Clinical Features and Efficacy of Diagnostic Methods in Adults with Asymptomatic Microscopic Hematuria / 대한비뇨기과학회지

PURPOSE: Asymptomatic microscopic hematuria is a difficult problem faced at the offices of many urologists. This study was aimed at evaluating the ability for the detection of significant lesions, according to the grade of microscopic hematuria and the comparison of various diagnostic modalities. MATERIALS AND METHODS: Between March 1999 and December 2003, 755 adult patients that visited our hospital due to asymptomatic microscopic hematuria were examined according to the diagnostic algorithm. The male-to-female ratio was approximately 1:1.1 (366:389). Microscopic hematuria was divided into five grades. Lesions found at evaluation were categorized as either highly or moderately significant or insignificant lesions. RESULTS: 221 (29.3%) out of 755 patients were found to have lesions during evaluation. Of these 221 patients, 33 with highly significant lesions, including 4 urologic malignancies, 127 with moderately significant lesions and 61 with insignificant lesions, were detected. Correlation was shown between the degree of microscopic hematuria and the likelihood of detecting significant urologic diseases. The sensitivity and specificity for the detection of significant lesions by urine cytology, ultrasonography (USG), intravenous pyelography (IVP), cystoscopy, computed tomography (CT) and the combination of USG and IVP were 2.5/96.3%, 35.6/96.5%, 34.7/ 96.0%, 7.4/97.7%, 100/98.2% and 44.8/94.8%, respectively. CONCLUSIONS: The combination of USG and IVP for the detection of significant lesions at the initial examination was more beneficial than USG or IVP. Cystoscopy and CT are necessary additional diagnostic modalities for patients with abnormal findings at the initial examination and for those patients with asymptomatic microscopic hematuria who are at high risk.

Testicular Tuberculosis Mimicking Testicular Malignancy / 대한비뇨기과학회지

Genitourinary tuberculosis is the most common manifestation of an extrapulmonary tuberculous infection. The most common site of genital tuberculosis is the epididymis, but testicular tuberculosis is very rare. A 30 year old patient presented with a painless right testicular mass. Under the clinical diagnosis of a right testicular tumor, a right radical inguinal orchiectomy was performed. The pathological diagnosis revealed testicular tuberculosis, without involvement of the epididymis.

Primary Malignant Melanoma of the Male Urethra / 대한비뇨기과학회지

A primary malignant melanoma occurring within the male urethra is a very rare disease, which usually shows highly malignant potential. Due to the low incidence, the clinical features of this disease remain unclear, and the mode of treatment controversial. Herein, we report a case of a malignant melanoma of the male urethra in a 77 year old man, who was managed by transurethral resection, and has remained uneventful for a 6 month follow-up period.

The Effectiveness of Adjuvant Chemotherapy in the Transitional Cell Carcinoma of Urinary Bladder with Lymph Node Involvement Treated by Radical Cystectomy / 대한비뇨기과학회지

PURPOSE: To assess the impact of adjuvant chemotherapy on the survival of patients treated surgically for a bladder transitional cell carcinoma (TCC). MATERIALS AND METHODS: We retrospectively analyzed the data from 243 patients with bladder TCC who underwent a radical cystectomy. The mean age of the patients was 61.2 years, with a median follow-up of 46.8 months. The influence of prognostic factors, including age, gender, tumor stage, grade and chemotherapy, on the 5-year survival rate were analyzed. The difference in the survival rates among the prognostic factors were analyzed by univariate and multivariate analyses. RESULTS: The overall 5-year survival rate was 72%. The significant prognostic factors for the 5-year survival according to the univariate analysis were lymph node involvement, tumor stage, age and chemotherapy. From the multivariate analysis, lymph node involvement was the most independent of the prognostic factors for survival. Patients with lymph node involvement had a worse prognosis than those without (p<0.001). Adjuvant chemotherapy in patients with lymph node involvement had a great impact on survival (p=0.001). CONCLUSIONS: When treating a bladder TCC with a radical cystectomy, lymph node involvement, tumor stage, age and chemotherapy were significant factors influencing survival. Adjuvant chemotherapy will provide a therapeutic role in invasive bladder TCC, with lymph node involvement, following a radical cystectomy.

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.

Dual-Isotope SPECT Imaging with Thallium-201 and Technetium-99m MIBI in Detecting Coronary Artery Disease / 영남의대학술지

We evaluated the results of sequential SPECT dual-isotope imaging with Tl-201 and Tc-99m MIBI in 24 patients, all of whom also had coronary angiography within the past one month. Coronary angiography showed that 12 patients had no CAD, 4 patients had one-vessel CAD, 7 patients had two-vessel CAD and 1 patient had three-vessel CAD. Serial studies of resting Tl-201 and dipyridamole stress Tc-99m MIBI were completed within 2 hours. When more then 50% of coronary artery narrowing was considered significant. The overall sensitivity and specification of CAD detection were 91.7%. The sensitivity of CAD detection in patients with one-vessel and multi-vessel diseases was 75% and 100%, respectively. Therefore, sequential dual-isotope SPECT demonstrated high sensitivity and specificity of CAD detection. In conclusion, sequential dual-isotope imaging is feasible and can be completed in a short time and may therefore enhance laboratory throughput and patient convenience.