh CH (謝政興), Wen HS, Chen SC. Testicular ptosis: a new recognition and its management. The 29th Annual Meeting of American Society of Andrology. Abstract book, P56, Baltimore, 2004.

118.Lin MY, Hsu GL, Hsieh CH (謝政興), Wen HS, Chen SC. The electrocoagulation effect on penile sinusoids. The 29th Annual Meeting of American Society of Andrology, Abstract book, P57, Baltimore, 2004.

119.Wen HS, Hsu GL, Hsieh CH (謝政興), Lin MY, Chen SC. Guidelines for determining the amount of grafting required for correction of penile curvature. The 29th Annual Meeting of American Society of Andrology, Abstract book, P60, Baltimore, 2004.

120.Wen HS, Hsu GL, Hsieh CH (謝政興), Lin MY, Chen SC. Outpatient penile implantation with the patient under a novel method of crural block. The 29th Annual Meeting of American Society of Andrology, Abstract book, P95, Baltimore, 2004.

121.Hsu GL, Hsieh CH (謝政興), Wen HS, Lin MY, Wang T, Fong TH, Tseng GF. Penile veins play a pivotal role in erection: the hemodynamic evidence. The 26th Congress of the Urological Association, ROC, B5, 2004.

122.Hsieh CH (謝政興), Lin CW, Hsu GL, Chen SC, Huang HM, Tseng GF. Evolution of the mammalian penis: the anatomical evidence. The 26th Congress of the Urological Association, ROC, B4, 2004.

123.Lin MY, Hsu GL, Hsieh CH (謝政興), Wen HS, Chen SC, Wu CH. Penile venous surgery for impotence: should it be abandoned? The 26th Congress of the Urological Association, ROC, B6, 2004.

124.Wen HS, Hsu GL, Hsieh CH (謝政興), Chen SC, Chen YC, Huang HM, Tseng GF. Guidelines for determining the amount of grafting required for correction of penile curvature. The 26th Congress of the Urological Association, ROC, P1, 2004. (Best Poster Award)

125.Hsu GL, Chen YC,Hsieh CH (謝政興), Wen HS, Chen RM, Chen SC. The effect of electrocoagulation on the sinusoids in the human penis. International Journal of Andrology. 11(Suppl):A56, The 7th Asian Congress of Urology, Hong Kong, 2004.

126.Hsu GL, Hsieh CH (謝政興), Lin CW, Chen YC, Tseng GF. The distal ligament is an essential structure in the human penis: a comparatively anatomical study of mammalian penises. International Journal of Andrology. 11(Suppl):A55, The 7th Asian Congress of Urology, Hong Kong, 2004.

127.Hsu GL, Hsieh CH (謝政興), Chen YC, Chen SC, Wen HS, TsengGF. The destiny of the penile vein: could it be recurrent? International Journal of Andrology. 11(Suppl):A57, The 7th Asian Congress of Urology, Hong Kong, 2004.

128.Hsu GL, Hsieh CH (謝政興), Wen HS, Chen YC, Wang T, Tseng GF. Penile veins play a pivotal role in erection: the hemodynamic evidence. International Journal of Andrology. 11(Suppl):A57, The 7th Asian Congress of Urology, Hong Kong, 2004.

129.Hsu GL, Hsieh CH (謝政興), Chen YC, Chen SC, Wen HS, Tseng GF. Penile venous surgery: shall it be abandoned? International Journal of Andrology. 11(Suppl):A23, The 7th Asian Congress of Urology, Hong Kong, 2004.

130.Chen YC, Hsu GL, Hsieh CH (謝政興), Chen SC, Wen HS, Tseng GF. Guidelines for venous patch for penile curvature correction. International Journal of Andrology. 11(Suppl):A57, The 7th Asian Congress of Urology, Hong Kong, 2004.

131.Chen YC, Hsu GL, Hsieh CH (謝政興), Wen HS, Chen SC, Tseng GF. Oral sildenafil plus penile venous surgery: a good option for medical intractable impotence. International Journal of Andrology. 11(Suppl):A23, The 7th Asian Congress of Urology, Hong Kong, 2004.

132.Hsu GL, Hsieh CH (謝政興), Wen HS, Ling PY, Chi LJ. Insufficient response to venous surgery: is penile vein recurrent or residual? The 23rd General Scientific Meeting of the Taiwanese Association of Andrology, P60, 2005.

133.Hsieh CH (謝政興), Hsu GL, Wen HS, Ling PY, Chi LJ. Is ballooning formation a necessary complication of tunical repair? The 23rd General Scientific Meeting of the Taiwanese Association of Andrology, P59, 2005.

