Preoperative Detrusor Contractile Strength Measurement in the BPH Patients with Residual Urine / 대한비뇨기과학회지

When the bladder is obstructed by BPH, the contractile strength is increased to empty completely. If the obstruction is too severe to overcome by detrusor contraction, there will be residual urine. If detrusor is still compensated there will be no postoperative residual urine. But if detrusor is decompensated with "fading contraction" there will be postoperative residual urine. So the measuring of detrusor contractile strength is a very important test to predict the postoperative residual urine. We calculated the mechanical power generated per unit area of the detrusor surface(WF; Watts factor) to measure the detrusor contractile strength in 14 BPH patients with more than 100ml of residual urine preoperatively and compared the amount of preoperative residual urine with postoperative residual urine to evaluate the diagnostic value of WF in predicting the absence or presence of residual urine postoperatively. The WF in each 3 patients whose detrusor contractile strength seemed to be decreased with more than 50 ml of postoperative residual urine was less than 4W/m2, that was decreased than normal(4-11W/m2). In contrast, the WF .in each 11 patients whose detrusor contractile strength seemed to be normal or increased with less than 50ml of postoperative residual urine was more than 4W/m2, that was normal or increased. There was no significant difference in the amount of preoperative residual urine between both group of patients(p=0.2253, Wilcoxon rank sum test). There was no statistically significant relationship between the WF and the amount of preoperative residual urine in both group of patients(r =-0.028, p=0.92). In conclusion, WF measurement was a useful test in checking the detrusor contractile strength to predict the absence or presence of postoperative residual urine in patients with more than 100ml of residual urine.

Comparisons of the effects of testicular torsion through a scrotal wall incision and an abdominal wall incision on the contralateral testis in prepubertal rats / 대한비뇨기과학회지

Unilateral spermatic cord torsion has been shown to cause damage to the contralateral testis in humans and animal models. In the present paper, we have examined contralateral testes of prepubertal Sprague-Dawley rats 14 days after 720 torsion to determine the effect of scrotal surgery versus abdominal approach and to determine the effect of therapeutic orchiectomy versus detorsion. Torsion periods were 2. 6 and 24 hours. Histologic examinations of contralateral testis at the end of the experiment demonstrate that all rats of both the orchiectomy and detorsion groups had a significantly reduced mean seminiferous tubular diameter compared to controls (p<0.001). But the groups of abdominal approach had a smaller reduced mean seminiferous tubu1ar diameter than the groups of scrotal approach. These results indicate that these contralateral alterations seem to be caused by generalized perineal inflammatory responses as well as immunologic responses.

Torsion of the appendix testis: 3 cases / 대한비뇨기과학회지

Torsion of the appendix testis ranks second in causes of acute scrotal swelling in children Prompt surgical exploration in children with torsion of the appendix testis is necessary if scrotal swelling obscures diagnosis or induces persistent scrotal pain. Exploration of both testes at the first operation adds little trouble to the operation and eliminates the possibility of Further torsion.

The effect of testicular torsion on the contralateral testis in rats / 대한비뇨기과학회지

Prepubertal male Sparague-Dawley rats were used to investigate the effects of unilateral testicular torsion on the contralateral testicular histology. All rats were divided into eight experimental group (5 animals each), one of which was used for experimental control (sham operation). We have examined contralateral testes to determine the effect of therapeutic orchiectomy or detorsion after active physical 720' torsion (six hrs., twelve hrs., twenty four hrs.) through hemi-scrotal incision, and the effect of torsion only for two weeks. The contralateral testes demonstrated significant decreased weights variously and smaller seminiferous tubular diameter in both the orchiectomy and detorsion groups compared to the torsion only group, and there was marked contralateral testicular alterations in the torsion only group compared to the control group. These studies indicate that testicular torsion will cause contralateral testicular damage, and these contralateral alterations may be caused by generalized perineal inflammatory responses rather than immunologic phenomenon.

