Comparison of an Indwelling Period Following Ureteroscopic Removal of Stones between Double-J Stents and Open-Ended Catheters: A Prospective, Pilot, Randomized, Multicenter Study

PURPOSE: The aim of this study was to evaluate whether long-term, postoperative ureteral stenting is necessary after ureteroscopic removal of stones (URS) during an uncomplicated surgical procedure. MATERIALS AND METHODS: We prospectively examined 54 patients who underwent URS for lower ureteral stones from February 2010 to October 2010. Inclusion criteria were a stone less than 10 mm in diameter, absence of ureteral stricture, and absence of ureteral injury during surgery. We randomly placed 5 Fr. open-tip ureteral catheters in 26 patients and removed the Foley catheter at postoperative day 1. The remaining 28 patients received double-J stents that were removed at postoperative day 14 by cystoscopy under local anesthesia. All patients provided visual analogue scale (VAS) pain scores at postoperative days 1, 7, and 14 and completed the storage categories of the International Prostate Symptom Score (IPSS) at postoperative day 7. RESULTS: The VAS scores were not significantly different on postoperative day 1 but were significantly smaller in the 1-day ureteral catheter group at postoperative days 7 and 14 (p<0.01). All of the storage categories of the IPSS were significantly lower in the 1-day ureteral stent group (p<0.01). The ratio of patients who needed intravenous analgesics because of severe postoperative flank pain was not significantly different between the two groups (p=0.81). No patients experienced severe flank pain after postoperative day 2, and no patients in either group had any other complications. CONCLUSIONS: One-day ureteral catheter placement after URS can reduce postoperative pain and did not cause specific complications compared with conventional double-J stent placement.

Primary Malignant Melanoma of the Male Urethra

Primary malignant melanoma occurring within the male urethra is very rare. Here we report a case of malignant melanoma of the urethra in a 74-year-old man. He presented with asymptomatic gross hematuria for 5 months. His glans penis and adjacent penile skin had become discolored black 10 years ago. Cystourethroscopy showed a smooth oval-shaped elevated mass in the fossa navicularis. There were no abnormal findings in the proximal urethra and urinary bladder. Computed tomography did not detect any inguinal lymph node enlargement or distant metastases. The patient underwent partial penectomy and ilioinguinal lymph node dissection. Grossly, the distal urethra revealed an ovoid pigmented nodule, that measured 1 x 0.5 cm. Microscopic findings showed a nodular malignant melanoma arising in the urethral mucosa with pagetoid spread to the epidermis of the glans penis. There were no recurrences over a period of 12 months after surgery without chemotherapy. This is the second case of a primary malignant melanoma of the male urethra in Korea.

Relationships between Relative Proportion of Tissue Components, Urodynamic Parameters, and Low Urinary Tract Symptoms in Patients with Benign Prostatic Hyperplasia

PURPOSE: This study was designed to investigate the relationship between the histological composition of the prostate, preoperative clinical parameters, and the results of transurethral resection of prostate (TURP). MATERIALS AND METHODS: A total of 61 patients with benign prostatic hyperplasia (BPH) who had undergone TURP were enrolled retrospectively. Slides were surveyed for relative areas (%) of glandular epithelium (GE), stroma (ST), and smooth muscle (SM) in stroma by performing immunohistochemistry, and the mean outcomes were calculated with a computer-assisted image analyzer (x200). RESULTS: Total prostate volume was less than 40 ml in 19 patients (group 1), 40 to 80 ml in 23 patients (group 2), and more than 80 ml in 19 patients (group 3). The percentage of SM was significantly greater in group 1 (29.5+/-4.2%) than in group 3 (23.7+/-3.2%), but GE and ST did not differ significantly. AG number was significantly higher in group 3 than in the other groups but did not correlate with SM. Improvements in International Prostate Symptom Score, which were similar in each group, were positively correlated with SM. CONCLUSIONS: SM in prostate adenoma is increased in men with a small prostate and may play an important role in lower urinary tract symptoms in small BPH

Efficacy and Safety of Intravenous Propofol Anesthesia during Transrectal Ultrasound-Guided Prostate Biopsy

