A Testicular Tumor Incidentally Found after Trauma / 대한비뇨기과학회지

A testis tumor is comparatively rare and most of them are discovered as a palpable asymptomatic mass. We recently experienced two cases of incidental testicular tumor during scrotal exploration for trauma. Pathologic study revealed a mixed germ cell tumor and mature teratoma, so we report here on these two cases with a review of the related literatures.

A Testicular Tumor Incidentally Found after Trauma / 대한비뇨기과학회지

A testis tumor is comparatively rare and most of them are discovered as a palpable asymptomatic mass. We recently experienced two cases of incidental testicular tumor during scrotal exploration for trauma. Pathologic study revealed a mixed germ cell tumor and mature teratoma, so we report here on these two cases with a review of the related literatures.

The Change of Continence Indices after Tension Free Vaginal Tape Procedure / 대한비뇨기과학회지

PURPOSE: This study was performed to assess the difference of the continence indices before and after the tension-free vaginal tape procedure (TVT). MATERIALS AND METHODS: We reviewed retrospectively our experience with 30 patients treated with the TVT procedure for stress urinary incontinent women, between January 2002 and December 2003. A comprehensive medical history, physical examination, urinalysis, urine culture, voiding diary, uroflometry and cystourethrogram were performed preoperatively and 3 months after surgery. The positions and mobilities of the bladder neck and the urethra were compared preoperatively and postoperatively by cystourethrograms both at rest and during voiding. The surgical outcomes were evaluated by global satisfaction question, and the definition of success or failure determined by using Stamey's criteria. Multiple parameters, with regard to the uroflometry, and cystourethrogram were analyzed using chi-square tests. RESULTS: In the 30 patients followed up, the TVT procedure was successful in 93.3% (cured 83.3%, improved 10%) 3 months after the procedure. The position and mobility of the bladder neck showed no significant difference before and after surgery, but significant change in the urethral knee angle in cured and improved patients during maximum straining was noted cystourethrographically on cured and improved patients during maximum straining. The preoperative peak flow rates and average flow rates were significantly decreased after surgery, but the residual urine was not. There were no serious complications related to the procedure. CONCLUSIONS: The TVT procedure is an effective surgical procedure for the treatment of female stress urinary incontinence. The procedure seems neither to change the hypermobility nor to elevate the position of the bladder neck. Urinary continence after surgery is most probably achieved by creating a dynamic mid urethral kinking at stress.

The Therapeutic Effect of TUNA for the Treatment of BPH Based on Pressure-flow Studies / 대한비뇨기과학회지

PURPOSE: We investigated the effects of transurethral needle ablation (TUNA) in men with benign prostatic hyperplasia (BPH) using a pressure-flow study. MATERIALS AND METHODS: A total of 25 patients with symptomatic BPH, and an obstructive pattern on urodynamics, were treated with TUNA. We evaluated the patients before TUNA treatment using the International Prostate Symptom Score (IPSS), quality of life scores (QOL), uroflowmetry, postvoid residual volume (PVR) and pressure-flow studies, for a mean of 6 months following treatment. RESULTS: At 6 months after TUNA, the IPSS decreased from a mean of 22.69 to 7.65 (p<0.01). The QOL scores improved from a mean of 4.65 to 2.13 (p<0.01). The peak flow rate and PVR improved from a mean of 8.13ml/sec to 13.79ml/sec and 98.52ml to 39.52ml (p<0.01), respectively. A reduction in the mean detrusor pressure at maximum flow rate (67.21cmH2O to 47.43cmH2O, p<0.01) and the Abrams-Griffiths number (51.39 to 20.65, p<0.01) indicated that TUNA can significantly lower bladder pressure. With the exception of one patient, no patient complained of any severe side effects. CONCLUSIONS: In patients with BPH, TUNA resulted significant clinical improvements, with no major complications, and slightly decreased the bladder outlet obstruction. We suggest that TUNA is a safe and effective method for treating bladder outlet obstructions due to BPH, especially, in patients at high risk of operative morbidity and mortality, and for aged patients afraid of sexual dysfunction and retrograde ejaculation.

The Therapeutic Effect of TUNA for the Treatment of BPH Based on Pressure-flow Studies / 대한비뇨기과학회지

PURPOSE: We investigated the effects of transurethral needle ablation (TUNA) in men with benign prostatic hyperplasia (BPH) using a pressure-flow study. MATERIALS AND METHODS: A total of 25 patients with symptomatic BPH, and an obstructive pattern on urodynamics, were treated with TUNA. We evaluated the patients before TUNA treatment using the International Prostate Symptom Score (IPSS), quality of life scores (QOL), uroflowmetry, postvoid residual volume (PVR) and pressure-flow studies, for a mean of 6 months following treatment. RESULTS: At 6 months after TUNA, the IPSS decreased from a mean of 22.69 to 7.65 (p<0.01). The QOL scores improved from a mean of 4.65 to 2.13 (p<0.01). The peak flow rate and PVR improved from a mean of 8.13ml/sec to 13.79ml/sec and 98.52ml to 39.52ml (p<0.01), respectively. A reduction in the mean detrusor pressure at maximum flow rate (67.21cmH2O to 47.43cmH2O, p<0.01) and the Abrams-Griffiths number (51.39 to 20.65, p<0.01) indicated that TUNA can significantly lower bladder pressure. With the exception of one patient, no patient complained of any severe side effects. CONCLUSIONS: In patients with BPH, TUNA resulted significant clinical improvements, with no major complications, and slightly decreased the bladder outlet obstruction. We suggest that TUNA is a safe and effective method for treating bladder outlet obstructions due to BPH, especially, in patients at high risk of operative morbidity and mortality, and for aged patients afraid of sexual dysfunction and retrograde ejaculation.

