Assessment of Necessary or Adequate Diagnostic Requirement in Urologic Disease -2. Value of Intravenous Pyelography in Benign Prostatic Hyperplasia- / 대한비뇨기과학회지

There have been some pros and cons about the of routine intravenous pyelography in benign prostatic hyperplasia. Herein we analyzed 196 patients who underwent intravenous pyelography before prostatectomy at Dept. of Urology, Seoul National University Hospital from Jan. 1976. to Dec. 1983. Of 196 patients 140 (72%) showed normal upper tract with cystogram compatible with benign prostatic hyperplasia(Group I), 22(11%) dilated upper tract(Group II), 20(10%) incidental upper tract abnormalities including 9 urolithiasis(Group III), and 14(7%) completely normal findings(Group IV). There was a significant relationship between Group II and serum BUN value. Cystoscopy revealed evidence of prostatic enlargement in 14 cases and other abnormal findings including bladder tumor which were not shown on routine IVPs. We conclude that intravenous pyelography is not always necessary in diagnosis of benign prostatic hyperplasia when urine analysis and serum BUN are normal Instead, we recommend KUB to observe renal outline and calculi, and preoperative routine cystoscopy to evaluate prostatic enlargement and bladder neck obstruction.

The Diagnostic Value of Bone Scan and Serum Phosphatase Level for the Early Detection of Bone Metastasis of the Urogenital Tumors / 대한비뇨기과학회지

22 patients with proved urogenital malignancies was done to determine the value of bone scanning versus roentgenographic skeletal survey in assessing the degree of metastatic involvement with serum phosphatase level. Findings on bone scans were positive in 11 patients and in 6 patients of these patients results of radiologic of radiologic skeletal survey were negative. Of these 11 patients with positive scanning, 3 patients showed elevation of serum acid phosphatase and 4 other patients showed elevation of serum alkaline phosphatase. And of the others with negative scanning, 1 patient showed elevation of acid phosphatase and elevation of alkaline phosphatase in 3 other patients.

The Diagnostic Value of Bone Scan and Serum Phosphatase Level for the Early Detection of Bone Metastasis of the Urogenital Tumors / 대한비뇨기과학회지

22 patients with proved urogenital malignancies was done to determine the value of bone scanning versus roentgenographic skeletal survey in assessing the degree of metastatic involvement with serum phosphatase level. Findings on bone scans were positive in 11 patients and in 6 patients of these patients results of radiologic of radiologic skeletal survey were negative. Of these 11 patients with positive scanning, 3 patients showed elevation of serum acid phosphatase and 4 other patients showed elevation of serum alkaline phosphatase. And of the others with negative scanning, 1 patient showed elevation of acid phosphatase and elevation of alkaline phosphatase in 3 other patients.

A Clinical Obervation on the Sarcoma of Bladder and Prostate / 대한비뇨기과학회지

Sarcoma of prostate and bladder is rare malignant disease and its prognosis is very poor because of rapid growing tendency. Recently the combined treatment of surgery, radiotherapy and chemotherapy has increased the survival rate, significantly A clinical observation and retrospective analysis were made on 9 patients with primary sarcoma of bladder and prostate which were admitted during the period of 8 years and 8 months from January. 1971 to August, 1979. The results obtained were as follows: 1. The age distribution ranged from 2 years to 51 years and the prostate sarcoma was most common in the young age group upto 15 years. 2. The presenting symptoms were dysuria in 6 patients (67%), acute urinary retention in 4 patients(44%), hematuria in 3 patients(33%), frequency in 2 patients(22%), G-I symptoms were also noticed in 4 patients(44%). 3. The histologic types were 6 rhabdomyosarcoma. 1 leiomyosarcoma, 1 liposarcoma and 1 lymphoma. 4. Among 2 cases in which metastasis was confirmed, lung and liver were the sites of metastasis in a prostate rhabdomyosarcoma and the cervical lymph node in a bladder lymphoma. 5. Four patients of 9 prostate and bladder sarcomas were treated with surgery and/or chemotherapy and/or radiotheraphy. Of these, 1 patient is alive 4 months since surgery to date, 2 patients died within l year and 1 patients is presumed dead.

