ABSTRACT
Traumatic rupture of the corpus cavernosum of the penis is rare and has been reported infrequently. We experienced 4 cases of penile fracture for recent 2 years. They occurred during coitus(1 case), masturbation(2 cases), and through blunt trauma(1 case). The former 3 cases were treated with immediate surgical intervention about 12 hours after injury. When the last case patient visited hospital 5 days after injury, the penile abscess treated immediately with surgical intervention had developed. Surgery consisted of complete evacuation of the hematoma or pus and repairing of the tear at the tunica albuginea. The results were excellent, with complete early recovery of erectile function. Delayed wound healing was observed only in a patient who underwent surgery about 5 days after injury, but this did not cause any complication afterward. In our experiences, immediate surgical treatment is recommended in patients with fracture of the penis.
Subject(s)
Humans , Male , Abscess , Hematoma , Penis , Rupture , Suppuration , Wound HealingABSTRACT
PURPOSE: The overuse and misuse of antimicrobial agents and their resultant emergence of resistant microorganisms have made choices regarding antimicrobial therapy more difficult. We studied the changes of antibiotic sensitivity to the causative organisms of urinary tract infection(UTI) for recent 5 years in order to give some useful informations about the choice of adequate drug in the treatment of UTI. MATERIALS AND METHODS: We analysed 1191 uropathogens and their antibiotic sensitivities of the 1132 patients who admitted or visited the National Police Hospital and had more than 105cfu/ml on urine culture from January 1994 to December 1998 retrospectively. RESULTS: The common pathogenic organisms were E. coli(51.5%), staphylococcus(15.7%), pseudomonas(9.1%), klebsiella(7.5%) and enterobacter(4.0%), enterococcus(3.4%), proteus(3.1%) in order. The incidence of E. coli decreased from 50.8% in 1994 to 41.3% in 1998 but the incidence of other gram negative organisms like pseudomonas, klebsiella, enterobacter, proteus and acinetobacter increased from 24.8% in 1994 to 42.6% in 1998. In E. coli isolates(the majority of positive cultures), resistance to six antibiotics changed significantly: ampicillin(19.4% to 15.5%), piperacillin(44.1% to 32.0%), cephalothin(70.6% to 58.6%), gentamicin(62.8% to 60.2%), tobramycin(95.0% to 88.1%), and ciprofloxacin(87.6% to 76.3%). The sensitivity rates of the gram negative organisms including E. coli were very low in 1998 (ampicillin 11.6%, piperacillin 36.6%, and trimethoprim/sulfamethoxazole 49.3%). CONCLUSIONS: We think that E. coli is still the most important organism in the UTI but we shoud be concerned about the increasing incidence of other gram negative organisms like pseudomonas, klebsiella, enterobacter, proteus and acinetobacter. And prior to receiving the bacteriological report, using ampicillin, trimethoprim/sulfamethoxazole as the first choice in the treatment of UTI shoud be reconsidered.
Subject(s)
Humans , Acinetobacter , Ampicillin , Anti-Bacterial Agents , Anti-Infective Agents , Enterobacter , Incidence , Klebsiella , Piperacillin , Police , Proteus , Pseudomonas , Retrospective Studies , Urinary Tract Infections , Urinary TractABSTRACT
We report a rare case of well differentiated paratesticular liposarcoma in a 72-year -old male. His chief complaint was left painless scrotal mass for about three years. The mass was composed of hard, soft, and rubbery components and its size was 20x5x5 cm in dimension. Scrotal ultrasonography showed huge highly echogenic multilobulated mass with some calcification and CT scan excluded the presence of nodal involvement. Left radical orchiectomy was performed as treatment and the patient has survived 24 months without evidence of recurrence. Paratesticular liposarcoma is very rare and most of them are low-grade malignancies and treatment is radical orchiectomy with wide local excision.
Subject(s)
Humans , Male , Liposarcoma , Orchiectomy , Recurrence , Tomography, X-Ray Computed , UltrasonographyABSTRACT
PURPOSE: To assess the ability of scrotal Doppler ultrasonography to confirm the diagnosis of clinical varicoceles and detect subclinical varicoceles. MATERIALS AND METHOD: Sixty patients with clinically evident varicocele were examined by scrotal doppler ultrasonography(gray scale: 60 patients, spectral Doppler: 35 patients, color Doppler: 22 patients). A control group of 21 patients with no suspected scrotal pathology also were studied. The age range of the varicocele group was 12-49 years. The normal group consisted of 21 subjects aged 19-23 years. Ultrasonographic measurement of scrotal vein diameter of patients before and during Valsalva maneuver, and scrotal vein blood flow reversal with Valsalva maneuver was compared with the findings of varicocele by physical examination. RESULTS: Significant differences were found in scrotal vein diameter before and during Valsalva maneuver between normal and varicocele testicular units. Cut-off points were selected in an arbitrary fashion on the basis of scattergram. Using this cut-off points and blood flow reversal, we found that 12(23%) of 53 patients with a clinically palpable left unilateral varicocele had an ultrasonographically positive subclinical right varicocele. 8(38%) of 21 patients without a clinical varicocele had a positive scrotal ultrasound. CONCLUSIONS: We suggest that scrotal doppler ultrasonography is a reliable means of confirming the clinical varicocele and screening the subclinical varicoceles.
