An Experience of Spastic Neurogenic Bladder Treated with Augmentation Cystoplasty and External Urethral Sphincterotomy / 대한비뇨기과학회지

A 41-year-old man with a 12-year history of urinary incontinence and frequency was presented our hospital. He had a spinal cord injury after fell down from a utility pole. Spastic neurogennic bladder and detrusor external sphincter dyssynergia was diagnosed and augmentation cystoplasty was performed. And we performed additional external sphincterotomy to avoid intrmittent self catheterization. He can retain as much as 800m1 of urine without urinary incontinence and voids with abdominal pressure and retains little residual urine. We report the good result of additional external urethral sphincterotomy after augmentation cystoplasty.

The Effects of Intravesical BCG Instillation on Bladder Cancer Induced by N-butyl-N-(4-hydroxybutyl) Nitrosamine / 대한비뇨기과학회지

PURPOSE: We investigate the effects of intravesical BCG therapy on the occurance of superficial bladder cancer induced by N-butyl-N-(4-hydroxybutyl) nitrosamine(BBN) in Fisher 344 rats in vivo. We also examine whether NO mediated the antitumor activity of BCG against superficial bladder cancer in Fisher 344 rats. MATERIALS AND METHODS: BBN(0.1%) is orally administered for 20 weeks and it is combined with BCG(0.27mg) or NG-monomethyl-L-arginine (NG MMA, 10mg). once every week from 8th week to 19th week. The rats are sacrified at 20th week. NO secretion in urine for 24 ours is significantly increased in the BCG treated rats compared to the animals treated with saline or NGMMA. RESULTS: Pathologic findings demonstrate that the incidence of carcinoma is not statistically different in saline, BCG, NGMMA(p>0.05). However the size and number of tumor is decreased in the BCG treated rats compared with saline or NGMMA treated rats bearing bladder cancer induced by BBN(p<0.05). Inducible NO synthase(iNOS) is strongly induced in bladder tissue of rats treated with BCG and NGMMA but not in saline. CONCLUSIONS: Intravesical instillation of BCG on bladder cancer induced by BBN does not decrease the cancer occurrence but reduces the number and size of bladder cancer. Our results suggest that nitric oxide induced by intravesical instillation of BCG may mediate antitumor activity against the occupance of superficial bladder cancer.

Comparison of the Results after Lithotripsy of EDAP LT-01+ and Modulith SLX for Urinary Stones / 대한비뇨기과학회지

We attempted to compare the result of EDAP LT-01+ lithotripsy with Modulith SLX lithotripsy for management of urinary stones. We evaluated 1,544 patients (1,731 renal units) treated with EDAP LT-01+ ESWL (Group A) and 668 patients (707 renal units) treated with Modulith SLX ESWL (Group B). The results were obtained as follows; 1. Between the group A and B, stones were located in kidney (except staghorn calculi) in 666 cases (38.5%) and 160 cases (22.6%), in staghorn calculi in 31 cases (1.8%) and 13 cases (1.8%), in ureteropelvic junction (UPJ) in 65 cases (3.8%) and 19 cases (2.7%), in upper ureter in 469 cases (27.0%) and 200 cases (28.3%), in lower ureter in 491 cases (28.4%) and 271 cases (38.3%) and in bladder in 9 cases (0.5%) and 10 cases (1.4%), respectively. 2. Success rates according to stone size were 99.4% and 99.6% in less than 1 cm:, 97.5% and 97.2% in 1 cm2 to 2 cm2, 92.4% and 91.3% in 2 cm2 to 3 cm2 and 82.2% and 78.1% more than 3 cm2 respectively in the group A and B. There. was no statistically significant difference between two groups (,p>0.05). 3. Success rates ccording to stone location were 98.8% and 100% in renal stone (except staghorn calculi) , 83.9% and 84.6% in staghorn calculi,92.3% and 94.7% in UPJ stone, 97.7% and 98.5% in upper ureteral stone, 98.4% and 98.6% in lower ureteral stone and 66.7% and 30% in bladder respectively in the group A and B. There was no statistically significant difference between two groups (p>0.05). 4. Average shock wave sessions and time (min.) were 4.0 and 1.8 and 42.1 and 28.6 respectively in the group A and B. These differences were statistically significant (p=3 days) in 1.6% and 10.7%, steinstrasse in 5.1% and 12.5%, fever (>=38 degree C) in 2.1% and 2.3% and perirenal hematoma in 0% and 0.7% respectively in the group A and B. We concluded that success rates according to location and size of urinary stone were similar between two groups. But, treatment time of the group B was significantly shorter than that of the group A. Treatment sessions of the group B were decreased compared with the group A. Gross hematuria and steinstrasse were occurred significantly more in the group B compared to the group A (p<0.05).