Clear Cell Adenocarcinoma of the Urinary Bladder / 대한비뇨기과학회지

A case of a clear cell carcinoma of the urinary bladder is reported. A 48-year-old female was referred to our hospital complaining of gross hematuria and terminal dysuria. She had a nodular tumor, 3x4cm in diameter, located on the bladder neck, trigone and posterior urethra. The patient underwent anterior pelvic exenteration and urinary diversion with an ileal conduit. A histopathological examination revealed a tumor composed of cells with eosinophilic cytoplasm, and partly of cells with clear cytoplasm or hobnail-shaped cells, arranged in tubular and papillary architectures. This showed the findings of a clear cell adenocarcinoma of the bladder and urethra. The patient underwent 6 courses of adjuvant chemotherapy with cisplatin and 5-FU. The patient shows no evidence of recurrence or metastasis at the 8 month postoperative follow-up.

New Technique of Orthotopic Ileal Neobladder: Early Experience / 대한비뇨기과학회지

PURPOSE: During the last 10 years, a multitude of different ileal neobladders have been reported. The ureterointestinal anastomotic site stricture has been shown to be one of the most common late complications. To avoid the stricture, a new orthotopic ileal neobladder was constructed, with two chimneys and two afferent ileal limbs beside the reservoir. MATERIALS AND METHODS: Twenty-six men, with invasive bladder cancer, underwent a radical cystectomy, with the creation of a two chimney ileal neobladder. The mean follow-up was 18 months. The complications were assessed and divided into those related or unrelated to the urinary tract. The continence was evaluated using patient questionnaires. RESULTS: There was no case of an ureteroileal anastomotic site stricture. Five cases of vesicoureteral reflux were noted in the 52 ureteral units. Good, or satisfactory, day- and nighttime urinary continence was reported at the 6 month follow-up by 92.3 and 69.2% of patients, respectively. CONCLUSIONS: The ileal neobladder with two chimneys would be an appropriate technique for the reduction of the ureteroileal anastomotic stricture rate and to overcome some of limitations of the ureteral length.

The Change of Prostate Specific Antigen after Treatment in Chronic Prostatitis Associated with Elevated Serum Prostate Specific Antigen / 대한비뇨기과학회지

PURPOSE: Men with documented chronic prostatitis, with elevated serum prostate specific antigen (PSA), were investigated to assess whether treatment lowers serum PSA and thus avoids unnecessary biopsies. MATERIALS AND METHODS: The medical records of 46 men who presented with serum PSA higher than 4ng/ml, and subsequently diagnosed with chronic prostatitis, were retrospectively reviewed. After the administration of antibiotics and anti-inflammatory drugs for 4 to 8 weeks, the follow-up PSA levels were determined, and those with levels higher than 4ng/ml underwent a prostate biopsy. RESULTS: The mean PSA level decreased 61% from 11.66ng/ml before, to 3.79ng/ml after, treatment (p<0.001). In 30 patients the serum PSA level decreased to below 4ng/ml (mean 1.69), with these patients no longer having an indication for a prostate biopsy. In the remaining 16 patients the serum PSA level remained elevated above 4ng/ml, so they underwent a prostate biopsy. Pathological study revealed benign prostatic hyperplasia in 11 cases and prostate cancer in 5. The PSA level in patients associated with benign prostatic hyperplasia decreased 61.9% with treatment, from 19.96 to 7.88ng/ml (p=0.006) and the PSA in those associated with prostate cancer decreased 30.6% with treatment, from 12.85 to 7.32ng/ml (p<0.05). CONCLUSIONS: This study demonstrates that chronic prostatitis can cause elevation of serum PSA levels, and when identified, antibiotics and anti-inflammatory treatment can lower these levels and an unnecessary prostate biopsy can be avoided.

Crossed Testicular Ectopia in a Patient with Bilateral Cryptorchism / 대한비뇨기과학회지

Crossed testicular ectopia is an uncommon anatomical abnormality in which both gonads migrate toward the same hemiscrotum. We report a case of crossed testicular ectopia associated with bilateral cryptorchism. The crossed ectopic and intra-abdominal testis was fixed in it's own hemiscrotum by laparoscopic orchiopexy.