Comparison between Transperineal Ultrasonography and Chain Cystourethrography in Stress Urinary Incotinence / 대한비뇨기과학회지

PURPOSE: This study was designed to determine the diagnostic availability of transperineal ultrasongraphy compared with chain cystourethrography for patients with stress urinary incontinence. MATERIALS AND METHOD: Twenty-seven outpatient women with stress urinary incontinence, who underwent both transperineal ultrasonography and chain cystourethrography for the last ten months, participated in this study. The mean age was 47 years(range 37 to 66 years). The posterior urethrovesical angle(PUVA) at lest and during strain, and both an increment of PUVA and bladder neck descent during strain were measured in the two methods, respectively. Wilcoxon Matched-Pairs Signed-Ranks test was used for the comparative analysis of the results. RESULTS: The mean of PUVAS at rest and during strain were 118.9 degrees and 142.3 degrees, respectively, and the mean of the increment of PUVAS during strain was 23.5 degreesin transperineal ultrasonography. The mean of PUVAS at rest and during strain were 130.7 degrees and 158,0 degrees, respectively, and the mean of the increment of PUVAS during strain was 27.3 in chain cystourethrography. There were statistically significant differences in PUVAS, but no significant differences in the increment of PUVAS during strain between the two methods. During strain condition, the mean descent of bladder neck was 11.8mm in transperineal ultrasonography and 13.7mm in chain cystourethrography, and there were no significant differences between the two methods. CONCLUSIONS: Compared with chain cystourethrography, the transperineal ultrasonography made no significant differences in the diagnosis of stress urinary incontinence using both the increment of PUVAS and the bladder neck descent caused by the increase of abdominal pressure during strain. In addition, the transperineal ultrasonography is considered to be replaceable for chain cystourethrography, as that is noninvasive, devoid of risks of irradiation, and removes the noticeable discomfort or embarrassment for the patient in the diagnosis of stress urinary incontinence.

Effect of Intravesical BCG Instillation on the Expression of Inducible Nitric Oxide Synthase in Mouse / 대한비뇨기과학회지

PURPOSE: Bacillus Calmette-Guerin(BCG) therapy for superficial bladders carcinoma and carcinoma in situ is believed to exert its antitumor effects through immune mechanisms when BCG is instilled into the bladder, but its detail mechanisms are poorly understood. Recently, intravesical BCG instillation is known to induce nitric oxide(NO) which is revealed to be tumoricidal . This experiment was performed to determine the intravesical localization and alteration of expression of inducible nitric oxide synthase(iNOS) after BCG instillation. MATERIALS AND METHODS: Normal saline(0.85m1/kg, control group) and BCG(6mg/kg, experimental group) were instilled intravesically in fifty four female mice. After 2 hours, each mouse urinated after removal of urethral ligature, and was sacrificed at 6th, 12th, 18th hour, 1st day, 1.5th, 2th, 3th, 7th and 14th day, respectively. Immunohistochemistry was performed on paraffin embedded bladder tissue using anti-inducible NOS antibody(Transduction Labaratories, USA.). RESULTS: Inflammatory cells were infiltrated in the bladder wall in the BCG-treated group, but not in the control group. Number of inflammatory cells among BCG-treated group, was the highest in the 18th hour group and was reduced gradually with time elapse thereafter In the control group, immunoreactivity of iNOS to be positive in the all intermediate cell layer and a few basal cell layer of bladder transitional epithelium, which did not change as time passed. In the BCG-treated group, immunoreactivity of iNOS increased from 6 hours after BCG instillation, and gradually decreased from 7 days to restore to the level of the control group. However, some cells of transitional epithelium showed reduced immunoreactivity, focally. CONCLUSIONS: These results suggest that iNOS is tonically expressed in transitional epithelium of mouse bladder which is further induced by BCG instillation. Also, NOS-mediated NO production is supposed to be one of factors to induce tumoricidal erect by BCG instillation.

Two Cases of Renal Angiomyolipomas with Tuberous Sclerosis / 대한비뇨기과학회지

We report two cases of bilateral renal angiomyolipoma with tuberous sclerosis who had skin lesions like butterfly shaped adenoma sebaceum on face, shagreen patch on back, leaf-shaped hypopigmented spot on both extremities, mental retardation, and seizure, which they are treated unilateral simple nephrectomy and selective arterial embolization, each other.