ABSTRACT
From January 1980 to December 1989, 172 patients with transitional cell carcinoma of the bladder treated by transurethral resection (TUR) or total cystectomy with urinary diversion were analyzed retrospectively. Fifty-six patients underwent total cystectomy with urinary diversion and 116 underwent TUR. The 5-year survival rates in a total of 172 patients were noted in 96.6, 48.6, 32.7, 30.6 and 44.1% or those with stage Ta-1, T2, T3a, T3b and T4 disease, respectively and in 94.7, 87.9 and 52.1% of those with grade 1, 2 and 3 disease, respectively. The 5-year survival rates in 56 total cystectomy patients were noted in 94.1, 80.0. 31.0 and 28.6% of those with stage Tis-1, T2, T3a and T3b-4 disease, respectively and in 75.0, 80.0 and 45.3% or those with grades 1, 2 and 3 disease, respectively. The 3-year recurrence rates in 116 TUR patients were noted in 14.3, 43.1 and 55.9% of those with grade 1, 2 and 3 disease, respectively. Stage and grade were the most important prognostic factors in survival for cystectomy and tumor recurrence in TUR patients, respectively.
Subject(s)
Humans , Carcinoma, Transitional Cell , Cystectomy , Recurrence , Retrospective Studies , Survival Rate , Urinary Bladder Neoplasms , Urinary Bladder , Urinary DiversionABSTRACT
One hundred and fifty strains of Gram negative bacilli isolated from urine of patients with urological disease were tested for resistance to antimicrobial drugs including quinolones. Escherichia coli (61 strains) was most frequently isolated, and followed by Klebsiella spp. (36), Pseudomonas aeruginosa (12). and Proteus spp. (6) in the decreasing order. New quinolone carboxylic acid compounds such as enoxacin (Ex). norfloxacin (Nf), ciprofloxacin (Cp), pefloxacin (Pf), and ofloxacin (Of) showed very high antimicrobial activities against the majority of organisms tested except P.aerogi. nose. In P.aeruginosa all strains were resistant to nalidixic acid, and 25-33% to Ex. Nf. Cp, Pf, and Or. The majority of strains tested were found to be resistant to beta-lactam antibiotics except moxalactam (Mr). aminoelycoside drugs except amikacin (Ak), and other drugs tested such as chloramphgnicol, tetracycline. rifampin and etc.. but in P.aeruginosa, 33-58% were resistant to Mx and Ak. Organisms multiplyine resistance to 5 or more druge were noted in almost all isolates tested The stain numbers of multiplying resistance to 5 or more drugs were 51 strains (83.6%) of E. Coli 24 strains (66.7%) of Klebsielle spp., 10 strains (83.3%) of P.aeruginosa, and 5 strains (83.3%) of Prorteus spp.
Subject(s)
Humans , Amikacin , Anti-Bacterial Agents , Ciprofloxacin , Drug Resistance, Microbial , Enoxacin , Escherichia coli , Klebsiella , Moxalactam , Nalidixic Acid , Norfloxacin , Nose , Ofloxacin , Pefloxacin , Proteus , Pseudomonas aeruginosa , Quinolones , Rifampin , Tetracycline , Urologic DiseasesABSTRACT
Between January 1987 and February 1990, records of 5Z patients with 60 impalpable testes who had surgery were reviewed retrospectively regarding localization and management of the testes. Seven out of 60 testes turned out to be palpable by careful examination under anesthesia. Ultrasonogram detected 8 testes (5 intracanalicular and 3 preperitoneal) out of 25 testes. Laparoscopy provided and in planning the appropriate surgical approach in all 8 testes. Of the 47 testes found at surgery 19 were intraabdominal, 14 intracanalicular, 12 in preperitoneal and 1 located in superficial inguinal area. Also 13 vanished testes were confirmed during surgery examining blind end of spermatic vessels and vasa. Two patients with intersex ( true hermaphroditism and hernia uteri inguinalis) were presented as unilateral impalpable testes. 42 testes were brought down surgically utilizing regular orchiopexy in 26 testes, transabdominal orchiopexy in 8 testes, Fowler-Stephens orchiopexy in 7 testes and staged orchiopexy in 1 testis were done with acceptable results. transabdominal approach is recommended in cases of suspecting intraabdominal testis or intersex.
Subject(s)
Humans , Anesthesia , Hernia , Laparoscopy , Orchiopexy , Ovotesticular Disorders of Sex Development , Retrospective Studies , Testis , Ultrasonography , UterusABSTRACT
To assess the penile hemodynamic function and penile anatomy, duplex ultrasonography combined with intracavernous papaverine injection was undertaken in psychogenic, neurogenic and vasculogenic impotence patients, and patients with priapism and Peyronie's disease Patients. The results were as follows ; 1. In 7 neurogenic and 7 psychogenic impotence patients, changes of luminal diameter of cavernous artery and peak flow velocity were 0.69 +/- 0.13mm, 8.99 +/- 2.54cm/sec in flaccid phase, and 1.13 +/- 0.12mm, 21.38 +/- 8.43cm/sec in erection phase. 2. In 4 vasculogenic impotence patients, changes of luminal diameter and peak flow velocity were minimal. 3. Penile ultrasound is considered valuable in the evaluation of extent of Peyronie's plaque and determination of the type of priapism. Penile duplex ultrasonography combined with papaverine injection is considered the best screening method of vasculogenic impotence, and valuable in the evaluation of the penile structures.
