Poor Preoperative Glycemic Control Is Associated with Dismal Prognosis after Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: A Korean Multicenter Study / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The purpose of this study is to evaluate the effect of diabetes mellitus (DM) and preoperative glycemic control on prognosis in Korean patients with upper tract urothelial carcinoma (UTUC) who underwent radical nephroureterectomy (RNU). MATERIALS AND METHODS: A total of 566 patients who underwent RNU at six institutions between 2004 and 2014 were reviewed retrospectively. Kaplan-Meier and Cox regression analyses were performed to assess the association between DM, preoperative glycemic control, and recurrence-free, cancer-specific, and overall survival. RESULTS: The median follow-up period was 33.8 months (interquartile range, 41.4 months). A total of 135 patients (23.8%) had DM and 67 patients (11.8%) had poor preoperative glycemic control. Patients with poor preoperative glycemic control had significantly shorter median recurrence-free, cancer-specific, and overall survival than patients with good preoperative glycemic control and non-diabetics (all, p=0.001). In multivariable Cox regression analysis, DM with poor preoperative glycemic control showed association with worse recurrence-free survival (hazard ratio [HR], 2.26; 95% confidence interval [CI], 1.31 to 3.90; p=0.003), cancer-specific survival (HR, 2.96; 95% CI, 1.80 to 4.87; p=0.001), and overall survival (HR, 2.13; 95% CI, 1.40 to 3.22; p=0.001). CONCLUSION: Diabetic UTUC patients with poor preoperative glycemic control had significantly worse oncologic outcomes than diabetic UTUC patients with good preoperative glycemic control and non-diabetics. Further investigation is needed to elucidate the exact mechanism underlying the impact of glycemic control on UTUC treatment outcome.

Characteristics of urinary retention in female inpatients managed with medical treatments

PURPOSE: We aimed to analyze the characteristics of urinary retention (UR) in female inpatients managed with medical treatments. MATERIALS AND METHODS: We retrospectively analyzed the medical records of female inpatients referred to the department of urology for UR at our institution from January 2009, to December 2014. UR was defined as a difficulty in self-voiding despite a sufficient urine volume or >300-mL postvoid residual. The data included patients' age, body mass index (BMI), ambulatory status, medical and surgical history, classes of taking drugs, and urinary tract infection. RESULTS: A total of 182 women were included as retention group, mean age of 72.64±12.94 years and BMI of 22.94±3.10 kg/m2. In the chi-square analysis, cardiovascular disorders (p=0.000), diabetes mellitus (p=0.008), metastatic malignancy (p=0.008), chronic renal disorders (p=0.028) were found significantly. In the multiple logistic regression analysis, cardiovascular disorders (p=0.002; odds ratio [OR], 0.491), metastatic malignancy (p=0.013; OR, 2.616) were found to increase the risk of UR. The most common surgical history was anti-incontinence surgery (7.2%). In term of medication use, the most prescribed agents were nonsteroidal anti-inflammatory drugs (NSAIDs) (53.8%). The patients taking multiple drugs with antimuscarinic effects except of NSAIDs, narcotics and diuretics were 48 (26.4%). Urinary tract infection was identified in 43 patients (23.6%). CONCLUSIONS: UR in females managed with medical treatments could be occurred occasionally. We think that thorough attentions are needed for UR to patients with cardiovascular disorders including diabetes mellitus, metastatic malignancy, chronic renal disorders urinary tract infection, and more careful interests when managing with drugs with antimuscarinic effects.

Balloon-Occluded Percutaneous Transhepatic Obliteration of Isolated Vesical Varices Causing Gross Hematuria

Gross hematuria secondary to vesical varices is an unusual presentation. We report such a case recurrent gross hematuria in a male patient who had a history of bladder substitution with ileal segments that had been treated by balloon-occluded percutaneous transhepatic obliteration of vesical varices.

