Relationship Between Chronic Periodontitis and Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia / 대한배뇨장애요실금학회지

Purpose@#We investigated the relationship between lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) and chronic periodontitis (CP). @*Methods@#A total of 103 middle-aged men who had received a health checkup were included. All participant data were prospectively collected. CP was defined as a 30% increase in the number of probed sites with a clinical attachment level of ≥4 mm among all probed sites. LUTS/BPH were assessed using transrectal ultrasonography, the International Prostate Symptom Score (IPSS), uroflowmetry, and postvoiding residual urine volume. @*Results@#The median age, IPSS, prostate volume, and maximal flow rate were 55.0 years, 9.0, 29.0 mL, and 20.0 mL/sec, respectively. In addition, the prevalence of CP was 27.2%. The IPSS total, IPSS voiding, IPSS storage, and quality of life (QoL) scores were significantly higher in patients with CP (median [interquartile range, IQR]–IPSS total: 8.0 [5.0–13.5] vs. 12.0 [7.5–20.5], P=0.004; IPSS voiding: 5.0 [2.0–9.0] vs. 8.5 [4.0–15.0], P=0.002; IPSS storage: 3.0 [2.0–5.0] vs. 4.0 [3.0–6.0], P=0.021; QoL: 2.0 [1.0–3.0] vs. 3.0 [2.0–4.0], P=0.015). Additionally, the average flow rate was significantly lower in patients with CP (median [IQR] (mL/sec): 9.0 [8.0–13.0] vs. 8.0 [6.0–11.0], P=0.047). After adjustment for age, testosterone level, prostate volume, glucose level, cholesterol level, and waist circumference, the IPSS total and voiding scores were significantly and positively related to CP (IPSS total: odds ratio [OR], 1.141; 95% confidence interval [CI], 1.045–1.245; P=0.003; IPSS voiding: OR, 1.243; 95% CI, 1.092–1.415; P=0.001). @*Conclusions@#Our data suggest that LUTS/BPH is significantly related to CP.

Relationship Between Chronic Periodontitis and Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia / 대한배뇨장애요실금학회지

Purpose@#We investigated the relationship between lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) and chronic periodontitis (CP). @*Methods@#A total of 103 middle-aged men who had received a health checkup were included. All participant data were prospectively collected. CP was defined as a 30% increase in the number of probed sites with a clinical attachment level of ≥4 mm among all probed sites. LUTS/BPH were assessed using transrectal ultrasonography, the International Prostate Symptom Score (IPSS), uroflowmetry, and postvoiding residual urine volume. @*Results@#The median age, IPSS, prostate volume, and maximal flow rate were 55.0 years, 9.0, 29.0 mL, and 20.0 mL/sec, respectively. In addition, the prevalence of CP was 27.2%. The IPSS total, IPSS voiding, IPSS storage, and quality of life (QoL) scores were significantly higher in patients with CP (median [interquartile range, IQR]–IPSS total: 8.0 [5.0–13.5] vs. 12.0 [7.5–20.5], P=0.004; IPSS voiding: 5.0 [2.0–9.0] vs. 8.5 [4.0–15.0], P=0.002; IPSS storage: 3.0 [2.0–5.0] vs. 4.0 [3.0–6.0], P=0.021; QoL: 2.0 [1.0–3.0] vs. 3.0 [2.0–4.0], P=0.015). Additionally, the average flow rate was significantly lower in patients with CP (median [IQR] (mL/sec): 9.0 [8.0–13.0] vs. 8.0 [6.0–11.0], P=0.047). After adjustment for age, testosterone level, prostate volume, glucose level, cholesterol level, and waist circumference, the IPSS total and voiding scores were significantly and positively related to CP (IPSS total: odds ratio [OR], 1.141; 95% confidence interval [CI], 1.045–1.245; P=0.003; IPSS voiding: OR, 1.243; 95% CI, 1.092–1.415; P=0.001). @*Conclusions@#Our data suggest that LUTS/BPH is significantly related to CP.

