Histopathologic Changes of Undescended Testis / 대한비뇨기과학회지

Undescended testis is one of the most common anomalies of genitourinary tract in children but optimal time for treatment of it has not been determined still. We examined the changes of seminiferous tubules according to ages in 41 patients with undescended testis which orchiectomy or testicular biopsy were performed in the Department of Urology, Kyung Hee University Hospital during the period from January, 1979 to April, 1985 and following results were obtained. l. The ages of 41 patients ranged from 6 years to 48 years. Of these,36 patients were unilateral and 5 patients were bilateral undescended testis. 41 undescended testes were located in inguinal canal, 2 in high scrotum and 3 above the internal inguinal ring. 2. Mean Tubular Diameter was average 48.5 Um from 6 years to 12 years, 81.2 Um at 14 years and 118.4 Um at 24 years. But in normal group, it was average 95.7 Um from 6 years to 12 years, 2l3.6 Um at 14 years and 229.4 Um at 17 years. So, there was already severe damage in development of seminiferous tubules in undescended testis at 6 years. 3. Mean Tubular Fertility Index was average 19.7% from 6 years to 17 years, 42% at 19 years, average 10.8% from 20years to 30 years and 0% at 48 years. But in normal group, it was 78.0% at 6 years and 100% at I4 years. So. there was already severe damage in formation of spermatogonia in undescended testis at 6 years. 4. The thickness of basement membrane of seminiferous tubules in undescended testis was 2.2 Um at 6 years and increased with age to 9.9 Um at 24 years.

A Clinical Review of the Ureteroneocystostomy / 대한비뇨기과학회지

Primary vesicoureteral reflux, distal ureteral obstruction or stricture and injuries are the main indications for the ureteroneocystostomy There are several operative techniques in ureteroneocystostomy and these should be antireflux to preserve renal function. To prevent the reflux, sufficient submucosal length, minimum ureteral manipulation, adequate butters and making the new orifice near the trigone are stressed. We performed ureteroneocystostomy in 19 patients(20 ureters) in last 10 years. We evaluate the preoperative state, operative technique, postoperative course and follow up of these cases and report with the review of the articles Results were 1. 19 cases included 5 VUR, 6 ureteral injuries by transabdominal hysterectomy, 3 bladder tumors involving ureteral orifices, 2 ureteroceles with obstruction and 3 chronic inflammatory strictures. 2. Ureteroneocystostomy were done by Cohen in 4, Glenn-Anderson in 2, Politano-Leadbetter in 3, Boari-Kuss in 5, Paquin in 2 and fish-mouth in 3 cases 3. Ureteral stent and suprapubic cystostomy were made in all cases but one. Duration of stenting was 4-14 days and cystostomy was 6-14 days. 4. There were improvements in 16 cases, but failed in 2 ureters of reflux cases.

The Diagnostic Value of Testicular Scanning / 대한비뇨기과학회지

Among causes of acute scrotum, epididymitis and testicular torsion are most common causes. There is difficulty in differential diagnosis of testicular torsion and acute epididymitis because of their similarities in clinical features. Recently, the radioisotope testicular scanning in imaging procedures has been introduced as that is simple, rapid and a high accuracy. So, 28 cases with scrotal swelling and pain were studied by means of testicular scanning in the Department of Urology, Kyung Hee University Hospital during the period from February, 1981 to September, 1983. The following results were obtained: 1. 2 cases those were diagnosed as testicular torsion clinically showed typical findings of torsion on scanning. They were confirmed as torsion by operation. 2. 16 cases were diagnosed as acute epididymitis clinically. 13 of them gave the scan findings compatible with epididymitis and all cases were well improved with antibiotic therapy. Remaining 3 cases showed findings of torsion and were confirmed surgically. 3. 8 cases were diagnosed as testicular injury clinically. In 5 cases scan showed findings of trauma and were also confirmed by operation. In the other 3 cases. scan showed findings of epididymitis and all of them were improved with antibiotic therapy. As above results testicular scan is easily available and accurate diagnostic method in the evaluation of patient with acute scrotal disorders.

A Case of Carcinosarcoma of Urinary Bladder / 대한비뇨기과학회지

A case of carcinosarcoma of the bladder in a 57 year-old man is presented. This tumor tends to be large, bulky, intraluminal tumor that grows rapidly and infiltrate widely. Irrespective of this histogenesis, it tends to be aggressive and requires an early radical operation.

