35 Cases of Percutaneous Stone Extraction / 대한비뇨기과학회지

On a standpoint of commonly available ESWL for the treatment of urinary stone, percutaneous stone extraction had the role of cooperation to it, and sometimes it could be the first procedure of choice. We have performed percutaneous extraction of the renal and upper ureteral stones in 35 renal unite. The overall success rate was 78.4%, average operation time was 81 minutes, mean fluoroscopic exposure time was 11 minutes, average postoperative hospital stay was 7 days. Causes of failure were as followings ; five inadequate calyceal puncture, one ureteral perforation, one impacted stone, and one downward stone migration. The complications were inappropriate position of the nephrostomy tube, prolonged hematuria through nephrostomy tube, and partial ureteral avulsion. They were not serious but resolved by conservative management.

Initial Experience of Three Cases of Radical Retropubic Prostatectomy / 대한비뇨기과학회지

From December 1986 to August 1988, three patients with early prostatic cancer diagnosed primarily by fine needle aspriation cytology and/or Tru-cut needle biopsy underwent potency preserving radical retropubic prostatectomy. Herin we report the results and associated problems. Most difficulty was the diagnosis of the early prostatic cancer. We used fine needle aspiration cytology to diagnose the prostatic cancer primarily. One case of class V on the preoperative cytologic examination has proved to be BPH with chronic prostatitis postoperatively. Another problem was possibility of major bleeding intraoperatively, and complications were uncommon and not serious.

Initial Experience of Three Cases of Radical Retropubic Prostatectomy / 대한비뇨기과학회지

From December 1986 to August 1988, three patients with early prostatic cancer diagnosed primarily by fine needle aspriation cytology and/or Tru-cut needle biopsy underwent potency preserving radical retropubic prostatectomy. Herin we report the results and associated problems. Most difficulty was the diagnosis of the early prostatic cancer. We used fine needle aspiration cytology to diagnose the prostatic cancer primarily. One case of class V on the preoperative cytologic examination has proved to be BPH with chronic prostatitis postoperatively. Another problem was possibility of major bleeding intraoperatively, and complications were uncommon and not serious.

A Case of Renal Oncocytoma / 대한비뇨기과학회지

We report a case of renal oncocytoma in 46-year old woman and review the literature. She had been asymptomatic except a visible protruding mass on the left abdomen and she underwent successful transperitoneal nephrectomy. The kidney weighed 4,800 gm, presented a well capsulated round mass and homogenous tan-brown colored cut surface. Renal oncocytoma, a rare neoplasm thought to arise from proximal tubular epithelial cells, exhibits a benign clinical course. They tend to misdiagnosed as renal cell carcinoma preoperatively. Histopathological studies confirm the oncocytic feature of the tumor cells, it shows finely granular eosinophilic cytoplasm(oncocyte) light microscopically, and the cytoplasm is filled with innumerable mitochondria with a paucity of other organelles ultrastructurally.

A Case of Aldosteronoma / 대한비뇨기과학회지

Primary aldosteronism, characterized by hypertension, hypokalemia and hyperaldosteronemia caused by chronic overproduction of aldosterone independent of normal renin-angiotensin system, due to aldosteronoma, or to bilateral cortical nodular hyperplasia, or to adrenal carcinoma rarely. We report a case of left adrenal adenoma which was diagnosed by classic clinical symptoms, laboratory data, adrenal venography and abdominal computerized tomography. We performed left adrenalectomy with subcostal transperitoneal approach, and then blood pressure and laboratory data were normalized postoperatively.

Initial Experience of Percutaneous Removal of Upper Ureteral Stone / 대한비뇨기과학회지

We tried percutaneous extraction of upper ureteral stones in five patients via Wolf rigid ureteroscope with grasping forceps. The procedure was performed at two session. The nephrostomy tract dilation was carried out by combination of metal dilator and Amplatz teflon renal dilator under fluoroscopy. All the five cases of PCN were successful without any complication at first trial. The advantage of this technique is low postoperative morbidity, rapid convalescence, sooner return to work and cheap price. It seems that endourological treatment of mid ureteral stone as well and upper ureteral stone can be extracted through percutaneous nephrostomy tract.