Subject(s)
Humans , Diagnosis , Mass Screening , Pathology , Physical Examination , Ultrasonography , Ultrasonography, Doppler , Valsalva Maneuver , Varicocele , VeinsABSTRACT
PURPOSE: We evaluated the effects of epidermal growth factor(EGF) and transforming growth factor-alpha (TGF-alpha) on the growth of human transitional cell carcinoma cell lines. MATERIALS AND METHODS: T-24, KK47 and KU-1 cell lines established from human transitional cell carcinoma tissues were used. We cultured the cell lines in serum-free media for 48 hours and then administered EGF and TGF-alpha in the concentrations of 0.1ng/ml, 1ng/ml, 10ng/ml and 100ng/m1 respectively. We analysed the effects by MTT assay at 144 hours. RESULTS: There were statistically significant stimulatory effects on the growth of three cell lines in all cultures. Enhanced growth was also observed in the culture with administration of EGF and TGF-alpha simultaneously. None of stimulatory effects were dose-related. CONCLUSIONS: We should take into consideration of possible role of EGF which are excreted in urine in very high concentration in a biologically active form and TGF-alpha of which urinary level increases with various type of bladder injuries in occurrence, progression and recurrence of transitional cell carcinoma of urothelium.
Subject(s)
Humans , Carcinoma, Transitional Cell , Cell Line , Culture Media, Serum-Free , Epidermal Growth Factor , Recurrence , Transforming Growth Factor alpha , Transforming Growth Factors , Urinary Bladder , UrotheliumABSTRACT
We report a case of male infertility secondary to pituitary apoplexy, which occurred as a sequela of korean hemorrhagic fever. A 32 years old male patient with past history of korean hemorrhagic fever was studied because of infertility and erectile impotence. The size of his testicles were about 8ml in Rt. and Lt. Semen analysis, endocrinologic studies, and brain MRI demonstrated hypogonadotrophic hypogonadism due to panhypopituitarism. The patient was treated with HCG (2,000 IU) administered intramuscularly three times per week for 6 months. After the treatment, improvement of male secondary sex characteristics such as hair growth and testicle size was noted. Promotion of sexual potency and improvement of semen quality were also noted. Following the treatment, his wife conceived after 6 months.
Subject(s)
Adult , Humans , Male , Male , Brain , Erectile Dysfunction , Hair , Hemorrhagic Fever with Renal Syndrome , Hypogonadism , Infertility , Infertility, Male , Magnetic Resonance Imaging , Pituitary Apoplexy , Semen Analysis , Sex Characteristics , Spouses , TestisABSTRACT
We analysed 101 patients with voiding symptoms of suggestive prostatism to evaluate the diagnostic values of digital rectal examination (DRE), serum prostate specific antigen (PSA) and transrectal ultrasonography (TRUS) in the detection of prostate cancer. Final diagnoses confirmed histopathologically by TRUS-guided needle biopsy resulted in 31 prostate cancers. The prostate cancer detection rates by DRE, PSA (>2.5 ng/ml) and TRUS were 47.5%, 34.1% and 48.1%, respectively. Sensitivity and specificity of DRE, TRUS and serum PSA were 90%, 40%, 81%, 42.9% and 100%, 14.3% respectively. Especially PSA had too low specificity in discrimination of malignant diseases from the benign. Three out of 31 patients with prostate cancer showed only one abnormal findings from three items. Patients with abnormal findings in DRE-PSA, TRUS-PSA and DRE-TRUS showed the detection` rates of cancer 57.1%, 54.3% and 62.5% respectively. The detection rate was highest as 73.5% when patients showed abnormal findings in all three items. Our results suggest that the combination of DRE, TRUS and serum PSA increased the detection rate of cancer but several points such as cost-effectiveness and efforts to increase specificity methodologically should be taken into consideration before we apply those diagnostic modalities to screening of prostate cancers as routine procedures.
Subject(s)
Humans , Biopsy, Needle , Diagnosis , Digital Rectal Examination , Discrimination, Psychological , Mass Screening , Prostate , Prostate-Specific Antigen , Prostatic Neoplasms , Prostatism , Sensitivity and Specificity , UltrasonographyABSTRACT
Von Recklinghausen`s neurofibromatosis is an unusual disorder with a wide variety Of manifestations. The initial findings may at times involve the female genitalia. When the phallus is affected, the urologist has an opportunity for the establishment of an accurate diagnosis as well as for cosmetic correction. We report a case of neurofibromatosis with an involvement of clitoris in 1l-year-old girl.
Subject(s)
Female , Humans , Clitoris , Diagnosis , Genitalia, Female , Neurofibromatoses , Neurofibromatosis 1ABSTRACT
To determine the value of ultrasonography for the diagnosis of testicular rapture due to blunt trauma, we reviewed 69 patients of blunt scrotal trauma, which were evaluated by ultrasound before treatment. Thirty patients were managed conservatively, of which 3 cases were explored lately due to persistent pain or mass, and 39 explored immediately. Of the 30 patients treated conservatively the injury was resolved in 27. Surgical exploration of the 42 cases revealed testicular rupture in 29 and simple hematocele in 13. Analysis of the 29 cases with testicular rupture demonstrated that orchiectomy rates were 20% in early exploration and 53% in delayed exploration. in the 27 cases the testicular rupture was correctly diagnosed by ultrasonography, and there were 4 false-positive and 2 false-negative diagnoses of rupture. The specificity and sensitivity for the diagnosis of testicular rupture are 70% and 93%, and the positive and negative predictive values are 87% and 82%, respectively. Ultrasonography used in conjunction with a thorough physical examination is highly sensitive in identifying testicular rupture, and can provide objective information supporting the need for early surgical exploration in patients with blunt scrotal trauma.