A Case of Persistent Mullerian Duct Syndrome / 대한비뇨기과학회지

Male pseudohermaphroditism can result from defects in androgen synthesis, androgen action, and mullerian duct regression, and from other uncertain causes. A rare form of male pseudo- hermaphroditism is characterized by the persistence of mullerian derivative in phenotypic male. The retention of mullerian structures can be ascribed to failure of the Sertoli cells to synthesize mullerian duct inhibitory factor, a defect in the response of the duct to that factor, or possibly discordant timing of the release of that factor. We experienced a case of persistent mullerian duct syndrome, which is phenotypically normal male with a right inguinal hernia and a left undescended testis, bilateral fallopian tubes and a uterus. Herein we report a case of early orchiopexy with this syndrome and brief review of the literatures.

Benign Prostatic Hyperplasia: A Comparative Study of Transurethral Resection and Open Surgery / 대한비뇨기과학회지

The results of 114 transurethral resection of the benign prostatic hyperplasia were compared with that of 41 open surgery from the period of January 1988 to June 1993. In a review of the medical history, 70.2% of the patients subjected to TUR and 63.4% of the patients subjected to open surgery were associated with one or more other systemic diseases. 17.5% of the patients in TUR and 19.5% of the patients in open surgery were associated genitourinary diseases. On the basis of the systemic disease in the anesthetic records, patients were classified according to wide variety of risk strata. Postoperative complication rate in cases of with or without anesthetic risk was 48.3 % and 43.5% in TUR, and 87.1 % and 80.0% in open surgery respectively. There seemed to be no relation between anesthetic risk and complication. The mean operation time was shorter in the patients subjected TUR than the patients subjected to open surgery. The mean duration of the postoperative catheterization and hospitalization were shorter in the patients with TUR than compared to the patients with open surgery Total complication rate was significantly lower in TUR than open surgery( 47.4% in TUR. 85.4% in open surgery). Mean weight of resected prostate was heavier in open surgery than TUR. The urinary retention necessitating reoperation was 3.5% in TUR. Pre- and postoperative mean maximum flow rates were 8.6+/-2.6 and 17.2+/-6.7ml/sec in TUR, and 8.4+/-3.2 and 18.2+/-6.7ml/sec in open surgery. Pre- and postoperative mean Boyarsky symptoms score were 15.27 and 7.43 in TUR, and 15.52 and 7.67 in open surgery. The results of mean maximum flow rates and mean Boyarsky symptoms score were same in the patients with TUR and open surgery.

Clinical review of nephrectomy on tuberculous non-functioning kidneys / 대한비뇨기과학회지

A clinical observation was made on 23 patients with tuberculous non-functioning kidneys who underwent nephrectomy during the period from February 1986 to June 1992. We reviewed these cases according to primary nephrectomy on tuberculous non-functioning kidneys. The following results were obtained. In pathologic findings of the 27 cases in which tuberculous non-functioning kidneys were suspected, 4 cases were no evidence of tuberculosis. Those were xanthoeranulomatous pyelonephritis (2 cases) and chronic pyelonephritis with hydronephrosis (2 cases). Coexisting renal cell carcinoma was found in 1 case. 4 cases (17.1%) were hypertensive at the time of presentation and 3 cases or them had a decrease in blood pressure after nephrectomy. No perioperative mortality occurred and perioperative complications (sinus arrhydrmia, wound infection, wound dehisdence, ileus) were in 4 cases (17.4 %). There was no evidence of recurrence during follow-u periods. (Follow-up mean periods: 18.5 months) Thus, it is concluded that primary nephrectomy is an important adjunct in the comprehensive management of the unilateral, tuberculous non-functioning kidneys, for accurate diagnosis, removal of infection source, early control and prevention of presenting symptoms.