A Study for Clarifying the Necessity of Additional Antibiotic Therapy in Patients Undergoing TURP, Given Antibiotics During Catheter-indwelling and Showing Sterile Urine after Catheter-removal / 대한비뇨기과학회지

Faced with patients who underwent TURP and who were given antibiotics until catheter-removal, usually complain of urinary frequency or burning on ruination and showing sterile urine (less than l00 bacteria per ml., in clean-caught midstream about 24 hours after catheter-removal), we often hesitate to make a decision whether they should be given antibiotics or not. So we divided 27 such patients into three groups : group l ; 7 patients, no additional antibiotics after catheter-removal, group 2; 12 patients, antibiotics for one week after catheter-removal and we performed weekly urine culture for clarifying the necessity of additional antibiotic therapy and its appropriate duration, if necessary. The following results and conclusions were obtained. I. Group l showed bacteriuria in 86%(6 of 7 patients). 2.Group 2 and 3 showed bacteriuria 5%(1 of 20 patients). 3. These data suggested that additional antibiotic therapy rather than stopping antibiotic therapy might be justified(P : less than 0.001). 4. Group 2 showed no bacteriuria and group 3 showed bacteriuria in one patient which disappeared promptly. Namely, there was no practical difference in the incidence of bacteriuria between the two groups. 5. 9 cases of fungiuria were found, all of which developed in patients given antibiotics perioperatively for more than 2 weeks. 6. Considering the above items and cost-effectiveness, a week`s additional antibiotic therapy is probably an appropriate answer to treating the above-mentioned patients. 7. Main causative organism in post-TURP bacteriuria was Pseudomonas spp(4of 7 cases).

Congenital Anterior Urethral Diverticulum: A Report of Two Cases / 대한비뇨기과학회지

Urethral diverticula in children occur primarily in males. Although the etiology can be secondary to distal meatal stenosis with infection, most of them are congenital in origin. Being easily overlooked, anterior urethral diverticula are not uncommon and should always be borne in mind in cases of bladder outflow obstruction. With brief review of literatures, we report 2 cases of congenital anterior urethral diverticulum found in a 4-year-old boy and a male newborn.

A Case of Vesicocolonic Fistula / 대한비뇨기과학회지

A 17 year-old female patient with chief complaints of pneumaturia and fecaluria was found to have s vesicocolonic fistula. A transurethral attempt to catheterize the suspect tract, which was on the left posterior wall of the bladder, and radiography, following injection of dye through the catheter, proved that the fistu1ous tract was communicating with the sigmoid colon. Excision of the fistulous tract corrected successfully the pathology. Histopathologic findings were of chronic non-specific colitis.

Clinical Observation on Benign Prostatic Hyperplasia / 대한비뇨기과학회지

A clinical observation was made on 127 cases of benign prostatic hyperplasia, admitted to the Department of Urology, Chonnam National University Hospital during the period from January 1970 to August 1979. The results are summarized as follows: 1. There was an increasing tendency of annual distribution from 5 patients in 1970 to 32 patients in 1978. 2. Most of the patients were in the 7th and 8th decades of life (89%) with a mean age of 71.4 years old. 3. Seventy four patients (58.3%) suffered from acute urinary retention prior to admission. 4. Pyuria was revealed in 32 cases (25.2%), hematuria it 84 cases (66.1%), and azotemia in 4O cases (31.5%). 5. Associated conditions present were cardiovascular in 26 cases, respiratory in 21 cases, urologic in 15 cases, and miscellaneous in 6 cases. The most common associated conditions were hypertension in 20 cases and pulmonary tuberculosis in 15 cases. 6. Management was done with retropubic combined prostatectomy (RCP) in 12 cases, TURP in 33 cases. suprapubic transvesical prostatectomy (STP) in 23 cases, cystomy in 7 cases, and indwelling catheterization in 24 cases. 7. Prostatectomy was not performed in 31 cases because of patient refusal (14 cases) and associated conditions (17 cases) 8. The mean operating time was 87.5 minutes for RCP, 92.2 minutes for STP and 52.7 minutes for TURP. 9. The mean weight of the removed tissue was 48gm for open prostatectomy and 6.8gm for TURP. 10. The mean volume of transfused blood was 267ml for RCP, 591ml for STP and l45ml for TURP. 11. The mean period of postoperation was lO.6days for RCP, 11.7 days for STP and 4.6 days for TURP 12. The mean period of postoperative hospitalization was 13.4 days for RCP, 14.5 days for STP and 7.8 days for STP 7.8 days for TURP. 13. RCP postoperative complications were delayed healing with suprapubic urine leakage in 5 cases rebleeding in 2 cases, and acute epididymitis in 2 cases. STP postoperative complications were death due to hemorrhagic shock in 1 case, delayed healing with urine leakage in 2 cases, rebleeding in 3 cases, and prolonged gross hematuria more than 2 weeks in 2 cases. TURP postoperative complications were inability to void after removal of the urethral catheter in 1 case. prolonged gross hematuria more than two weeks in 1 case, and rebleeding in 3 cases.