The Relationships between Thyroid Hormone Levels and Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia

PURPOSE: We examined the association between thyroid hormone and lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: A total of 5,708 middle aged men were included. LUTS/BPH were assessed using the international prostate symptom score (IPSS), total prostate volume (TPV), maximal flow rate (Qmax), and a full metabolic workup. Thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels were measured using chemiluminescence immunoassay. We divided participants into quartiles based on their TSH and FT4 levels: first to fourth quartile (Q1–Q4). RESULTS: There was a significant increase in the percentage of men with IPSS>7, Qmax7 were significantly different between FT4 quartile groups (ORs; [5–95 percentile interval], p; TPV≥30 mL, Q1: 0.000 [references]; Q2: 1.140 [0.911–1.361], p=0.291; Q3: 1.260 [1.030–1.541], p=0.025; Q4: 1.367 [1.122–1.665], p=0.002; IPSS>7: Q1: 0.000 [references]; Q2: 0.969 [0.836–1.123], p=0.677; Q3: 1.123 [0.965–1.308], p=0.133; Q4: 1.221 [1.049–1.420], p=0.010). In men with above median levels of testosterone, the FT4 correlated positively with TPV, even after adjusting for confounders. However, the FT4 was not correlated with TPV in men with below median levels of testosterone. TSH was not related to LUTS/BPH measurements. CONCLUSIONS: TPV, IPSS, and Qmax were significantly related to FT4. TPV and IPSS were significantly and independently related to FT4. Additionally, the relationship between FT4 and TPV was distinct when testosterone levels are high.

Huge pheochromocytoma presented with paraaortic lymph node and spine metastases / 영남의대학술지

Approximately 10–15% of pheochromocytomas are malignant. There are insufficient histologic criteria for the diagnosis of malignant pheochromocytoma. Thus, the term malignant pheochromocytoma is restricted to tumors with local invasion or distant metastases. We experienced a case of malignant pheochromocytoma recurred with spinal metastasis 4 years after the surgery for huge benign pheochromocytoma. A 68-year-old female was admitted for trunk and back pain. The patient had a history of surgery 4 years ago for a 10.0×9.5×7.5 cm sized benign pheochromocytoma at the left adrenal gland. A thoracolumbar magnetic resonance imaging showed a tumor in the 7th thoracic vertebral body and a 24-hour urinary norepinephrine increased, suggesting metastatic recurrence of malignant pheochromocytoma. After metastasectomy in the 7th thoracic vertebral body, urine catecholamine was normalized and pain also disappeared. However, a metastatic lesion was found in the paraaortic area on a follow-up abdominal computed tomography scan and an additional metastasectomy was performed. The pathology confirmed the diagnosis of metastatic pheochromocytoma in the paraaortic lymph nodes. She is supposed to be treated with adjuvant iodine 131-meta-iodobenzylguanidine therapy. In our experience, a close follow-up should be considered in patients who had a huge benign pheochromocytoma due to the possibility of malignant metastases.

Huge pheochromocytoma presented with paraaortic lymph node and spine metastases / 영남의대학술지

Approximately 10–15% of pheochromocytomas are malignant. There are insufficient histologic criteria for the diagnosis of malignant pheochromocytoma. Thus, the term malignant pheochromocytoma is restricted to tumors with local invasion or distant metastases. We experienced a case of malignant pheochromocytoma recurred with spinal metastasis 4 years after the surgery for huge benign pheochromocytoma. A 68-year-old female was admitted for trunk and back pain. The patient had a history of surgery 4 years ago for a 10.0×9.5×7.5 cm sized benign pheochromocytoma at the left adrenal gland. A thoracolumbar magnetic resonance imaging showed a tumor in the 7th thoracic vertebral body and a 24-hour urinary norepinephrine increased, suggesting metastatic recurrence of malignant pheochromocytoma. After metastasectomy in the 7th thoracic vertebral body, urine catecholamine was normalized and pain also disappeared. However, a metastatic lesion was found in the paraaortic area on a follow-up abdominal computed tomography scan and an additional metastasectomy was performed. The pathology confirmed the diagnosis of metastatic pheochromocytoma in the paraaortic lymph nodes. She is supposed to be treated with adjuvant iodine 131-meta-iodobenzylguanidine therapy. In our experience, a close follow-up should be considered in patients who had a huge benign pheochromocytoma due to the possibility of malignant metastases.