Urodynamics in Patients with Chronic Prostatitis / 대한비뇨기과학회지

Urodynamic studies including uroflowmetry, CO2 cystometry, electromyography, urethral pressure profilometry were performed on 15 cases of the chronic prostatitis in the Department of Urology, Kyung Hee University Hospital recently. The following results were obtained: 1. The uroflowmetry was performed in 15 cases. The average of the maximum flow rates was 16.57+/-4.68ml/ sec (M+/-SD). In only 4 cases the maximum flow rate was within normal range, but the other 11 cases revealed decreased rates than normal. 2. The CO2 cystometry was performed in 14 cases. In only one case the bladder capacity was 1,003ml, but the other findings were normal. The other 13 cases revealed normal findings. In 12 cases the external anal sphincter EMG was performed with cystometry simultaneously, there was no detrusor-sphincter dyssynergia. 3. The urethral pressure profilometry was performed in 14 cases. The average of the functional profile length was 3.06+/-0.78cm (M+/-SD). The average of the maximum urethral pressure was 85.36+/-27.99cmH

Diuresis Renography in Equivocal Upper Urinary Tract Obstruction / 대한비뇨기과학회지

It is well recognized that dilation of upper urinary tract can occur in the absence of either reflux or mechanical obstruction. The demonstration of the cause of upper urinary tract dilation may critically alter the management of a patient. So several diagnostic methods were designed to demonstrate it, but their clinical application were not satisfactory due to inaccuracy, invasiveness and technical difficulty. Diuresis renography has recently been introduced as a method of evaluating upper urinary tract dilation found on intravenous urography. It is a simple, rapid, non invasive test which has enable to define the cause. 23 cases which have equivocal upper urinary tract dilation on intravenous urography were examined by diuresis renography in the Department of Urology, Kyung Hee University Hospital, during the period from October 1980 to March 1982 and three differential categories were obtained as follows. 1. Normal type (9 cases): Both standard and diuresis renograms were normal. 2. Obstructive type (3 cases): Initial renogram was obstructive and remained so during diuresis. 3 cases in this category were confirmed by operation and follow-up intravenous urography. 3. Atonic type (11 cases): Initial renogram tracing was obstructive but rapid isotope elimination occurred after diuresis.

Study on Serum and Urinary Uric Acid Level in Patients with Urinary Stone / 대한비뇨기과학회지

Currently, uric acid disorders, especially including hyperuricosuria, are thought to be important in the formation Of idiopathic calcium urolithiasis. Herein, we estimated the serum concentration and urinary excretion of uric acid in I22 stone-formers, comparing to those in 56 controls. Also, various theories about the pathogenesis of uric acid disorder and stone formation were discussed. The results were as follows: 1. Serum uric acid levels of stone-formers were significantly higher than those of controls, in total and female, but, not in male. 2. Urinary uric acid levels of stone-formers were significantly higher than those of controls in total, male and female. 3. Hyperuricemia was significantly more frequent for stone-formers in total, male and female. 4. Hyperuricosuria was significantly more frequent for stone-formers in total, but, not significantly more frequent for stone-formers in male and female. 5. The incidence of stone-formers, in whom hyperuricemia and hyperuricosuria were not present at the sometime, was significantly less than that Of controls. These results suggest the possibility that uric acid disorder may play some roles in the genesis of urinary stone.

A Case of Renal Angiomyolipoma / 대한비뇨기과학회지

Renal angiomyolipoma is a sort of benign tumor of the kidney, which is composed of blood vessel, fat tissue and smooth muscle. Its occurrence is uncommon, and its diagnosis had been difficult, because its radiographic and clinical features are similar with renal cell carcinoma. But recently the ultrasonographic and computed tomographic images of renal angiomyolipoma are sufficiently characteristic to permit accurate radiologic diagnosis. Herein we present a case of angiomyolipoma of the right kidney in 32 year old housewife, which has been preoperatively diagnosed with the computed tomography and ultrasonography, and managed with nephrectomy.

