Short Term Results of Tension-Free Vaginal Tape Procedure with Vaginal Hysterectomy / 대한비뇨기과학회지

Purpose : To evaluate the short term result of the tension-free vaginal tape (TVT) procedure in conjunction with vaginal hysterectomy in patients with concurrent stress incontinence and gynecological diseases. Materials and Methods: All patients (32 women) underwent the TVT procedure in conjunction with vaginal hysterectomy between June 2001 and April 2003. Preoperative histories, subjective questionnaires of the degree of incontinence, physical examinations, one hour pad tests and full urodynamic testing were evaluated. The postoperative clinical outcomes, patient satisfaction and complications were checked after 3-months. Results: Thirty-two women who met the study criteria were identified. The mean follow-up time, parity, age, operating time and length of hospital stay were 9.2 months, ranging from 3 to 18 months, 2.6, ranging from 1 to 5, 52.5 years, ranging from 40 to 68, 73 minutes, ranging from 55 to 122 minutes and 4.3 days, ranging from 3 to 9 days, respectively. From the questionnaires, 22 patients were found to be mildly incontinent, 7 moderately incontinent and 3 severely incontinent. All patients were cured of gynecological disease. All cases of mild, 5 of moderate and 2 of severe incontinence were cured. The three remaining patients improved. Twenty-eight patients were satisfied after the operation and 1 had intraoperative bladder perforation. Conclusions: The TVT procedure in conjunction with a vaginal hysterectomy for stress incontinence with other gynecologic disease is considered safe and efficacious, although a longer follow-up will be necessary to determine the long term effect.

Ureteroscopic Removal of Multiple Renal Pelvis and Lower Calyceal Stones / 대한비뇨기과학회지

The goal of surgical stone management is to achieve maximal stone clearance with minimal morbidity to the patient. Because of its efficacy, efficiency and low morbidity, extracorporeal shock wave lithotripsy(ESWL) is the first-line treatment for almost all urinary calculi. However, stone clearance after ESWL has been shown to be affected by the stone burden, location, chemical composition and kidney anatomy. Especially, the success rate for ESWL is reduced in lower pole stone(LPS). Percutaneous nephrolithotomy(PNL) and retrograde ureteroscopic intrarenal surgery(RIRS) are alternative treatment options for stones refractory to ESWL such as LPS. Although effective, PNLsubjects the patient to increased morbidity compared to ESWL and RIRS. Because of its low morbidity and relatively high success rate, RIRS for LPS is an attractive treatment modality in selective patients. We report a case of multiple renal pelvis and lower calyceal stones treated with ureteroscopy.

Fibrous Pseudotumor of Paratesticular Region / 대한비뇨기과학회지

A fibrous pseudotumor of the paratesticular region is rare, but one of the most common neoplasma of this area. It has also been called a nodular fibrous proliferation, pseudofibromatous periorchitis, benign fibrous paratesticular tumor, and fibrous mesothelioma (pseudofibroma). Complete surgical excision, by orchiectomy, appears to be curative. A case of a fibrous pseudotumor is reported and the clinical presentation and radiographic and histological findings described.

Metastatic Ureteral Tumor from the Lung Squamous Cell Carcinoma after Complete Remission / 대한비뇨기과학회지

Ureteral tumors are relatively uncommon, accounting for approximately 1.2% of all urothelial tumors. Metastatic ureteral tumors are even rarer. The primary lesions include breast, melanomas, bladder, colon, stomach, lung, and esophageal, prostate, ovarian, kidney, urethral and vaginal carcinomas. Patients usually have lumbar or flank pain, dysuria, frequency, and in the latter stages, anuria. We report a case of a metastatic ureteral tumor from a lung squamous cell carcinoma after complete remission.

Idiopathic Retroperitoneal Fibrosis Treated with Medical Therapy / 대한비뇨기과학회지

Retroperitoneal fibrosis, although benign, has a malignant course due to an encasement and obstruction of the retroperitoneal structures, particularly the urinary system. The most common treatment is often a surgical exploration followed by urologic intervention. However, steroid or azathioprine therapy has been advocated, with varying results and major side-effects. Recently, the successful medical therapy in patients with an early stage and low malignant potential has been reported. Here we report a male patient who underwent successful treatment of an idiopathic retroperitoneal fibrosis with tamoxifen and prednisolone.