A case of urethral replacement with polytetrafluoro-ethylene graft for multiple anterior urethral strictures

Recently, the authors had an opportunity to treat a 73-year-old male patient who was transferred to our institution with problematic multiple strictures of the anterior urethra subsequent to a suprapubic cystostomy. A proximal urethra was reconstructed with scrotal skin, but due to the shortage of distal skin, as a last resort we reconstructed a distal urethra using a polytetrafluoroethylene graft in place of 10 cm long urethral strictures. About 5 months after surgery, we had to reexplore the polytetrafluoroethylene graft area because of pain and found, much to our surprise, that the urethra had been completely regenerated around the length of polytetrafluoroethylene graft which now remained freely detached in the urethral canal. Following removal of the polytetrafluoroethylene graft, the patient could urinate normally and was subsequently discharged without further problems. We concluded that this case was incidentally successful with good regeneration of urethral mucosa of the anterior urethra by grafting a polytetrafluoroethylene tube.

Long-term follow-up of Penile Prosthesis Implantation / 대한비뇨기과학회지

Forty eight patients with erectile failure were treated with penile prosthesis between December 1983 and March 1987 and following results were obtained. 1. The range of patient age was 23 to 75 years and the fifth decade(33.3%) was most common, followed by the fourth decade(25%) and the sixth decade(18.8%). 2. The etiology of erectile failure was spinal cord injury(31.3%), vasculogenic(27.1%), diabetes mellitus(22.9%) and radical cystectomy(8.3%). 3. The type of penile prosthesis was AMS malleable 600(62.5%), Jonas silicone silver(31.3%) and AMS Hydroflex(6.3%). The length of penile prosthesis was in the range of 13 to 21 cm and in 37 cases(77.1%) it was between 16 and 18 cm. The diameter of penile prosthesis was 9.5 mm(50%) and 11 - 11.5 mm(47.9%). 4. There were 4 cases of early complication ; prolonged pain in 2 cases and voiding difficulty in 2 cases were treated conservatively. There was 1 case of late complication ; the glans erosion in paraplegic patient. 5. Forty seven cases(97.9%) are now enjoying their sexual lives with penile prosthesis at follow-up of more than 3 months up to more than 3 years. From the above results, the implantation of penile prosthesis is a safe and effective method in the treatment of erectile failures.

The Comparison of Nocturnal Erection and Audiovisual Stimulating Erection / 대한비뇨기과학회지

This study is to compare the diagnostic usefulness and relationships between AVS penogram. Snap gauge test, and NPT monitoring in impotent patients confirmed using multidisciplinary diagnostic approach at the Department of Urology, Yonsei University College of Medicine from December 1986 to June 1987. Following results were obtained. 1. Among 24 cases of Group I(AVS penogram) 20 cases(83.3%) were psychogenic impotence, where 15 cases(75%) revealed sufficient penile rigidity on the Snap gauge test. 4 cases(16.7%) of group I were organic impotence, which revealed incomplete penile rigidity on the Snap gauge test. Among 45 cases of Group II-B(AVS Penogram) 34 cases(75.6%) were psychogenic impotence, where 28 cases(82.4%) showed sufficient penile rigidity on the Snap gauge test. 10 cases(24.4%) of Group II-B were organic impotence, which showed incomplete penile rigidity on the Snap gauge test. Among 17 cases of Group II-A and II-C 5 cases were psychogenic impotence, all of which revealed sufficient penile rigidity on the Snap gauge test. >From above results, the AVS Penogram is not a confirmative method, but using AVS Penogram and the Snap gauge test simultaneously will give useful information differentiating organic impotence and psychogenic impotence. 2. In comparison of AVS penogram and NPT monitoring, among 20 cases 7 cases of erectile curve showed similar shape, but the precise mechanism of each penile erection is not yet certain, more study is needed in the near future.

A Case of Urinary Incontinence Treated with AMS 800 Artificial Sphincter / 대한비뇨기과학회지

A 31 year old male patient presenting urinary incontinence 2 years after the traumatic injury of the posterior urethra and bladder neck, fails to respond to the alpha-adrenaergic agents and other ordinary methods. However, using the artificial sphincter(Model AMS 800) implantation, he successfully voided freely without urinary incontinence and the residual urine. The urethral closing pressure was significantly increased. The radiographic findings of inflation and deflation of the sphincter revealed satisfactory functions.

A Study on the Sperm Motility According to the Cryopreservation method of Human Semen / 대한비뇨기과학회지

There is a general growing appreciation that clinical use of frozen-stored human semen is a practical, successful, safe and valuable method in both infertility and population control. However cryopreservation results in reduced motility and fertility of human semen. The factors which influence cryosurvival of human semen are poorly understood. The influence of initial temperature of cryopreservation, ratios of HSPM to semen, cooling rates, freezing rates, thawing methods and duration of cryopreservation on the survival of human spermatozoa was studied. The following results were obtained by carefully observing the motility of post-thaw sperms. 1. Ratios of 1:1, 1:2, 1:3, and 1:4 of HSPM to semen did not affect sperm cryosurvival. 2. The initial temperature of cryopreservation had no significant influence on the cryosurvival of spermatozoa. 3. The optimal cooling rate from room temperature(20+/-2 degrees C) to 4 degrees C and subsequently frozen-thawed in LN2 was found to be 0.5C and 1 degrees C per minute. 4. The optimal freezing rate from 4 degrees C to -80 degrees C was found to be 5 degrees C and 10 degrees C per minute. 5. Slow thawing in room temperature(20+/-2 degrees C) resulted in better survival than rapid thawing in 37 degrees C. 6. There was no significant difference in the post-thaw sperm motility up to 5 months cryopreservation.

Experience of Urethral Replacement with Gore-Tex(Polytetrafluoroethylene) Graft for a Difficult Urethral Strictures: l case / 대한비뇨기과학회지

In a 73 year old male patient with multiple urethral strictures, we performed urethral replacement with Gore-Tex(Polytetrafluoroethylene) graft about l0cm long. On a follow up, 5 months later, operative field was reexplored due to pains and we found that urethral regeneration was complete around the Gore-Tex graft while the graft itself was remaining inside the urethral lumen in a freely detached state. After the removal of Core- Tex graft, patient could void in a normal fashion quite satisfactory. We think that urethral replacement graft with Gore-Tex should be given a consideration as a last resort.

A Case of Ectopic Ureter Entering Seminal Vesicle Associated with Ectopic Renal Dysplasia / 대한비뇨기과학회지

We presented one case of 43 years old man with ectopic ureter entering the seminal vesicle associated with ectopic renal dysplasia. He had complained of perineal and lower abdominal discomfort, hemospermia. The definite diagnosis was made by seminal vesiculogram through vas deferens. We report the case with brief review of literatures.

Spontaneous Regression of Primary Renal Cell Carcinoma: A Case Report

Spontaneous regression of metastases or primary lesions of malignancy is a most intriguing phenomenon. However there were no reports of spontaneous regression of primary renal cell carcinoma. We reviewed a case of renal mass which was considered to be a spontaneously regressed renal cell carinoma. This diagnosis was supported by the size of the renal mass, its total necrosis, and the discovery of a few remaining tumor cells. We cautiously report this case as a spontaneously regressed primary renal cell carcinoma in a 54 year old woman.