Obesity in Korean Men: Results from the Fourth through Sixth Korean National Health and Nutrition Examination Surveys (2007~2014)

PURPOSE: Obesity is related to many diseases, including urological conditions. We investigated the prevalence, risk factors, and treatment of male obesity. MATERIALS AND METHODS: This study included 17,485 men older than 20 years of age who participated in the fourth, fifth, and sixth administrations of the Korean National Health and Nutrition Examination Survey. Two main cutoff points for obesity were defined: a body mass index (BMI) ≥25 kg/m2 and a BMI≥30 kg/m2. Additionally, we defined obesity requiring pharmacotherapy as the presence of a BMI≥30 kg/m2 or a BMI≥27 kg/m2 co-occurring with at least one associated comorbid medical condition, such as hypertension, dyslipidemia, or diabetes. RESULTS: The prevalence rates of a BMI≥25 kg/m2, a BMI≥30 kg/m2, and obesity requiring pharmacotherapy were 35.7%, 3.4%, and 10.5%, respectively. The prevalence of obesity increased over time for all definitions of obesity. The prevalence of obesity requiring pharmacotherapy was highest in Jeju (12.5%) and lowest in Gangwon-do (7.7%). Having a higher income, being a non-manual worker, and having completed a high level of education were significantly related to obesity requiring pharmacotherapy. More than 70% of patients with obesity requiring pharmacotherapy reported taking diet pills, eating functional foods, or consuming a one-food diet for weight reduction, but only 13.9% reported exercising for this purpose. CONCLUSIONS: Male obesity is a common condition, the prevalence of which is expected to continue to increase over time. A better strategy is required to manage male obesity in Korea.

Incidence of Nitrituria and Its Association With Metabolic Syndrome: Results From the Korean National Health and Nutrition Examination Survey V (2010-2012) / 대한배뇨장애요실금학회지

PURPOSE: To investigate the incidence of nitrituria and the relationship between nitrituria and metabolic syndrome (MetS). METHODS: Data from the Korean National Health and Nutrition Examination Survey V were used. A total of 19,083 participants were included. The chi-square test, the Mantel-Haenszel extension, logistic regression analysis, and multiple linear regression were used to analyze the data. RESULTS: A total of 2.0% of the participants had nitrituria. The incidence of nitrituria significantly increased with age (P trend<0.001). In addition, nitrituria in women began to significantly increase in the fifth decade, more than in men, and this difference was maintained in the 60s, 70s, and greater than 70s age groups (P<0.001). After adjusting for confounders, the odds ratio (OR) for nitrituria in the MetS group was significantly increased, as compared to the OR for nitrituria in the group without MetS (MetS: OR, 1.577; 95% confidence interval [CI], 1.134-2.192; P=0.007). The glycosylated hemoglobin of the nitrite positive group was significantly higher than the negative group (adjusted mean ±standard error: 6.108 ±0.081 vs. 5.883±0.065, P<0.001). CONCLUSIONS: An effective health policy for urinary tract infection (UTI) is needed for older age groups and women. Screening or management guidelines for UTI are needed in MetS patients.

Multiple Endocrine Neoplasia Type 1 Presenting with an Invasive Giant Prolactinoma / 대한내과학회지

Pituitary tumors occur in 15-50% of patients with multiple endocrine neoplasia of type 1 (MEN1). To the best of our knowledge, no MEN1 case in which the initial lesion was an invasive giant prolactinoma has been reported from Korea. We describe a patient in whom a skull-base tumor involved the sellar and parasellar spaces. A 49 year-old female presented with headache and diplopia. The tumor was ultimately identified as a giant prolactinoma; the serum prolactin concentration increased from 155.6 ng/mL to 3,234.3 ng/mL after cranial irradiation. She was evaluated in terms of incidental hypercalcemia and was found to have parathyroid hyperplasia. Genetic analysis revealed a missense mutation in the MEN1 gene (c.643G>A, p.Val215Met). Two years of treatment with a dopamine agonist reduced, but did not normalize, the serum prolactin concentration. We highlight the aggressive behavior of the giant skull-base tumor, and the diagnostic delay caused by a high-dose hook effect of the MEN1-related prolactinoma.

