ABSTRACT
Urachal adenocarcinoma is a rare neoplasm with difficulty in differentiation from other tumors originated from gastrointestinal systems, female genitalia or prostate. We present a patient of urachal adenocarcinoma of the bladder, who was treated with partial cystectomy and en bloc excision of urachus. She has been well without evidence of local recurrence or metastasis for up to 32 months of follow-up periods. A brief review of the literatures of urachal adenocarcinoma is made.
Subject(s)
Female , Humans , Adenocarcinoma , Cystectomy , Follow-Up Studies , Genitalia, Female , Korea , Neoplasm Metastasis , Prostate , Recurrence , Urachus , Urinary Bladder , Urinary Bladder NeoplasmsABSTRACT
For the treatment of genuine stress urinary incontinence(GSUI), various surgical approaches have been developed since early in this century. Laparoscopic bladder neck suspension has recently been described as an alternative method to the open surgical correction of GSUI. We had treated 16 patients of GSUI with laparoscopic Burch procedure from May to November 1995. Mean age of the patients was 42.5 years(range:28-77years) and mean parity was 3.7. There was no serious operative complications such as bladder rupture or bleeding needed transfusion. The duration of follow up was 6.2 months(range:3-9 months) in average. Incontinence was completely disappeared in 11 patients(68.7%) and significantly improved in 5 patients (31.3%), and no patient was recurred during follow up periods. Postoperatively, there was no significant complication, except two cases of urinary tract infection. Early results of the small number of women studied suggest that this new technique can provide successful outcomes in properly selected patients.
Subject(s)
Female , Humans , Follow-Up Studies , Hemorrhage , Neck , Parity , Rupture , Urinary Bladder , Urinary Incontinence , Urinary Tract InfectionsABSTRACT
Forty two patients (ages 55 to 88 years) who had bladder outlet obstruction due to benign Prostatic hyperplasia were treated with TULIP procedure from October 1993 to Apri1 1994. Preoperatively, the patients underwent digital rectal examinations, determination of prostate specific antigen levels and transrectal ultrasound guided biopsies when necessary to rule out the presence of prostatic cancer. The overall preoperatively estimated weight of prostate gland was 37.3+/-5.0g by transrectal ultrasonography, and all types of prostatic enlargement, including median lobe obstruction, were treated. The TULIP device incorporates ultrasound visualization with 90 degree angle, side-firing Nd: YAG laser to induce coagulation necrosis of prostatic tissue. Treatment was performed primarily under epidural anesthesia, and the mean irradiated laser energy was 20,315 joules. There were no intraoperative complications such as hemorrhage or post-transurethral resection syndrome, and no blood transfusions were required. The patients were evaluated at three months following treatment. The subjective symptom scores were significantly decreased from 23.7+/-4.3 to 3.2+/-1.9 for a 87% improvement(P<0.001). Maximum flow rate increased from 8.2+/-3.2ml/sec to 13.7+/-3.4ml/sec, for a 67% improvement (P<0.001). For three months follow-up period epididymitis was developed in 2 cases, but these were easily handled with antibiotics. There were no patients of incontinence or impotence, as a complication, after TULIP procedure With these results we can conclude that TULIP is a reliable and effective procedure of little morbidity, especially for the aged patients with various medical problems.