Morphologic Changes of the Urinary Bladder Mucosa Induced by E. coli / 대한비뇨기과학회지

This study was carried out to investigate pathogenesis of E. coli-induced cystitis by light and electron microscopy with immunocytochemistry. A group of ICR mice was intravesically given 0.3ml of E. coli DIE 174 lysate( 1000000000/ml). Another group was given E. coli lysate after acid solution(pH 4.5) washing for 30 minutes. The urinary bladders were observed at 2 hours and 24 hours after E.coli lysate irrigation. On light microscopy, submucosal edema, congestion, and perivascular neutrophilic infiltration occurred 2 hours after E. coli lysate irrigation. The congestion and acute inflammation were more pronounced 24 hours after. In cases of acid washing and E. coli lysate irrigation, mucosal acute inflammatory infiltration with edema and congestion was marked at early stage. Necrosis of transitional cells developed with time. On immunostain for E. coli, surface of transitional cells was stained 2 hours after E. coli lysate irrigation. At 24 hours after irrigation, intercellular spaces of transitional cells were stained. In cases of acid washing and E. coli lysate irrigation, entire mucosa was stained at early stage. Electron microscopically, transitional cells revealed increase of cytoplasmic processes, enlargement of cytoplasmic vesicles, and widening of intercellular spaces. There were large amounts of various shapes of lysosomes in neutrophils and monocytes infiltrated in the mucosa in acid washing groups. According to the above results, it is concluded that E. coli lysate may easily penetrate into the bladder mucosa and that the mucosal mucopolysaccharide plays as a barrier against bacterial invasion.

Effects of Doxazosin Mesylate in Patients with Benign Prostatic Hyperplasia / 대한비뇨기과학회지

The clinical effect of doxazosin mesylate, a selective long acting alpha-1 adrenergic blocker, were evaluated in 31 patients with symptomatic benign prostatic hyperplasia ranging from 49- 85 years old. All patients underwent a urodynamic evaluation and symptom score checking before enrollment into the study. The dose of doxazosin was 2mg per day. And the mean duration of treatment was 157 days. 31 patients were followed on doxazosin for 3 to 12 months with mean 7.5 months. The adverse drug reactions were observed only 1 case. The parameters used to assess the effectiveness of doxazosin included peak and mean urinary flow rates, micturition symptom scores and residual urine, and global assessment by the patient The peak and mean urinary flow rates increased by 77% and 86%, respectively. The obstructive and irritative symptom scores were improved by 51% and 41% respectively. The improvements in urinary flow rates and symptom scores were maintained for this interval. Although this preliminary experience with doxazosin is encouraging, the ultimate role of doxazosin for the long term treatment of benign prostatic hyperplasia needs further evaluation.

Result of modified two-layer vasovasostomy and modified one-layer vasovasostomy using stent under microscope / 대한비뇨기과학회지

Modified two layer vasovasostomy and modified one layer vasovasostomy with stent under micro- scope were performed in 63 patients from April 1987 to December 1991 in Fatima General Hospital. Among 56 patients who could be followed up post-operatively, modified two layer vasovasostomy under microscope was performed in 26 patients and modified one layer vasovasostomy with stent under microscope was performed in 31 patients. Patients whose vesovasostomy had been performed using modified two layer technique had a 80.0% patency rate and they had a 60% prenenancy rate. Patients whose vasovasostomy had been performed using modified one layer with stent technique had a 77.4 % patency rate and they had a 54.8 % pregnancy rate. In conclusion, we found a little difference in pregnancy rate and patency rate between two technique but we experienced that modified one layer technique with stenting was easier, more time-saving and cost-effective than two layer technique.

Comparison of the transvaginal procedure and retropubic procedure for stress incontinence / 대한비뇨기과학회지

For the successful surgical treatment of genuine stress urinary uncontinence many procedures have been applied. We report on 36 cases of stress incontinence surgically treated by the tansvaginal procedure (19 cases) and retropubic procedure(17 cases) during the period from November, 1981 to October, 1991. The patient varied in age from 34 to 65 years in the transvaginal procedure and 26 to 68 years in the retropubic procedure(total mean age was 47.2 years). The surgical procedures were performed by Pereyra`s method 17 cases. Stamey`e method 2 cases. MMK's method 11 cases. Montague`s method 1 case. Burch`s method 5cases. Clinical symptom classification (grade I - Grade IV)of stress incontinence reported by Ball was used. There were symptom distribution of Grade I, 3 cases ; Grade II, 14 cases; Grade III, 2 cases in the transvaginal procedure. Grade I, 3 cases; Grade II, 11 cases : Grade III, 3 cases were done by the retropubic procedures. The success rate was 84% in the trensvaginal procedure and 89% in the retropubic procedure with minimum follow up of six months. Postoperative complications were urinary retention 8 cases, bladder perforation 1 case, vaginitis 1 case (total 59%) in the transvaginal procedures, while urinary retention10 cases. wound infection 1 case (total 70%) in the retropubic procedures. The values of post-operative days on catheter, operative time and postoperative hospitalization in the transvaginal procedures were 6.8+/-2.1 days. 91.6+/-23.2 minutes and 7.2+/-0.5 days, and in the retropubic procedures 6.9+/-3.2, 123.5+/-21.5 and 7.8+/-0.6 respectively (p<0.01). On the basis of the results we concluded that the transvaginal procedure had advantages including operative simplicity, extensive indication, rarer postoperative complication, compared with retropubic procedures.

A case of renomedullary interstitial cell tumor(so-called renal medullary fibroma) / 대한비뇨기과학회지

Although fibromas are the most common renal medullary tumor identified at autopsy. their small sized and benign course make clinical detection extremely difficult. Only 9 clinical cases of renal medullary fibromas have been reported. Many fibromas of the renal medulla, previously considered as bamahomas. seemed to be composed of tumerous transformation of renomedullary interstitial calls Herein we report on a patient with huge renal medullary fibroma treated by right radical nephrectomy.