A Case of Renal Oncocytoma with Synchronous Contralateral Renal Cell Carcinoma / 대한비뇨기과학회지

Renal oncocytoma has been recently defined histopathologically but many controversies have arised about its origin and differential diagnosis. Until the present time nearly all renal oncocytoma were considered to be benign nature, but rare cases have been reported to be metastasized. We reported a case of renal oncocytoma and synchronous contralateral renal cell carcinoma treated by radical nephrectomy on one side and enucleation on the other side.

A Case of Renal Oncocytoma with Synchronous Contralateral Renal Cell Carcinoma / 대한비뇨기과학회지

Renal oncocytoma has been recently defined histopathologically but many controversies have arised about its origin and differential diagnosis. Until the present time nearly all renal oncocytoma were considered to be benign nature, but rare cases have been reported to be metastasized. We reported a case of renal oncocytoma and synchronous contralateral renal cell carcinoma treated by radical nephrectomy on one side and enucleation on the other side.

Mucinous Adenocarcinoma Arising in the Renal Pelvis: A Case Report / 대한비뇨기과학회지

Mucinous adenocarcinoma of the renal pelvis is a extremely rare disease and reported less than 50 cases in literature. This tumor is known to be commonly associated with renal stone, hydronephrosis and pyelonephritis. We report a case of mucinous adenocarcinoma of the renal pelvis in hydronephrotic kidney with multiple renal stones.

Effect of Alum Solution in Massive Bladder Hemorrhage / 대한비뇨기과학회지

Continuous bladder irrigation with 1% alum solution was performed in 10 patients with various lesions in whom massive bladder hemorrhage persisted despite evacuation of clots and normal saline irrigation. Hematuria ceased promptly in all patients without any complication. So, we report them with the literature review.

Asymptomatic Bacteriuria in Schoolgirls / 대한비뇨기과학회지

One thousand one hundred forty nine (1149) young women, 13-21 years of age, were examined by urinalysis and bacteriologic methods for the frequency and natural course of asymptomatic bacteriuria. Five percent (58/1149) of the women were found to have a significant bacteriuria, of which 58.6% (34/58) had a transient colonization in the urinary tract and another 41.4 % had a persistent bacteriuria. 66.7% (16/24) of recurrent bacteriuric subjects had gram negative rod bacilli. In 8.6%(5/58) of asymptomatic bacteriuric subjects, symptomatic urinary tract infection developed within 6 months. An incidence of pyuria in asymptomatic urinary tract infection is 80%, but a sensitivity of pyuria to bacteriuria was low in asymptomatic urinary tract infection. A predictive value for detection of asymptomatic bacteriuria by pyuria was 19%. With urine collection by urethral catheterization a chance of contamination can be diminished, but may not be eliminated a chance of contamination from urethral mucosa. Randomized double blind study showed that asymptomatic bacteriuria can be effectively controlled by daily single dose of trimethoprim sufamethoxazole for five days.

Experience of Gil Vernet Antireflux Surgery / 대한비뇨기과학회지

A new antireflux surgical technique was introduced by Gil Vernet in 1984, which is simple and rapidly accomplished without mobilization of the distal ureter. The technique involves a single stitch that implicates the trigone, effectively lengthening the intramural segment of terminal ureter, which is particularly effective in patients with megatrigone. We applied this new technique in 2 children with vesicoureteral reflux, of whom one had unilateral grade III reflux and the other bilateral grade II and grade IV reflux. Vesicoureteral reflux and urinary tract infection were lost at follow up voiding cystourethrogram and urinalysis 4 months after operation. We think that this new technique is excellent method in surgical treatment of vesicoureteral reflux.

Experience of 191 Cases of Urethral Rupture and Stricture / 대한비뇨기과학회지

A clinical evaluation was made on 191 patients with urethral rupture and stricture, who had been admitted to the department of Urology during l3 years from l972 to 1984. We have tried the various methods in management of urethral rupture and stricture, such as 1) simple traction by balloon catheter 2) end-to-end anastomosis 3) perineal traction on the prostate 4) immediate cystostomy, and delayed urethroplasty in urethral rupture; 5) urethral dilatation 6) internal urethrotonry 7) end-to-end anastomosis 8) pull-through urethroplasty 9) transpubic urethroplasty 1O) scrotal inlay urethroplasty 11) perineal skin flap urethroplasty in urethral stricture. Especially, we have compared the primary realignment of urethral rupture with delayed urethroplasty Primary realignment with perineal traction on the prostate was most excellent in management of complete posterior urethral rupture, which had a low morbidity, complication, and cost. Immediate cystostomy, and delayed end-to-end anastomosis was good in management of complete anterior urethral rupture. We thought that the difference of result after primary. realignment or delayed urethroplasty of urethral rupture did not depend upon the alternative of them but the degree of urethral injury, surgeon's skill and the adequate application of them according to the state of patients at the time of urethral injury.