A Clinical Observation on 28 Cases of Hypernephroma / 대한비뇨기과학회지

Although, renal carcinoma represent 2 to 3% of all human cancers, the impredictable nature, and unique clinical and biological features of renal carcinoma place it among the most interesting of human malignancies. Total surgical excisions offers the only certain cure for nephrocarcinoma, but additional benefit may be achieved by utilization of adjuvantive methods including surgical excision of metastasis, radiation, chemotherapy, and immunotherapy. So, 28 patients with renal cell carcinoma were analyzed retrospectively in order to 1) determine the effectiveness of systemic chemotherapy-hormonal and non-hormonal, 2) identify the clinical features of renal cell carcinoma that may be important in prognosis and 3) characterize the paraneoplastic features of renal cell carcinoma. The classic triad of signs and symptoms including pain, hematuria, and palpable tumor mass presents in only 7%. Paraneoplastic syndrome occurred in up to 28.6% Metastasis was present at diagnosis in 25 % of the cases and developed within 1 year in an additional 10.7%. Surgery was employed to 23 patients for the purpose of complete cure of the disease or palliation and adjuvantive therapy was employed either to palliate symptoms or to attempt eradication of metastatic deposits to 9 patients with or without surgery. Most of metastatic disease was unresponsive objectively to either primary nephrectomy or to a variety of chemotherapy trial. Improving diagnostic capabilities and the introduction of more sophisticated diagnostic equipment promise to provide still earlier identification of patients with renal cell carcinoma and to allow surgical intervention at curable stages of disease.

Overall Clinical Statistics in the Urology Department of Seoul National University Hospital for the Past 24 Years (1954~1977) / 대한비뇨기과학회지

A clinical and statistical observation was made on out-patients and in-patients admitted to the Department of Urology, Seoul National University Hospital for the past 24 years from 1954 to 1977. The observations were summarized as follows. 1. During the period, the total number of out-patients was 63,438 and that of in-patients, 6,028. 2. In the out-patients, lower urinary tract infections such as urethritis and prostatitis were the most common diseases regardless of the time period. 3. In the in-patient, the frequency of the disease has been changed with the lapse of time in the order of the occurrence. The interesting changes of the disease order related to the time period were noted as follows. 1954-1960 : genitourinary tuberculosis, urolithiasis, tumor, injury and congenital anomaly. 1961-1970 : urolitiasis, tumor, genitourinary tuberculosis, injury, infection and congenital anomaly. 1971-1977 : tumor. urolithiasis, genitourinary tuberculosis, congenital anomaly, injury and infection. 4. In 1977, 10 major diseases were tumor, ureteral stone, infertility, renal tuberculosis, B. P. H. hypospadias, varicocele, renal stone, scrotal injury and renal tumor 5. Major operations were performed on 4,122 cases during the period. Nephrectomy and ureterolithotomy were the most common operations. Recently, total cystectomy with ileal loop diversion, transurethral procedure and vasovasostomy, which require more skillful techniques, are increasing in number.

A Clinical Observation 20 Cases of Ureteroileocutaneostomy / 대한비뇨기과학회지

A Clinical observation on 20 cases of ureteroileocutaneostomy was made who had been admitted to the Dept. of Urology from March 1, 1973 to August 31, 1977. 1. The most common underlying disease was bladder carcinoma, and only one case was neurogenic bladder. 2. Among the patients only one case was undertaken original Bricker's operation, and the others were by the modified conjoined ureteroileocutaneostomy. 3. Major complications were incisional hernia, ureteroileal obstruction, sepsis and stoma hernia with ureteral obstruction. 4. In the patient with unilateral ureteroileal obstruction, hypertension was corrected after nephrectomy.