ABSTRACT
Complete urethral loss with vesicovaginal fistula is very infrequently encountered by the urologist. Urethral reconstruction may be accomplished with either bladder or vaginal wall flap. Moreover, it usually is necessary to reinforce the continence of reconstructed urethra with a well-vascularized pedicle flap from either the Martius labial flap, gracilis, perineum, or rectus. We report a case of the complete urethral loss with vesicovaginal fistula treated successfully with bilateral Martius labial fat graft.
Subject(s)
Female , Humans , Perineum , Transplants , Urethra , Urinary Bladder , Vesicovaginal FistulaABSTRACT
Polyorchidism is a rare anomaly. It may result from transverse division of the urogenital ridge, a hypothesis that best explains the anatomical features of the supernumerary testicle. Until recently, histology provided the only proof of polyorchidism but new imaging techniques, such as sonography and magnetic resonance imaging(MRI), allows a highly accurate diagnosis of supernumerary testes rendering biopsy unnecessary. We report a case of polyorchidism in a 24 month-old-boy in whom the scrotal sonogram and magnetic resonance imaging confirmed the presence of 2 testicles without any evidence of tumor within his right hemiscrotum and who was treated conservatively and followed up 2 years.
Subject(s)
Biopsy , Diagnosis , Magnetic Resonance Imaging , Testis , UltrasonographyABSTRACT
PURPOSE: To study the cellular events occuring during bladder development and regeneration, we used the human Dura mater (Tutoplast(R)) for augmenting the rat bladder. We compared their intravesical threshold pressure and volume, and observed the regenerative capacity of urothelium and smooth muscle cell within Tutoplast(R). MATERIALS AND METHODS: Among a total of 67 rats, 11 normal rats were checked their intravesical threshold pressure and volume(Group 1). 9 rats underwent only vesicotomy(Sham operation) and were checked their threshold pressure and volume at 2 months and 3 months postoperatively(Group 2). 47 rats underwent augmentation cystoplasty with Tutoplast(R) after partial cystectomy, which were checked pressure and volume at 1 day, 3-7 days, 2-4 weeks, 2-6 months postoperatively(Group 3). Specimens were examined histologically to assess the regeneration of urothelium and smooth muscle cell on the graft. RESULTS: There was a significant increase in intravesical volume of group 3 compared with group 1 and 2. There was a significant decrease in intravesical pressure of group 3 compared with group 2, but there was no significant difference between group 1 and 3. The specimens of 1 day postopratively showed inflammatory findings. Epithelialization on the graft margin was noted at 3 days postoperatively. At 7 days postoperatively, there was epithelial hyperplasia on the graft site. At 2 weeks postoperatively, there was a partial absorption of Tutoplast(R) as well as favorable progression of epithelialization. Smooth muscle regeneration and complete epithelialization were shown at 3 months postoperatively and absorption of Tutoplast(R) was completed thereafter. CONCLUSIONS: The regeneration of bladder cellular constituents within Tutoplast(R) will be valuable for further understanding the mechanism controlling bladder development and regeneration. Further studies will be necessary for using this method as an alternative strategy to the classical bladder augmentation.
Subject(s)
Animals , Humans , Rats , Absorption , Cystectomy , Dura Mater , Hyperplasia , Muscle, Smooth , Myocytes, Smooth Muscle , Regeneration , Transplants , Urinary Bladder , UrotheliumABSTRACT
PURPOSE: We did electrovaporization to reduce the absorbed volume of irrigant and bleeding during TURP, and compared the effects on intraoperative and postoperative serum electrolyte, osmolality, and blood loss between this method and the classic TURP. MATERIALS AND METHOD: Of the 45 BPH patients, 21 patients underwent TURP (Group l), while the other 24 patients were electrovaporized with vaportrode(Group ll). They were followed preoperatively, 30 min intraoperatively, immediate postoperatively, 6 hours and 24 hours postoperatively with measurements of serum sodium, potassium, glucose and BUN. The amount of absorbed irrigant, serum osmolality, effective osmolality, blood loss were calculated and compared between the two groups. RESULTS: Although the group ll showed a longer operation time and used a larger amount of irrigant than the group l, there was not a significant difference in the amount of blood loss between the two groups and lesser amount of irrigant was absorbed than the group l. There was not a significant decrease in postoperative serum Hb and Hct level compared with preoperative level in the group ll. Serum sodium level were significantly decreased during postoperative period every patients in the group l. The serum osmolality and effective osmolality levels were significantly decreased postoperatively as compared with the preoperative levels in the group l, but were not in the group ll. CONCLUSIONS: These results show that electrovaporization may be the effective method in preventing complications such as hyponatremia and hypoosmolality during perioperative period. This method may also be helpful in reducing blood loss.
