A Clinical Study on Early Nephrectomy with Short-term Antituberculous Chemotherapy for Nonfunctioning Tuberculous Kidney / 대한신장학회잡지

PURPOSE: A clinical review was performed to evaluate the importance and effectiveness of early nephrectomy & the result of short-term chemotherapy on unilateral, nonfunctioning tuberculous kidneys. METHODS: Retrospective study was made on 34 patients with nonfunctioning tuberculous kidneys who underwent nephrectomy from February 1986 to December 1998. All patients were evaluated by annual frequency, age, sex and site distribution, presenting symptoms, tuberculous lesion on organs other than kidney, cystoscopic finding, urinalysis and urine AFB smear & culture, urine Tb-PCR, CBC & ESR finding, perioperative morbidity and mortality, treatment distribution(Group 1 and 2) and drug toxicity. RESULTS: In pathologic findings of the 39 cases in which nonfunctioning tuberculous kidneys were suspected, 5 cases had no evidence of tuberculosis. Those were xanthogranulomatous pyelonephritis(2 cases), chronic pyelonephritis with hydronephrosis(2 cases) and complicated multilocular cyst(1 case). Coexisting renal cell carcinoma was found in 1 case. 4 cases(11.7%) were hypertensive at the time of presentation and 3 cases of them had a decrease in blood pressure after nephrectomy. 7 cases(20.5%) had febrile symptom, 5 cases of them had renal & perirenal abscess(4 cases) and cutaneous fistula(1 case). No perioperative mortality occurred and perioperative complications(sinus arrhythmia, wound infection, wound dehiscence, ileus) were in 5 cases(14.7 %). There was no evidence of recurrence during follow-up periods(Follow-up mean periods : 18.5 months). CONCLUSION: Early nephrectomy is an effective treatment in the comprehensive management of the unilateral, nonfunctioning tuberculous kidneys, for accurate diagnosis, removal of infection focus, early control of presenting symptoms and prevention of tuberculosis recurrence. And this should be followed by postoperative, acceptable short-term antitubercul ous chemotherapy.

The Partial Neurectomy of the Dorsal Nerve of the Penis for Patient with Premature Ejaculation / 대한남성과학회지

PURPOSE: A clinical review was performed to evaluate the effectiveness of the partial neurectomy of the dorsal nerve of the penis on the treatment of premature ejaculation. PATIENTS AND METHODS: The study was made on 143 patients with premature ejaculation (mean age 38 years; range 22~53 years) who underwent the partial neurectomy of the dorsal nerve of the penis from January 1997 to September 1999. All patients were evaluated by change on pre- and post-operative ejaculatory latency and biothesiometry, postoperative satisfaction, management on unsatisfactory patients and postoperative complication. RESULTS: Pre- and post-operative vibration perception threshold of glans penis on biothesiometry was significantly decreased from mean 2~3 mA (range 1~6 mA) to 8~10 mA (range 3~15 mA) (p<0.01). Change on pre- and post-operative ejaculatory latency was prolonged from mean 1~3 minutes (55.2%) to 5~10 minutes (47.6%)(p<0.01). The postoperative results were satisfactory in 117 cases (81.8%). At follow-up 2 to 34 months postoperatively, 17 cases (11.8%) were complicated by glans pain, discomfort(7 cases), penile edema (6 cases), wound dehiscence(3 cases), and delayed ejaculation (1 case). CONCLUSION: The partial neurectomy of the dorsal nerve of the penis is an effective treatment in the comprehensive management of the premature ejaculation with glans hypersensitivity, for good results, a simple operative technique and a few postoperative complication. However, it must be followed up for long-term effectiveness and its complication.

Clinical review of nephrectomy on tuberculous non-functioning kidneys / 대한비뇨기과학회지

A clinical observation was made on 23 patients with tuberculous non-functioning kidneys who underwent nephrectomy during the period from February 1986 to June 1992. We reviewed these cases according to primary nephrectomy on tuberculous non-functioning kidneys. The following results were obtained. In pathologic findings of the 27 cases in which tuberculous non-functioning kidneys were suspected, 4 cases were no evidence of tuberculosis. Those were xanthoeranulomatous pyelonephritis (2 cases) and chronic pyelonephritis with hydronephrosis (2 cases). Coexisting renal cell carcinoma was found in 1 case. 4 cases (17.1%) were hypertensive at the time of presentation and 3 cases or them had a decrease in blood pressure after nephrectomy. No perioperative mortality occurred and perioperative complications (sinus arrhydrmia, wound infection, wound dehisdence, ileus) were in 4 cases (17.4 %). There was no evidence of recurrence during follow-u periods. (Follow-up mean periods: 18.5 months) Thus, it is concluded that primary nephrectomy is an important adjunct in the comprehensive management of the unilateral, tuberculous non-functioning kidneys, for accurate diagnosis, removal of infection source, early control and prevention of presenting symptoms.

Clinical observation of 30 cases who underwent epididymectomy: especially, on the cases of tuberculous epididymitis / 대한비뇨기과학회지

A clinical investigation was undertaken on 30 patients who underwent epididymectomy during the period from April 1986 to November 1991. In this study. clinical reasons of epididymectomy were as follows: First, for confirming of tuberculous epididymitis( 19 cases). Second. for treatment of chronic epididymitis(8 cases). Third, for treatment of acute epididymitis(2 cases). Pathohistologic findings were tuberculous epididymitis( 15 cases), chronic epididymitis(9 cases), sperm granuloma(3 cases). cystadenoma(2 cases). spermatocele(1 case). The highest occurrence was observed in the age groups of 20 to 39(60%) in tuberculous epididymitis. 30 to 49(66.6%) in chronic epididymitis. Tuberculous epididymitis was presented clinically non-tenderful epididymal nodule 66%, tenderful epididymal nodule 33%, scrotal fistula 20%. Chronic epididymitis was tenderful epididymal nodule 80%. scrotal swelling 26.6%. In urine examination, tuberculous epididymitis was observed on pyuria 40%, hematuria I3%. and tubercle bacilli 1 case. Chronic epididymitis was pyuria 37.5%, urine culture(E. coli 10(5)/ml) 25%. Tuberculous epididymitis corresponds b 268 of total male patients with genitourinary tuberculosis. The lateralization showed 46% in the left 33% in both side, 20% in the right. The most common affected region of epididymis was diffuse(40%). followed by tail 33%, head 26%. Associated tuberculous lesions. lung 25%, kidney 13%. vas 33.3%, testis 20%.

A case of fibroepithelial polyp of the ureter diagnosed with ureteroscopic finding and biopsy / 대한비뇨기과학회지

The differential diagnosis of benign tumors from other intra-ureteric lesions was difficult. But. recently. it is easy due to developed diagnostic procedures. such as ureteroscopy. We herein report a case of fibroepithelial polyp of the left ureteropelvic junction which was diagnosed with ureteroscopic finding and biopsy with brief review or literatures.