A Protocol for Transrectal, Ultrasonography-guided, 41-core Prostate Needle Biopsy / 대한비뇨기과학회지

PURPOSE: We evaluated the rate of prostate cancer detection using the transrectal ultrasound(TRUS) guided, 41-core prostate needle biopsy protocol. MATERIALS AND METHODS: Between May 2006 and May 2007, 110 patients received a 12-core prostate needle biopsy(Group I) and 62 patients underwent a 41-core prostate needle biopsy(Group II) under local anesthesia. In addition to sextant biopsy, 41-core prostate needle biopsies were obtained from the each lateral peripheral zone(base, mid, and apex glands), midline peripheral zone(base, mid, and apex glands) and each transition zone. RESULTS: There were no significant differences between the two groups for age, prostate-specific antigen(PSA), or prostate volume. The cancer detection rate in the Group I and Group II was 19.1% and 24.2%, respectively. We found a significantly higher detection rate in the 41-core biopsy with prostate volumes of more than 40cc(28.1% vs 11.3%). The intraoperative pain score was lower in Group II than Group I(1.57+/-1.45 vs 3.17+/-1.73, p<.01). CONCLUSIONS: The 41-core prostate needle biopsy protocol is safe and intraoperative pain is low. The cancer detection rate of the 41-core prostate needle biopsy was higher than the 12-core prostate needle biopsy in patients with a prostate volume of more than 40cc.

Bladder Rupture during Voiding Cystourethrography / 대한비뇨기과학회지

A ruptured bladder, or extravasation from the bladder, is almost always associated with trauma. Spontaneous extravasation, or iatrogenic extravasation, is extremely rare, with only few reported cases. Herein, two cases of bladder rupture, which occurred during voiding cystourethrography (VCUG), one in an 18 month old patient and the other in a 6 week old patient, due to instill dye by high pressure, are presented.

Analysis of Complications and Causes of Revision of Penile Prosthesis / 대한남성과학회지

PURPOSE: Penile prosthesis implantation to correct the irreversible erectile dysfunction is a common. We investigated complications and causes of revision after implantation of the penile prosthesis. MATERIALS AND METHODS: We followed 72 patients who underwent penile prosthesis implantation performed by the same surgeon from January 1993 to July 2006. The medical records of all patients were retrospectively reviewed. The mean follow up duration was 30.3 months, and average age at operation was 56.7+/-11.0 years. RESULTS: The malleable penile prosthesis was implanted on 8 patients. The inflatable penile prosthesis was implanted on 63 patients and Dynaflex was implanted in the one patient. Of the patients implanted inflatable penile prosthesis, complications were developed in the 14 patients and 17 cases of complications were developed. Of the complications, mechanical complications were broken of connecting tubing(7), mulfunction of Dynaflex(1) and difficulty of deflation(1). Of 17 complications, non-mechanical complications were urethral stricture(5), erosion of urethra(1), migration of reservoir into the bladder(1) and SST deformity(1). CONCLUSIONS: Penile prosthesis has high complications rates, and revision rate also is high. Mechanical failure was the most common cause of surgical revision. Although urethral stricture is rare complication, it was developed in the 5 patients due to mal-rotation of the cylinder.

Metabolic Stone Risk Factors Associated with Papillary Calcification on Unenhanced Spiral Computed Tomography / 대한비뇨기과학회지

PURPOSE: Increasing evidence suggests that Randalls plaque contributes to the pathogenesis of urinary stone formation. The purpose of our study is to compare the incidence of the abnormal metabolic stone risk factors between the calcium stone former with papillary calcification and the calcium stone former without papillary calcification on unenhanced spiral computed tomography (CT). MATERIALS AND METHODS: A series of patients with calcium stones (n=49) underwent unenhanced spiral CT and complete metabolic evaluation after they consumed a random diet for 1 month after stone removal. Of the 49 patients, 38 patients showed papillary calcification on unenhanced spiral CT and 11 patients did not. Their blood was evaluated by using a multichannel analysis sequential multichannel autoanalyzer (SMA)-20 and PTH tests. The 24-hour urinary constituents were assayed for calcium, oxalate, citrate, total volume, phosphorus and sodium. We compared the incidence of abnormal metabolic risk factors between the two groups. Statistical analysis was performed by chi-square tests. RESULTS: The incidences of hyperuricemia were 27.3% in the patients without papillary calcification and 31.6% in the patients with papillary calcification. The incidences of hypernatriuria were 18.2% versus 42.1%, the incidences of hypercalciuria were 36.4% versus 26.3%, the incidences of hyperuricosuria were 18.2% versus 18.4%, the incidences of hyperoxaluria were zero versus 28.9%, and the incidences of hypocitraturia were 45.5% versus 44.7%, respectively. The difference between the two groups was statistically significant only for hyperoxaluria (p=0.043). CONCLUSIONS: Hyperoxaluria is the only metabolic risk factor that more frequently occurred in the patients with papillary calcification. Our date suggest that hyperoxaluria may be an important factor in the pathogenesis of papillary calcification.