A Clinical Observation on Staghorn Calculi of the Kidney / 대한비뇨기과학회지

A clinical observation was made on 23 patients of renal staghorn calculi which were treated at the Department of Urology, Hangang sacred Heart Hospital, Hallym College. The results were as follows: 1. Patients ranged in age from 17 to 62 years and there were 12 males and 11 females, giving a male to female ratio of approximated 1.1 to 1. The right kidney was involved more than the left. Eleven patients (47.8%) had multiple renal calculi and 1 of the 23 patients had bilateral renal staghorn calculi. 2. As for methods of surgery, extended pyelolithotomy in 9 cases, nephrolithotomy in 5 cases, nephrolithotomy with partial nephrectomy in 1 case and nephrectomy in 8 cases were performed. 3. Postoperative complications included 3 cases of residual stone and 3 cases of urinary infection. 4. Recommendable surgical method for renal staghorn calculi is the preservation of kidney according to operation technique.

A Clinical Observation on Staghorn Calculi of the Kidney / 대한비뇨기과학회지

A clinical observation was made on 23 patients of renal staghorn calculi which were treated at the Department of Urology, Hangang sacred Heart Hospital, Hallym College. The results were as follows: 1. Patients ranged in age from 17 to 62 years and there were 12 males and 11 females, giving a male to female ratio of approximated 1.1 to 1. The right kidney was involved more than the left. Eleven patients (47.8%) had multiple renal calculi and 1 of the 23 patients had bilateral renal staghorn calculi. 2. As for methods of surgery, extended pyelolithotomy in 9 cases, nephrolithotomy in 5 cases, nephrolithotomy with partial nephrectomy in 1 case and nephrectomy in 8 cases were performed. 3. Postoperative complications included 3 cases of residual stone and 3 cases of urinary infection. 4. Recommendable surgical method for renal staghorn calculi is the preservation of kidney according to operation technique.

A Clinical Observation on Scrotal Trauma and Testicular Rupture / 대한비뇨기과학회지

The incidence of testicular rupture by blunt trauma has been considered rare. But if testicular rupture has developed, the diagnosis of which is difficult. In the 50 cases of scrotal trauma patients, we investigated in the frequency of testicular rupture and early exploration in comparison with delayed exploration. Then the incidence of testicular rupture was in 46.1% of the cases of exploration, and early exploration of for scrotal trauma has resulted in higher testicular salvage rate than delayed exploration.

A Clinical Observation on Scrotal Trauma and Testicular Rupture / 대한비뇨기과학회지

The incidence of testicular rupture by blunt trauma has been considered rare. But if testicular rupture has developed, the diagnosis of which is difficult. In the 50 cases of scrotal trauma patients, we investigated in the frequency of testicular rupture and early exploration in comparison with delayed exploration. Then the incidence of testicular rupture was in 46.1% of the cases of exploration, and early exploration of for scrotal trauma has resulted in higher testicular salvage rate than delayed exploration.

Clinical Evaluation of Catheter-induced Urinary Tract Infection by Sterile Closed Drainage / 대한비뇨기과학회지

In 57 hospitalized patients with temporary closed sterile urinary-catheter drainage, incidence of acquired bacteriuria was evaluated by culture, colony count, drug sensitivity and the following results were obtained. 1. Incidence of infection was 0% within 3 days, 18.2%o within 5 days, 41.7% within 7 days, 60.9%0 after 7 days. 2. Of 117 bacterial strains isolated by culture of urine 82.1%o was gram negative bacteria and 17.1%o was gram positive. The frequency of isolated organisms were as followings: Escherichia coli ............. 44.4%, Pseudomonas aeruginosa ............. 19.7%, Staphylococci ............. 14.5%, Caliform bacilli ............. 9.5%, Proteus ............. 6.8%, Streptococci ............. 4.2%, Yeast ............. 0.9%. 3. Most organisms were highly resistant to any of antibiotics which were Kanamycin, Gentamicin, Ampicillin, Streptomycin, Tetracycline, Cephoran, Geopen, Amiktam. 4. Closed sterile drainage system was much effective in delaying bacteriuria than open drainage system in comparison with 70.8% of bacteriuria within the first 3 days of open catheter drainage demonstrated in previous report.

