A Case of Female Urethral Bilobed Diverticulum, which is diagnosed by using positive pressure urethrogram

No abstract available.

The Treatment and Outcome of 32 Cases of Benign Ureteral Stricture Using Balloon Dilatation / 대한비뇨기과학회지

PURPOSE: Although it is well known that surgical treatment has been gold standard in most cases of ureteral stricture, but its effect was not satisfactory. The development of balloon catheters and advances in endourology offer attractive alternative management compared to surgery in the treatment of urethral strictures. The purpose of this study is to determine the effectiveness of balloon dilatation as an alternative treatment in the management of benign ureteral stricture. MATERIALS AND METHODS: We reviewed the records of 32 patients, treated during the last 5 years for benign ureteral stricture disease. Balloon dilatation of benign ureteral strictures were performed in a percutaneous antegrade(10 patients) or retrograde(22 patients) fashion followed by placement of a 6 Fr. stent for 6-8 weeks. The underlying diseases or conditions of the benign ureteral stricture were tuberculous ureteritis in 15, surgery to ureter in 8, iatrogenic cause in 5, and primary cause in 4. RESULTS: The over-all rate of succesful management of benign ureteral stricture diseases using endoscopic techniques was 75 percent. The significant complications were not observed in all patients. CONCLUSIONS: Based on the result of our experiences, we suggest the use of balloon dilatation as the initial treatment method in benign urethral stricture.

Early Postoperative Periprosthetic Radiological Findings in Cementless THRA : Comparison between Porous - coated Implant and Hydroxyapatite - coated Implant / 대한정형외과학회잡지

We compared radiologically two groups of total hip prostheses, 36 porous-coated and 51 hydroxyapatite-coated, which had been implanted in 87 hips of 73 patients with avascular necrosis of the femoral head. Radiographs were taken at postoperative 1 year and 2 year, and used to compare various radiological parameters between the two groups. For the acetabular side radioluscent line and osteolysis were evaluated, and for the femoral side radioluscent line, osteolysis, stress shielding. endosteal new bone formation, subsidence and cortical hypertrophy were evaluated; their location was identified according to the zones described by DeLee and Charnley for the acetabulum and according to those described by Gruen et al for the femur. In both groups there was no subsidence. In terms of osteolysis, stress shielding and cortical hyper-trophy there was no significant difference between the two groups throughout the period. Radioluscent line in the acetabulum was more common around the porous-coated cup, but was focal and not progressive. The rate of radioluscent line in the femur was a little higher around hydroxyapatite-coated stem especially in zone 5. Endosteal new bone formation was excellent in both groups, but was more extensive around hydroxyapatite-coated stem. This study suggests that hydroxyapatite coating play a certain role in terms of bony ingrowth.

Transurethral Resection of Prostate under Local Anesthesia in Patients with Benign Prostatic Hyperplasia / 대한비뇨기과학회지

This study was performed for the patients with benign prostatic hyperplasia who had underlying diseases which increase the risk of spinal or general anesthesia. Standard transurethral resections of prostate were done on patients with prostatic hyperplasia under local anesthesia. The selection criteria were urinary retention or below 10 ml/sec of maximum flow rate, coexist with medical problems which increase the risk of spinal and general anesthesia. Local infiltrations of 1% lidocaine were done at penoscrotal junction on each side of the corpus spongiosum, the lateral portion of the prostate and the bladder neck. This anesthesia was supplemented usually by modest dose of intravenous tranquilizers and analgesics under the continuous monitoring by an anesthesiologist. The Visual Pain Analogue Scale(VAS) was used for the evaluation of intraoperative and postoperative pain. The mean operating time, amount of the resected tissues and intraoperative and postoperative visual analogue scale were 50.2 min, 16 grams. 2.7 and 2.0. We thought that this type of anesthesia was a safe, simple and effective procedure.

