ABSTRACT
Patients with end stage renal disease who require chronic dialysis show a significantly increased risk of developing renal cell carcinomas, with a demonstrated incidence of 0.22-1.5%. Despite these impressive data, monitoring of patients with chronic renal failure is only briefly mentioned in the literature and there is only one report in korea. Herein, we report three cases of renal cell carcinomas developing in patients with chronic renal failure with a brief review of literature.
Subject(s)
Humans , Carcinoma, Renal Cell , Dialysis , Incidence , Kidney Failure, Chronic , KoreaABSTRACT
PURPOSE: Endopyelotomy is a minimally invasive surgical alternative to the classic open surgery in the treatment of ureteropelvic junction obstruction with similar success rates. We analyzed factors influencing success rates after endopyelotomy based on clinical data. MATERIALS AND METHOD: Between 1989 and 1997, we performed percutaneous antegrade endopyelotomy in 53 cases of ureteropelvic junction obstructions. Among these patients, 47 patients have been followed with range from 3 to 70 months(mean 18.1 months). Of the 47 patients, 36 had primary UPJ obstruction and 11 had secondary UPJ obstruction. A rigid urethrotome(cold knife) was employed in 31 cases, a electrotome(hot knife) in 10 and a balloon dilator in 6. A stent(14/7Fr endopyelotomy stent or 6Fr double-J stent) was placed for 4 to 12 weeks after the procedure. Coexisting stones or infundibular strictures were managed simultaneously. RESULTS: Overall success rate(measured by symptom-free status and improved uroradiographic findings) was 80.9%(86.1% in primary and 63.6% in secondary cases). Success rates related to the method of incision were as follows; 87.1% with a cold knife, 80% with a electric knife and 50% with a balloon dilator only. 14/7Fr endopyelotomy stent was used in 21 patients with a successful outcome in 19(90.5%), while 25 received 6Fr double stent with a successful outcome in 18(72%). Success rates according to the duration of stenting were as follows; 86.7% in the 8-week group, 78.6% in the 6-week group and 66.7% in the 4-week group. CONCLUSIONS: Our experience indicates that endopyelotomy can be selected as the initial procedure of choice for the selected patients with UPJ obstruction. The small number of patients in each parameter did not reach statistical significance. However, there was a trend for better results in patients with primary UPJ obstruction and with the use of 14/7Fr endopyelotomy stent.
Subject(s)
Humans , Constriction, Pathologic , StentsABSTRACT
Gas-forming infections in the genitourinary tract are usually associated with diabetes mellitus, and emphysematous pyelonephritis is a common disease among them. However, gas forming infection occurring in the scrotum is extremely rare. We experienced a case of gas-forming scrotal wall abscess in a 45-year-old diabetic man, who showed clinical symptoms mimicking acute epididymo-orchitis.
Subject(s)
Humans , Middle Aged , Abscess , Diabetes Mellitus , Pyelonephritis , ScrotumABSTRACT
Changes in the urinary tract associated with prolapse uteri have been known for a long time. However, women who have a prolapse uteri are often free of symptoms. When symptoms are present they are above all, urinary tract infection, difficulties in emptying the bladder, increased frequency of micturition, stress incontinence, and ureteral obstruction. We reviewed 82 patients who had prolapse uteri of grade II and III in order to evaluate the effects of prolapse uteri to the urinary tract. There were 5 patients (6.1%) who had urinary tract infection and urine culture revealed the growth of E. coli in 3 of them. Only 1 patient (1.2%) had high blood urea nitrogen. 51 (62.2%) out of 82 patients showed voiding problems (frequency, voiding difficulty, stress incontinence) and 53 (64.6%) out of 82 patients had cystocele of several degrees, but there was no difference between the degree of prolapse uteri and both voiding problems and cystocele. Vaginal hysterectomy with anterior and posterior colpoperineorraphy was performed in 68 (88. 3%) out of 77 patients who underwent surgical treatment by gynecologists, and in 22 (91.7%) out of 24 patients who showed difficult urination, their symptoms were improved immediately after surgery. Bladder neck suspension was performed simultaneously in 3 patients who showed stress urinary incontinence with prolapse uteri. Intravenous pyelography or abdominal ultrasonography was performed to evaluate accompanied ureteral obstruction in 8 patients who had severe cystocele. In 5 patients, upper tract deteriorations were noted. Bilateral hydroureteronephrosis was found in 3 patient, unilateral lower ureteral dilatation in 1 patient, and severe parenchymal damage in 1 patient. In conclusion, we believe that urologist should participate in managing those patients who have prolapse uteri to improve their voiding problems and prevent upper urinary tract deterioration.