PURPOSE: Transrectal ultrasonography (TRUS)-guided prostate biopsy causes fear and pain in 65% to 90% of patients. This study was designed to evaluated the use of intravenous propofol anesthesia during TRUS-guided prostate biopsy. MATERIALS AND METHODS: Between January 2006 and June 2008, 195 men undergoing a transrectal prostate biopsy were divided into 2 groups according to anesthetic technique. Group A consisted of 99 patients who received intravenous propofol infusion through an 18 gauge needle during TRUS-guided prostate biopsy. Group B consisted of 96 patients who intrarectally received 10 ml of 2% lidocaine gel 10 minutes before TRUS-guided prostate biopsy. Pain scores were assessed on a visual analogue scale immediately after prostate biopsy. RESULTS: The pain score was significantly reduced in group A compared with group B. There was a significant difference in the mean pain score between the 2 groups (1.0+/-1.3 in group A versus 2.9+/-2.0 in group B; p<0.01). Also, there was a significant difference in the willingness to undergo rebiopsy between the 2 groups (83.8% in group A versus 17.7% in group B; p<0.01). However, the complication rates were not significantly different between the 2 groups. Gross hematuria was found in 14% of group A patients and 18% of group B patients. CONCLUSIONS: Our results proved the advantage of intravenous propofol anesthesia during TRUS-guided prostate biopsy. Intravenous propofol infusion can be a safe and simple technique that significantly reduces pain during TRUS-guided prostate biopsy.

Intratesticular Varicocele Associated with Ipsilateral Extratesticular Varicocele

Intratesticular varicocele is a rare entity and refers to a dilated intratesticular vein radiating from the mediastinum testis into the testicular parenchyma. A 22-year-old man was admitted to our hospital with left testicular pain. On physical examination, a grade III varicocele was noted on the left side. Gray-scale ultrasound and color Doppler ultrasound examinations revealed intratesticular and extratesticular varicocele. The patient underwent spermatic vein ligation by open modified Palomo varicocelectomy.

The Effect of Short Term Dutasteride Therapy on Microvessel Density in Benign Prostatic Hyperplasia / 대한비뇨기과학회지

PURPOSE: Several studies have shown that finasteride limits hematuria in patients with benign prostatic hyperplasia(BPH). However, there are few reports addressing dutasteride therapy. We evaluated the effect of dutasteride on intraoperative blood loss and on microvessel density(MVD) in patients with BPH. MATERIALS AND METHODS: We studied 39 patients with BPH who underwent transurethral resection of the prostate(TURP). Group I included 22 patients who received dutasteride 0.5mg daily for 2 weeks preoperatively, and group II included 17 patients who did not. Blood loss was evaluated by comparing preoperative and postoperative hemoglobin. Sections from the prostatic suburothelium and hyperplastic prostate were individually stained for CD 34. MVD was calculated by counting the number of positively stained blood vessels in 5 random high power fields. There were no significant differences between the groups in terms of age, total prostatic volume, resected prostatic weight, or prostate-specific antigen (PSA). RESULTS: The mean MVD in the suburethral portion in dutasteride-treated patients was significantly lower than that seen in untreated patients(14.47 versus 22.19 vessels per high power field, p=0.026). In nodular hyperplasia, there was no significant difference in MVD between the two group(14.72 versus 15.24 vessels per high power field, p=0.801). CONCLUSIONS: Short term pretreatment with dutasteride decreases suburethral prostatic MVD in patients with BPH and may help reduce blood loss during TURP, particularly in huge BPH, which sometimes bleeds excessively during operation.

The International Prostate Symptom Score: Discrepancies between Self-administration and Physician-administration / 대한비뇨기과학회지

PURPOSE: The International Prostate Symptom Score (IPSS) is the most commonly used scoring system to quantify the lower urinary tract symptoms of benign prostate hyperplasia. The objective of this study was to measure any discrepancies in the Korean version of the IPSS when it is administered by the patients themselves as opposed to when it was administered by the physician. MATERIALS AND METHODS: Seventy two patients were asked to fill out two IPSS questionnaires during their first visit; one was self-administered and the other was administered by a physician in an interview. The total IPSS, quality of life and the individual questions were compared between the two modes of administration. RESULTS: Statistically significant differences were found in the mean total IPSS (16.9+/-8.44 versus 15.0+/-7.53, respectively) and the scores on questions 3 (intermittency) and 4 (urgency) between the self and physician administered IPSS (2.40+/-2.03 versus 1.47+/-1.88 and 1.86+/-1.87 versus 1.26+/-1.58, respectively). Thirty one patients (44.3%) demonstrated a difference of more than 3 points on the total IPSS score. CONCLUSIONS: This study suggests that there may be discrepancies between the self and physician administered IPSS scores. Therefore, physicians should review the score of each question, and especially those on intermittency and urgency.