134.Wen HS, Hsu GL, Hsieh CH (謝政興), Ling PY, Chi LJ. Venous surgery has a role in treating patients with erectile dysfunction: clinical evidence of synergic effect with sildenafil. The 23rd General Scientific Meeting of the Taiwanese Association of Andrology, P61, 2005.

135.Hsieh CH (謝政興), Hsu GL, Wen HS, Ling PY, Chi LJ. Can pure local anesthesia for outpatient penile surgeries be strictly followed? The 23rd General Scientific Meeting of the Taiwanese Association of Andrology, P77, 2005.

136.Hsieh CH (謝政興), Hsu GL, Wen HS, Ling PY, Chi LJ. Insufficient response to venous surgery: is penile vein recurrent or residual? The 20th Congress of the Taiwan Surgical Association, ROC, Abstract book, P128, 2005.

137.Hsieh CH (謝政興), Hsu GL, Wen HS, Ling PY, Chi LJ. Venous surgery has a role in treating patients with erectile dysfunction: clinical evidence of synergic effect with sildenafil. The 20th Congress of the Taiwan Surgical Association, ROC, Abstract book, P133, 2005.

138.Hsu GL, Hsieh CH (謝政興), Ling PY, Wen HS, Chi LJ. Can pure local anesthesia for outpatient penile surgeries be strictly followed? The 30th Annual Meeting of American Society of Andrology, Abstract book, P, Seattle, 2005.

139.Hsieh CH (謝政興), Hsu GL, Ling PY, Wen HS, Chi LJ. Venous surgery has a role in treating patients with erectile dysfunction: clinical evidence of synergic effect with sildenafil. The 30th Annual Meeting of American Society of Andrology, Abstract book, P, Seattle, 2005.

140.Hsieh CH (謝政興), Hsu GL, Ling PY, Wen HS, Chi LJ. Is ballooning formation a necessary complication of tunical repair? The 30th Annual Meeting of American Society of Andrology, Abstract book, P, Seattle, 2005.

141.Hsu GL, Hsieh CH (謝政興), Ling PY, Wen HS, Chi LJ. Insufficient response to venous surgery: is penile vein recurrent or residual? The 30th Annual Meeting of American Society of Andrology, Abstract book, P, Seattle, 2005.

142.Hsu GL, Hsieh CH (謝政興), Wen HS: Can pure local anesthesia for outpatient  penile surgeries be strictly followed? International Journal of Andrology. 28(Supplement 1):P-204,The 8^th International conference of Andrology, Seoul, Korea, 2005.

143.Hsu GL, Hsieh CH (謝政興), Wen HS: Penile venous stripping surgery for erectile dysfunction: should it be abandoned? International Journal of Andrology. 28(Supplement 1):P-205, The 8^th International conference of Andrology, Seoul, Korea, 2005.

144.Hsu GL, Hsieh CH (謝政興), Wen HS: Insufficient response to venous surgery: is penile vein recurrent or residual? International Journal of Andrology. 28(Supplement 1): P-206, The 8^th International conference of Andrology, Seoul, Korea, 2005.

145.Hsu GL, Hsieh CH (謝政興), Wen HS: The synergism of penile venous surgery and oral sildenafil in treating patients with erectile dysfunction. International Journal of Andrology. 28(Supplement 1): P-207, The 8^th International conference of Andrology, Seoul, Korea, 2005.

146.Hsu GL, Hsieh CH (謝政興), Wen HS: Guidelines for determining the amount of grafting required for correction of penile curvature. International Journal of Andrology. 28(Supplement 1): P-208, The 8^th International conference of Andrology, Seoul, Korea, 2005.

147.Hsu GL, Hsieh CH (謝政興), Wen HS: Distal ligament in human glans: a comparative study of penile architecture. International Journal of Andrology. 28(Supplement 1):P-209, The 8^th International conference of Andrology, Seoul, Korea, 2005.

148.Hsu GL, Hsieh CH (謝政興), Wen HS: Is a herniation complication necessary in tunical repair? International Journal of Andrology. 28(Supplement 1): P-211, The 8^th International conference of Andrology, Seoul, Korea, 2005.

149.Hsu GL, Hsieh CH (謝政興), Wen HS: Penile veins play a pivotal role in erection: the hemodynamic evidence. International Journal of Andrology. 28(Supplement 1): F-14,The 8^th International conference of Andrology, Seoul, Korea, 2005.

1.Hsieh CH (謝政興), Wang CJ, Lin MC, Liu SP, Yu HJ, Chen SC, Hsieh JT, Hsieh TS, Law HS, Chen J, Tsai TC, Hsu TC, Chiu TY. The results and complications of transurethral resection of prostate in patients with benign prostatic hyperplasia. Annual Meeting of the Urological Association, ROC, 1993.

