Adenomatoid Tumor of the Spermatic Cord / 대한비뇨기과학회지

Adenomatoid tumors are rare benign neoplasms thought to be of mesothelial origin. Although most reported cases developed from the epididymis, rare cases have been reported in the testicular tunica, spermatic cord and ejaculatory ducts. Because of the benign nature of this tumor, the treatment of choice is local excision. We report a rare case of adenomatoid tumor of the spermatic cord treated by local excision.

Application of the Clinical Pathway for Transurethral Resection of Prostate / 대한비뇨기과학회지

PURPOSE: The purpose of a clinical pathway(CP) is to standardize the clinical practice of specialists to optimize the medical care. The objective of this study is to develop CP for transurethral resection of the prostate (TURP) for patients with benign prostatic hyperplasia(BPH) and to evaluate the results of the CP. MATERIALS AND METHODS: 18 patients with BPH and who were managed according to the CP between November 2006 and April 2007 were compared with 38 patients, for whom this pathway had not been used between the period of November 2005 to October 2006. The patients had no other disease except benign prostatic hyperplasia. The results such as the operative time, the resection volume, the length of the hospital stay, the complication rates, the catheter indwelling time and the maximal flow rate were compared between the CP group and the non-CP group. RESULTS: There were no statistically significant differences between both groups for the postoperative complication rates(p=0.683). With the application of the clinical pathway, the mean duration of the hospital stay and the catheter indwelling time were significantly lower for the CP group than that for the non-CP group(p<0.001). Statistically, there were no significant differences of the maximal flow rate and International Prostate Symptom Score(IPSS) between the two groups. All members of the CP group were satisfied with the application of the CP. CONCLUSIONS: The application of the clinical pathway for patients undergoing transurethral resection of prostate has reduced the catheter indwelling time and the length of the hospital stay. This improves the bed use and hospital efficiency while it also results in a higher level of patient satisfaction. Furthermore, reducing the variability of medical care has improved its quality.

Effects of Medication with Dutasteride on Detection of Prostate Cancer in Patients with Serum Prostate-specific Antigen Level of 4~10 ng/ml / 대한남성과학회지

Purpose: We assessed the effects of medication with dutasteride on serum prostate-specific antigen (PSA), PSA density (PSAD) and prostate volume to avoid unnecessary biopsies. Materials and Methods: Between 2005 and 2007 patients with serum PSA level of 4~10 ng/ml were recruited in this prospective study. Patients were treated with 0.5 mg of dutasteride once daily for 3 months. PSA, PSAD and prostate volume were measured at baseline and at the end of treatment. The patients with a high PSA level (> or =4 ng/ml) after medication with dutasteride had a prostate biopsy. The patients were divided as group I (prostate cancer; n=29) and group II (benign disease; n=55). We compared the changes of serum PSA, PSAD, and prostate volume change between two groups. Results: In group I, PSA, PSAD and prostate volume decreased from baseline means of 8.16 ng/ml, 0.23 ng/ml/cm3 and 46.81 cc to 5.69 ng/ml, 0.18 ng/ml/cm3 and 40.41 cc. The difference in PSA, PSAD and prostate volume was -0.2%, -2.1% and -3.6% for group I. On the contrary, in group II, PSA, PSAD and prostate volume decreased from baseline means of 7.65 ng/ml, 0.16 ng/ml/cm3 and 56.48 cc to 4.48 ng/ml, 0.11 ng/ml/cm3 and 51.35 cc. The difference in PSA, PSAD and prostate volume was -41.4%, -33.3% and -9.1% for group II. When 4.83 ng/ml and 0.15 ng/ml/cm3 were chosen as the PSA and PSAD cutoff levels after treatment with dutasteride, unnecessary biopsies could be avoided effectively. Conclusions: These data suggest that the magnitude of changes in serum PSA and PSAD after 3 months of dutasteride challenge could be useful to avoid unnecessary prostate biopsies in patients with elevated PSA level.

Congenital Renal Arteriovenous Malformation in Pregnancy / 대한비뇨기과학회지

Congenital arteriovenous malformation of the kidney is a rare condition and there have been few reported cases that were detected during pregnancy because of a fistula. Of the 7 such cases in the literature, either a nephrectomy or partial nephrectomy was done during pregnancy, or an abortion was induced. We report here on a case of arteriovenous malformation that was treated successfully by therapeutic embolization. The patient's convalescence was unremarkable and a healthy newborn was delivered without any complications.