A Clinical Observation on the Nephrectomized Patients / 대한비뇨기과학회지

A retrospective analysis of 132 patients who underwent nephrectomy in the Department of Urology, Kyung Hee University Hospital, during the period from January 1972 to December 1980 was presented. The results were as follows: 1. The total number of in-patients during the above period was 2,301 and nephrectomies were performed in 132 of 1,427 total urologic operations (9.3%). 2. Age distribution showed the highest in 4th decade with 22.7%, the youngest was 11 months and the oldest 78 years, and male to female ratio was 68 to 64. 3. The causative diseases of the nephrectomy were renal tuberculosis 48 cases (36.4%), tumor 15 cases 11.4%. hydronephrosis 11 cases (8.3%), pyonephrosis 10 cases (7.6%), anomaly 8 cases (6.1%) and hypertension 6 cases (4.5%) in order. 4. Anterior abdominal extraperitoneal transverse approach was the most frequently used method in 103 cases (78.0%) 5. Post-operative complications were seen in 29 cases (22.0%), of which wound infection was common in anterior abdominal extraperitoneal transverse approach.

A Clinical Observation on Retrograde Pyelography / 대한비뇨기과학회지

Authors reviewed 110 cases of retrograde pyelography which performed in the Dept. of Urology, Kyung Hee University Hospital during the period from January 1977 to December 1980. And the results were as follows. 1. Indication was 34 cases (31%) of nonvisualizing kidney, 31 cases (28%) of obstructive lesion, 21 cases (19%), of inadequate filling in pelviocalyceal system, 7 cases (6.5%) of impaired renal function. 6 cases (5.5%) of upper tract abnormality, l cases (0.9%) of allergy to contrast media and other 10 cases. 2. On the nonvisualizing kidney, hydronephrosis (23.5%) was most common and normal (20.5%), ureter stone (20.5%) in order. 3. For assessment of obstructive lesion, UPJ stricture (39%) was most common and ureter stone (32%), normal (16%), ureter tumor, UVJ stricture in order. 4. Inadequate filling on excretory urogram revealed normal (24%), renal tumor (19%), renal tuberculosis (9.5%) and chronic pyelonephritis scar (9.5%) etc. 5. The patients who had poor renal function or poor general condition and upper tract abnormality were well defined with retrograde pyelography and available for diagnosis and treatment. 6. Complication were seen in 2 cases (1.8%). One was acute pyelonephritis and the other was pyonephrosis.

Primary Carcinoma Arising in Vesical Diverticula / 대한비뇨기과학회지

Primary carcinoma arising in the diverticular wall of the urinary bladder is the most serious complication. The clinical importance is that the carcinoma is difficult to diagnose early, widespread at diagnosis and has poor prognosis. Recently, vigilant studies including bladder mapping reveal premalignant changes and carcinoma in situ adjacent to carcinoma and suggest these premalignant changes evolve to flank carcinoma. For early detection and improving the prognosis, be required through cystoscopic examination including diverticular wall and multiple punch biopsies as well as consecutive urine cytologic examination. Author report two cases of primary carcinoma arising in bladder diverticulum. One revealed carcinoma in situ accompanied with adjacent atypical hyperplasia in diverticula mucosa incidentally found at the pathologic examination on the divertiuclectomy specimen. The other case showed invasive transitional cell carcinoma(Grade IV, Stage D) of diverticulum. The two cases described suggest that vesical diverticulum should be removed into to with a good amount of surrounding bladder wall.

Clinical Observation on the Total Cystectomy of the Bladder tumor / 대한비뇨기과학회지

A retrospective analysis of 9 patients of bladder tumor who underwent total cystectomy in the Department of Urology. Kyung Hee University Hospital, during the period from May, 1977 to April, 1981. The results were as follows: 1. The age of the patients ranged from 52 to 65 years, the average age 59.8 years, and male to female ratio was 7 to 2. 2. Hematuria was the most commonly found in 9 patients, frequency in 5 patients, and dysuria in 3 patients. 3. Errors in clinical staging were also common-1 case was overstaged, 3 cases understaged, 3 cases corresponded and 2 casts inadequate for the clinical staging, but the pathologic grade proved to be equal that estimated from the 2 cases of transurethral biopsy. 4. There were 8 cases of total cystectomy and 1 case of radical cystectomy, the methods of urinary diversion and remodeling of urinary tract were ileal conduit in 6 cases, bilateral cutaneous ureterostomy in 3 cases. 5. Operative death was none but the complications were followed by total cystectomy and urinary diversion in 8 cases as wound disruption, pneumonia, atelectasis, irritation dermatitis, vaginal vault bleeding, pyelonephritis, stromal stricture, stricture of ureteroileal anastomosis site and delayed wound healing.