Modified Pull through urethroplasty(Netto procedure) in posterior urethral stricture / 대한비뇨기과학회지

To avoid the ball valving obstruction and the interference with ejaculatory process by intussuscepted urethra in Badenoch`s pull through operation, the modified Badenoch operation(Netto procedure) was used in five patients with the post traumatic posterior urethral stricture. The technique was that bulbous urethra was intussuscepted into prostatic tissue only about 5-10mm and the superficial external layer of the bulbous urethra was sutured to superficial external surface of the prostate with 4-6 interrupted sutures at the point of intussusception. Of the 5 patients, 4 have and had satisfactory results and one with dilation.

A Clinical Observation on the Nephrectomized Patients / 대한비뇨기과학회지

A clinical observation on the nephrectomized 114 patients in the department of Urology, Han Gang Sung Sim Hospital, during the period from January, 1972 to December, 1979 was presented with brief review of the literature. The result were as follows: 1. The total number of in-patients during above period was estimated to 1492. and nephrectomies were performed in the 114 of the 913 urologic operations. (12.4%) 2. The age distribution ranged from 1 year to 66 years with the most common age groups in the 4 th decades. (22.8%) 3. The ratio of male to female was 1.2 to 1. 4. Among the symptoms on admission, hematuria was in 82 cases (71.9%), flank pain in 74 cases (64.9%), and urinary frequency in 46 cases. (40.4%) 5. The causative diseases of the operated kidney showed the highest in renal tuberculosis (30.7%), renal tumor (18.4%), calculous disease (17.5%). renal injury (14.9%) and hydronephrosis (10.5%) by sequence. 6. Flank approach with 1 rib resection was the most frequently used in 52 of 114 cases. 7. Postoperative complications were seen with 3 cases of wound infection, 2 cases of wound dehiscence, 2 cases of atelectasis, 1 case of pneumonia, and 1 case of paralytic ileus. 8. 110 cases (96%) were discharged within 2 weeks after surgery.

A Clinical Study on Growth Rate of Urinary Calculi / 대한비뇨기과학회지

to elucidate growth rate of urinary calculi, a statistical analysis of 39 urinary calculi were undertaken and analysis with infrared spectroscopy was also performed in possible 31 cases. The men growth rate in length and width were obtained by measuring difference between size on the initial X-ray film and late film. The results were as followings. 1. Renal stones grew more rapidly than ureteral stones (p<0.01). On the growth rate of the ureteral stones, length showed more rapid growth rate than width (p<0.01). 2. Infected stones grew more rapidly than non-infected cases (p<0.01). 3. On the growth rate and compositions of stones, calcium phosphate stones showed most rapid growth rate and then calcium oxalate calcium phosphate stones and calcium oxalate stones were delayed in growth among 3 groups (p<0.05).

Management of Posterior Urethral Injury Associated with Pelvic Fracture / 대한비뇨기과학회지

Recently we experienced 10 cases of posterior urethral injury associated with pelvic fracture. Of these patients 5 underwent primary realignment with perineal traction on the prostate (Selikowitz method), and the other 5 underwent immediate cystostomy and delayed urethroplasty (Johanson method). Comparison of the post-operative complications didn`t appear to show significant differences in the 2 groups, although the numbers were small. But patients who performed immediate cystostomy and delayed urethroplasty showed some disadvantages of the long period of treatment, high charges, often multiple hard procedures and the long time of operation. Therefore in the initial management of posterior urethral injury, we think it better to take primary realignment in Korean socioeconomic circumstances, if the patient is not in the high risk.