Comparative Analysis of Clinical Parameters in Acute Pyelonephritis / 대한비뇨기과학회지

PURPOSE: To compare the variable inflammatory parameters of acute pyelonephritis patients treated with inpatient therapy at 13 hospitals, according to the age and gender distributions. MATERIALS AND MATHODS: A total of 3,544 medical records of patients with confirmed acute pyelonephritis, and admitted to hospital between January 2000 and December 2005, were retrospectively analyzed. RESULTS: The mean age of the patients was 43.2+/-16.2 years old, with a male:female ratio of 1 : 5.1. The average duration of hospital admission was 7.9+/-5.3 days. Underlying diseases were found in 23.0% (749/3,252 patient), largely due to diabetes (35.1%). Radiological abnormal findings were found in 13.7%. The leukocyte count, ratio of segmented form, erythrocyte sedimentation rate (ESR), c-reactive protein, pyuria, positive blood culture, positive urine culture were 11,014+/-5,778/mm(3), 74.8+/-14.5%, 44.0+/-32.0 mm/hr, 12.4+/-9.3mg/dl, 83.9%, 10.5% and 46.7%, respectively. E. coli grow in 79% of the urine culture positive patients. In a comparison of 3 age groups (61 years), the elderly patients had a greater number of underlying diseases and more pathogens in cultured blood. When divided into males and females, the elderly male patients had more pathogen in cultured urine, but contrary to the male patients, the elderly female patients had elevated leukocyte count and erythrocyte sedimentation rate. Also, the old patient group had more resistance to ampicillin when they had E. coli as the uropathogen (p=0.021). Patients with higher ESR required longer hospital admission periods. CONCLUSIONS: It was found that variable clinical parameters of acute pyelonephritis patients treated with inpatient therapy differed according to both gender and age group in Korea. Therefore, these factors should be taken into account in the treatment plan.

Results of Long-term Follow-up for the Pubovaginal Fascial Sling Procedure in the Treatment of Female Stress Urinary Incontinence / 대한비뇨기과학회지

PURPOSE: We report results of long-term follow-up (more than 2 years) for the pubovaginal fascial sling procedure in the treatment of female stress urinary incontinence (SUI). MATERIALS AND METHODS: A retrospective analysis of 51 women with SUI, consecutively having undergone a pubovaginal fascial sling procedure, was undertaken. Patients were evaluated preoperatively, by physical examination, voiding cystourethrography, Q-tip test, and urodynamic study including; valsalva leak point pressure (VLPP), and their incontinence ranked according to the Stamey grades. Of the 51 patients, 19 cases (37%) were anatomically incontinent, 24 cases (47%) were intrinsically sphincter deficient (ISD) and 8 cases (16%) were of the equivocal type, according to VLPP. The patients were assessed by questionnaire and SEAPI (stress-related leakage, emptying ability, anatomy, protection, inhibition) scores, postoperatively. RESULTS: The pubovaginal fascial sling procedure was effective in 96.1% (cured 84.3%, improved 11.8%) of SUIs, with more than 2 years follow up (mean follow up 34.1 months; 24 to 49 months). There was no significant relationship between VLPP and success rate, and no significant changes in the postoperative outcome over time. The main complications were de novo urge incontinence (3 cases; 5.8%) and permanent urinary retention (3 cases; 5.8%), with transvaginal urethrolysis being performed in the latter cases. CONCLUSIONS: We would conclude that the pubovaginal fascial sling procedure is an effective treatment modality for the female SUI.