Subject(s)
Humans , Glucose , Hemorrhage , Hyponatremia , Osmolar Concentration , Perioperative Period , Postoperative Period , Potassium , Prostatic Hyperplasia , Sodium , Transurethral Resection of ProstateABSTRACT
PURPOSE: The effect of a urethral catheter on pressure-flow study has important implications for the practice and interpretation of pressure flow studies. We wonder which catheter would be adequate for pressure flow study. We report 3 different size of catheters(4Fr, 10Fr, 12Fr) effects on urinary flow rate, voiding pressures and pressure flow plot. MATERIALS AND METHOD: Pressure flow studies were carried out on 141 patients(male;88, female;53), whose diseases were BPH in 22, prostatodynia in 37,urethral syndrome in 36, Hinman syndrome in 2, neurogenic bladder in 28, unstable bladder in 10, urethral stricture in 2 and bladder stone in 2. RESULTS: There was no significant difference between pre- and postcatheterization maximum flow rate in 4Fr group. But there were significant difference between pre- and post-catheterization maximum flow rate in 10Fr and 12Fr group. The detrusor pressure was significantly higher in 10Fr and 12Fr group than in 4Fr group. The larger size of catheter groups had more obstructive patterns in pressure flow plot. CONCLUSIONS: These results showed 4Fr catheter had less effect on pressure flow study than 10Fr, 12Fr catheter.
Subject(s)
Catheters , Urethral Stricture , Urinary Bladder , Urinary Bladder Calculi , Urinary Bladder, Neurogenic , Urinary CathetersABSTRACT
The incidence of acute urinary retention in females is very low but the causes are diverse. So, it is important to verify the causative diseases trough history taking, physical examination including neurologic tests and it is essential to find adequate therapeutic modalities. MATERIALS AND METHODS: We experienced 45 female patients who visited under the chief complaint of acute urinary retention and reviewed, evaluated retrospectively or prospectively during 4 years. The patients are divided 1) transient causes: immobilization after surgery, constipation, medications, herpes zoster, psychogenic causes 2) neurologic causes: cerebral concussion, peripheral neuropathy, brain tumor, herniated nucleus pulposus, spinal cord injury, previously undiagnosed diabetes 3) pelvic causes: difficult labor, uterine prolapse,, pelvic bone tumor, vaginal invasion of rectal cancer, imperforate hymen. RESULTS: Screening test were done through physical examination, history taking, routine urinalysis. Most patients recovered voiding after correction of underlying diseases. CONCLUSIONS: The patients who showed persistent retention were further evaluated through neurologic tests, urodynamics, pelvic ultrasonography and serious diseases as blain tumor, polyneuritis, metastaic pelvic bone tumor were diagnosed.
Subject(s)
Female , Humans , Brain Concussion , Brain Neoplasms , Constipation , Herpes Zoster , Hymen , Immobilization , Incidence , Mass Screening , Neuritis , Pelvic Bones , Peripheral Nervous System Diseases , Physical Examination , Prospective Studies , Rectal Neoplasms , Retrospective Studies , Spinal Cord Injuries , Ultrasonography , Urinalysis , Urinary Retention , Urodynamics , Uterine ProlapseABSTRACT
PURPOSE: Laparoscopy is a signigicant step forward in the evolution of minimally invasive surgery and laparoscopic varicocelectomy can be an alternative approach to the conventional open surgery or embolization. MATERIALS AND METHODS: Between July, 1994 and July 1995, laparoscopic varicocelectomies were performed in 20 clinical patients whose age ranged 6-29 years. TITLES: Spermatic artery saving was performed successfully in 16 cases. Hospitalization was 1 day and only 1 patient complained of persistent scorotal discomfort and palpable varicocele mass(grade 1). Conclusions : Early return to normal activity, simplicity of spermatic vein dissection, preservation of spermatic artery, access to bilateral veins have do this new technique an alternatives to routine high ligation.
Subject(s)
Humans , Arteries , Hospitalization , Laparoscopy , Ligation , Minimally Invasive Surgical Procedures , Varicocele , VeinsABSTRACT
Selected number of urinary E. coli isolates from patients were subjected to the tests to characterize in vitro properties, compared with the strains of normal flora in intestinal tract or other sources. Further studies were carried out for determination of the mechanism of pathogenesis by using rabbit as an experimental animal model. Both strains of 87E1 and 87E51 which had one type of pili, were eliminated rapidly 4 or 8 days after inoculation into renal pelvis of rabbit. On the contrary, 88E18 strain which had both types of pili successfully colonized in urinary tract and the rabbit died due to urosepsis after the 8th day of experiment. The result of bacterial count colonized in the tissue by colony forming unit (CFU)per gram were similar to those in the urine.