2.Hsieh CH (謝政興), Lin MC, Huang TH, Chiu TY. Acquired isolated LH deficiency: a case report. Annual Meeting of the Urological Association, ROC, 1994.

3.Hsieh CH (謝政興), Chiang GJ, Yu HJ, Chiu TY, Lai MK. The distribution of serum prostate-specific antigen in health men. Annual Meeting of the Urological Association, ROC, 1995.

4.Hsieh CH (謝政興), Liu SP, Hsieh JT, Shun CT, Ko FN, Lai MK. The effect of hypercholesterolemia with or without treatments on the rabbit corpus cavernosum smooth muscle. Annual Meeting of the Urological Association, ROC, 1995.

5.Hsieh CH (謝政興), Liu SP, Hsieh JT, Lai MK. Evaluation of normal intrarenal arterial blood flow with ultrasound-Angio. Annual Meeting of the Urological Association, ROC, 1995. (Best Poster Award)

6.Hsieh JT, Liu SP, Hsieh CH (謝政興), Cheng JT, Lai MK. The regulation among sympathetic, dopaminergic and serotonergic systems of rat seminal vesicle -ex vivo evaluation. Annual Meeting of the Urological Association, ROC, 1996.

7.Hsieh CH (謝政興), Lai MK, Chueh SC, Chen SC, Chiang LY, Chen WC. The effects of fullerenols on the preservation of canine renal grafts – preliminary report. Annual Meeting of the Urological Association, ROC, 1996.

8.Hsieh CH (謝政興), Yu HJ, Chie WC, Lai MK. Correlation of prostate specific antigen density with prostate biopsy in patients with intermediate prostate specific antigen level. Annual Meeting of the Surgical Association, ROC, 1996.

9.Hsieh CH (謝政興), Liu SP, Hsiao PJ, Lai MK. Application of endoluminal ultrasound for ureteral lesions. Annual Meeting of the Surgical Association, ROC, 1996.

10.Hsieh CH (謝政興), Hsieh JT, Liu SP, Lai MK, Cheng JT. The regulation of rat seminal vesicle among sympathetic, dopaminergic and serotoninergic systems -ex vivo evaluation-. The 7th World Meeting on Impotence, ISSIR, San Francisco, USA, 1996.

11.Hsieh JT, Hsieh CH (謝政興), Cheng JT. The effect of negative pressure vaccum device on spinal cord injury patients. The 7th World Meeting on Impotence, ISSIR, San Francisco, USA, 1996.

12.Hsieh JT, Hsieh CH (謝政興), Law HS, Lai MK. The responses to serotoninergic agents in the rat seminal vesicle -in vivo evaluation-. Annual Meeting of the Urological Association, ROC, 1997.

13.Hsieh JT, Hsieh CH (謝政興), Law HS, Lai MK. The responses to serotoninergic agents in the rat seminal vesicle -in vivo evaluation-. Annual Meeting of the Association of Andrology , ROC, 1997.

14.Hsieh CH (謝政興), Hsieh JT, Cheng JT. The regulation among adrenergic, dopaminergic and serotonergic systems of rat seminal vesicle – ex vivo. The 6th Biennial Asia Pacific Meeting on Impotence, APSIR, Kuala Lumpur, Malaysia, 1997.

15.Hsieh JT, Law HS, Hsieh CH (謝政興), Cheng JT. In vivo evaluation of serotoninergic agents on premature ejaculation by inhibiting the seminal vesicle pressure response to electric nerve stimulation. The 6th Biennial Asia Pacific Meeting on Impotence, APSIR, Kuala Lumpur, Malaysia, 1997.

16.Hsieh CH (謝政興), Liu SP, Law HS, Hsieh HS. The inhibitory responses to sympatholytic agents and dopamine antagonists in the rat seminal vesicle. Annual Meeting of the Association of Andrology, ROC, 1998.

17.Hsieh JT, Hsieh CH (謝政興), Liu SP, Lai MK, Cheng JT. In vivo evaluation of serotoninergic agents and alpha adrenergic blocker on premature ejaculation by inhibiting the seminal vesicle pressure response to electric nerve stimulation. Annual Meeting of the American Urological Association, USA, 1998.

18.Chen YT, Hsieh CH (謝政興), Yang SSD. Encrustation and extensive stone formation of double J catheter –two case reports. Annual Meeting of the Urological Association, ROC, 1999.

