An Experience of Vaginoplasty with Rectos Abdominis Myocutaneous Flap for Testicular Feminization Syndrome / 대한비뇨기과학회지

Testicular feminization syndrome is characterized by 46,XY karyotype, bilateral testes, absent or hypoplastic wolffian duct, female appearing external genitalia, blind vaginal pouch, and absent or rudimentary muillerian derivatives. We experienced vaginoplasty using rictus abdominis myocutaneous flap with modified Burch bladder neck suspension in a 51-year-old patient with testicular feminization syndrome combined with stress urinary incontinence.

Transrectal Ultrasonography in Female Stress Urinary Incontinence / 대한비뇨기과학회지

Radiologic chain cystourethrography for stress urinary incontinence (SUI) has several disadvantages including the risk of excessive radiation, the time required for the test, and the discomfort of the patients. Nowadays it is widely accepted that transrectal ultrasonography for evaluating bladder and urethra provides similar information about SUI comparing with the conventional radiographic examination. We evaluated the effectiveness of transrectal ultrasonography in the diagnosis of SUI in 30 women with SUI and in normal 20 women as a control. The results of evaluation were as follows: 1. Mean age was 52.9 in SUI group and 48.5 in control group, and mean parity was 2.8 in SUI group and 3 In control group. 2. According to the symptom grading by Stamey, 8 patients (27%) were Grade I and 22 (73%) were Grade II. 3. The mean value of posterior urethrovesical angle (PUVA) at resting state was 139 +/- 14.7 degrees in control group and 145 +/- 15.2 degrees in SUI group (p>0.05). 4. The mean value of PUVA at strain state was 146 +/- 7.9 degrees in control group and 169 +/- 12.1 degrees in SUI group (p<0.05). 5, Bladder neck descent was 7.3 +/- 2.7 mm (mean+/-SD.) in control group and 13.7+/-6.2 mm in SUI group (p<0.05). 6. Diagnostic criteria of SUI in transrectal ultrasonography are more than 149.5 degrees in PUVA at strain state, and more than 9.1 millimeter in bladder neck descent. 7. Sensitivity and specificity of transrectal ultrasonography in the diagnosis of SUI were 86% and 80% in PUVA at strain state, 80% and 80% in bladder neck descent, respectively. 8. There was significant change of transrectal ultrasonographic finding in pre and post-bladder neck suspension (p<0.05). In conclusion, transrectal ultrasonography is simple, non-invasive, not shameful, and free of radiation, so might be a useful diagnostic method in female SUI.

A Case of Huge Retroperitoneal Lipoma / 대한비뇨기과학회지

Retroperitoneal lipoma probably constitute the group of the most massive solid abdominal tumors; their etiology is unknown; their symptoms insidious; and recurrence and sarcomatous change frequent. The clinical diagnosis was made by clinical symptoms, physical findings and radiologic evaluation such as intravenous urography, ultrasonography, computed tomography, angiography and so on. Abdominal CF scan provided clinically the most useful information regarding the state of tumors and also their effect on adjacent structures and shows homogenous appearing fat tissue with a low attenuation coefficient identical to that found in the subcutaneous fat. We present a case of treatment for a huge retroperitoneal lipoma in a 46-year-old man.

A Case of Leiomyoma of the Kidney / 대한비뇨기과학회지

Renal leiomyoma, a rare benign tumor, is a challenging diagnostic and therapeutic condition. The preoperative diagnosis of renal leiomyoma is very difficult, and the only definite method to distinguish between a leiomyoma and other renal tumor is postoperative microscopic evaluation. We report a case of leiomyoma of the kidney which was managed by radical nephrectomy under the impression of malignant renal mass which was incidentally found by ultrasonographic examination for health check in a 43-year-old woman.

A Case of Primary Lumbar Epidural Lymphosarcoma: Case Report

Round cell sarcomas involving spinal epidural space such as Hodgkin's disease, plasma cali sarcoma reticulum cell sarcoma and lymphosarcoma are well known diseases. Of those, primary lymphosarcoma arising at spinal epidural space has been reported as the very rare disease by Bucy and other authors. The clinical pictures of the disease were presented by the compression of the spinal cord or cauda equina. If the condition treated promptly and properly with surgery and radiation therapy, the outlook would be good both for recovery and life in most instances. We have experienced a case of primary lymphosarcoma involving lumbar spinal epidural space in a 13 year-old male and obtained a good result after surgery and radiation therapy.