153 Cases of Laser Lithotripsy / 대한비뇨기과학회지

The pulsed laser lithotripsy has been used in the treatment of urinary calculi. We treated 153 patients of stones, via the pulsed dye laser(Technomed Pulsolith) with 7.5 and 6.5 F. rigid ureteroscope between January 1992 and January 1995. Stones were in bladder(4 cases), upper ureter(17), mid ureter(31) and lower ureter(101). The laser lithotripsies were applied for impacted stones and relatively large stones(more than 6 mm) The success rates according to location were 47%(8/17) in upper ureter, 77%(24/31)in middle ureter, 95%(96/101)in lower ureter and 100%(4/4) in bladder and mean success rate was 86% (132/153). There were 21 failures due to upward migration(9 cases), poor visual field(7), laser resistant stone(3) and malfunction of laser(2). Complications were showed in 28 cases that were gross hematuria(16 cases), ureteral perforation(6), fever(4) and ileus(2), but most of them might be related to ureteroscopy rather than laser, and all of them were resolved with conservative management. So laser lithotripsy is safe and effective method of middle and lower ureteral calculi, and upward migration of stones, the major cause of failure may be resolved by use of extracorporeal shock wave lithotripsy and flexible ureteroscope.

A Case of Urethral Diverticulum Combined with Giant Stone / 대한비뇨기과학회지

A case of one of the largest stone in a giant penile urethral diverticulum which disturbed voiding and ejaculation was responded with review of some literatures.

A Clinical Observation on High Lumbar Disc Herniation / 대한정형외과학회잡지

The purposes of this clinical study are to observe the clinical findings of the high lumbar disc herniation, to analyze the of the posterior approach and to define the surgical indications of the high lumbar disc herniation. We analyzed the 13 cases which were treated at the Deparment of the Orthopaedic Surgery, National Medical Center from March 1988 to December 1992(Mean follow up rate : 17. 2 months). 1. We operated 10 cases by posterior approach and 1 case by anterior approach due to marked degenerative osteophyte. 2. We evaluated the post-operative results by modified Macnab criteria, the 2 cases showed no symptomatic improvement because of respectively associated high lumbar osteophyte and lower lumbar spinal stenosis. 3. On conclusion, suspicion is important in cases of incompatible clinical symptoms and signs of the intervertebral disc herniation. MRI is the most recommended diagnostic tool, because it can provide the high lumbar levels with saggital section image and differentiate herniation from degenerative osteophyte. As for the surgical indications of high lumbar disc herniations, we suggest marked dural compression by disc or sequestered disc materials in MRI, definite neurological complications such as ankle clonus, increased DTR, weakness of quadriceps and hip flexor muscle and severe radiating pain on the anterior thigh. We recommended the posterior approach for the surgical intervention of high lumbar disc herniation except cases marked degenerative osteophytes.

Ender Nailing with Distal Wiring Technique in the Treatment of Intertrochanteric Femoral Fracture / 대한정형외과학회잡지

In the treatment of elderly hip fracture, early mobilization as a means of reducing early postoperative morbiyt and morbidity is mandatory. Even though Ender nailing have many advantages, most serious problems with use of Ender nailing method are distal migration of nails, subsequent loss of fixation and limited knee joint motion. To prevent these difficult problems, we have used distal wiring technique with Ender nailing since 1988. In operation, we performed Ender nailing as usual manner under image intensifier and for the prevention of the nail migration, we performed circumferential wiring through the each Ender nail eye and above the adducter tubercle of the distal femur. Forty six cases were available with minimum follow-up of six months which were healed radiologically and clinically (Mean follow up: 21 months). The mean age was 74 years (Range: 52 years-88 years)and showed 26 cases of famale and 20 cases of male. The radiological morphometry using Singh index showed poor bone quality: 36 cases were below Grade III and the fracture type was classified by Tronzo criteria. In results, patients who had Ender nailing with distal wiring showed no distal migration, however one case of proximal migration was observed at the beginning stage of this technique. So, in elderly trochanteric fracture, to reduce the complication of the Ender nailing, especially nail migration, the authors recommend the Ender Nailing with distal wiring technique.