Correlation of Voiding Dysfunction with the Lesion Site of Cerebrovascular Accident / 대한비뇨기과학회지

PURPOSE: Cerebrovascular accident is a serious neurological event, it can have temporary or permanent effects on survivors, including memory, cognition and volitional control of voiding. However, the correlation between the brain lesion site and type of voiding dysfunction is less well understood. This study was performed to evaluate the type of voiding dysfunction on the anatomic lesion of brain in patients with urinary symptoms after a cerebrovascular accident. MATERIALS AND METHODS: Urodynamic evaluation was undertaken in 74 patients who had suffered from voiding dysfunction. Computerized tomography(CT) and magnetic resonance imaging(MRI) were performed to localize the lesion in central nervous system. RESULTS: Damage to basal ganglia and/or internal capsule(6 of the 11 patients) and cerebral cortex(12 of the 21 patients) showed frequent detrusor hyperreflexia, while multiple lesion(21 of the 39) exhibited frequent detrusor areflexia. Uninhibited relaxation of sphincter in detrusor hyperreflexia was only observed in cerebral cortex lesion. CONCLUSIONS: Correlation of bladder dysfunction with the anatomical lesion of cerebrovascular accident was not conclusive, but was suggestive of directions to be taken in the future studies for the improvement of the life quality and preservation of renal function

A Change of Serum Prostate Specific Antigen Correlated with Clinical Status of Prostate Cancer Patient / 대한비뇨기과학회지

PURPOSE: It has been reported that serum prostate specific antigen(PSA) generally increase in direct proportion to clinical status of prostate cancer, but some reports suggest that PSA level is not correlated with clinical stage in 10% of the patients of prostate cancer. We evaluate the value of PSA about clinical status of prostate cancer through comparing disease status and PSA of patient at initial diagnosis of prostate cancer. MATERIALS AND METHODS: A clinical study was retrospectively made on sixty patients with prostate adenocarcinoma. The patients were admitted to the Department of Urology between January of 1992 and December of 1996. Results were obtained through statistical analysis of the correlation between PSA level and clinical status by performing serum PSA, chest X-ray, bone scan, pelvic CT or pelvic MRI. At the time of the analysis patients were diagnosed with prostate adenocarcinoma pathologically. RESULTS: Mean PSA level of patients with bone metastasis and no metastasis was 125.4 and 97.89ng/m1, respectively and correlation between the two groups was not observed, so bone scan could not be replaced by measuring serum PSA. The number of hot uptake In bone scan wasn't correlated with serum PSA level. Gleason score wasn't correlated with serum PSA level. Multiple comparisons in groups which were classified by bone metastasis and lymphatic metastasis had no statistical significance. CONCLUSIONS: As the result of the above observations, we predict that there is a problem in evaluating clinical status with PSA as compared with the value at initial diagnosis or as a predictor of recurrence in patients with radical prostatectomy.

Clinical Study of Stage I Renal Cell Carcinoma / 대한암학회지

PURPOSE: This study was attemped to investigate the prognostic factors for the outcome of stage I renal cell carcinoma after radical nephrectomy. MATERIALS AND METHODS: Twenty nine patients treated from 1984 to 1995 at Kyung Hee University Medical Center were studied retrospectively. All of them were diagnosed with pathologic Robson stage I renal cell carcinoma after radical nephrectomy. RESULTS: Males were affected three times more frequently than females. The tumor was detected on the right kidney in 15 cases, and on the left in 14. Average follow up period was 36.6 months, average disease free interval was 29.4 months and median survival was 30 months. During the follow up, 9 patients (31.0%) expired due to liver and lung metastasis at postoperate 21.6 months on average. Eleven patients (37.9%) developed distant metastasis in the follow up. There was no local recurrence of tumor. Seventeen patients were diagnosed incidentally without clinical symptoms. In our retrospective study for stage I renal cell carcinoma, there were no predictive prognostic parameters for predicting the outcome of patients, except for the incidental diagnosis of the tumor. CONCLUSIONS: These results suggest that incidental diagnosis of the tumor may be the most important prognostic factor for the outcome of stage I renal cell carcinoma. Although the patients were confirmed as stage I renal cell carcinoma pathologically after radical nephrectomy, close follow up is very important, because of high incidence of metastasis. We recommand that chest X-ray, abdominal ultrasonogram and bone scan should be checked at 3 months interval for postoperative one year even though stage I renal cell carcinoma.

Foreign Body Induced Bladder Stone After Bladder Neck Suspension: A Case Report / 대한비뇨기과학회지

Bladder stone formation may be associated with the intravesical foreign body. Frequency of bladder foreign body in female is less than male. We present a case of bladder stone formation for nylon suture materials in a 47-year-old female patient who has been treated by bladder neck suspension for stress incontinence. Patient was successfully treated by surgical removal of suture materials without recurrence of stress incontinence.