Myelomatous Pleural Effusion with Elevated ADA Activity / 대한내과학회지

Multiple myeloma is a plasma cell neoplasm mainly involving the bone marrow and skeletal system. Myelomatous pleural effusion is rare, accounting for less than 1%. In cases with high adenosine deaminase (ADA) activity, with lymphocytic exudate in the pleural fluid, tuberculous pleural effusion should be differentiated first. We report herein a rare case of a unilateral pleural effusion in a patient who was undergoing chemotherapy for multiple myeloma, with an ADA level of > 100 IU/L and lymphocytic exudate in the pleural fluid. An acid fast bacillus stain and polymerase chain reaction test for tuberculosis were negative. Consequently, the patient was diagnosed with myelomatous pleural effusion with elevated ADA activity.

Correlation Between the Visual Prostate Symptom Score and International Prostate Symptom Score in Patients With Lower Urinary Tract Symptoms / 대한배뇨장애요실금학회지

PURPOSE: To evaluate the correlation between the Visual Prostate Symptom Score (VPSS) and International Prostate Symptom Score (IPSS). METHODS: We enrolled 240 new male patients who had visited National Police Hospital more than twice during a 6-month period starting from July 2013. At initial visit, the Korean version of the IPSS and VPSS, uroflowmetry, and transrectal ultrasonography were used to evaluate urinary symptoms. After medication, IPSS and VPSS questionnaires were issued again. The Spearman correlation test and the Mantel-Haenszel test were used to evaluate the relationship between the IPSS and VPSS. RESULTS: The median age, total prostate volume, total IPSS, and total VPSS were 59.0 years, 28.0 mL, 12, and 9, respectively. Total VPSS, VPSS obstructive symptoms, VPSS irritative symptoms, and VPSS quality of life (QoL) significantly correlated with the total IPSS, IPSS obstructive symptoms, IPSS irritative symptoms, and IPSS QoL, respectively (correlation coefficient, P-value: 0.632, <0.001; 0.431, <0.001; 0.696, <0.001; and 0.799, <0.001; respectively). The change in the total IPSS after treatment also significantly correlated with the change in total VPSS after treatment (correlation coefficient, P-value: 0.364, <0.001). There were significant correlations between maximal flow rate and IPSS/VPSS obstructive symptoms (correlation coefficient, P-value: -0.190, 0.004; -0.269, <0.001, respectively). Additionally, there was a significant increase in the ratio of the maximal flow rate <15 mL/sec to VPSS obstructive symptoms as the severity of the VPSS obstructive symptoms increased (P trend <0.001). CONCLUSIONS: VPSS might be useful in evaluating lower urinary tract symptoms at the initial visit and assessing these symptoms at longitudinal follow-up examinations.

Preoperative Predictors of Varicocelectomy Success in the Treatment of Testicular Pain

PURPOSE: We performed the present study to evaluate the prognostic factors for the surgical outcome of varicocelectomy in the treatment of a painful varicocele. MATERIALS AND METHODS: A total of 77 patients undergoing varicocelectomy were enrolled. All the patients were examined for body mass index (BMI), varicocele grade, testosterone, follicle stimulating hormone (FSH), luteinizing hormone (LH), semen analysis, maximal vein diameter, and discrepancy of testicular volume. At a follow-up visit 3~6 months after the surgery, the patient response was graded as a complete response, partial response, or no response. The resolution of pain was defined as a complete or partial response. We used logistic regression analyses to determine the preoperative factors for predicting a complete response and the resolution of pain. RESULTS: Ten subjects were lost to follow-up. The remaining 67 patients were included in this study. The pain was completely resolved in 47.8% of patients, partial resolution was observed in 25.4% of patients, and failure was reported in 26.9% of patients. Among the parameters, only a longer duration of pain (> or =3 months) was an independent factor related to the complete response of pain (odds ratio, 7.371; p=0.010) and the resolution of pain (odds ratio, 7.209; p=0.042). The parameters of semen analysis results, testosterone, LH, FSH, BMI, grade, ultrasonography results, and the type of surgical approach did not significantly predict the resolution of pain. CONCLUSIONS: The duration of pain (> or =3 months) was an independent prognostic factor for the complete response of pain and the resolution of pain.

