Kidney Preserving Surgery in Renal Trauma:. Experience by Early Vascular Approach Technique / 대한비뇨기과학회지

PURPOSE: To evaluate the usefulness and safety of unified technique of vascular control before renal exposure in reconstructive surgery of renal trauma. MATERIALS AND METHODS: From July 1995 to June 1997, 10 patients with major renal trauma who operated by unified approach technique were included in this study. Blunt trauma was the mechanism of injury in 8 patients and 2 were resulted from penetrating(stab) injury. Of the injuries 2 were grade 3, 7 grade 4, 1 grade 5. RESULTS: Of the 10 patients, 8(80%) were performed kidney preserving surgery and 2(20%) resulted in nephrectomy. Partial nephrectomy was underwent in 6 patients(with vascular repair in 2 cases) and renorrhaphy in 2 patients. Pedicle flap of omentum was used mainly and polyglycolic acid mesh also used in 2 cases as coverage material of parenchymal defect. Complications occurred in 2 cases(20%) but none resulted in renal loss with the mean followup of 10 months(1 to 15 months). CONCLUSIONS: Unified approach technique of vascular control before renal exposure seems to be a safe and effective method for reconstructive surgery in renal trauma. To confirm this result, studies with more cases and longer followup are needed.

The Clinical Characteristics of Urologic Patients Who Visited Emergency Center / 대한비뇨기과학회지

PURPOSE: This study was performed to analyze the clinical characteristics of urologic patients who visited emergency center and provide a fundamental data for further study, and to add some help in the management of the patients. Materials and Methods: Among the total 99,935 patients who visited the emergency center from July 1, 1993 to June 30, 1995, the clinical data of 3,063 urologic patients was reviewed retrospectively. RESULTS: The most common group of age was 4th decade, and male predominated over female by 2.6 : 1. The peak time of patient's entrance to emergency center was between 20 : 00 and 24 : 00 (24.4%) and second peak was 00 : 00 and 04 : 00 (18.5%). Flank pain (57.5%) was the most common symptom and urinary retention (10.3%), gross hematuria (9.7%), irritative voiding symptoms (7.5%) followed that. The common diseases or injury were urinary stone (56.4%) and benign prostatic hyperplasia (8.0%), renal injury (4.0%), acute cystitis (3.7%) respectively. The admission rate was 23.3% and the ratio between urologic department and other departments was 4 : 1. Trauma was occupied 12.5% in all urologic patients and common disease or injuries that needed emergent operation were bladder rupture (23.5%), testicular torsion (18.5%), and renal trauma (16.0%). 7 patients with multiple injury were expired due to 1 urologic cause (renal trauma) and 6 non-urologic causes. CONCLUSIONS: The most common cause that brings the urologic patients to the emergency center is flank pain associated with urinary stone and the factors related to increased occurrence are male, age of 4th decades and midnight.

A Case of Extensive Emphysematous Infection in Renal Cell Carcinoma / 대한비뇨기과학회지

Emphysematous urinary tract infection is a rare, life-threatening necrotizing infection characterized by gas generation, and usually occurs in patients with diabetes and/or urinary tract obstruction. We herein report a unique case of emphysematous renal infection occurred in. an old diabetic man with renal cell carcinoma. This case suggests that renal cell carcinoma should be also considered a rare cause of emphysematous renal infection showing mass contour.