19.Yang SSD, Chen YT, Hsieh CH (謝政興). Laser incision of prostate – preliminary report. Annual Meeting of the Urological Association, ROC, 1999.

20.Yang SSD, Chen YT, Hsieh CH (謝政興), Chen SC. Preservation of the distal thin urethra in hypospadias repair. Annual Meeting of the Urological Association, ROC, 1999.

21.Hsieh CH (謝政興), Chen YT, Yao WC, Yang SSD. Percutaneous nephrolithotomy under ultrasonographic guidance with patients in the supine position: experience in En Chu Kong hospital. Annual Meeting of the Urological Association, ROC, 1999. (Best Poster Award)

22.Hsieh CH (謝政興), Chen YT, Yang SSD. Chondrosarcoma of the urinary bladder associated with a giant vesical calculi: report of a case and review of the literature. Annual Meeting of the Urological Association, ROC, 1999.

23.Yang SSD, Chen YT, Hsieh CH (謝政興), Chen SC. Preservation of the thin distal urethra in hypospadias repair. The 1st Symposium of Pediatric Urology, Urological Association, ROC, 1999.

24.Chen YT, Yang SSD, Hsieh CH (謝政興). Management of ureterocele – four case reports. The 1st Symposium of Pediatric Urology, Urological Association, ROC, 1999.

25.Yang SSD, Hsieh CH (謝政興), Chen YT, Chen SC. The application of appendicovesicostomy as a continent atherizable stoma. The 1st Symposium of Pediatric Urology, Urological Association, ROC, 1999.

26.Yang SSD, Hsieh CH (謝政興), Chen YT, Chen SC. The size of the urethral meatus and its relationship with circumcision in taiwanese boys. The 1st Congress of the Asian-Pacific Association of Pediatric Urology, Beijing, China, 1999.

27.Hsieh CH (謝政興), Chen YT, Yang SSD. Viagra Safety Test in Impotent Patients at High Risk. The 7th Biennial Asia Pacific Meeting on Impotence, APSIR, Tokyo, Japan, 1999.

28.Hsieh CH (謝政興), Chen YT, Yao WC, Yang SSD. Percutaneous nephrolithotomy under ultrasonographic guidance with patients in the supine position. Annual Meeting of the Surgical Association, ROC, 2000. (Best Poster Award)

29.Hsieh CH (謝政興), Chen YT, Yang SSD. Viagra safety test in impotent patients at high risk. Annual Meeting of the Surgical Association, ROC, 2000.

30.Hsieh CH (謝政興), Chen YT, Yang SSD. Chondrosarcoma of the urinary bladder associated with a giant vesical calculi: report of a case and review of the literature. Annual Meeting of the Surgical Association, ROC, 2000.

31.Huang HE, Yang SSD, Chen YT, Hsieh CH (謝政興). Management of ureterocele – four case reports. Annual Meeting of the Surgical Association, ROC, 2000.

32.Wu HC, Yang SSD, Chen YT, Hsieh CH (謝政興). Laparoscopic orchiopexy of the intra-abdominal testis. Annual Meeting of the Surgical Association, ROC, 2000.

33.Yang SSD, Chen YT, Hsieh CH (謝政興). Salvage urethroplasty with snodgrass’ procedure. Annual Meeting of the Surgical Association, ROC, 2000.

34.Chen YT, Hsieh CH (謝政興), Yang SSD. Simultaneous nephroscopy and cystoscopy with patient in tilted dorsal lithotomy position. Annual Meeting of the Surgical Association, ROC, 2000.

35.Chen YT, Hsieh CH (謝政興), Yang SSD. Various contact medium to reduce pain in eswl: petroleum jelly versus ultrasound gel. Annual Meeting of the Surgical Association, ROC, 2000.

36.Hsieh CH (謝政興), Lin HH, Chen YT, Yang SSD. Prostate stromal sarcoma: report of a case and review of the literature. Annual Meeting of the Urological Association, ROC, 2000.

37.Huang SW, Chen YT, Hsieh CH (謝政興), Yang SSD. Management of ureteric calculi during pregnancy by rigid ureteroscopy and electrohydraulic lithotripsy. Annual Meeting of the Urological Association, ROC, 2000.

38.Yang SSD, Tsai YC, Chen YT, Hsieh CH (謝政興). The Nd:YAG contact laser resection of benign prostatic enlargement-a preliminary report. Annual Meeting of the Urological Association, ROC, 2000.

39.Chen YT, Yang SSD, Hsieh CH (謝政興). Tilted dorsal lithotomy position for simultaneous retrograde and percutaneous endoscopy managementof ureter stricture. Annual Meeting of the Urological Association, ROC, 2000.

