A 10-Year Retrospective Study of the Operative Treatment Results of Adult Type Hydrocele / 대한비뇨기과학회지

PURPOSE: Although hydrocelectomy is commonly performed in general urological practice, the incidence of complications and the outcomes of this procedure seem to be underreported in the literature. We evaluated the incidence of complications and the outcomes of patients who underwent hydrocelectomy. MATERIALS AND METHODS: Between January 1996 and December 2005, 289 patients with hydrocele were retrospectively assigned into three groups according to the degree of dissection or the amount of the excision of the hydrocele sac. Group 1 included 78 patients who were treated by dissection and excision of the entire hydrocele sac. Group 2 consisted of 149 patients who were treated by dissection and eversion of the hydrocele sac. The 62 patients in group 3 underwent operations in which there was little or no dissection of the hydrocele. We analyzed the complications, the effects of surgical treatment and the results according to the surgical techniques. RESULTS: The duration of recovery showed no differences among the three groups. The overall complication rate was 36.3%. Transient scrotal swelling occurred in 28.0% of the patients, hematoma in 2.7%, wound infection in 1.7%, and injury to the epididymis or testis, chronic pain and persistent swelling occurred in 1.3%. The overall incidence of postoperative complications was significantly lower among the patients in group 3. The rate of scrotal swelling was significantly correlated to the volume of the hydroceles and the amount of the excision of the hydrocele sac. CONCLUSIONS: The long term results of hydrocelectomy were good. The most common complications following scrotal surgery for hydroceles were scrotal swelling, hematoma, wound infection and injury to the epididymis and testis. Most of the complications were treated by conservative management.

Effects of Ovariectomy and Estrogen Replacement on Rat Bladder Physiology and Morphology

PURPOSES: An overactive bladder is highly prevalent in middle-aged woman, especially during the postmenopausal period. We evaluated the relationship between detrusor overactivity and postmenopausal state and the effects of estrogen replacement for detrusor overactivity caused by the ovariectomy in rat. MATERIAL AND METHODS: Thirty female Sprague Dawley rats were divided into three groups: the control, the ovariectomy group and the estrogen replacement group after the ovariectomy. The ovariectomy and estrogen replacement groups had the bilateral ovariectomies at 12 weeks of age. After 2 weeks, the control and ovariectomy groups were injected weekly with saline, while the estrogen replacement group was injected with estradiol benzoate (500 migrogram/kg) weekly. After 12 weeks, the voiding frequency study was recorded and a cystometrogram was performed while awake. The harvested bladders were used in the carbachol-induced detrusor muscle contraction study and the distribution of estrogen, M2 and M3 muscarinic receptors in the rats' bladder. RESULTS: The ovariectomy group voided more frequently than the others (p=0.005). During the awake cystometrogram, the detrusor characteristics of the ovariectomy group were a higher mean intervoiding pressure and smaller bladder capacity than the others (p=0.000). There was no significant statistical difference between the control and estrogen replacement group. The other cystometric parameters were not statistically different either. The detrusor muscle contraction study showed no difference between three groups. There was a significant difference in the distribution of M2 and M3 receptors of bladder mucosa between the control and ovariectomy group. CONCLUSIONS: This study suggested that the detrusor overactivity resulted from increased connective tissue ratio and decreased M2, M3 receptor in the bladder mucosa. Moreover, estrogen replacement in the postmenopausal state had the effect of reversing the physiological and morphological changes caused by an estrogen deficiency in the bladder.