The Prostate Cancer Detection Rate on the Second Prostate Biopsy according to Prostate-Specific Antigen Trend

PURPOSE: To identify the prostate cancer detection rate on the patients who had second prostate biopsy out of the patients who were reported negative in their first biopsy. MATERIALS AND METHODS: From July 2006 to February 2012, prostate biopsy was performed on 843 patients with over 4 ng/ml and on 618 biopsy negative patients PSA was performed from between 6 months and 9 months after biopsy. On 164 patients, second biopsy was performed, and 42 patients were selected. If there was less than 10% change between PSA before the prostate biopsy and PSA measured during 6 to 9 months after the first biopsy it was considered as no change. If above 10% increase, it was considered increase and if above 10% decrease it was considered as decrease. RESULTS: The cancer detection rate in PSA increase group was 20%, the detection rate in no change in PSA level but still over the normal range group 8.3%, and that in the PSA decrease group was 0%. When comparing prostate cancer group and non-cancer group, it is more probable to have prostate cancer when they are older, prostate volume is smaller and PSA density is higher. CONCLUSIONS: The second biopsy is strongly recommended when PSA level shows no change or increase, age is older, prostate volume is smaller or PSA density is higher.

Initial Experience with Retroperitoneal Laparoendoscopic Single-Site Surgery for Upper Urinary Tract Surgery

PURPOSE: To report our initial clinical experience and perioperative outcomes of retroperitoneal laparoendoscopic single-site surgery (RLESS) for upper urinary tract surgery. MATERIALS AND METHODS: Between June 2009 and October 2010, we performed RLESS in 23 patients for various indications including radical nephrectomy (n=4), nephroureterectomy (n=2), simple nephrectomy (n=10), and renal cyst ablation (n=7). RLESS was performed with a homemade single-port device with a conventional rigid laparoscopic instrument and laparoscope. The parameters analyzed were age, body mass index, operative time, estimated blood loss, transfusion, time of oral intake, visual analogue pain scale score (VAPS), length of hospital stay, and complications. RESULTS: One case of simple nephrectomy was converted to open nephrectomy because of severe adhesion and inadequate surgical exposure. RLESS was completed in 23 patients. Mean operative time was 168.7+/-29.2, 227.5+/-50.0, 230.0+/-56.5, and 70.5+/-8.9 minutes for simple nephrectomy, radical nephrectomy, nephroureterectomy, and renal cyst ablation, respectively. Estimated blood loss was 113.0+/-149.8, 170.0+/-156.8, 400.0+/-141.4, and 22.8+/-16.0 ml. The time to oral intake after surgery was 1.4+/-0.5, 1.2+/-0.5, 1.5+/-0.7, and 1.1+/-0.3 days. The mean VAPS score was 1.1+/-0.2, 2.1+/-0.5, 2.0+/-0.5, and 1.0+/-0.0 of 10 (range, 0.8 to 2.6). The hospital stay was 4.6+/-1.5, 3.7+/-0.5, 6.0+/-1.4, and 3.2+/-1.7 days. No major perioperative complications were observed. CONCLUSIONS: The initial outcomes of our experience suggest that RLESS is a technically feasible and safe procedure for upper urinary tract surgery. Prospective comparative studies with conventional retroperitoneal laparoscopic surgery are needed to confirm the potential benefits of RLESS.

Virulence Characteristics and Phylogenetic Background of Ciprofloxacin Resistant Escherichia coli in the Urine Samples from Korean Women with Acute Uncomplicated Cystitis

To clarify the characteristics of the virulence factors (VFs) of ciprofloxacin resistant Escherichia coli (CFRE) with acute uncomplicated cystitis (AUC), we determined the VFs and the phylogenetic background of all 54 CFRE strains and the 55 randomly selected ciprofloxacin sensitive E. coli strains (CFSE) from patients with AUC in 22 Korean hospitals. The prevalence of the VFs was as follows: fimA, papEF, papGIII, sfaI, dafaBC, cnf1, and hlyA were presented in 96%, 54%, 68%, 91%, 49%, 72%, and 29% of the samples, respectively. The expressions of papEF, cnf1, and hlyA were significantly more prevalent in the CFSE. Moreover, the expressions of cnf, and papEF significantly reduced the risk of ciprofloxacin resistance. The CFSE was also marginally associated with the group B2 (P=0.05). Although the presence of pyuria and a previous cystitis history were not related with the phylotyping and the expressions of VFs, group B2, and fimA and papEF were more expressed in the younger age patients (P<0.05). In conclusion, the CFRE exhibits a selective loss of VFs and the non-B2 phylotype in Korean AUC patients. The group B2 and the presence of fimA and papEF are associated with a younger age of AUC patients.