Endoscopic Evaluation of the Female with Lower Urinary Tract Symptoms / 대한비뇨기과학회지

463 female patients visited our hospital due to lower urinary tract symptoms during the period from March 1st, 1980 to February 28th, 1981. Among them, 127 female patients whose urinalysis was normal were performed endoscopic examination and studied clinically, based on endoscopic findings. The results are summerized as follows. 1) The endoscopic findings were classified into 5 groups. Group I: Almost normal urethral mucosa, bladder neck and vesical mucosa, 11 cases. Group II: Gray-whitish velvety trigone with almost normal urethra and bladder neck, 16 cases. Group III: Mild granular hyperemia of the urethra, bladder neck and trigone 31 cases. Group IV: Mild bullous hyperemia of the urethra, bladder neck and trigone with a few pseudopolyps, 43 cases. Group V: Marked granular hyperemia of the urethra with many pseudopolyps and bullous hyperemia of bladder neck and trigone, 26 cases. 2) The most common age group was in 4th decade (33.8%). Group I and group II were younger than group IV and group V. 3) Common symptoms were frequency (78.0%), tenesmus (68.5%), painful urination (26.8%), urgency (20.5%), suprapubic discomfort (33.1%) and lumbago (18.9%). There were no significant differences among 5 groups. 4) 47 cases had the history of urethritis-cystitis and it was outstanding in group IV and group V. 5) Trabeculation (52.8%) was the most common change in bladder on cystoscopic examination. Meatal stenosis which was found in 44 cases (34.6%) was the most common associated disease. Endoscopic examination was necessary to establish the correct diagnosis and determine the therapeutic choice such as conservative, surgical and psychological treatment in female urethral syndrome.

Observation of Prostatic Secretion Cultures In Patients with Chronic Prostatitis / 대한비뇨기과학회지

An observation of prostatic secretion culture was performed on 145 cases of the chronic prostatitis in the Department of Urology, Kyung Hee University Hospital from March 1980 to February 1981. The following results were obtained: 1. Of 145 cases who performed prostatic secretion culture, 114 cases (78.6%) revealed positive culture and the remained 31 cases (21.4%) revealed negative culture. 2. Of 114 cases who revealed positive culture, 112 cases (98.4%) were Gram positive organisms. The details are as follows: Staphylococcus epidermidis, the most common organism, 74 cases (61.2%); Staphylococcus aureus, 25 cases (20.7%); Streptococcus fecalis, 8 cases (6.6%); Alpha streptococcus, 7 cases (5.8%): Diphtheroid, 4 cases (3.3%); Bacillus species, 1 case. 3. Of 114 cases, Gram negative organism, Klebsiella pneumoniae, was found in only 1 case. And the other 1 case was Candida species. 4. The culture of prostatic secretion is of great value and important procedure in the treatment and differential diagnosis of chronic non-bacterial prostatitis and bacterial prostatitis.

The Cell Surface Antigen A,B,O(H) as An Indicator of Malignant Potential in Bladder Carcinoma: A Preliminary Report / 대한비뇨기과학회지

Currently, the cell surface antigen A,B,O(H) is thought to be an important indicator of malignant potential in bladder carcinoma. Herein, we performed SRCA test in 54 bladder carcinoma for detection of such an isoantigen, comparing the SRCA result to its tumor grade and stage. Also, various significances including the clinical application of SRCA test for the management of the bladder carcinoma were discussed. The results were as follows: 1. Of 54 patients, 34 patients were low stage(0-A) and low grade(1-2). 2. There is a significant correlation between tumor grade and SRCA test: Of 38 patients with low grade. 19 patients were SRCA positive, but of 16 patients with high grade. all were SRCA negative. 3. There is a significant correlation between tumor stage and SRCA test: Of 36 patients with low stage, 18 patients were SRCA positive, but of 18 patients with high stage(above B1), only one patient was SRCA positive. 4. There is a high possibility of false-negative results in detecting O(H) isoantigen: Of 36 patients with low stage, 6 patients were blood group 0 who were all SRCA negative. but 30 patients with other blood groups showed variable SRCA results. 5. There is a considerable correlation between tumor recurrence and SRCA result: Of 20 patients who were followed more than one year after initial TUR, 8 patients were SRCA positive, of these 4 patients were recurred, but 9 patients of 12 patients with SRCA negative were recurred.