Clinical Observation on Benign Prostatic Hyperplasia / 대한비뇨기과학회지

A clinical observation was made on 127 cases of benign prostatic hyperplasia, admitted to the Department of Urology, Chonnam National University Hospital during the period from January 1970 to August 1979. The results are summarized as follows: 1. There was an increasing tendency of annual distribution from 5 patients in 1970 to 32 patients in 1978. 2. Most of the patients were in the 7th and 8th decades of life (89%) with a mean age of 71.4 years old. 3. Seventy four patients (58.3%) suffered from acute urinary retention prior to admission. 4. Pyuria was revealed in 32 cases (25.2%), hematuria it 84 cases (66.1%), and azotemia in 4O cases (31.5%). 5. Associated conditions present were cardiovascular in 26 cases, respiratory in 21 cases, urologic in 15 cases, and miscellaneous in 6 cases. The most common associated conditions were hypertension in 20 cases and pulmonary tuberculosis in 15 cases. 6. Management was done with retropubic combined prostatectomy (RCP) in 12 cases, TURP in 33 cases. suprapubic transvesical prostatectomy (STP) in 23 cases, cystomy in 7 cases, and indwelling catheterization in 24 cases. 7. Prostatectomy was not performed in 31 cases because of patient refusal (14 cases) and associated conditions (17 cases) 8. The mean operating time was 87.5 minutes for RCP, 92.2 minutes for STP and 52.7 minutes for TURP. 9. The mean weight of the removed tissue was 48gm for open prostatectomy and 6.8gm for TURP. 10. The mean volume of transfused blood was 267ml for RCP, 591ml for STP and l45ml for TURP. 11. The mean period of postoperation was lO.6days for RCP, 11.7 days for STP and 4.6 days for TURP 12. The mean period of postoperative hospitalization was 13.4 days for RCP, 14.5 days for STP and 7.8 days for STP 7.8 days for TURP. 13. RCP postoperative complications were delayed healing with suprapubic urine leakage in 5 cases rebleeding in 2 cases, and acute epididymitis in 2 cases. STP postoperative complications were death due to hemorrhagic shock in 1 case, delayed healing with urine leakage in 2 cases, rebleeding in 3 cases, and prolonged gross hematuria more than 2 weeks in 2 cases. TURP postoperative complications were inability to void after removal of the urethral catheter in 1 case. prolonged gross hematuria more than two weeks in 1 case, and rebleeding in 3 cases.

A Case of Cushing's Syndrome caused by Adrenocortical Carcinoma / 대한비뇨기과학회지

A case of Cushing's syndrome caused by adrenocortical carcinoma in 11-year-old boy is presented with brief review of literatures.

Clinical Observation on Bladder Tumor / 대한비뇨기과학회지

A clinical observation was made on 91 of the 107 patients with bladder, tumors seen in the Department of Urology, Chonnam University Medical School during the period from January, 1971 to December, 1978. The following results were obtained : 1. During the period, 1,377 patients were hospitalized, there were 107 cases of bladder tumors giving a rate of 7.8%. 2. There were 72 males and 19 females for a ratio of 3.8: 1. In addition, 81.3% of the patients were over 50 years of age. 3. The most common symptom was gross hematuria (85.9%), with frequent urination (53.8%), dysuria (34.1%), painful urination (33.0%) and abnormal urinary stream (35.2%) also frequently seen. 4. 38.5% of the patients visited the hospital within three months after the occurrence of the initial symptom. 71.6% within 1 year and 8.8% five years after the appearance of the initial symptom. 5. Among the 91 patients, 48 (52.7%) had multiple tumors while 43 (47.3%) had single tumor. Regardless of origin, in 47 cases (51.7%) the trigone was involved and in 41 cases (45.1%) the tumor was located near the ureteral orifices. 6. Among the 87 cases in which an IVP was performed 48 cases (55.2%) revealed normal upper urinary tracts and 66 cases (75.9%) showed a filling defect in the bladder. 7. Pathologic examination, performed in 86 cases, revealed transitional cell carcinoma in 77 cases (89.5%). 8. Operation was performed on 83 patients with thirteen patients receiving more than two operations. Partial cystectomy was performed 29 times, open resection with coagulation 25 times, TUR 23 times, radical or simple total cystectomy 21 times and total urethrectomy 4 times. 9. One year after treatment, out of a total of 75 cases, 30 cases (40.0%) had follow-up studies done. Of those, 23 (76.7%) survived. Five years after treatment, out of a total of 19 cases, 11 cases (57.9%) had follow-up studies done. Of those 11. 7 (63.7%) survived. 10. Of the 39 follow-up studies, operation was performed in 37 cases with 18 (48.6%) of those patients exhibiting persistent or recurrent tumors.