Subject(s)
Female , Humans , Male , Arteries , Erectile Dysfunction , Hemodynamics , Impotence, Vasculogenic , Mass Screening , Papaverine , Penile Induration , Phenobarbital , Priapism , UltrasonographyABSTRACT
One hundred kidney transplantations have been performed between November 1982 and July 1989. Twenty-seven patients received kidneys from living donors with multiple renal arteries. In eighteen patients both vessels were anastomosed, and in nine patients: a tiny polar vessel was sacrificed resulting in a small infarct in the grafted kidney. Results of transplantation in these patients were compared to those of recipients with or without infarcted kidney in regard to time, sex and age. Results using kidneys with anastomosed double renal arteries without infarct were almost as successful as those from a living donor with single renal arteries( well function kidney, serum creatinine <2.0mg/dl:70%). In contrast, recipients of kidneys with polar infarcts appear to have undergone more episodes of acute tubular necrosis, hypertension, or both(well function kidney :25%). Therefore, living donor with bilateral double renal arteries should be regarded as acceptable donor if both vessels can easily be anastomosed. If, however, a polar vessel has to be sacrificed. it is suggested that related living donor with polar artery should be excluded.
Subject(s)
Humans , Arteries , Creatinine , Hypertension , Kidney , Kidney Transplantation , Living Donors , Necrosis , Renal Artery , Tissue Donors , TransplantsABSTRACT
Adenocarcinoma of the bladder is a rare tumor with incidence in the range between 0.6 and 2.0 % of all epithelial bladder neoplasms. Its prognosis is generally poor compared to transitional cell carcinoma of the bladder. During the past 10 years since 1979, we have experienced 8 cases (3.2%) of adenocarcinoma the bladder among 252 cases of epithelial bladder neoplasms. Six cases of these were primary adenocarcinoma and 2 cases were of urachal origin. Overall two year survival rate was 23% with only 1 case free of cancer up to 3 years. Histologically, the tumors were classified as colonic type (4 cases), clear cell type (1 case), and not otherwise specified type (3 cases), without signet ring cell and colloid type. It might as well be concluded that there is no significant correlation between histologic type and survival rate. However there seems to be a significant correlation between clinical stage and survival rate.
Subject(s)
Adenocarcinoma , Carcinoma, Transitional Cell , Colloids , Colon , Follow-Up Studies , Incidence , Prognosis , Survival Rate , Urinary Bladder Neoplasms , Urinary BladderABSTRACT
Urethrocutaneous fistula is the most common complication in hypospadias repair. De-epithelialized flap technique vas introduced to prevent fistula formation in hypospadias repair. Herein, we reviewed our recent experience of 26 hypospadias repairs using same principle and described the surgical technique of procedures using various skin flaps. Of 10 cases with hypospadias repair, 3 cases developed the fistula and of 16 cases with fistula repairs, 3 cases of fistula recurred respectively.
Subject(s)
Female , Male , Fistula , Hypospadias , SkinABSTRACT
A consecutive series of 41 patients with renal cell carcinoma treated by nephrectomy from 1976 to 1986 is presented. The crude 2-year survival rate for all patients was 63% and for patients without distant metastases 84%. The importance of factors relating to prognosis was investigated with multivariate survival analysis(Cox's statistical regression models). Stage and metastases were strongly and independently associated with survival. The presence of regional lymph node and tumor cell type showed a statistically significant association with survival. But the invasion of renal vein, tumor size, the age and sex of the patients, grade, presence or absence of gross hematuria sedimentation rate and side or site of the tumors showed no prognostic significance.
Subject(s)
Humans , Carcinoma, Renal Cell , Hematuria , Lymph Nodes , Neoplasm Metastasis , Nephrectomy , Prognosis , Renal Veins , Survival RateABSTRACT
Since Memmalaar first reported the use of bladder mucosa graft technique in penoscrotal hypospadias in 1947, this technique has been used with reasonable success for the reconstruction of new urethra for the posterior hypospadias and hypospadias cripples. The a bladder mucosa is abundantly available, sterile and has good elasticity. This mucosa does not produce hair, does not excoriate, and does not desquamate from the exposure of the urin. Two new urethrae in patients with posterior hypospadias, aged 11 and 21, were successfully reconstructed with bladder mucosal graft technique. A minor meatal stricture developed in one patient. However, the over-all results of this technique appear to be satisfactory.
Subject(s)
Female , Humans , Male , Constriction, Pathologic , Elasticity , Hair , Hypospadias , Mucous Membrane , Transplants , Urethra , Urinary BladderABSTRACT
Renal hypertension is found to be the cause in 5-15ft of patients with hypertension, and may be vascular or parenchymal in nature. Renal studies in diagnostic technique and vascular reconstructive techniques now enable successful management in many patients with renal hypertension. We experienced one case of renovascular hypertension due to renal vein hypoplasia. This rare renal venous hypertension has been diagnosed preoperatively and can be cured by nephrectomy, so we reported this case with brief review of the literature.
Subject(s)
Humans , Hypertension , Hypertension, Renal , Hypertension, Renovascular , Nephrectomy , Renal VeinsABSTRACT
Rigid transurethral ureteroscopy has been utilized on twenty-two occasions for the treatment of distal ureteral calculi. This resulted in successful stone removal and avoidance of an open operation in 77.3 percent of the cases. The advantages of this type of treatment are that it enables endoscopic access to a surgically difficult portion of the ureter and allows direct visualization during basket manipulation of ureteral calculi. It is concluded that the ureteroscopic stone manipulation could be the first choice of treatment in distalureteral calculi.