Primary Bladder Signet Ring Cell Carcinoma Extended to Prostate / 대한비뇨기과학회지

A primary signet ring cell carcinoma (PSRCC) of the urinary bladder is a rare variant of a mucin-producing adenocarcinoma. The prognosis of a PSRCC is poor, as silent progression in a linitis platica fashion leads to delayed diagnosis. Herein, the case of a PSRCC of the bladder, which extended to the prostate, which was treated with a cystoprostatectomy, is reported.

Clusterin Expression and Apoptosis in Transitional Cell Carcinoma of the Bladder / 대한비뇨기과학회지

PURPOSE: The clusterin expression has been associated with tumorigenesis of various malignancies, including tumors of the prostate, colon and breast. Furthermore, the expression of clusterin is modulated by many factors that are believed to regulate tumor growth and apoptosis. We studied the clusterin expression in transitional cell carcinoma (TCC) of the bladder and we investigated its correlation with apoptosis. MATERIALS AND METHODS: Eighty five bladder tumor specimens from radical cystectomy or transurethral resection were subjected to immunohistochemical clusterin staining with Ig G clusterin Ab. We examined the immunohistochemical localization of clusterin, and this was followed by TUNEL staining to detect the apoptotic cells. After double-staining with Hoechst 33258, we detected the apoptotic cells under a fluorescence microscope and we calculated the apoptotic index. RESULTS: Invasive TCC showed a stronger positive expression of clusterin as compared with superficial TCC, but the positivity of the clusterin expression was not in proportion to the tumor grade. The apoptotic indices of cancer were 0.52+/-0.28%, 0.30+/-0.16% and 0.17+/-0.11% in Grade I, Grade II and Grade III superficial TCC, respectively, and it was 0.23+/-0.13% in Grade III invasive TCC. Apoptotic cells were not detected in the cancer cells stained with clusterin. Conversely, clusterin was not expressed in the cells showing apoptosis. CONCLUSIONS: These results suggest that clusterin could be used as a marker to provide prognostic information for the TCC patients. The apoptotic index revealed that apoptosis and the clusterin expression have correlation with transitional cell cancer. Further study will be needed to clarify the role of clusterin as a therapeutic target for cancer treatment.

The Role of Retrograde Urethrography as a Predictor of Early Recovery of Urinary Continence after Radical Retropubic Prostatectomy

PURPOSE: This study is designed to explore the role of retrograde urethrography as a predictor of recovery of urinary continence after radical retropubic prostatectomy. MATERIALS AND METHODS: A total of 40 patients who underwent radical retropubic prostatectomy from January 2005 to April 2007 were investigated. Among them one neurogenic bladder patient and one follow up loss patient were excluded. Voiding pattern and urinary incontinence were investigated with voiding diary monthly after Foley catheter removal. Recovery of urinary continence was defined as usage of less than 1 diaper per day. Pericatheter urethrography was conducted 2 weeks after operation. If definite bladder-urethral extravasation was not detected, an retrograde urethrography was performed immediately. 30 patients with sufficient length of urethra, regular margin of urethra and beaky appearance were defined as Group A, and 8 patients without above mentioned characteristics were marked as Group B. Differences between two groups were compared in terms of age, prostate volume, prostate specific antigen, urodynamic parameters, and duration of urinary incontinence. RESULTS: No significant differences were found in age, prostate volume, PSA between two groups. In group A, recovery rates of urinary continence were 70% (21 persons), 100% (30 persons) at 1,3 months after removal of catheter, respectively. In group B, rates of urinary continence recovery were 16.6% (1 person), 37.5% (3 persons), 75% (6 persons) at 1,3,4 months, respectively and 1 person regained continence at 7 months. CONCLUSION: A catheter free retrograde urethrography can be easily added after confirmation of bladder urethra anastomosis site healing. It gives us some valuable informations about external sphincter. The characteristics of retrograde urethrography can be used as a predictor of early recovery of postoperative incontinence.

