The assessment of symptomatic improvement of patients with benign prostatic hyperplasia after transurethral prostatectomy / 대한비뇨기과학회지

Although transurethral prostatectomy is the most common treatment method of benign prostatic hyperplasia, the exact indication and efficacy of this method is variable and controversial. We performed this study to determine the efficacy of transurethral prostatectomy on men with moderate symptoms or benign prostatic hyperplasia. The efficacy parameters evaluated included the change of maximal flow rate, Boyarsky symptom score and the global assessment of voiding symptom by the patient after transurethral prostatectomy. The mean maximal flow rate improved 204% after transurethral prostatectomy, and the mean obstructive and irritative symptom scores decreased 84% and 59% respectively. But the irritative symptom score of unsatisfied patients decreased only. 41%. Over all, 80% of the patients were satisfied with the result of the operations. The improvement of the irritative symptoms is not expected after a transurethral prostatectomy, and therefore, the operative procedure is not indicated. But the symptoms of the unsatisfied patients were similar to the comparative group (healthy men over 50 years of age). Although this comparative group had nocturia (11%), frequency (32%), urgency (29%), they felt no necessity for special medical attention, but hesitancy, intermittency, terminal dribbling and dysuria led the patient to seek help in a hospital.

Leukemoid reaction with renal cell carcinoma / 대한비뇨기과학회지

Renal cell carcinoma has been recognized for several years as a relatively common cause of paraneoplastic syndromes. Fever, polycythemia, hypercalcemia, amyloidosis, abnormal liver function, Cushing's syndrome and neuropathy have been ostm frequently reported in association with renal cell carcinoma, but leukemoid reactions have been reported only rarely with this tumor. Recently we experienced a leukemoid reaction in a 64-year old female patient who presented with an advanced case of renal cell carcinoma. According to the literature the mortality is 100% with leukemoid reactions in renal cell carcinoma, and indeed this patient expired. We therefore, consider this reaction as a late manifestation of a bizzare presentation of renal cell carcinoma.

A Case of Vesico-Sigmoido-Appendiceal Fistula / 대한비뇨기과학회지

We report a case of vesico-sigmoido-appendiceal fistula from unknown origin in a 29 years old female who was presented with the chief complaints of fecaluria and bladder irritation symptoms The diagnostic procedure such as excretory urography, cystography, barium enema, cystoscopy and proctoscopy were performed, and the vesico-recto-appendiceal or vesico-sigmoido-appendiceal fistula was suspected. On operation, the tip of appendix was communicated with the sigmoid fistulous tract and opened into the bladder in a common pathway. The patient underwent appendectomy, sigmoid fistulectomy, and partial cystectomy and the postoperative course was uneventful.