Large Epithelial Inclusion Cysts after In-situ Vaginal Wall Sling Procedure / 대한비뇨기과학회지

Since the procedure of a full thickness vaginal wall sling for stress urinary incontinence was first described, concern has been raised regarding the potential formation of inclusion cysts due to buried vaginal mucosa. Recently, two female patients, who underwent an in-situ vaginal wall sling procedure, visited our department presenting with painless large anterior vaginal wall masses. The masses were cystic, and cyst excisions performed. The cyst fluid was aseptic and the cyst wall lined with stratified squamous epithelium. At the 1 year follow up, the patient remained continent and the cyst had not reformed. To our knowledge, this is the first reported case of inclusion cyst formation after an in-situ vaginal wall sling procedure in Korea. An epithelial inclusion cyst is an under-recognized complication of the in-situ advancing vaginal wall sling. The vaginal surgeon should be aware of the potential for an epithelial inclusion cyst and actively search for their formation at the postoperative examination following an in-situ sling placement.

Improving the Accuracy of Hemodynamics Using a Vasoactive Medication Re-dosing during Dynamic Infusion Cavernosometry and Cavernosography / 대한비뇨기과학회지

PURPOSE: Dynamic infusion cavernosometry and cavernosography (DICC) is a recognized technique for evaluating the hemodynamics of an erection. During DICC, complete corporeal smooth muscle relaxation is essential for obtaining accurate data. A means of promoting maximal smooth muscle relaxation is repeat doses of vasoactive medication during vascular testing. The effect of re-dosing with vasoactive medication on the hemodynamics was investigated in impotent men undergoing DICC. MATERIALS AND METHODS: A total of 81 patients having undergone DICC, between January 2002 and December 2003, were prospectively reviewed. When the veno-occlusive parameters were abnormal, the intracavernous vasoactive agent dose was repeated a maximum of 3 times. Arterial insufficiency was diagnosed when the cavernosal artery systolic occlusion pressure was less than 100mmHg or more than 30mmHg below brachial arterial pressure. Venous leakage was diagnosed when the flow-to- maintain value was greater than 3ml/min or the pressure decay was greater than 45mmHg/30sec. The proportion of men in whom the vascular diagnosis had altered was analyzed using this regimen. RESULTS: Of the 81 subjects, 69 (85.2%) warranted re-dosing based on their abnormal veno-occlusive parameter. Of these 69 patients, the veno- occlusive values were corrected in 22 (31.9%) by repeat medication; therefore, they would have been falsely diagnosed with venous leakage during vascular evaluation. 13 patients (59.1%) of all corrections occurred with the second dose, while 9 patients (40.9%) of the patients required a third dose of medication. CONCLUSIONS: Re-dosing with a vasoactive agent should be considered during vascular evaluation where incomplete corporeal smooth muscle relaxation is suspected. This approach increases the likelihood of a more accurate diagnosis and decreases the risk of a false diagnosis of venous leakage.

Xanthogranulomatous Cystitis Presenting as a Urachal Carcinoma / 대한비뇨기과학회지

Xanthogranulomatous cystitis (XC) is a very rare benign chronic inflammatory disease of unclear etiology. Herein is reported the case of a 46-year-old woman who presented with a painless lower abdominal palpable mass. According to the cystoscopic, ultrasonographic and enhanced computed tomographic (CT) findings, a urachal carcinoma could be suggested. Partial cystectomy was performed as the presence of a urachal carcinoma could not be ruled out. There was no recurrence of the XC more than 12 months after the partial cystectomy.

Xanthogranulomatous Cystitis Presenting as a Urachal Carcinoma / 대한비뇨기과학회지

Xanthogranulomatous cystitis (XC) is a very rare benign chronic inflammatory disease of unclear etiology. Herein is reported the case of a 46-year-old woman who presented with a painless lower abdominal palpable mass. According to the cystoscopic, ultrasonographic and enhanced computed tomographic (CT) findings, a urachal carcinoma could be suggested. Partial cystectomy was performed as the presence of a urachal carcinoma could not be ruled out. There was no recurrence of the XC more than 12 months after the partial cystectomy.

A Case of Echinococcal Hydatid Cyst as Misdiagnosed to the Bladder Cancer / 대한비뇨기과학회지

Hydatid disease is a parasitic infection that is caused by the larval stage of Echinococcus granulosus. This disease is widely distributed in a temperate and subtropical countries, and it is especially prevalent in sheep and cattle raising countries. The most common infection site is the liver, and the second most common site is the lung. We report here on our experience with Echinococcal hydatid cysts that were found in the bladder of a 38 year old worker from Uzbekistan. The cysts were surgically removed and the patient was managed postoperatively with albendazole.

A Case of Echinococcal Hydatid Cyst as Misdiagnosed to the Bladder Cancer / 대한비뇨기과학회지

Hydatid disease is a parasitic infection that is caused by the larval stage of Echinococcus granulosus. This disease is widely distributed in a temperate and subtropical countries, and it is especially prevalent in sheep and cattle raising countries. The most common infection site is the liver, and the second most common site is the lung. We report here on our experience with Echinococcal hydatid cysts that were found in the bladder of a 38 year old worker from Uzbekistan. The cysts were surgically removed and the patient was managed postoperatively with albendazole.

Effects of Nitric Oxide on the Induction of Experimental Allergic Orchitis in Guinea Pig

BACKGROUND: Production of nitric oxide (NO) by inducible NO synthase (iNOS) has been implicated in the pathology of autoimmune disease. It is unknown whether iNOS expression is increased within testes and whether iNOS and NO have essential roles in the pathogenesis of EAO. METHODS: EAO was induced in guinea pig testes at 17 days after secondary immunization by administration of crude extract (CE) and purified glycoprotein 1 (GP1) from normal guinea pig testes. iNOS gene expression was assessed by RT-PCR and Northern blot analysis in testes. Localization of iNOS and Mac-1 and the indicator of NO-mediated tissue injury, nitrotyrosine, were detected in the testicular lesion by immunohistochemistry. RESULTS: In control testes, inflammation and iNOS gene expression were not detected, whereas, in CE- and GP1-injected testes, inflammation and marked iNOS gene expression were evident at day 17 after secondary immunization. Immunohistochemistry of Mac-1 showed the colocalization with iNOS protein and nitrotyrosyl proteins in intertubules, suggesting that NO produced by infiltrated macrophages may be involved in inflammatory lesions of intertubules. Intraperitoneal administration of aminoguanidine significantly prevented EAO with reduction of inflammation, iNOS expression and nitrotyrosine formation. CONCLUSION: These results suggest that NO production by macrophages may be important in the pathogenesis of CE- and GP1-induced EAO. Furthermore, this study demonstrated the therapeutic potential of iNOS inhibitor in the treatment of inflammatory and autoimmune mediated-diseases.