Ureterorenoscopy in the Evaluation of Upper Urinary Tract Disease / 대한비뇨기과학회지

A prospective study of our first 76 cases of ureterorenoscopy using extended length rigid and flexible endoscopes was performed. 63 stone manipulation were attempted in 61 patients by 2 endoscopists 46(73.0% ). Analyzed sequentially, removal was successful in 21 of 32 attempts(65. 6%) among the initial 40 cases and in 25 of 31 (80.6% ) among the subsequent 36 cases. Of 12 calculi larger than 5mm and of 12 positioned above the iliac vessels 6(46.2%). 7(58.3%), respectively, were removed successfully. Diagnostic and therapeutic uses of the ureteroscope in and delineation of ureteral filling defect(5 cases). In 4 cases information was obtained endoscopically that was not possible by standard diagnostic techniques. The direct visual approach to the ureter has distinct advantages over blind ureteral instrumentation.

Pressure/Flow Study in BPH / 대한비뇨기과학회지

BPH is found in 50% of males over the age of 50 and there is increase in incidence with age. But some patients with BPH do not induce bladder outlet obstruction and some patients with prostatism are not caused by bladder outlet obstruction. So, urodynamic study including pressure/flow study was performed in 45 males with prostatism to evaluate the degree of obstruction, and we measured maximal intravesical pressure, maximal detrusor pressure, prostatic urethral length, residual urine, minimal urethral resistance and pressure/flow plots. The 45 males were divided into 3 groups by maximal flow rate(MFR)(A: MFR>=15, B: 10<=MER<=15, C: MFR<10) and there was significant difference between each group only in minimal urethral resistance(P<0.05). The result of pressure/flow plots of A group showed that 93% (13/14) was nonobstructive pattern and the rest one was obstructive pattern which was caused by detrusor hyperreflexia. In B group. we could know the degree of obstruction in 58%(7/12) only with minimal urethral resistance and we could decide the degree of obstruction with pressure/flow plots in rest 5 cases whose minimal urethral resistances were between 0.43 and 0.65 unit. The result of pressure/flow plots of C group showed that 89%(17/19) was obstructive pattern and the rest 2 cases were nonobstructive patterns which were caused by detrusor hyporeflexia. In conclusion, with pressure/flow plots and minimal urethral resistance, we can decide the degree of obstruction in patients with prostatism especially whose MFR are between 10 and 15 ml/sec.

A comparison between early and delayed treatment of male genital trauma / 대한비뇨기과학회지

Male genital traumas on penis, scrotum and testis primarily result from external violences including motor vehicle accidents, industrial mishaps, gunshots, laceration, rights and sexual intercourse. The loss or function in this system may be not vital but the quality of patient`s life be deleterious if they are not properly managed. So, we reviewed 98 patients with male genital tract trauma in the view point or early and delayed treatment, and concluded that early diagnosis and judicious treatment gave patients the best chances of recovering urinary and genital function after genital trauma.

The prostate specific antigen in detection of the prostate cancer / 대한비뇨기과학회지

We measured the concentration of serum PSA and prostatic acid phosphatase for studying the usefulness of PSA in 145 cases with BPH and 24 cases with prostate cancer. PSA was more sensitive and same specific as PAP in diagnosis of prostate cancer(n < or = 20 ng/ml). The diagnostic accuracy and positive predictive rate or PSA were higher than PAP, positive predictive rate war highest in PSA(n < or = 10 ng/ml) with abnormal digital rectal examination. PSA was a simple and useful method for detection of prostate cancer. But, by strict statistical criteria alone, PSA by itself didn`t qualify as an effective screening tool. By combination with digital rectal examination and transrectal ultrasonography, it may be useful in early detection of prostate cancer.

Rigid ureteroscopic removal of ureteral stone performed at outpatient department / 대한비뇨기과학회지

Between January 1990 and February 1991, ureteroscopic removal of ureteral stone was performed in 40 cases at outpatient department under local anesthesia(36 cases) and epidural anesthesia(4 cases). The results were as follows. The success rate of ureteral stone removal was 82.1% (32 among 39 cases) in lower ureter, 86.7 %(26 among 30 cases) in female and 70.0%(7 among 10 cases) in male. Anesthetic methods were local(36 cases), and epidural(4 cases), Mean duration of hospitalization was 1.4 days(0-7 days). The associated complication rate was low, with most patients being treated conservatively. Therefore, we believe that the ureteroscopic stone removal at outpatient department can be done safely if we select patients properly(especially women). have adequate equipment and execute properly the basic technique.

The post-TURP change of the serum electrolyte and osmolarity by preoperative administration of furosemide / 대한비뇨기과학회지

To see the effectiveness of preoperatively administered furosemide for preventing Hypo-osmolarity and hyponatremia during TURP, 30 patients undergoing TURP were followed every preoperatively, 30 min intra-operatively as well as immediate postoperatively, 6 hours and 24 hours postoperatively with measurements of serum sodium, serum potassium and serum osmolarity. Among the 30 patients, 15 patients (experimental group) were administered furosemide immediately before TURP, the other 15 patients (control group) were not administered. We compared the changes of serum sodium, serum potassium and osmolarity of experimental group with those of control group. The result showed that the serum sodium and serum osmolarity were decreased significantly (p<0.01) in control group, but were not decreased significantly in experimental group. Thus, the preoperatively administered furosemide may prevent the dilutional hyponatremia and hypo-osmolarity during TURP, and may be helpful in high risk patient such as congestive heart failure and poor renal function.