A Case of Bilateral Ureterocele Combined with Bladder Stone and Papillary, Cystic, Glandular Metaplasia / 대한비뇨기과학회지

Ureterocele, cystic dilatation of the lower end of the ureter, is not a common urogenital disease and occuring more frequently in female than in male. One case of bilateral ureterocele, combined with bladder stone and papillary, cystic, glandular metaplasia, was presented with a brief review of the literature.

Sinus Histiocytosis with Massive Lymphadenopathy : Report of A Case with Perineal Involvement / 대한비뇨기과학회지

The term "sinus histiocytosis with massive lyrnphadenopathy," introduced in 1969 by Rosai and Dorfman, refers to a newly recognized disease entity characterized by painless cervical lymphadenopathy, fever, leukocytosis, increased erythrocyte sedimentation rate, and hypergammaglobulinemia. The typical course is one of insidious onset, protracted duration of the active disease state, and eventual spontaneous remission, occasionally with subsequent recurrences. Lymph nodes other than those in the cervical area may be involved, and extranodal involvement can occur (such as in the orbit, skin, or respiratory tract) Clinically, this entity may closely simulate malignant lymphoma or nonneoplastic conditions with lymphadenopathy. We present a case in which this disease process involved the perineum.

Clinical Observation on the Bladder Tumor / 대한비뇨기과학회지

A Clinical observation was made on the patients with bladder tumor admitted to the Department of Urology, Kyung Hee University Hospital during the period from January, 1973 to December,1979 Followings were the results: 1. During the period, 57 cases of bladder tumor among the 1716 total number of in-patients were hospitalized, giving a incidence rate of 3.3%. 2. Age distribution was between 4 and 85 years, the highest incidence rate was in the age group of 60-69 years. 3. Hematuria was the most common symptom occurred in 87.7%, frequency in 61.1%. dysuria in 52.6% and the others. 4. Among the 53 cases performed I.V.P., 79.3% of cases revealed normal upper tract, filling defect in the bladder was observed in 69.8% of them. 5. Associated diseases with bladder tumor were B. P. H. or B. N. C. each in 12.3% and U. T. I. in 31. 6%. 6. Pathologic examination was possible on 49 cases, transitional cell carcinoma occupied 44 cases, in 89.8% and Grade I was found most frequently. 7. 14 cases were studied by the non-invasive, simple method as computerized tomography: the effective staging procedure in invasion of bladder wall itself could be diagnosed very helpfully but distant metastasis not diagnosed very exactly, comparison with the operation stage. 8. 47 cases were treated, T. U. R. or T. U. C. were tried initially in 21 cases.

A Case of Takayasu Arteritis with Renovascular Hypertension / 대한비뇨기과학회지

Takayasu arteritis is an arteritis of undetermined etiology which affects the aorta, the proximal portion of its major branches, and the pulmonary arteries. Involvement of the one or both renal arteries resulting in stenosis or occlusion lead to ischemia and renovascular hypertension. Herein we reported a case of Takayasu arteritis with renovascular hypertension in 10 years old male and hypertension was corrected by surgery.

Angiolymphoid Hyperplasia (Kimura`s Disease): A Case Report / 대한비뇨기과학회지

Angiolymphoid hyperplasia with eosinophilia (Kimura`s disease) is a pathologic term, given to a lesion starting usually as a papule or a cluster of papules in the skin of the head, neck and elsewhere of adults. This lesion is as extraordinary in its behavior as it is in its histology. Histologically, the characteristic features include abnormal vascular proliferations due to the growth of atypical histiocytic cells as the common dominator for all of these lesions. These lesions were apparently benign and can usually cured by surgical excision, adrenocorticosteroids and irradiation. Spontaneous remission also occurs. Herein, We report a case of this rare entity involving scrotum, reviewing the similar descriptions in western literature under various different headings.