Transurethral Prostatectomy Using a 22F Continuous Running Irrigation System Resectoscope / 대한비뇨기과학회지

PURPOSE: The twenty-six F sized continuous running irrigation transurethral resection (TUR) system has showed a relatively high risk for inducing postoperative urethral stricture in Korean men. We evaluated the efficacy and safety of recently available 22F continuous running irrigation TUR system for treating benign prostatic hyperplasia (BPH) patients. MATERIALS AND METHODS: A total of seventy patients with severe symptomatic BPH underwent transurethral prostatectomy (TURP). The 26F system was used in 31 cases and the 22F system was used in 39 patients. The total resection weight, the resection rate, and the intraoperative and immediate postoperative complication rates were compared between the 2 groups. The patients were followed for 2 weeks, 4 weeks and 3 months postoperatively to check for the development of urethral stricture. RESULTS: The total resection weight was 14.8+/-9.5gm in the 22F group and 11.2+/-10.2gm in the 26F group (p>0.05). The resection rates were 0.24+/-0.10gm/min and 0.19+/-0.11gm/min, respectively. The rate of urethral stricture requiring any type of management was 15.4% (6/39) in the 22F group and 38.7% (12/31) in the 26F group (p<0.05). Visual internal urethrotomy was performed in 2.6% (1/39) and 9.7% (3/31) of the patients, respectively. Other complications were 1 capsular perforation, 1 TUR syndrome, 1 epididymitis and 1 delayed bleeding in the 22F group, and 1 intraoperative fever and 1 epididymitis in the 26F group. CONCLUSIONS: TURP using the 22F continuous running irrigation system enabled the surgeon to resect prostate adenoma with a similar speed and effectiveness as compared with the 26F system, and it significantly reduced the risk of urethral stricture. Performing TURP with using this system can be considered as a first line therapy for the BPH patients who require surgery.

The Efficacy of Transurethral Resection of Prostate on the Patients with Benign Prostatic Hyperplasia and Detrusor Hyperactivity with Impaired Contractility

PURPOSE: Detrusor hyperactivity with impaired contractility(DHIC) can be found in many elderly patients with benign prostatic hyperplasia(BPH). It is hard to expect the efficacy of transurethral resection of prostate(TURP) on such patients. Therefore, we retrospectively estimated the effect of TURP on BPH patients with DHIC. MATERIALS AND METHODS: Eighteen male patients with BPH and DHIC were underwent TURP. Through urodynamic studies, DHIC was identified. Findings of bladder outlet obstruction were evaluated with TRUS and/or diagnostic cystoscopy in all patients. They were requested to go through uroflowmetry and international prostate symptom score(IPSS), before and after TURP. The subjective satisfaction scale was measured after TURP. RESULTS: Total IPSS(from 20.6 to 12.5), obstructive symptom score(from 11.5 to 6.0), and maximal flow rate (from 6.0 ml/sec to 14.6 ml/sec) of the patients were improved significantly(p0.05). Only 2(12%) of the patients were unsatisfied with the outcomes of TURP. CONCLUSION: We suggest that TURP can be used as a good therapeutic option for selected patients with BPH accompanied with DHIC.

Post Treatment Change of Nocturia in Patients with Benign Prostatic Hyperplasia

PURPOSE: It seems that nocturia is not improved even after various forms of treatment in benign prostatic hyperplasia(BPH) patients. We studied the relationship of nocturia with other components of the International Prostate Symptom Score(IPSS) in BPH patients and also evaluated the changes of nocturia score following medical or surgical treatments to determine whether the nocturia score behaves differently. MATERIALS AND METHODS: Between March 2002 and March 2004, a total of 198 men with BPH were enrolled in this study. Baseline symptom scores and the change after treatment were analyzed particularly focused on nocturia score. RESULTS: On baseline score analysis, the nocturia score correlated with frequency and urgency scores(p=0.01). Total IPSS score was changed from 21.8+/-6.5 to 10.1+/-6.7 after treatment(p<0.001). The changes of nocturia score were 2.4+/-1.2 to 1.8+/-1.1 in the younger group and 3.1+/-1.3 to 2.2+/-1.2 in the older group, 2.9+/-1.3 to 2.1+/-1.1 in the surgical treatment group and 2.3+/-1.2 to 1.7+/-1.1 in the medical treatment group. The improvement of nocturia score was minimal after treatment. CONCLUSION: It seems that nocturia score behaves differently in the symptom complex of BPH. These facts should be considered when we consult patients with BPH complaining of nocturia.

alpha-Adrenoceptor Antagonistic Effect of Palmatine on the Prostatic Urethral Pressure of the Rabbit / 대한비뇨기과학회지