Antipsychotic-Induced Sexual Dysfunction and Its Management

Sexual dysfunction is a common condition in patients taking antipsychotics, and is the most bothersome symptom and adverse drug effect, resulting in a negative effect on treatment compliance. It is known that hyperprolactinemia is a major cause of sexual dysfunction. Based on the blockade of dopamine D2 receptors, haloperidol, risperidone, and amisulpride are classed as prolactin-elevating antipsychotics, while olanzapine, clozapine, quetiapine, ziprasidone, and aripiprazole are classed as prolactin-sparing drugs. Risperidone and the other typical antipsychotics are associated with a high rate of sexual dysfunction as compared to olanzapine, clozapine, quetiapine, and aripiprazole. With regard to treatment in patients suffering from sexual dysfunction, sildenafil was associated with significantly more erections sufficient for penetration as compared to a placebo. Subsequent studies are needed in order to provide physicians with a better understanding of this problem, thereby leading toward efficacious and safe solutions.

Relationship between Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia and Metabolic Syndrome in Korean Men

PURPOSE: To investigate any associations between lower urinary tract symptoms (LUTS)/benign prostate hyperplasia (BPH) and metabolic syndrome (MetS). MATERIALS AND METHODS: In all, 1,224 male police officers in their 50s who had participated in health examinations were included. LUTS/BPH was assessed by serum prostate-specific antigen, International Prostate Symptom Score (IPSS), transrectal ultrasonography, maximum urinary flow rate (Q max), and postvoid residual urine volume (PVR). In addition, testosterone was also examined. The MetS was defined using NCEP-ATP III guidelines. We used the multiple linear regression test and logistic regression analyses to examine the relationships. RESULTS: MetS was diagnosed in 29.0% of participants. There was no significant difference in the percentage of cases of BPH (IPSS >7, Q max or = 20 ml) (14.2% in the non-MetS group vs. 17.2 in the MetS group; p value=0.178). The total IPSS score and the Q max were not significantly different. The prostate volume and PVR were significantly greater in the subjects with MetS. After adjusting for age and testosterone, the presence of MetS was not associated with BPH (multivariate odds ratio, 1.122; 95% confidence interval, 0.593~2.120). Additionally, MetS was not related to IPSS (Beta, -0.189; p value=0.819), prostate volume (Beta, 0.815; p value=0.285), Q max (Beta, -0.827; p value=0.393), or PVR (Beta, 0.506; p value=0.837). CONCLUSIONS: According to our results, the MetS was not clearly correlated with LUTS/BPH in Korean men in their 50s.

Study of Prostate of Korean Young Adult Using Transrectal Ultrasonography / 대한비뇨기과학회지