A survey on the clinical practice and the guidelines for sexually transmitted infections in Korea

Every year 150 million new cases of sexually transmitted infection are expected to occur around the world with high occurrence and morbidity rates in both males and females. To respond to dramatically changing social and cultural environments, clinical treatment guidelines for diagnosis, treatment, and prevention of sexually transmitted infections have been developed in many countries, and South Korea has also prepared treatment guidelines which can be used in medical institutions treating primarily these diseases. Against this background, this study conducted a 31-item questionnaire survey by mail and e-mail to investigate the actual clinical practices of physicians treating sexually transmitted infections. In total, 250 and 1,068 questionnaires were distributed through mail and e-mail, respectively, and 274 of them were completed and returned for a response rate of 20.8%. According to the results, physicians' actual clinical practices were found to be different from textbook guidelines to some degree. Therefore, treatment guidelines that take into account the current situation for sexually transmitted infections should be developed in Korea, and a foundation for national management of the diseases should be established through active advertisements.

Association of Polymorphisms in the Prostate-Specific Antigen (PSA) Gene Promoter with Serum PSA Level and PSA Changes after Dutasteride Treatment in Korean Men with Benign Prostatic Hypertrophy

PURPOSE: Studies of genetic variation in the prostate-specific antigen (PSA) gene have improved the diagnostic accuracy of PSA for diagnosing prostate diseases in Caucasians. However, the reference ranges and pharmacokinetics of PSA differ significantly according to race. Therefore, we evaluated the association between genetic variations in the PSA promoter area and benign prostatic hyperplasia (BPH) phenotypes in Korean BPH patients. MATERIALS AND METHODS: One hundred twenty-one men were enrolled. The initial serum PSA level, prostate size, and PSA changes at 3 months after treatment with dutasteride were determined. We amplified the promoter region of the PSA gene (nucleotide positions -158 to -356 and -5217 to -5429) and sequenced the products. RESULTS: Three relatively well characterized single-nucleotide polymorphisms (SNPs; rs3760722, rs266867, and rs266868), six uncharacterized SNPs (rs17554958, rs266882, rs4802754, rs2739448, rs2569733, and rs17526278), and one novel SNP (nucleotide position -5402) were found. There were no statistically significant correlations between any of the SNPs of the PSA promoter area and age-adjusted prostate sizes, initial PSA levels, or PSA variations after 3 months of dutasteride treatment. CONCLUSIONS: SNPs in the PSA promoter area were not associated with BPH phenotypes. We could not predict serum PSA changes after dutasteride treatment on the basis of PSA promoter genotype in Korean patients with BPH.

Primary Renal Carcinoid Tumor

Carcinoid tumors are low-grade malignant tumors arising from neuroendocrine cells. Primary renal carcinoid tumors are extremely rare, and only 56 cases have been reported in the literature. Because of the rarity of the lesion, its histogenesis and prognosis are unclear. Here we report a case of a primary renal carcinoid tumor in a 51-year-old man that was found incidentally in a medical examination and was treated by transperitoneal radical nephrectomy.

Effect of Mitomycin-C on Experimentally Induced Urethral Stricture in Rats

PURPOSE: Urethral stricture is a fibrotic process and, although it is one of the oldest known urologic diseases, it remains a common problem with a high recurrence rate. Mitomycin-C has been reported to have anti-replication properties in animal and clinical studies. The aim of this study was to observe the intraurethral impact of the use of mitomycin-C on scar formation and fibrosis in an experimental rat model of urethral stricture. MATERIALS AND METHODS: Twelve male Sprague-Dawley rats were used. With the animals under deep anesthesia, an internal urethrotomy was made with a cold knife. After the urethral injury, the rats were grouped randomly as follows: group 1 (control, n=4), group 2 (3 mg/l of mitomycin-C, n=4), and group 3 (5 mg/l of mitomycin-C, n=4). The rats were sacrificed 14 days later to evaluate epithelial proliferation and fibrosis. The penile urethra was removed and histopathologically examined by H&E staining, Masson trichrome staining, and immunohistochemistry with anti-collagen type I antibody. RESULTS: The stained specimens were examined under a light microscope. The extent of fibrosis and re-epithelization after urethral injury was greater in the areas with trauma than in those without. These findings were significantly reduced in the groups treated with mitomycin-C as compared with group 1, but there was no statistical difference between group 2 and group 3. Mitomycin-C treatment also prevented increases in collagen type I, whereas group 1 showed increases in collagen type I and collagen contents at the stricture site. CONCLUSIONS: These results suggest that mitomycin-C might inhibit the renewal of the epithelium and the synthesis of collagen secreted by fibroblasts in the affected urethra and then prevent scar formation. This raises the possibility of the use of mitomycin-C to prevent urethral stricture caused by trauma.