PURPOSE: Palmatine is an isoquinoline alkaloid, with multiple pharmacological actions, including anti-inflammatory activity. The aim of this study was to examine the effect of palmatine on the prostatic urethral pressure in anesthetized rabbit. MATERIALS AND METHODS: 10-week-old male New Zealand White rabbits (3.0-3.5kg) were used in the experiment. After anesthetized with urethane (800mg/kg i.v.), a midline incision was made, and the urinary bladder completely drained. To prevent filling of the bladder, polyethylene tubes were inserted into the bilateral ureters. Using a 3-F MIKRO-TIP catheter transducer positioned in the prostatic urethra, urethral pressure was recorded continuously. To record the blood pressure, the left femoral artery was cannulated with an angiocatheter. After a stabilizing period, phenylephrine (1mug/kg) was intravenously administered two or three times. When the increase in the urethral pressure became stable, palmatine was administered intravenously (0.5-3.0mg/kg), followed by phenylephrine, with no time interval. RESULTS: In the anesthetized rabbits, an intravenous bolus injection of palmatine (0.5-3.0mg/kg) caused no significant change in the resting prostatic urethral pressure (p>0.05), but decreased the blood pressure (p<0.05). After administration of phenylephrine, the urethral pressure increased from 7.5 0.8 mmHg to 26.5 2.6 mmHg, with the difference in the pressure (19.0 3.1 mmHg) being statistically significant (p<0.01). The intravenously administered palmatine (0.5-3.0mg/kg) dose-dependently inhibited the phenylephrine-induced increases in the prostatic urethral pressure and mean blood pressure. The maximal inhibition was obtained when a palmatine dose of 3.0mg/kg was administered, at which point, the decrease in the urethral pressure was 73.1% (p<0.01). CONCLUSIONS: These results indicate that palmatine inhibits the phenylephrine-induced increases in the prostatic urethral pressure and blood pressure in the anesthetized rabbits.

Early Results of SPARC (Suprapubic Arc) Procedures for the Female Patients with Stress Urinary Incontinence

PURPOSE: The Suprapubic Arc (SPARC) procedure has recently been introduced as a new surgical treatment option for stress urinary incontinence in women. We have reported our early results of SPARC procedures. MATERIALS AND METHODS: A total of 23 patients received SPARC procedures at our hospital between November 2002 and August 2003. All the patients were evaluated with history taking, physical examination, urodynamic study and cystography preoperatively. The procedure was carried out under IV propofol or spinal anesthesia. The enrolled patients were followed-up for more than 3 months postoperatively. The cure rate was evaluated and perioperative and postoperative complications were assessed. RESULTS: The mean age of the patients was 48.8 years (ranges from 32 to 67 years) and eight patients had past history of previous abdominal or pelvic surgery. The mean hospital stay was 1.9 days (ranges from 1 to 7 days). Mean follow-up period was 7.9 months (ranges from 3.7 to 14.0 months). Nineteen of the 23 patients (82.6%) were completely cured and 2 patients (8.7%) were much improved, hence the total success rate of the procedure was 91.3%. Bladder perforation during procedure occurred in 7 patients (30.4%) but conservative management sufficed. No serious complication was occurred. CONCLUSION: Our early results show that the SPARC procedure is a effective treatment option for the management of stress urinary incontinence. But we suggest that surgeons should be careful to avoid the bladder injury especially in their early period of experience.

Therapeutic Effects of Imipramine and DDAVP in Enuretic Children: A Randomized Prospective Study / 대한비뇨기과학회지

PURPOSE: The therapeutic effects of imipramine and DDAVP in primary monosymptomatic enuretic children were compared using a randomized, prospective study. MATERIALS AND METHODS: The study subjects consisted of 23 children, with a mean age of 7.9 years, complaining of monosymptomatic nocturnal enuresis. Baseline evaluations, at the first visit, included voiding diary, enuresis diary, uroflowmetry, urine osmolality, and urine and serum osmolality after a water deprivation test and electrocardiography. After the administration of medication, the changes in the enuretic episodes and adverse effects were evaluated every month. RESULTS: Sixteen children received medication, and after 2 weeks the drug response rate was 57.1% (4/7) in the imipramine group and 33.3% (3/9) in the DDAVP group. Ten of the 16 children completed the study. After 12 weeks of study, the response rate was 75% (3/4) in the imipramine group and 50% (3/6) in the DDAVP group. There were no significant differences in mean urine osmolalities and functional bladder capacities between the response and no-response groups. During the study, side effects developed in only three of the children in the imipramine group. Of these, one demonstrated tachycardia on a follow-up electrocardiography and another complained of irritability, insomnia, a dry mouth and blurred vision. Subsequently, the two children dropped out due to these side effects. CONCLUSIONS: The imipramine and DDAVP had similar therapeutic effects, but the DDAVP had fewer side effects, and was better tolerated, than the imipramine.