An Experimental Study on Ureteral Tissue Damage with Technomed Pulsolith Laser Irradiation in Human in Vitro / 대한비뇨기과학회지

The pulsed dye laser(Technomed pulsolith) with a wave-length of 504nm was irradiated directly in vitro on four human ureters which were obtained by ureteronephrectomy. The irradiation was at 5Hz with a pulse energy of 40 to 100mJ and total pulse count of 200 to 1000. Immediately after irradiation, the ureteral tissues were fixed with formalin solution and H&E stain. The extent of tissue damage was examined with light microscope. In this experimental study, we observed that mucosal damage occurred from pulse energy of 60mJ, total pulse rate of 600 and submucosal damage occurred from pulse energy of 80mJ, total pulse rate of 800. But We believed that the pulsed dye laser was safe because most stones were fragmented at less than a pulse energy of 80mJ, a total pulse rate of 800, and the ureter was irradiated indirectly during laser lithotripsy.

A Case of 47XYY Syndrome with Azoospermia / 대한비뇨기과학회지

The XYY syndrome is a rare entity, which is a phenotypic man with a 47 XYY It was first reported by Sandberg and associates in 1961. The XYY individual is seldom detected during childhood or even in adult because the features of XYY syndrome are often subtle and not overtly suggestive of a chromosomal abnormalities. We have reported a case of XYY syndrome associated with absence of pubic and axillary hair, no voice mutation and azoospermia. Clinical, endocrinologic and genetic studies were presented and theories regarding the etiology of the XYY syndrome were discussed with review of the literature.

Initial experience of ureteral laser lithotripsy using the technomed pulsolith / 대한비뇨기과학회지

From January 1992 to January 1993, 45 patients with calculi ranging in size from 5x4mm to 22 x 17mm underwent lithotripsy with a new pulsed dye laser (Technomed Pulsolith) under the ureteroscope. The results were obtained as follows; 1. The success rates according to location were 60% (3/5) in upper ureter, 63% (7/11) in mid ureter and 93% (27/29) in lower ureter. The mean success rate was 82% (37/45). 2. The success rates according to stone size were 100% (4/4) in below 5mm, 77% (10/13) in 6 to 10mm and 82% (23/28) in above 10mm. 3. The total number of failure was eight. That occurred due to various. The causes of failure were the poor visualization in five cases, the laser resistant calcium oxalate stones in two cases and the upward migration in one case. Six cases of failure were resolved in spontaneous passing, and two cases were managed by ureterolithotomy. 4. Complications were showed in 17 cases that was gross hematuria in 12 cases (26.6%) and ureteral perforation in 5 cases (11.1%). However, no surgical intervention was needed in all cases. We conclude that laser lithotripsy with Technomed Pulsolith was considered to be effective and safe procedure for the treatment of lower ureteral calculi.

A case of sparganosis forming giant hematoma in the scrotum / 대한비뇨기과학회지

Sparganosis is a parasitic infestation caused by sparganum on several species of tapeworm related to diphyllobothrium latum. We experienced a case of the sparganum infestation with giant hematoma in scrotum.

A case of leiomyoma on urethrovaginal septum / 대한비뇨기과학회지

Leiomyoma is rare. Most of patients present with urinary tract infection, hematuria, dyspareunia, or complaint of mass. A case of leiomyoma on urethrovaginal septum in a 36 years old female was presented. The presenting symptom was a protruding mass at the anterior vaginal wall The mass was removed surgically and confirmed as a leiomyoma pathologically.

Ultrasound-guided Aspiration and Instillation of 95% Ethanol for Simple Renal Cyst / 대한비뇨기과학회지

Percutaneous aspiration followed by instillation with 95% ethanol was performed on 15 patients with benign renal cyst. 86.6% of patients showed remarkable reduction in size of renal cyst or abscence of cyst on sonography. Nine(81.8%) of the 11 symptomatic patient were relieved of subjective symptoms such as flank pain after instillation. There was no major complication with this procedure. A slight local irritable pain was noticed in 2 cases and 1 patient had not flush but three symptom were only temporary. This treatment seems to be a safe and simple and effective way to prevent recurrence of the cyst.

