Analysis of Urinary Stone Components during the Last Two Decades / 대한비뇨기과학회지

PURPOSE: The accurate analysis of urinary stone components is fundamental for studying of the etiology of stone formation and it is essential for the treatment of urinary stone and its prevention. We compared the analysis of urinary stone components during the last two decades. MATERIALS AND METHODS: Stone analysis was performed by Louis C. Herring and Company. The urinary stones were aobtained from January, 1986 to December, 2005. We compared the stone components of the first decade (Group A, 301 cases) with that of the second decade(Group B, 158 cases). RESULTS: The mean age was 47.2+/-14.5 in Group A and 46.0+/-10.2 in Group B(p=0.658). The ratio of males to females was 2.04:1 in Group A and 1.98:1 in Group B(p=0.888). Ureteral stones were the most common stones in both groups. Among all the components analyzed in Group A, calcium oxalate made up 73.1% of the total. Other components found in the stones were uric acid 12.3%, calcium phosphate 8.3%, magnesium ammonium 5.3%, ammonium acid urate 0.7% and cystine 0.3%. In Group B, calcium oxalate was only 56.3% of the total and uric acid was 22.2%, calcium phosphate was 11.4%, magnesium ammonium phosphate was 8.2%, ammonium acid urate was 1.3% and cystine was 0.6%. On comparison of the stones of the two groups, the incidence of calcium oxalate was decreased in Group A(73.1% vs 56.3%, p0.05). CONCLUSIONS: In this study, the incidence of calcium oxalate was decreased and that of the uric acid was increased in the recent decade. These changes of stone components probably resulted from the increased animal protein diet.

Enterogenous Cyst of the Testis

We present a rare case of an enterogenous cyst of the testis in a 21-year-old man. On ultrasonography, an ovoid hypoechoic solid mass (2x2x1.5 cm) was confined to the right testis. The left testis and bilateral epididymis were within normal limits. Grossly, the tumor was a unilocular cystic mass, without a solid component. Microscopically, the cystic mass was composed of mucin-secreting simple columnar epithelial lining cells, lamina propria and a well-differentiated muscularis propria. There was no evidence of any germ cell derivatives or neoplasia in the cystic mass and in the surrounding testicular parenchyma. Immunohistochemistry showed a positive reaction for cytokeratin and the epithelial membrane antigen in the epithelial lining; in addition, it was positive for smooth muscle actin in the well-differentiated muscularis propria.

Transurethral Resection of Prostate for Large Benign Prostatic Hyperplasia: a Comparative Study with Open Prostatectomy / 대한남성과학회지

PURPOSE: Open prostatectomy have been considered primarily when the prostate volume is large(e.g. >75 cc). However, with the development of surgical skills and instruments, transurethral resection of prostate(TURP) can be an alternative. We assessed the feasibility of TURP for patients with large benign prostatic hyperplasia(BPH) by comparing the efficacy of TURP with that of open prostatectomy, retrospectively. MATERIALS AND METHODS: From January 2000 to March 2005, a total of 54 BPH patients with a prostate larger than 75 cc in volume on transrectal ultrasonography underwent surgery in our hospital. Among these patients, 26 patients underwent TURP(Group T) and 28 patients underwent suprapubic prostatectomy(Group O). Group T was subclassified Group T-1(prostate volume 75~100 cc, n=12) and T-2(prostate volume > or = 100 cc, n=14). In the same way, Group O was divided into Group O-1(n=9) and O-2(n=19). Operative time, time to catheter removal, hospitalization, and complications were compared. Operative results were evaluated at 6 months postoperative by comparing preoperative and postoperative International Prostate Symptom Scores(IPSS), maximal flow rates(Qmax) and post void residual(PVR). RESULTS: Preoperatively, there were no significant differences in IPSS, Qmax or PVR between Groups T-1 and O-1 or between Groups T-2 and O-2. Although delta IPSS, delta Qmax and delta PVR improved in Group O-2 more than T-2, there were no statistically significant differences between Group T-1 and O-1. The mean operative time, time to catheter removal, and hospitalization were shorter in Group T than Group O. Postoperative complication rates were similar in the T and O groups. In Group T, there was no TUR syndrome, but urinary tract infections and urethral stricture were more common than in Group O. However, Group O had higher incidences of severe complications, including wound infection or bleeding requiring transfusion. CONCLUSIONS: Open prostatectomy is commonly considered when prostate volume is greater than 75 cc. If enough resection is performed, TURP is a valuable non-invasive surgical method with respect to absence of incision, effective symptom improvement, and short hospitalization in symptomatic BPH patients who have prostate volume less than 100 cc.