Is the 3-day Stenting Sufficient for Ureteroscopic Lithotripsy? / 대한비뇨기과학회지

PURPOSE: There has been great demand for indwelling stents for preventing pain, obstructive symptoms and other complications after endoscopic procedures. However, there is no consensus on the placement of a ureteral stent after an ureteroscopy. Inherent stent related problems warrant the minimum possible stenting duration without compromising the results of an ureteroscopy. A prospective randomized trial was performed to evaluate whether 3-day stenting is sufficient for ureteroscopic lithotripsy. MATERIALS AND METHODS: A total of 38 patients underwent an ureteroscopic lithotripsy. There were no severe operative complications. The patients were randomized into 2 groups; Group A: 18 patients who had an internal stent for 3 days after the ureteroscopic lithotripsy, and group B: 20 patients with a stent for 2 weeks. The ureteroscopic lithotripsies were performed with an 8Fr. or 10Fr. ureteroscope, under intravenous propofol anesthesia. Postoperative symptom questionnaires were acquired from each patient. A radiological follow-up was performed at least 4 weeks after the stent removal in all patients. RESULTS: There were no significant differences in the age, sex, stone size or usage of the instrument between the 2 groups. Of the 38 patients, 32 (84%) had discomfort associated with the indwelling stent. The most common symptom was irritative voiding symptom. There were no significant differences in the flank pain and ureteral stricture between the 2 groups. CONCLUSIONS: There was no difference between the 3-days and 2-weeks indwelling stented groups with respect to complications. Therefore, 3 days seems to be a more adequate duration for the decrease stent related complications and symptoms after an ureteroscopic lithotripsy, with no serious intraoperative complications.

High Flow Priapism Treated by Repeated Embolization / 대한남성과학회지

We describe a case of priapism after perineal blunt trauma in a 32-year old man who complained of painless and persistent erection. We confirmed high-flow priapism by cavernosal blood gas analysis, Doppler ultrasonography, and arteriography. A pseudoaneurysm was blocked by selective carvernosal artery embolization with autologous clot. Penile tumescence did not completely disappear during the following 4 weeks, and the patient complained of penile discomfort. Reembolization of the cavernosal artery with autologous clot was successful in reversing the erection. The patient has normal erectile status and no complaints during 30 months follow-up.

Transurethral Incision for Ureterocele / 대한비뇨기과학회지

PURPOSE: A transurethral incision of the ureterocele offers several advantages. This study investigated the clinical efficacy of a transurethral incision in a ureterocele. MATERIALS AND METHODS: Twenty two children, 5 boys and 17 girls, received a transurethral incision as the primary treatment for their ureteroceles. Of the children, 12 had intravesical and 10 had ectopic ureteroceles. The initial presentations were abnormal findings in prenatal ultrasonography in 9 cases, fever in 7, UTI in 2, and others in 4. The median patient's age at the transurethral incision of the ureterocele was 3.3 months (range 0.2month to 4.1years). A cold knife or a 3-french Bugbee electrode was used. Their clinical courses were evaluated with a radiological and laboratory examinations. RESULTS: The transurethral incision resulted in the decompression of the ureterocele in 19 (86%), reflux to the upper moiety in 15 (68%), UTI in 2 (9%) and incontinence in 1 (4.5%). Eighteen patients (82%), 8 patients with an intravesical ureterocele and all 10 patients with an ectopic ureterocele, required secondary operations. A transurethral incision proved to be a definitive treatment for 4 (33.3%) patients with an intravesical ureterocele. Secondary operations were performed at 7.3 7.1months postoperatively. CONCLUSIONS: An endoscopic incision may be advocated as a definitive treatment modality for some patients with an intravesical ureterocele. Furthermore, by safely delaying reconstructive surgery, the majority of children can benefit from an endoscopic incision of the ureterocele.

Renal Cell Carcinoma with Deep Vein Thrombosis / 대한비뇨기과학회지

The association between cancer and deep vein thrombosis or pulmonary embolism has been recognized by most clinicians. Adenocarcinoma of the pancreas, female reproductive organs, breast, colon, lung, and prostate have been found to be associated with the highest risk of deep vein thrombosis. However, the isolated deep vein thrombosis is a rare phenomenon in renal cell carcinoma. Only two cases of deep vein thrombosis in renal cell carcinoma were reported in the literature. The tumor thrombi of renal cell carcinoma is found in renal vein and inferior vena cava, with the incidence of 20-49% and 5-10%, respectively. We report two cases of renal cell carcinoma which are associated with the deep vein thrombosis due to the obstruction of inferior vena cava by the tumor thrombi.