Iatrogenic Ureteral Injuries in Pelvic Surgery: A Review of 12 Cases / 대한비뇨기과학회지

We reviewed 12 patients with iatrogenic urethral injuries in pelvic surgery from May 1993 to May 1996. The patients ranged in age from 27 to 52 years (mean age 47). The diagnosis of urethral injury was made intraoperatively in 8 (66.7%) and postoperatively in 4 cases (33.3%). The ureteral injury patterns in intraoperative diagnosis group at recognition were classified into complete transsection in 5, partial transsection in 2 and ligation in 1 case. The clinical findings of postoperative diagnosis group were ureterocutaneous fistula in 1, ureteral obstruction in 2, and ureterovaginal fistula in 1 case. Presenting symptoms were fever in 1, urine leakage in 2, and flank pain in 1 case. The treatments in intraoperative diagnosis group included ureteroureterostomy in 4, ureteroneocystostomy in 2, and simple closure in 2 closes. In postopeative diagnosis group the treatments were initiated soon after establishment of the diagnosis, and consisted of ureteroneocystostomy with psoas hitch in 2, ureteral stunting with ureteroscope in 1, and ureteroureterostomy in 1 case. The RESULTS were good in 7 cases (87.5%) of intraoperative diagnosis group and 2 cases (50.0%) of postopertive diagnosis group. Of the 3 poor resulted cases 2 were managed with percutaneous nephrostomy, and 1 with ureteral stenting. We concluded that prompt recognition of ureteral injuries at occurrence with immediate repair RESULTS in few complications. Injuries detected postoperatively required more complicated procedures to repair the ureter. Because most of the ureteral injuries occurs by the non-urologic surgeon, especially gynecologist or general surgeon, it is important to let them know the fact that immediate repair of the ureter is important and cooperative relationships between urologist and non-urologist are also important during pelvic surgery.

Effects of Doxazosin Mesylate in Patients with Benign Prostatic Hyperplasia / 대한비뇨기과학회지

The clinical effect of doxazosin mesylate, a selective long acting alpha-1 adrenergic blocker, were evaluated in 31 patients with symptomatic benign prostatic hyperplasia ranging from 49- 85 years old. All patients underwent a urodynamic evaluation and symptom score checking before enrollment into the study. The dose of doxazosin was 2mg per day. And the mean duration of treatment was 157 days. 31 patients were followed on doxazosin for 3 to 12 months with mean 7.5 months. The adverse drug reactions were observed only 1 case. The parameters used to assess the effectiveness of doxazosin included peak and mean urinary flow rates, micturition symptom scores and residual urine, and global assessment by the patient The peak and mean urinary flow rates increased by 77% and 86%, respectively. The obstructive and irritative symptom scores were improved by 51% and 41% respectively. The improvements in urinary flow rates and symptom scores were maintained for this interval. Although this preliminary experience with doxazosin is encouraging, the ultimate role of doxazosin for the long term treatment of benign prostatic hyperplasia needs further evaluation.