Percutaneous Renal Tumor Biopsy in Small Renal Masses

With increased use of abdominal imaging studies, the diagnosis of kidney cancer has shifted toward early diagnoses of renal masses. Most of those tumors are small in sized. Treatment decision making for small renal tumors are challenging clinical problem, especially in elderly and unfit patients. Significant proportion of these small renal masses (SRMs) are benign tumors or low-grade renal cell carcinomas, with relatively indolent biologic and clinical behavior. According to the evidence suggests, percutaneous needle biopsies to clarify the pathological diagnosis of a renal mass as an aid to clinical decision making should be considered more frequently, especially in SRMs.

Percutaneous Renal Tumor Biopsy in Small Renal Masses

With increased use of abdominal imaging studies, the diagnosis of kidney cancer has shifted toward early diagnoses of renal masses. Most of those tumors are small in sized. Treatment decision making for small renal tumors are challenging clinical problem, especially in elderly and unfit patients. Significant proportion of these small renal masses (SRMs) are benign tumors or low-grade renal cell carcinomas, with relatively indolent biologic and clinical behavior. According to the evidence suggests, percutaneous needle biopsies to clarify the pathological diagnosis of a renal mass as an aid to clinical decision making should be considered more frequently, especially in SRMs.

The Effect of Dietary Calcium and Vitamin D on Renal Stone Formation

Up to 19% of men and 10% of women in the United States will form a kidney stone at some time and recurrence rates are as high as 20%–50% after 5 years. In Korea, some studies have shown that the incidence of kidney stones is as high as 30,000 per year, although the incidence has not increased significantly during the last decade. Calcium is very important for bone health, especially after middle age, and it is also an important factor in the formation of stones. Many studies have shown that ingestion of calcium during meals reduces the formation of stones. However, calcium supplements could reduce the risk of stone formations only when taken with meals. In the case of vitamin D, the intake of vitamin D did not increase the risk of stone formation. A large-scaled prospective study is needed.

An Uncommon Complication of Ileocystoplasty for Bladder Tuberculosis

These days, genitourinary tuberculosis (GUTB) rarely occurs in conjunction with pulmonary tuberculosis. Reconstructive surgery for GUTB has also decreased but may still be done in case of a grossly distorted genitourinary anatomy and dysfunction that are unlikely to regress with chemotherapy alone. Reconstructive bladder surgery for GUTB is a well-established procedure. The various complications associated with the reconstructive surgery have also been well documented. We present a case of an uncommon complication after ileocystoplasty.

Risk Factors for Persistent Storage Symptoms after Holmium Laser Enucleation of Prostate

OBJECTIVE: Holmium laser enucleation of prostate (HoLEP) is as fast-paced treatment that is one of the standard treatment for benign prostate hypoplasia. However, there is a rare case that the satisfaction rate of surgery is lowered due to storage symptoms such as frequency and urgency. We investigated the risk factors of bladder irritation symptoms persisted after holmium laser enucleation of prostate. METHODS: From January 2009 to December 2014, 220 patients underwent HoLEP in Soonchunhyang University Cheonan Hospital. Among them, 133 patients were selected who did not have any problem that could affect the voiding function including urologic cancer, neurogenic bladder, urinary tract infection, and bladder stone disease. At 3 months after surgery patients were divided into two groups: postoperative International Prostate Symptom Score (IPSS) storage symptom scores <8 (group I) and ≥8 (group II). The two groups were analyzed the parameters: preoperative (prostate size, uroflowmetry, IPSS, prostate calcification), intraoperative (operative time, resected prostate weight), and postoperative (IPSS, uroflowmetry). RESULTS: Of the 133 patients, 94 patients were assigned to group I and 39 patients were group II. Age of the patients, the prostate size, and maximal urinary flow rate showed no statistical difference in both groups. Preoperative storage symptom scores were significantly higher in group II (P<0.05) and IPSS voiding-to-storage subscore ratio was lower in group II without significance (P<0.05). The prostate calcification, periurethral prostatic calcification, and intravesical prostatic protrusion was no difference in the two groups. Postoperative IPSS, maximal urinary flow rate, and post-void residual urine volume was improved in two groups but storage symptom score was not improved in group II. Operative time and resected prostate weight were not found the differences, and postoperative parameters (maximal urinary flow rate, post-void residual urine volume) were showed no difference in both groups. However all of the IPSS was higher in group II. CONCLUSION: Many symptom improvements after HoLEP were observed but some patients may have difficulties due to persistent bladder irritation. Because bladder irritation sign could persist after surgery if preoperative storage symptom score was higher, it is necessary for a detailed description before surgery.