The Ciprofloxacin Resistance Pattern of Escherichia coli Isolated from Female Patients with Community- acquired Urinary Tract Infection in the Jeonnam and Gwangju Region for the Recent 2-years / 대한비뇨기과학회지

PURPOSE: The overuse of ciprofloxacin has recently increased the resistance of the Escherichia coli(E. coli). We studied the prevalence od the ciprofloxacin-resistant(CR) E. coli that were isolated from female patients with community-acquired urinary tract infection(CAUTI), and we demonstrated the resistant rate to other antibiotics to help physicians choose the suitable antibiotics to properly treat CAUTI. MATERIALS AND METHODS: From January 2006 to December 2007, we retrospectively analyzed 910 female patients with CAUTI. Among them, we chose 387 patients infected by E. coli and we evaluated the resistance rate to ciprofloxacin and its relationship with age, the disease causing the UTI and the previous antibiotics. We also compared the resistance to ciprofloxacin with that of other antibiotics, including cephalosporin and the other antibiotics recommended by the guidelines of the Infectious Diseases Society of America(IDSA). RESULTS: The incidence of UTI by E. coli increased with age(p<0.001), and it was highest in the 7th decade (59.0%). One hundred seventeen (30.2%) patients showed ciprofloxacin resistance. It was significantly related to an increased age(p=0.034), complicated UTI(p=0.04) and a previous history of antibiotic use(p=0.023). Trimethoprim/sulfamethoxazole(TMP/SMX) and fosfomycin showed similar resistance rates like ciprofloxacin; 31.8 and 28.2%, respectively. On the other hand, nitrofurantoin showed a low resistant rate of 5.7%. The resistance to cephalosporin was low in general; the lowest was cefepime(5.9%). CONCLUSIONS: Our results imply that the empirical use of ciprofloxacin for female patients with CAUTI is questionable, and especially for patients older than 40 years old, patients with complicated UTI and patients with a previous history of antibiotic use. Nitrofurantoin and cephalosporin can be useful agents for the treatment of female CAUTI.

Bladder Hemangioma as a Cause of Massive Hematuria: Treatment with Selective Arterial Embolization / 대한비뇨기과학회지

Hemangioma of the urinary bladder is a benign, congenital tumor that accounts for 0.6% of all primary bladder neoplasms. The most common symptom is gross hematuria. However, bladder hemangioma as a cause of massive hematuria is rare. The management of patients with hemangioma is controversial and numerous therapeutic approaches are available. Herein, we describe the use of selective arterial embolization to terminate an episode of massive hematuria in an 87-year-old woman with bladder hemangioma.

Relationship between the Success of Extracorporeal Shock Wave Lithotripsy (ESWL) and the Degree of Hydronephrosis when Treating Patients with Upper Ureteral Stones / 대한비뇨기과학회지

PURPOSE: We tried to determine the relation between the degree ofstone- induced hydronephrosis and the outcome of extracorporeal shock wave lithotripsy (ESWL) when treating patients with solitary upper ureteral stone. MATERIALS AND METHODS: 260 proximal ureteral stone patients with or without hydronephrosis were treated with ESWL between January 2003 and December 2006 and 8 of these patients were lost to follow up. The degree of hydronephrosis was defined by performing renal ultrasound. The patients were divided into four groups according to the degree of hydronephrosis. Group 0 (n=30) had no urinary system dilatation, group 1 (n=123) had a mild dilatation of the renal pelvis but no renal calices, group 2 (n=75) had a moderate dilatation of the renal pelvis and group 3 (n=24) had a severe dilatation of the renal pelvis and calices. In addition to the degree of hydronephrosis, the stone size, number of sessions, number of shockwave treatments applied and the success rate of ESWL were recorded. RESULTS: The success rate after ESWL treatment was 92.9% (n=234). There were no statistically significant differences among the groups for the stone size, number of sessions and number of applied shockwave treatments. There were a trend for a decreased success rate of ESWL with an increased degree of hydronephrosis, but this did not reach statistical significance (p=0.436). After ESWL, a few patients encountered minor complications such as gross hematuria, flank pain, stone street, fever and perirenal hematoma. Yet most cases were treated conservatively and there was no need for hospitalization. CONCLUSIONS: For the patients in our study who had a solitary calculus in the upper ureter, the degree of hydronephrosis caused by the stone does not affect the success rate after ESWL.