A Case of True Hermaphroditism with Testicular Torsion / 대한비뇨기과학회지

True hermaphroditism. in which both ovarian and testicular tissue are found in the same individual, is a rare disease. Recently the authors have seen a case of true hermaphroditism who had a testis on the right gonad and an ovotestis on the left gonad with a karyotype of 46 XX, and report this case here with a brief review of the literature.

A Case of Emphysematous Pyelonephritis / 대한비뇨기과학회지

Emphysematous pyelonephritis is a rare complication of severe acute pyelonephritis and a suppurative infection of the renal parenchyma characterized by the production of gas by bacteria through fermentation. Emphysematous pyelonephritis occurs in patient with diabetes mellitus or urinary obstruction. We review the diagnosis and management of emphysematous pyelonephritis and report a case of emphysematous pyelonephritis developed in renal tuberculosis.

A Clinical Observation on l0 Cases of Anatrophic Nephrolithotomy / 대한비뇨기과학회지

The surgical intervention of renal staghorn calculi was performed in 9 patients(lOkidneys) who had undergone anatrophic nephrolithotomy with in situ hypothermia. admitted to the Department of Urology, HaniI Hospital, during four years periods from June, 1982 to May, 1986. This operation technique is simple, easy but uneventful recoveries followed only in a small group. The results were summarized as followings : l. Postoperative hospitalizations were 13.1 days(ranged from 8 to 21). 2. Operating time required 194.5 minutes with mean time(ranged from 150 to 230). 3. Renal artery clamping time required 36.4 minutes with mean time(ranged from 23 to 65). 4. Blood loss during operation was 875ml on the average loss(ranged from 350 to l400). 5. Postoperative complications were nephrectomy l case, pneumothorax l case, deep vein thrombosis l cases remained stone 3 cases.

A Case of Pleomorphic Rhabdomyosarcoma of an Adult Prostate / 대한비뇨기과학회지

Rhadomyosarcoma of the prostate is relatively rare and highly malignant condition. Three major categories of rhabdomyosarcoma exist, which should be kept clearly separated: pleomorphic, embryonal, and alveolar Pleomorphic rhabdomyosarcoma is actually the least common of the three categories. It arises from myotome-derived skeletal muscle and occurs almost exclusively in adults. We make the unequivocal diagnosis of pleomorphic rhabdomyosarcoma only if we can detect cross striations in some of the tumor cells. Herein we experienced a pleomorphic rhabdomyosarcoma of the prostate which is generally not found in the urogenital area and reviewed literature briefly.

A Clinical Observation on Cystoscopic Manipulation of Distal Ureteral Stone / 대한비뇨기과학회지

We had been managed on 95 cases of distal ureteral stone with cystoscopic manipulation who were admitted to the Department of Urology, Han-iI Hospital during the period of 5 years from March 1st, 1981 to February 28th, 1986 using the Dormia stone dislodger and following results were obtained. 1. Among them, 41 cases were extracted immediately on primary application of the Dormia stone dislodgers and 7 cases were delivered by indwelling method and 13 cases were delivered spontaneously after ureteral meatotomy. 2. Over-all success rate was 67.4% but the subdivided success rate according to the size of stone decreased with increasing size of stone. 3. There were no major complication, but in one case basket was entrapped in the ureter.

A Case of Cystine Stone in a Child / 대한비뇨기과학회지

Cystinuria is an autosomal recessive inherited defect in renal tubular reabsorption of four amino acids, cystine, ornithine, lysine and arginine. Homozygotes were identified by the formation of urinary tract calculi composed of cystine and by gross hyperexcretion of above mentioned four amino acids. Urinary tract calculi composed primarily of cystine are rare in adults and children. These are usually pure and found exclusively in patients with cystinuria. Herein we report on a 4 and 3/12 years old male child with a right renal stone composed primarily of cystine which was confirmed by chemical analysis method postoperatively. After discharge he has been treated with D-penicillamine, large fluid intake and conversion of urine pH.