PURPOSE: The prostate of the young adult is not a subject which has received much attention, and the vast majority of prostate studies have placed their emphasis predominantly on elderly patients. It seems, then, that an investigation of the prostate in younger patients is warranted, and perhaps long past due. Thus, we attempted to determine the mean prostate volume in Koreans in their 20's. We also reported on the relationships between prostate size and body mass index, as well as body surface area, and compared the prostates of normal Korean youths with those of chronic prostatitis patients. MATERIALS AND METHODS: Between March 2002 and February 2008, we chronicled 583 cases of transrectal ultrasonography(control group: 271, chronic prostatitis group: 314) and calculated prostate volumes via the biplane method. 178 of the cases in the chronic prostatitis group were again examined after treatment. In all of the cases, body mass index and body surface area were assessed. RESULTS: The mean age of the patient was 22.83+/-2.46 years. The mean prostate volume of the 583 young adults was 15.58+/-3.11ml(control group: 15.61+/-3.16ml, chronic prostatitis group: 15.56+/-3.07ml). We ensured that there were no differences between the normal group and the chronic prostatitis group. The prostate volumes of the chronic prostatitis patients made no odds with the treated prostates. Additionally, prostate volume was directly proportional to the body mass index and the body surface area. CONCLUSIONS: The prostate volume of young Korean adults in their 20's was approximately 15.6ml. The development of chronic prostatitis in young men had no appreciable effect on prostate size, but was shown to induce a variety of histologic changes in the prostate, and these changes were similar to those observed in older patients.

IRIS-Transobturator Tape Procedure for the Treatment of Women with Stress Urinary Incontinence / 대한비뇨기과학회지

PURPOSE: We wanted to evaluate the clinical efficacy, safety and satisfaction of patients with IRIS-transobturator tape (TOT) operation for the women suffering with stress urinary incontinence. MATERIALS AND METHODS: 53 women with stress urinary incontinence who underwent the TOT procedure between February 2004 and June 2005 were included in this study. Preoperatively, the patients were evaluated with history taking, a physical examination, a voiding diary, a one-hour pad test, uroflowmetry and the post voided residual urine. The procedure was carried out using a previously established method under local anesthesia for 37 patients and under spinal anesthesia for 16 patients. The post-operative symptoms and patient satisfaction were assessed by questionnaire. RESULTS: The patients' mean age was 49.6 years (average age: 35-73 years). The mean follow-up was 10.9 months (average follow-up: 3-20 months). The mean operation time was 30.2 minutes (average time: 20-50 minutes). The mean duration of the post operative indwelling catheter was 1 hour for local anesthesia and 18 hours (range: 14-20 hours) for spinal anesthesia. Of the 53 patients, 49 (92.4%) of the patients were cured and 4 (7.6%) were significantly improved. The postoperative complications were urinary retention in 4 patients, and tape exposure by vaginal erosion in 1 patient. De novo urgency occurred in 1 patient and de novo urge incontinence occurred in 1 patient. CONCLUSIONS: Despite the short term follow-up period, the IRIS-TOT procedure is simple, effective and less invasive for the treatment of stress urinary incontinence in terms of the high success rate and the low complication rates.

Bladder Transitional Cell Carcinoma Masquerading as Tuberculous Contracted Bladder / 대한비뇨기과학회지

Bladder cancer is generally manifested with gross hematuria and this is the most common urinary tract neoplasm in Korea, but it is very rare to find it combined with a contracted bladder. A case of contracted bladder was suspected as being recurred urinary tuberculosis; because of her past history, the urine analysis and cystoscopic findings seemed to resemble the chronic inflammation associated with urinary tuberculosis, and the transurethral biopsy reported only chronic inflammation. Yet the final histopathologic report after cystectomy and urinary diversion revealed that there was no tuberculosis, but rather, there was bladder transitional cell carcinoma (TCC). Therefore, any contracted bladder found in an older age patient is considered to be a urinary TCC until proven otherwise. To the best of our knowledge, this is the first case of bladder TCC combined with contracted bladder.

The Impact of Height, Weight and Body Mass Index(BMI) in Young Men with Varicoceles / 대한남성과학회지