Efficacy and Safety of Uro-Vaxom Treatment for Patients with Recurrent Cystitis: An Open Multicenter Study / 대한비뇨기과학회지

PURPOSE: We wanted to investigate the efficacy and safety of the immunotherapeutic Uro-Vaxom for treating uncomplicated recurrent cystitis in female patients only. MATERIALS AND METHODS: Adult female patients were enrolled in this multicenter, open-label study if they had acute cystitis at the enrollment visit and positive results on urine culture (> or =10(3)CFU/ml). The patients were treated for 3 months with one capsule daily of Uro-Vaxom after antibiotic therapy, and they were observed for another 3 months. The primary efficacy criteria were the cystitis recurrence rates over 6 months, the distribution of cystitis and the proportion of patients with cystitis. RESULTS: A total of 50 patients were evaluated. During the 6-month trial, the number of cystitis recurrences was significantly reduced in comparison with the 6-month pretrial period (on the average 0.64 as compared to 3.0 recurrences, respectively p<0.001). The incidences of frequency, urgency and dysuria remained low until the end of the trial. Uro-Vaxom was well tolerated: side-effects were mentioned by 8% of the 50 patients, and there was no case leading to treatment withdrawal. CONCLUSIONS: Uro-Vaxom significantly reduced the incidence of cystitis during the 6 months of this study, including the 3 months of treatment. These results demonstrate that Uro-Vaxom is a valuable agent for prophylaxis of recurrent cystitis.

A Comparative Study of the Tension-free Vaginal Tape and Transobturator Vaginal Tape Inside-out for the Surgical Treatment of Female Stress Urinary Incontinence

PURPOSE: We compared the preoperative with the postoperative outcomes between tension-free vaginal tape (TVT) and transobturator vaginal tape inside-out(TVT-O) for the surgical treatment of female stress urinary incontinence MATERIALS AND METHODS: From January 2003 to December 2005, 72 women, one is TVT group(n=52) and the other is TVT-O group(n=20), after operation following were assigned. The preoperative and postoperative evaluations analysis and urodynamic study and Korean version of I-QoL, surgical outcomes, complications and uroflowmetry were analysed. RESULTS: All outcomes included the patients`states, incontinence quality of life(I-QoL)(p=0.013), the success rate of the cure(p=0.003) and the rate of the patient satisfaction(p=0.001) were not comparable statistically between two groups and there are no differences and no long-term complications such as bladder perforation or prolonged voiding difficulty. Preoperative and postoperative uroflowmetry was similar between the two groups. Mean operation time(TVT: 15.6 min, TVT-O: 13.2 min) was significantly shorter in TVT-O than in TVT. CONCLUSION: The observation of 1-year following-up shows the equally effectiveness between two groups(TVT and TVT-O) as the surgical treatment of stress urinary incontinence.

The Expressions of p53, gamma-H(2)AX and Ku70/Ku80 That was Caused by Hydronephrosis in the Kidney of Rats / 대한비뇨기과학회지

PURPOSE: There are little research about the factors of DNA damage and repair that might cause renal parenchymal damage under the condition of hydronephrosis. In this study, we studied the expressions of p53, gamma-H(2)AX and Ku70/Ku80 in rat kidney under the condition of hydronephrosis. MATERIALS AND METHODS: 16 Sprague-Dawley rats that were 7~8 weeks old were used. Partial ureteral obstruction was induced in 12 rats. And for the other 4 rats, a sham-operation was done as a control. The hydronephrosis-induced rats had their right kidney removed after 1, 2 and 3 weeks and the sham-operated rats underwent nephrectomy after 3 weeks. Those removed tissues were examined with immunohistochemical staining and western blot to confirm the degree of expression of p53, gamma-H(2)AX and Ku70/Ku80. RESULTS: The expressions of p53, gamma-H(2)AX and Ku70/Ku80 caused by hydronephrosis in the rat increased as time passed, and these expressions of controls were in a low level or they were negative. These results were similar with the results of the immunohistochemical staining and Western blot. CONCLUSIONS: This study confirmed that the protein expressions of gamma- H(2)AX, p53, and Ku70/Ku80 are increased, and these expressions are the DNA damage-related factors in the renal parenchyma of hydronephrosis-induced rats. We confirmed the possibility that DNA double strand breaks (DSBs) might be the main mechanism that induces renal parenchymal damage under the condition of hydronephrosis.