40.Yang SSD, Chen SC, Hsieh CH (謝政興), Chen YT. Normal size of the urethral meatus in the Taiwanese boys. Annual Meeting of the Urological Association, ROC, 2000.

41.Yang SSD, Tsai YC, Chen YT, Hsieh CH (謝政興). Laser incision of prostate-preliminary report. Annual Meeting of the Urological Association, ROC, 2000.

42.Chen YT, Huang HE, Yang SSD, Hsieh CH (謝政興). Nd-YAG laser incision of bladder neck for the management of bladder neck contacture and bladder neck dysfuncton. Annual Meeting of the Urological Association, ROC, 2000.

43.Yang SSD, Chen SC, Hsieh CH (謝政興), Chen YT. Tubularized incised plate (TIP) urethroplasty for proximal hypospadias. Annual Meeting of the Urological Association, ROC, 2000.

44.Yang SSD, Chen YT, Hsieh CH (謝政興). The ND:YAG contact laser resection of benign prostate enlargement–a preliminary report. The 5th Asian Congress on Urology, Beijing, China, 2000.

45.Yang SSD, Cheng SC, Hsieh CH (謝政興), Chen YT. Tubularized incision plate (TIP) urethroplasty for proximal hypospadias. The 5th Asian Congress on Urology, Beijing, China, 2000.

46.Chen YT, Yang SSD, Hsieh CH (謝政興). Tilted dorsal lithotomy position for simultaneous retrograde and percutaneous endoscopy management of ureter stricture. The 5th Asian Congress on Urology, Beijing, China, 2000.

1.Yu HJ, Chie WC, Hsieh CH (謝政興), Tsai CC, Lai MK. Clinical efficacy of prostate-specific antigen testing in patients with prostate disease (前列腺特異性抗原檢測在前列腺疾病患者中的臨床療效). Journal of the Formosan Medical Association. 95(10):782-8, 1996.

2.Hsieh JT, Chang HC, Law HS, Hsieh CH (謝政興), Cheng JT. In vivo evaluation of serotonergic agents and alpha-adrenergic blockers on premature ejaculation by inhibiting the seminal vesicle pressure response to electrical nerve stimulation (藉由抑制儲精囊壓力對電神經刺激的反應，體內評估血清素和α-腎上腺素阻斷劑對早發性射精(早洩)的作用). British Journal of Urology. 82(2):237-240, 1998.

3.Hsieh JT, Liu SP, Hsieh CH (謝政興), Lai MK, Cheng JT. An ex vivo evaluation of regulatory role of biogenic amines in rat seminal vesicle after pharmacological manipulation (運用藥物作用，體外評估生物胺在老鼠儲精囊的調節腳色). Life Sciences. 63(15):PL221-229, 1998.

4.Hsieh CH (謝政興), Huang TH, Law HS, Lin MC. Acquired hypothalamus secretory dysfunction with isolated luteinizing hormone deficiency (後天性下視丘腦分泌功能障礙伴隨黃體生成激素缺乏). Journal of the Urological Association ROC. 9:36-40,1998.

5.Hsieh JT, Liu SP, Hsieh CH (謝政興), Cheng JT. An in vivo evaluation of the therapeutic potential of sympatholytic agents on premature ejaculation (體內評估交感神經阻斷藥物對於早發性射精(早洩)的治療潛力). BJU International. 84(4):503-506, 1999.

6.Guh JH, Hsieh CH (謝政興), Teng CM. Investigation of the effects of some alkaloidal alpha1-adrenoceptor antagonists on human hyperplastic prostate (某些生物鹼α1-腎上腺素受體拮抗劑對於人類攝護腺增生影響的研究). European Journal of Pharmacology. 374(3):503-510, 1999.

7.Yang SSD, Chen YT, Hsieh CH (謝政興), Chen SC. Preservation of the thin distal urethra in hypospadias repair (尿道下裂修補手術中保留遠端薄壁尿道). Journal of Urology. 164(1):151-153, 2000.

8.Chen SC, Yang SSD, Hsieh CH (謝政興), Chen YT. Tubularized incised plate urethroplasty for proximal hypospadias (運用尿道板切開管狀尿道成形術治療近端尿道下裂). BJU International. 86(9):1050-1053, 2000.

9.Yang SSD, Hsieh CH (謝政興), Chen YT. Combined use of Nd: YAG contact laser incision and non-contact coagulation necrosis in the treatment of benign prostatic hypertrophy – a preliminary report (合併使用Nd：YAG接觸性雷射切開術及非接觸性凝血壞死治療良性前列腺肥大的初步報告). Formosan Journal of Medicine. 4:1-7, 2000.