PURPOSE: To assess the impact of physical characteristics on the incidence of varicoceles. Although previous reports have alluded to the fact that taller individuals may have a higher incidence of varicoceles, this has not been systematically studied. We hypothesized that physical characteristics such as height and weight could have a significant impact on the incidence of varicoceles. MATERIALS AND METHODS: We retrospectively reviewed charts of 145 patients who presented for evaluation of varicocele between 2000~2005. Each patients' age, symptoms, height, weight and body mass index (BMI) were recorded. Independent t-tests were performed to determine whether a correlation existed between presence of a varicocele and height, weight, or BMI. Moreover, we selected 90 patients whose varicocele was detected by pain and performed the same analysis in order to exclude selection bias. Additionally, we compared varicocele grade with height, weight and BMI by one-way ANOVA test. RESULTS: Our analysis showed that there was no association between height and the presence of a varicocele. However, the weight of the patient and the incidence of varicocele approached significance with greater weight associated with a lower incidence of varicoceles. There was also an association between BMI and the presence of varicoceles but the correlation did not depended on varicocele grade. CONCLUSIONS: Although previous reports have alluded to a higher incidence of varicoceles in taller patients, the current study found no correlation between height and the presence of a varicocele. Increased weight, however, was associated with a significantly lower incidence of varicoceles. Varicocele grade was not correlated with any factor. This study demonstrates that height is not a consideration when evaluating the infertile male, whereas weight may affect the ability to diagnose the varicocele.

Spontaneous Testicular Hemorrhagic Necrosis Masquerading as a Testis Tumor / 대한비뇨기과학회지

Spontaneous testicular hemorrhagic necrosis is a rare disease usually associated with testicular torsion. Partially involved and suspicious testis tumor cases are also defined from orchiectomy specimens. Herein, a spontaneous hemorrhagic necrosis, without any testicular torsion, but with involvement of the whole testicle and epididymis, is reported. A 21 year old patient, who presented with a painless left testicular enlargement of several days duration was believed, based on physical examination, ultrasonography and elevation of serum LDH, to have a testicular tumor. Diagnosis was made only after radical orchiectomy and histopathological examination.

Spontaneous Renal Rupture with Renal Pelvis Transitional Cell Carcinoma / 대한비뇨기과학회지

Spontaneous renal ruptures are clinically unusual, and usually occur secondary to various kinds of underlying disease, such as a benign or malignant tumor, vascular disease and infection, etc. A renal cell carcinoma is the most common cause, and those caused by a transitional cell carcinoma are extremely rare. Herein is reported our experience of a case of a spontaneous rupture, with a renal pelvis transitional cell carcinoma, in a 48-year-old man.

A Comparison of the Availability of the Urine ThinPrep(R)test and Urine Cytology in the Diagnosis of Bladder Cancer / 대한비뇨기과학회지

PURPOSE: In noninvasive tests for the diagnosis of bladder cancer, it has been reported that urine cytology has high specificity but low sensitivity. This study compared urine cytology and the urine ThinPrep(R)test, a recently introduced noninvasive test, for assessing the diagnosis of bladder cancer. MATERIALS AND METHODS: A single voided urine samples were obtained preoperatively from patients diagnosed with a transitional cell carcinoma of the bladder following a transurethral resection(TURB). The sensitivity and specificity of the urine ThinPrep(R)test was compared with the urine cytology, according to pathological stage, grade, size and number. RESULTS: In the test group(n=40), the overall sensitivity of the urine ThinPrep(R)test was 75% versus 47.5% for urine cytology(p=0.012). In the control group(n=41), the specificity of the urine ThinPrep(R)test was 97.7% versus 100% for urine cytology (p=0.314). The sensitivity of urine cytology increased with the increasing pathological stage, grade, tumor size and number. Although not significant, the sensitivity of the urine ThinPrep(R)test also increased as the grade, tumor size and number increased, but not for the pathological stage. In the <3cm, single, grade 2 and stage Ta groups the urine ThinPrep(R)test gave a significantly higher increase in the sensitivity than for the same groups by urine cytology. CONCLUSIONS: Although there was no significant increase in the sensitivity with grade 1 and stage T1, there were significant increases in the groups of stage Ta, grade 2, single and small size(<3cm) with the urine ThinPrep(R)test. Therefore it can be concluded that the urine ThinPrep(R)test has a potential to increase the sensitivity in low grade, low stage bladder cancer without loss of the high level of specificity and warrants further investigation, with more cases and controls, as an ancillary noninvasive test, with cystoscopy, in the diagnosis of bladder cancer.