Clinical observation of 30 cases who underwent epididymectomy: especially, on the cases of tuberculous epididymitis / 대한비뇨기과학회지

A clinical investigation was undertaken on 30 patients who underwent epididymectomy during the period from April 1986 to November 1991. In this study. clinical reasons of epididymectomy were as follows: First, for confirming of tuberculous epididymitis( 19 cases). Second. for treatment of chronic epididymitis(8 cases). Third, for treatment of acute epididymitis(2 cases). Pathohistologic findings were tuberculous epididymitis( 15 cases), chronic epididymitis(9 cases), sperm granuloma(3 cases). cystadenoma(2 cases). spermatocele(1 case). The highest occurrence was observed in the age groups of 20 to 39(60%) in tuberculous epididymitis. 30 to 49(66.6%) in chronic epididymitis. Tuberculous epididymitis was presented clinically non-tenderful epididymal nodule 66%, tenderful epididymal nodule 33%, scrotal fistula 20%. Chronic epididymitis was tenderful epididymal nodule 80%. scrotal swelling 26.6%. In urine examination, tuberculous epididymitis was observed on pyuria 40%, hematuria I3%. and tubercle bacilli 1 case. Chronic epididymitis was pyuria 37.5%, urine culture(E. coli 10(5)/ml) 25%. Tuberculous epididymitis corresponds b 268 of total male patients with genitourinary tuberculosis. The lateralization showed 46% in the left 33% in both side, 20% in the right. The most common affected region of epididymis was diffuse(40%). followed by tail 33%, head 26%. Associated tuberculous lesions. lung 25%, kidney 13%. vas 33.3%, testis 20%.

Clinical observation on renal injury: 66 cases / 대한비뇨기과학회지

The clinical observations were made on 66 patients of renal injuries during the period from 1985 to 1991) The results were as follows: I. The renal injuries were classified as contusion, laceration, rupture, pedicle injury according to Cass and Luxenberg`s classification. The patient numbers of each group were 42 (63.6%), 11 (16.3%).11 (16.3%) and 2 (3%). 2. The sonography was useful by complementary diagnostic tool of excretory urography in major renal injuries. 3. The computerized tomography was useful in diagnosing combined injuries and detecting injuries which were not detected in excretory pyelography. 4. The treatment of many. major renal injuries could be done conservatively with detailed and accurate diagnosis using computerized tomography.

A case of fibroepithelial polyp of the ureter diagnosed with ureteroscopic finding and biopsy / 대한비뇨기과학회지

The differential diagnosis of benign tumors from other intra-ureteric lesions was difficult. But. recently. it is easy due to developed diagnostic procedures. such as ureteroscopy. We herein report a case of fibroepithelial polyp of the left ureteropelvic junction which was diagnosed with ureteroscopic finding and biopsy with brief review or literatures.

A Case of Fibroma of Tunica Vaginalis / 대한비뇨기과학회지

Benign tumors within the scrotum are rare. The clinical recognition and correct identification are important from a standpoint of treatment and prognosis, as compared with the malignant testicular tumors. This benign tumor is also called fibrous pseudotumor of the testis. It is difficult to distinguish fibromas of the tunica vaginalis from tumors arising within the scrotum. The majority of the tumors of the testicular tunics are benign and therefore the prognosis is more favorable than those of the testes. Clinically, it is difficult to distinguish the fibroma of tunics from a malignant tumor of the testis. Final diagnosis is usually made after surgical exploration. A case of tunica vaginalis in 71-year-old male is presented with a brief review of literatures.

A Clinical Observation of Renal Cell Carcinoma / 대한비뇨기과학회지

Follow-up study was made on l0 patients of renal cell carcinoma who were treated at Seoul Paik Hospital since 1982. among the l0 cases, male was 9 cases and female was l case. Average patient age was 55.3 years, with a range of 45 to 67 years. Except one, all of the patients had hematuria either gross or microscopic, but the classic triad of hematuria, flank pain and abdominal mass was present in 3 patients. In 2 cases of the 5 cases who were not examined by C-T scan revealed renal tumor and concurred with pathologic finding. At initial diagnosis, distant metastasis was present in 30% of the patients and 1 patient had subcutaneous lesion and the solitary lesion of the lung. Mean survival time of stage IV renal cell carcinoma was 16 months in this report.