ABSTRACT
A total of fifty three patients with posterior urethral strictures followed by pelvic bone fracture were managed by one-stage perineal repair at Pusan National University from Jan. 1985. to Jun 1992. End-to-end anastomosis was performed in all cases, but other procedures were added to accomplish tension-free anastomosis in 34 cases. These techniques, which included distal urethra mobilization, corporeal body separation and inferior pubectomy wore performed in a progressive manner as needed. Excellent results were achieved and success rate was 97.8 % of all cases. And we evaluate complications after such progressive maneuvers and the relationship between type of posterior urethral injury based on urethrography, the types of surgical procedure and the types of pelvic bone fractures. Additional procedure were attributed to severe initial type IV urethral injury, unstable pelvic bone fracture and complex urethral stricture. In spite of performing additional procedures, the incidence of impotence, restrictue and incontinence made no differences. Therefore, separation of corporeal bodies and inferior pubectomy are safe and efficient method to treat nearly almost cases of urethral strictures including complex urethral strictures.
Subject(s)
Humans , Male , Erectile Dysfunction , Incidence , Pelvic Bones , Urethra , Urethral StrictureABSTRACT
Many parameters are available for study and evaluation for patients with benign prostatic hypertrophy (BPH). Of that, symptomatology has classically formed the urologist's initial data base on which to formulate evaluation of potential outlet obstruction, indication for surgery and evaluation of results of treatment. And, to identify surgical efficiency on reducing prostatism and clinical availability of symptom scoring system for quantitative, objective index of symptom status, we undertook long follow-up assessment of BPH with Boyarsky symptom score system on SO cases or open prostatectomy (OP group) and 135 cases of transurethral resection (TUR group) who treated surgically on Pusan National University from Jan. 1981 to Dec. 1990. Both surgical procedures are effective in reducing symptom status and higher preoperative symptom score was, the higher postoperative symptom store improvement resulted. Improvement of obstructive symptoms is significantly higher than that of irritative symptoms in both groups. The presence of acute urinary retention was significantly related with improvement of symptom score (p0.05). Although symptom score improvement did not completely reflex to comprehensive subjective symptom improvement, significant relationship was present. Therefore, it would be used as objective, quantitative index to access the voiding status of patients.
Subject(s)
Humans , Follow-Up Studies , Prostate , Prostatectomy , Prostatic Hyperplasia , Prostatism , Reflex , Urinary Retention , Urinary Tract InfectionsABSTRACT
As a part of ongoing effort to evaluate alternative treatments for benign prostatic hyperplasia (BPH}. we compared the outcomes of transurethral resection of prostate(TURP) with those of open prostatectomy(OP). To identify effect of TURP on high mortality due to cardiac death. We compared long-term mortality and the causes of death after each surgical procedures. From Jan 1981 to Dec. 1990, surgical management was underwent on 338 patients with BPH in Pusan National University Hospital. Of 338 patients. survival was identified in 70 of OP group and 166 of TURP group. Direct interview was possible in 50 of OP group and 135 of TURP group. Mean age and follow-up were 69.8 years old and 89.5 months in OP group and 68.7 years old and 45.4 months in TURP group. Both OP and TURP were effective in improving subjective voiding symptoms including comprehensive symptom and Boyarsky symptom score, but, no significant difference was observed between them. Postoperative convalescence period was significantly shorter in TURP group compared to OP group. The incidence of sexual dysfunction including loss of libido and poor erection was similar between two surgical groups, but the incidence of retrograde ejaculation was higher in TURP group than OP group. Postoperative mortality and leading causes of death were no difference between two groups. Conclusively, we could not find the significant differences between OP group and TURP group as to symptom improvement, long-term mortality and morbidity, and effectiveness on patient`s consent. Although we confess that further evaluation is needed for precise and objective results, such results show postoperative improvement of voiding symptoms, quality of life and long-term outcomes that may not depend on surgical options.
Subject(s)
Humans , Male , Cause of Death , Convalescence , Death , Ejaculation , Follow-Up Studies , Incidence , Libido , Mortality , Prostatic Hyperplasia , Quality of Life , Transurethral Resection of ProstateABSTRACT
Female pseudohermaphrodities are 46XX genetic females with normal Mullerian derivatives, but have various degrees of ambiguous external genitalia. While most of them are commonly associated with adrenogenital syndrome, some of them have been occasionally associated with maternal ingestion of testosterone or synthetic progestational agent, maternal virilizing tumor or rarely idiopathic. Herein, we present three cases of female pseudohermaphroditism which is unrelated with adrenogenital syndrome. One case is resulted from maternal ingestion of progestational agent during the first trimester of pregnancy, and the other idiopathic.
Subject(s)
Female , Humans , Pregnancy , 46, XX Disorders of Sex Development , Adrenogenital Syndrome , Eating , Genitalia , Pregnancy Trimester, First , TestosteroneABSTRACT
The clinical courses of four male patients who have concurrently discovered transitional cell carcinoma of the bladder and adenocarcinoma of the prostate were presented, each meets to Warren and Gate`s criteria. In the management of bladder cancer, 2 patients were treated by radical cystoprostatectomy with urinary diversion and remaining 2 by more conservative modalities such as transurethral resection of the bladder tumor. In the management of prostatic cancer, 3 patients were treated by hormonal therapy including bilateral orchiectomy and remaining1 by radiation therapy with bilateral orchiectomy. The modalities for management plan of all cases had decided by the stage and grade of transitional cell carcinoma of the bladder rather than adenocarcinoma of the prostate.
Subject(s)
Humans , Male , Adenocarcinoma , Carcinoma, Transitional Cell , Orchiectomy , Prostate , Prostatic Neoplasms , Urinary Bladder Neoplasms , Urinary Bladder , Urinary DiversionABSTRACT
The clinical courses of four male patients who have concurrently discovered transitional cell carcinoma of the bladder and adenocarcinoma of the prostate were presented, each meets to Warren and Gate`s criteria. In the management of bladder cancer, 2 patients were treated by radical cystoprostatectomy with urinary diversion and remaining 2 by more conservative modalities such as transurethral resection of the bladder tumor. In the management of prostatic cancer, 3 patients were treated by hormonal therapy including bilateral orchiectomy and remaining1 by radiation therapy with bilateral orchiectomy. The modalities for management plan of all cases had decided by the stage and grade of transitional cell carcinoma of the bladder rather than adenocarcinoma of the prostate.
Subject(s)
Humans , Male , Adenocarcinoma , Carcinoma, Transitional Cell , Orchiectomy , Prostate , Prostatic Neoplasms , Urinary Bladder Neoplasms , Urinary Bladder , Urinary DiversionABSTRACT
Congenital mesoblastic nephroma is relatively rare congenital disease. It occurs in the early neonatal period as an unencapsulted and locally invasive fibrous lesion. Survival following nephrectomy alone is excellent but local recurrence and metastases have been reported. Herein we present one case of congenital mesoblastic nephroma. A 13-day-old male infant admitted our hospital with chief complaint of palpable left abdominal mass. After nephrectomy, histologic diagnosis is congenital mesoblastic nephroma.