Efficacy of the NTrap(R) for the Treatment of Ureteral Stone: An Initial Clinical Experience / 대한비뇨기과학회지

PURPOSE: Retrograde migration of stone fragments is common when performing lithotripsy. A new device, the NTrap(R), is a device that prevents stone migration and it extracts calculi and other foreign bodies in the urinary tract. The aim of this study was to assess the efficacy and safety of ureteroscopic stone removal by using the NTrap(R). MATERIALS AND METHODS: From January 2006 to December 2006, 64 consecutive patients underwent endoscopic lithotripsy by using the NTrap(R), rigid ureteroscopy(8.6Fr) and pneumatic lithoclast. We analyzed the success rate of stone removal and the complication rate. RESULTS: The mean stone size and mean operation time were 9.36mm and 32 minutes, respectively. The overall stone-free rate was 100% and no patient had residual fragments greater than 3mm and they didn't require auxiliary treatment. The most common complications were gross hematuria and pain. CONCLUSIONS: The NTrap(R) is new ureteroscopic instrument that's a highly effective, safe modality for the treatment of ureteral stone.

Complications of Retroperitoneal Laparoscopic Surgery / 대한비뇨기과학회지

PURPOSE: Laparoscopic surgery is known to be safe and have low morbidity. Herein, all the complications of retroperitoneal laparoscopic procedures were evaluated. MATERIALS AND METHODS: A total of 120 retroperitoneal laparoscopic surgeries were performed between January 2002 and December 2005. Every abnormal event was investigated retrospectively, and classified in detail according to the surgical steps and severity. RESULTS: The complication ratio (total complications/total surgeries) was 0.38 (46/120). Open conversion was performed in 5 (4.2%). A transfusion was performed in 8 (6.7%) patients. 5 patients (4.2%) had neuromuscular problem related to position and 9 (7.5%) had access and insufflation related complications, including subcutaneous emphysema, abdominal wall hemorrhage, pneumothorax and pneumomediastinum. The intraoperative complications (5.8%) included peritoneal tearing, vascular injury and diaphragmatic injury. Postoperative complications occurred in 25 patients (20.8%), including pleural effusion, atelectasis/pulmonary infiltrate, wound dehiscence, paralytic ileus, retroperitoneal hematoma and urine leakage. 5 complications (4.2%) were classified as being major; main vascular injury (1.7%), urine leakage (1.7%) and diaphragmatic injury (0.8%). No serious complications, such as death, bowel injury, deep vein thrombosis, with pulmonary embolism, or gas embolism occurred. Other complications (41/46) were minor and managed conservatively, without any problem. CONCLUSIONS: The most common complications of retroperitoneal laparoscopic surgery seem to occur during the postoperative period, and are nonspecific to retroperitoneoscopy. Most complications are subclinical problems, which can be managed by conservative treatment. Retroperitoneal laparoscopic surgery is a safe procedure, with a low potential for complications.

Male Polythelia

Supernumerary nipples or polythelia are developmental abnormalities located along the embryonic mammary lines. It occurs sporadically but familial aggregation was been reported. Polythelia has been reported in association with congenital malformations, in particular with renal anomalies. We report a case of polythelia.

Ureteral Stricture from Retroperitoneal Fibrosis Caused by Isolated Common Iliac Artery Aneurysm / 대한비뇨기과학회지

Retroperitoneal fibrosis sometimes causes urological problem involving the ureter, but the mechanism is uncertain. An aortic aneurysm, including an iliac artery aneurysm, is thought to be one of the mechanisms of retroperitoneal fibrosis. However, cases caused by an isolated iliac artery aneurysm are very rare, and symptoms tend to be non-specific; therefore, no definitive treatment has been established. Herein, we report our recent experience of a patient with a left common iliac artery aneurysm involving the ureter, who underwent successful surgical therapy.