Three cases of the emphysematous pyelonephritis / 대한비뇨기과학회지

Emphysematous pyelonephritis is a rare complication of acute pyelonephritis that occurs in diabetics or urinary obstruction and spontaneous gas formation around renal parenchyme. Diagnosis. in appropriate clinical setting. is confirmed radiographically. Plain film demonstrates a surprising pneumonephrogram, mottled gas shadow in the renal parenchyme as well as perirenal gas. Surgical intervention after unsuccessful antibiotics and conventional medical measurement is necessary. We experienced 3 cases of emphysematous pyelonephritis which occurred in diabetic women with brief review of the literature.

A case of XX male syndrome / 대한비뇨기과학회지

The 46, XX male or sex-reversal syndrome is a rare entity, which may be reported first by de la Chapelle and associates in 1964, an additional 135 cases have been recognized, yet only 20 percent of these patients have been diagnosed during childhood. The 46, XX male may be associated with hypogonadism and infertility in adult, and occasionally, sexual ambiguity in the neonate. At least 10% of patients have had hypospadia or ambiguous external genitalia. The 46, XX male was diagnosed with cytogenic study, H-Y antigen, hormonal study testicular biopsy, radiologic study. Here, we report a case of 19 month-old child XX-male with hypospadia and chordee.

Change of plasma renin activity between pre and post-ESWL / 대한비뇨기과학회지

ESWL is clearly an effective noninvasive treatment for a wide variety of urinary tract calculi. However, numerous clinical and experimental reports present evidence that ESWL can cause acute and chronic complications, especially new onset hypertension. We evaluated that relationship between hypertension and plasma renin activity with follow-up of 1 month after one session ESWL and round that 3.1% of patient showed new onset hypertension. The plasma renin activity was slightly elevated 24 hours after ESWL, but by 1 month after procedure the renin had decreased to near pre-ESWL level. However. these data represented no statistically significant change (p>0.05). Therefore, we believed that at the moment no relation between plasma renin activity and hypertension at least early period of post-ESWL (1 month).

ESWL of Caliceal Diverticula Calculi / 대한비뇨기과학회지

Caliceal diverticula are eventrations of the upper collecting system lying within the renal parenchyma and communicating with renal pelvis or a calyx through a narrow channel. The incidence on a routine IVP is approximately 0.21 to 0.45 percent and stone formation in a caliceal diverticulum has arised from 9.5 to 50 percent. Traditionally, treatment has included nephrotomy with extraction of the calculi and percutaneous nephrolithotripsy, but more recently ESWL has been challenged due to less invasive and safer procedure. We report the results of 11 patients with calculi in caliceal diverticula treated with EDAP LT-01 lithotriptor. All patients were followed during 2-11 months (average in 6.6) The results were obtained as follows ; 1. The symptoms were included chronic vague flank pain in seven, acute renal colic in two, epigastric discomfort in one and incidentally diagnosed in one. 2. The location of diverticula were upper third in seven, mid third in three and lower third of kidney in one. The stone size showed under 10mm in seven, 11-20mm in three and over 21mm in one. 3. The average numbers of treatment were 2.2 sessions and average storage was 102. 4. The complete success rate in 63.6 % (stone free rate in 45.5 %) and partial success rate in 27.2% were showed. 5. The complete relief of symptom was in eight (72.7% ), partial in one (9.1%) and persistent symptom in two (18.2 9t ). 6. Complication was showed only gross hematuria for 1 day in 63.6 %, but all patients recovered with conservative treatment. Therefore, the possibility of producing a satisfactory result (relief of symptom in 81.1%) and the low morbidity of ESWL suggest that this treatment may be appropriate for calculi in caliceal diverticuli.

Initial Experience with ESWL for Urinary Calculi / 대한비뇨기과학회지

ESWL has been demonstrated to be a safe and efficacious means to treatment of urinary calculi. We report the results of 176 patients(203 cases) treated with EDAP LT-01 lithotriptor between January 24 1989 and August 24 1989. The patients were followed for over two months. The results were obtained as follows ; 1. The sex ratio was about 2.4: 1, 125(71.0%) in male and 51(29.0%) in female. The fifth decade(30.1%) was most, followed by fourth decade( 26.7 % ) and sixth decade(18.2%) 2. The stone location showed that kidney was 128 cases( 63.1% ) and ureter was 75 cases( 36.9%), The stone size showed that 94 cases(46.3%) in under 10mm, 75(36.9%) in 11-20mm and 34(16. 8%) in over 21mm. 3. The overall success rate(complete in 74.9% and partial in 23.6% ) was 98.5%. The complete success rate of 122 cases who treated with frequency of 10/sec. was 53.3 %, but 81 cases who treated with frequency of 5/sec. showed the complete success rate of 76.6%. 4. Adjunctive procedures after ESWL were performed 6(3%), including ureterolithotomy in 2(1.0%) and pyelolithotomy, PCNJ PCNL and URS in each 1 case(0.5% ). 5. Complications were showed that gross hematuria for over 1 day in 68.3%, nausea and vomiting in 26%, renal colic in 17.9% and ureteral obstruction in 8.9%. But, all patients re- covered with only conservative treatment except URS and PCN in each 1 case. 6. There were not statistically significant changes in level of BUN, Creatinine, SGOT, SGPT and Creatine phosphokinase, but S-amylase and LDH were significantlychanged(p <0.05).

A Case of Seminal Vesicle Cyst / 대한비뇨기과학회지

Seminal vesicle cysts are rare. Since the first case of a seminal vesicle cyst was reported by Zinner in 1914, about 20 cases have been reported in literature up to 1976. They are presented at the age of high sexual activity. They may be asymptomatic and discovered by rectal examination or may manifest with symptoms of bladder irritation, perineal or testicular pain, pain on ejaculation, etc. Here, we report a case of seminal vesicle cyst in a 38 years-old-man who was admitted under the impression of pelvic abscess.

