Clinical Value of Nocturnal Penile Erection by Rigiscan / 대한비뇨기과학회지

Continuous and simultaneous recording of nocturnal penile rigidity and tumescence is preferred than measuring tumescence alone to define the features of nocturnal penile erection and differentiate psychogenic from organic impotence. Rigiscan is suitable for this purpose. Authors studied to define the features of nocturnal penile erection by rigiscan in 24 normal Koreans and 18 patients with erectile dysfunction. The results were as follows : 1. In normal group, the number of normal erection was 4.2+/-0.9 times per night, duration was 21.1+/-7.4 minutes at tip and 26.3+/-9.8 minutes at base, tumescence change was 1.81+/-0.51 cm at tip and 2.23+/-0.72 cm at base, rigidity was 55.7+/-19.6 per cent at tip and 66.3+/-12.0 per cent at base. Maximal duration was 34.2+/-14.9 minutes at tip and 39.0+/-15.1 minutes at base, maximal tumescence change was 2.28+/-0.83 cm at tip and 2.64+/-0.78 cm at base, maximal rigidity was 65.4+/-11.8 per cent at tip and 75.8+/-12.5 per cent at base. The higher the age, the shorter the duration and number of events were(p<0.05). 2. In patient group, normal rigigram showed in 6 patients(3 of psychogenic, 3 of posterior urethral injury). Event and duration were shorter than normal group(p<0.05). The findings of flat trace or abnormal erection provide valuable information to screen the organic impotence.

The Results of Intracavernous Papaverine Injection: Experience with 92 Patients / 대한비뇨기과학회지

A total of 92 men with impotence underwent a trial of intracavernous injection of papaverine 30mg. Underlying causes of impotence were psychogenic (26 Pts.), posterior urethral injury (28 Pts.), spinal cord injury (15 Pts.), pelvic surgery (14 Pts.) and eldly (9 Pts.). The results were as follows 1. The underlying causes of impotence in papaverine responders were psychogenic 23 (88.5%), posterior urethral injury 19 (67.9%), spinal cord injury 13(86.7%), Pelvic surgery 5 (35.7%) and eldly 3 (33.3%). 2. Fourteen patients of the moderate papaverine responders underwent intracavernous injection of papaverine 30mg with phentolamine 1mg and 8 of them attained full erection. 3. After injection, the erection started in an average of 2.6 minutes, rigidity of penis attained in an average of 7.3 minutes, and erection status sustained for an average of 42.6 minutes in 60 patients. 4. Normal nocturnal penile tumescence monitoring (NPTM) or stamp test was found in 19 of 40 patient and 18 of them (94.7%) were papaverine responders, while 21 had an abnormal NPTM or stamp test and 11 of them were papaverine non-respoders. 5. A penile brachial index (PBI) of 0.6 or more was found in 62 of 73 patients and 53 of them(85.5 %) were papaverine responders, while 11 had an index of less then 0.6 and all of them were papaverine non-responders. 6. Thitry patients had sexual intercourse. Twenty-seven of them had a satisfactory result and 23 of them had ejaculation. 7. Papaverine induced prolonged erection occurred as major complicatiun in 4 patients after trial injection. Erection was subsided after intracavernous phenylepinephrine injection. There were minor complications such as ecchymosis at the injected site on the prepuce but subsided spontaneously in a few days. We conclude that intracavernous papaverine injectiun currently is a good screening technique for the differential diagnosis of severe vasculosenic impotence and is a useful chemical prosthesis of non-vasculogenic impotence.

Xanthogranulomatous Pyelonephritis in Childhood: A Case Report / 대한비뇨기과학회지

Xanthogranulomatous pyelonephritis (XGP) in childhood is not common and the characteristics of the disease are different from those in adults. A 14-year-old boy was admitted to Pusan National University Hospital complaining of fever and right flank pain. An excretory ungraphy shows compressed pelvocalyceal system by extraluminal space occupying lesion in right kidney CT and ultrasonogram of the kidney shows relatively well marinated localized bulging mass on right posterior aspect and invading to the right posterior Gerota's fascia, psoas muscle and quadratus lumborum muscle. Right nephrectomy was performed under the suspicion of Wilms` tumor. Pathologic findings revealed XGP postoperatively. We report a case of focal XGP in a child with review of the literature.

True Hermaphroditism / 대한비뇨기과학회지

True hermaphroditism is one of the rare congenital anomalies. Additional four cases of this anomaly are added to the 2 cases which were reported previously from the Dept. of Urology, Busan National University Hospital. Clinical review was performed about these 6 cases. The results were as follows; 1. The incidence of true hermaphroditism is 0.17% in 3,456 uro1ogicaladnrissions from Jan. 1964 to Mar. 1982, 1.6% in 380 admissions with congenital anomalies of the external genitalia and 25% in 24 admissions with hypospadias and cryptorchism during this period. 2. Hypospadias and cryptorchisrn are found in 6 cases, bifid scrotum 3 cases, and labioscrotal folds in 2 cases. Roentgenograms of retrograde urethrography were available in 4 cases and revealed blind vaginal pouch in 3 cases. Among these 3 cases, one had patent fallopian tube at the cephalad end of the pouch. The other one had well developed vagina and the uterus with patent fallopian tube. 3. The genital ducts were developed ipsilaterally in 9 gonads composed of pure testicular or ovarian tissues but developed to those of male pattern in 3 gonads containing the ovarian and testicular tissues. Among these 3 cases two cases did not have the vas deferens. 4. Of 6 gonads containing the testicular tissues, two were in the scrotum, 2 in inguinal and remained 2 were in the peritoneal cavity. Of gonads containing the ovarian tissues, seven were in the peritoneal cavity and one in the retroperitoneum. 5. Sex chromatin was positive in 3 cases, negative in 3 cases. 6. Of 5 cases who had been reared as male, two were assigned to female, one to male and remained 2 were not decided the sex. The other who had been reared as female was assigned to female. 7. The type of true hermaphroditism is lateral in 3 cases (Type I)and unilateral in 3 cases (Type IIIb 2 cases, Type IIIa I case)by the classification of Jones and Scott.

Bacteriological Study of Urinary Tract Infections / 대한비뇨기과학회지

Urine specimens were obtained from one hundred and thirty nine patients in-out-patient and in-patient service of B.N.U.H., Dept. of Urology, with the presumptive diagnosis of urinary tract infections or indwelling catheter. These specimens were processed by Triphenyltetrazolium Chloride test, quantitative test and identification of the organisms. The results were as follows: 1. Triphenyltetrazolium Chloride test was an easily performable and a fairmely accurate method for screening of urinary tract infections. 2. The urine specimens showed false negative reactions to triphenyltetrazoium Chloride in some cases with moderate (10(4) to 10(6) bacteria per milliliter) growth of bacteria or in the antibiotics used patients. 3. The incidence of urinary tract infections with gram negative bacilli are ninety-two percent. In their series, incidence of E. coli decreased and that of other gram negative bacilli increased such as Enterobacter, Proteus and Serratia, etc. This shift in the pathogen spectrum occurs mostly in the patients of complicated or lower urinary tract infections, in-patients, antibiotics used patients and the patients with indwelling catheter.

Adenocarcinoma of the Urinary Bladder: Report of Three Cases / 대한비뇨기과학회지

Adenocarcinoma of the urinary bladder is one of the least common in the bladder carcinoma, which may be divided into three categories, primary, secondary and urachal origin. We present three cases of adenocarcinoma of the bladder; two in a normally placed bladder and one in the urachal remnant. A brief review of the literatures of vesical adenocarcinoma is also given.