Subject(s)
Humans , Bacterial Load , Colon , Kidney Pelvis , Models, Animal , Stem Cells , Urinary Tract , Uropathogenic Escherichia coli , VirulenceABSTRACT
To overcome the limitations of clonogenic assay (low plating efficiencies, clumping artifacts, long assay duration), we performed chemosensitivity test using MTT and neutral red biologic assay on SC-115 (androgen stimulated mouse tumor) and TCC-SuP (human bladder tumor) cell lines. The anticancer agents tested were adriamycin, cisplatin, methotrexate and combination of these drugs. And the following results were obtained ; 1) The growth of two cell lines were inhibited dose-dependently by application of adriamycin, cisplatin and combination of drugs. But methotrexate was not effective on TCC-SuP cell line. 2) The neutral red biologic assay is more convenient and rapid method than MTT assay but staining ability is superior in MTT assay. 3) The MTT and neutral red biologic assay offer advantages in speed, simplicity, cost & safety for the chemosensitivity test and for determining the new regimen.
Subject(s)
Animals , Humans , Mice , Antineoplastic Agents , Artifacts , Biological Assay , Cell Line , Cisplatin , Doxorubicin , Methotrexate , Neutral Red , Staining and Labeling , Urinary Bladder Neoplasms , Urinary BladderABSTRACT
Fewer articles deal with unrelated malignancies in the same individual at different times. There are only a few reports of different histologic tumors of the urinary tract occurring simultaneously We are presenting 1 case of dissimilar malignancies of the urinary tract occurring simultaneously.
Subject(s)
Adenocarcinoma , Carcinoma, Transitional Cell , Kidney , Urinary Bladder , Urinary TractABSTRACT
Total 352 materials were obtained from the endocervix of prostitutes residing in Taegu area and 22 cases N, gonorrhoeae were isolated through T-M media culture, oxidase test, carbohydrate degradation test, Gram stain. Following results were obtained : 1. Among 22 isolates, 8 strains showed positive reaction to beta-lactamase test (36.4%). 2. Antimicrobial susceptibility test showed different MIC ranges between PPNG and non-PPNG group to penicillin, ampicillin. But, cephalosporins, quinolone derivatives showed similar MIC range between the PPNG and non-PPNG group. 3. MRH test which was available to detect pili of uropathic E, coli was not useful to evaluate adherence of N. gonorrhoeae. 4. In electrophoregram, 14 strains represented 2.6 megadalton cryptic plasmid and 2 strains of PPNG had both 4.5 and 3.2 megadalton plasmids. Therefore, further study is needed for demonstration of concurrent expression of both type (Asia and Africa) of plasmids.
Subject(s)
Humans , Ampicillin , beta-Lactamases , Cephalosporins , Neisseria gonorrhoeae , Neisseria , Oxidoreductases , Penicillins , Plasmids , Sex WorkersABSTRACT
Although the rates of tuberculosis cases are continuing decline with advent of newer drugs, sporadic cases of urinary tuberculosis still occur. During last 5 years, we experienced 22 cases of reconstructive surgery and 18 cases of endourologic procedures for preservation of renal function. The following results were obtained: 1. Reconstructive surgeries including ureteroneocystostomy etc. were underwent in 22 cases and improvement were noted in 18 cases. 2. In 18 endourologic cases, there has been a substantial improvement in renal function, decrease in upper tract dilatation and relief of symptom. Average indwelling duration was 2.4 months and the mean number of dilatation per patient was 1.8 time. 3. Endopyelotomy and direct ureterotomy with ureteroscope are useful modalities in multiple ureteral stricture or upper ureter stricture. 4. It should be emphasized that percutaneous antegrade stent indwelling was more easier than retrograde technique especially in failure cases.
Subject(s)
Humans , Constriction, Pathologic , Dilatation , Stents , Tuberculosis , Tuberculosis, Renal , Ureter , UreteroscopesABSTRACT
As the development of the percutaneous renal surgery, Ureteropelvic junction obstruction can be treated with endourologic technique instead of open surgery. Precutaneous endopyelotomy has been used mainly for the treatment of secondary ureteropelvic junction obstruction. But it was also successful for treatment of primary ureteropelvic junction obstruction. Recently, we performed endopyelotomy for 3 cases of ureteropelvic junction obstruction a 39 years-old male who had renal pelvic stones combined with ureteropelvic junction, a 32 years-old male with ureteropelvic junction obstruction and a 23 years-old male who had horseshoe kidney combined with ureteropelvic junction obstruction and good results were obtained.
Subject(s)
Adult , Humans , Male , Young Adult , KidneyABSTRACT
A renal arteriovenous fistula and arterial aneurysm are congenital or acquired in origin. Treatment has consisted of partial or total nephrectomy and ligation of branch artery traditionally. Recently the development of transcatheter arterial embolization technique has afforded a new therapeutic alternative Selective embolization using a embolic agent was found useful in management of arteriovenous fistula and aneurysm. With brief review of literatures, we report 5 cases treated successfully by selective transcatheter embolization.