6 Cases of Primary Obstructive Megaureter / 대한비뇨기과학회지

The massively dilated ureter is one of major therapeutic challenges that face the urologists. The goals of reconstructive procedures are the elimination of residual urine, effective ureteral peristalsis, efficient and/or urgent drainage. 6 cases of primary obstructive megaureter were presented with review of literatures. The results obtained were as follows ; 1. 6 cases were divided into 2 groups according to etiology with 4 adynamic segments and 2 intrinsic stenosis. 2. The underlying histopathologic features included 1 submucosal inflammation,2 submucosal fibrosis with inflammation and 2 submucosal fibrosis. 3. 5 cases were treated with Hendren's technique and 1 case treated by ureteral meatotomy. 4. All cases showed obvious improvement of upper tract without complication during follow-up period from 5 to 26 months.

A Case of Leiomyosarcoma of the Spermatic Cord / 대한비뇨기과학회지

The leiomyosarcoma of the spermatic cord is a rare malignant tumor which constitutes approximately about 10% of sarcomas of the spermatic cord and tunics. In Korea, only one case has been reported. Because the cases presented are too small to be mentioned, the efficacy of retroperitoneal lymph node dissection, radiotherapy and chemotherapy are not settled. The standard therapy for leiomyosarcoma has been radical orchiectomy with high ligation of the spermatic cord. Here, we report a case of the leiomyosarcoma of the spermatic cord and review the role of retroperitoneal lymph node dissection.

A Case of Bilateral Ectopic Ureteral Orifices associated with Bilateral Complete Ureteral Duplication / 대한비뇨기과학회지

An ectopic ureteral orifice inserts at a point other than the trigone of the bladder. Ectopic ureteral orifices in a girl commonly are associated with complete ureteral duplication comprises only 10 to 12 per cent of such patients. Continuous incontinence in a girl with an otherwise normal voiding pattern after toilet training is the classic sign of an ectopic ureteral orifice. Here, we report a 3-years-old girl who was admitted to our hospital due to continuous urinary incontinence and managed with the diagnosis of bilateral ectopic ureteral orifices associated with bilateral complete ureteral duplication.

The Comparison of Erectile Function Tests in Patients Complaining of Impotence after Trauma / 대한비뇨기과학회지

We studied 16 male patients complaining of impotence after trauma. Underlying causes of injury were posterior urethral injury (9 patients), pevic bone fracture (3 patients), perineal burn (2 patients), penile fracture (1 patient) and spinal cord injury (1 patient). Rigiscan was used for diagnostic test and compared with other erectile function tests (Papaverine injection test, Snap Gauge test, PBI(penile brachial index) and PDI (penile digital index) test, AVS (audiovisual stimulation) and Erectiometer tests. The results obtained were as follows: 1. In 9 patients shown normal rigiscan, the number of erection was 1.56+/-0.87 times per night, duration was 14.2+/-7.54 minutes at tip and 20.1+/-9.42 minutes at base, tumescence change was 2.30+/-1.64 cm at tip and 3.40+/-0.73 cm at base, rigidity was 66.28+/-13.33% at tip and 78.86+/-21.43% at base. 2. Among 9 patients shown normal rigiscan, 8 patients showed partial to full rigid erection in intracavernous Papaverine injection test. 3. In 7 patients shown abnormal rigiscan, the findings of Snap Gauge test, AVS test and Erectiometer test showed slight to absent responses, but 9 patients shown normal rigiscan presented variable findings. 4. 13 patients with PBI > or=0.75 and 15 patients with PDI > or =0.77 showed normal rigiscan. but patients shown abnormal rigiscan presented variable findings of PBI and PDI tests. Conclusively, rigiscan and intracavernous Papaverine injection test showed high corresponding rate, but other erectile function tests presented variable findings in patients complaining of impotence after trauma.

The Comparison of Erectile Function Tests in Patients Complaining of Impotence after Trauma / 대한비뇨기과학회지

We studied 16 male patients complaining of impotence after trauma. Underlying causes of injury were posterior urethral injury (9 patients), pevic bone fracture (3 patients), perineal burn (2 patients), penile fracture (1 patient) and spinal cord injury (1 patient). Rigiscan was used for diagnostic test and compared with other erectile function tests (Papaverine injection test, Snap Gauge test, PBI(penile brachial index) and PDI (penile digital index) test, AVS (audiovisual stimulation) and Erectiometer tests. The results obtained were as follows: 1. In 9 patients shown normal rigiscan, the number of erection was 1.56+/-0.87 times per night, duration was 14.2+/-7.54 minutes at tip and 20.1+/-9.42 minutes at base, tumescence change was 2.30+/-1.64 cm at tip and 3.40+/-0.73 cm at base, rigidity was 66.28+/-13.33% at tip and 78.86+/-21.43% at base. 2. Among 9 patients shown normal rigiscan, 8 patients showed partial to full rigid erection in intracavernous Papaverine injection test. 3. In 7 patients shown abnormal rigiscan, the findings of Snap Gauge test, AVS test and Erectiometer test showed slight to absent responses, but 9 patients shown normal rigiscan presented variable findings. 4. 13 patients with PBI > or=0.75 and 15 patients with PDI > or =0.77 showed normal rigiscan. but patients shown abnormal rigiscan presented variable findings of PBI and PDI tests. Conclusively, rigiscan and intracavernous Papaverine injection test showed high corresponding rate, but other erectile function tests presented variable findings in patients complaining of impotence after trauma.