Testicular Microlithiasis: Clinical Features in 18 Cases / 대한남성과학회지

PURPOSE: Testicular microlithiasis (TM) is an uncommon benign condition characterized by calcium deposits in the lumen of the seminiferous tubules. It may be associated with testicular malignancies and infertility. MATERIALS AND METHODS: We performed a retrospective review of clinical charts and scrotal ultrasound findings of 18 patients who were found to have TM. Scrotal ultrasound scans were performed using 5- to 10-mHz high-resolution transducers. The indication for ultrasonography was an abnormal scrotal examination. RESULTS: The mean age at presentation was 39.9 years (range 14 to 70 years). Most (15; 83.3%) of the patients had bilateral TM. There were no differences in the sonographic patterns and appearance according to patient age. A third of the patients (7; 38.9%) had benign epididymal lesions. Two with bilateral TM had unilateral testicular malignancy. A varicocele was identified in two men, who demonstrated normal semen parameters. A 16-year-old boy showed no interval sonographic changes at 1-year follow-up. CONCLUSIONS: Testicular microlithiasis usually affects both testes. The association between TM and progres sion of cancer is unclear.

The Value of Non-Enhanced Spiral CT in the Diagnosis of Suspected Urolithiasis / 대한비뇨기과학회지

PURPOSE: We prospectively determined the value of a non-enhanced spiral CT (NESCT) in the diagnosis of suspected urolithiasis by a comparison with excretory urography (EU). MATERIALS AND METHODS: After giving informed consents, 114 and 103 patients, with suspected urolithiasis, underwent either NESCT or EU, respectively. All the NESCT and EU films were assessed by 2 urologists and 1 radiologist with no knowledge of the clinical histories. The sensitivity, specificity, positive and negative predictive value, diagnostic accuracy and other valuable diagnostics in each group were compared. RESULTS: The sensitivity, specificity and accuracy of NESCT in diagnosing urinary calculi were 96.8, 95.2 and 96.5%, and for EU, were 75.3, 90.9 and 78.6%, respectively. The examinations were performed with an average of less than 5 minutes for the NESCT versus 113+/-31 minutes for the EU, and the times taken to a definitive diagnosis in the two groups were 2.4+/-0.3 and 59+/-5.2 hours, respectively. In the EU group, 24 patients (23.3%) had revisited and 11 (10.6%) were admitted for pain control, prior to the imaging evaluation, only 2 patients (1.7%) revisited, and none were admitted in the NESCT group. In our institution, the cost of a NESCT was more expensive than that of an EU (140,000 vs. 35,790 Won), however the cost-effectiveness is enhanced by the accuracy of NESCT, which lead to fewer ancillary studies. CONCLUSIONS: NESCT is accurate, reliable and safe, and has many advantages over EU, and therefore could be recommended as a first diagnostic modality for the evaluation of patients with suspected urolithiasis.

Clinical Characteristics of Genitourinary Tuberculosis in Children / 대한비뇨기과학회지

PURPOSE: The incidence of renal tuberculosis has decreased considerably in recent years, but the disease still threatens public health. Childhood genitourinary tuberculosis (GUTB) has been very rare. The aim of the study was to analyze the clinical aspects and characteristics of childhood GUTB. MATERIALS AND METHODS: A total of 145 cases of GUTB were diagnosed. We analyzed retrospectively the clinical manifestations of eight patients with GUTB younger than 15 years of age. RESULTS: The age of the patients, six boys and two girls, ranged from 5 to 14 years. Follow up period ranged from 12 to 145 months. Presenting features were diverse and included gross hematuria in five cases. Rarer presenting features included one case of epididymorchitis. All had had BCG vaccination at around 1 month old. Conclusive diagnosis was made on the basis of isolation of mycobacterium tuberculosis in five patients, whereas three patients were given a therapeutic trial based on clinical manifestations. The most common site of involvement was the kidney (7 cases). Temporary urinary diversional procedures were performed in two patients for relieving ureteral obstruction. Excisional surgery was needed in three patients, whereas one underwent ureteroneocystostomy for ureteric stricture. Response to antitubercular drug therapy was gratifying. No relapse was observed during follow-up period. CONCLUSIONS: Childhood GUTB is rare, but may become serious. The importance of early diagnosis is emphasized, and aggressive treatment is needed in advanced childhood tuberculosis for preservation of renal function.