The Effect of Piezoelectric Extracorporeal Shock Wave on Immature Rat Testis / 대한비뇨기과학회지

PURPOSE: The extent of ESWL(Extracorporeal Shock Wave Lithotripsy), a treatment for urinary calculus, shows gradual development and the treatment has become generally known as a noninvasive, safe, and efficacious method. Although the testicular effects are not within the vicinity of shock waves in carrying ESWL as a treatment for urinary calculus, research was initiated to examine effects which shock waves might cause on the testis. MATERIALS AND METHODS: After applying shock waves at intensity 4 for 1,000 times to the testis of Sprague Dawley immature rat, the histopathologic changes within the tissue of testis were observed after 1, 7, 14, 28 days, respectively. RESULTS: In the case of the experimental group having shock waves on the testis, destruction of seminiferous tubules, necrosis, and hemorrhage were found out a%or a day. One week later the atrophy of seminiferous tubules, interstitial fibrosis, and a small portion of chronic inflammatory cell appeared The capillary proliferation near the testis capsule also appeared. Two weeks later somewhat atrophied seminiferous tubules and proliferation of Leydig cells appeared. Diversely atrophied seminiferous tubules, diffusion of Leydig cell proliferation, calcified tubules, and foreignbody reaction were discovered after 4 weeks. As times went on, the tendency of recovery appeared. CONCLUSIONS: Noxious influences such as testicular atrophy and disturbance of spermatogenesis occurred in inflicting immediate shock wave on the testis. Therefore the need of more researches concerning long-term sequelae and the influences on the human body should be taken into consideration.

A Case of Vesical Dome Transitional Cell Carcinoma Resembling Urachal Carcinoma / 대한비뇨기과학회지

Vesical dome tumors are classified, according to their origin, as either vesical or urachal. A case of vesical dome tumor was diagnosed as an urachal carcinoma preoperatively because CT scan and cystoscopic findings were suitable to the diagnostic criteria of urachal carcinoma, but the transurethral biopsy result was transitional cell carcinoma (TCC). The final histopathologic report after extended partial cystectomy revealed that the tumor was originated from vesical mucosa and an intact urachal remnant was found around the resected mass. In a tumor situated on the midline of bladder dome, a transurethral biopsy before curative operation is essential.

Efficacy of the Preliminary Ultrasonographic Examination before Suprapubic Cystostomy by Trocar / 대한비뇨기과학회지

Suprapubic cystostomy by trocar is a simple, safe and useful method for urinary diversion in acute urinary retention. But rarely, severe complications occur during or after suprapubic cystostomy such as bowel perforation, through and through perforation of the bladder, rectal injury and severe hematuria. We studied the complications of suprapubic cystostomy retrospectively and compared 19 patients who performed ultrasonographic examination with 30 patients without ultrasonographic examination. The complications in 30 patients without preliminary ultrasonographic examination were initial failure in 4 cases (13.3%), extravesical Foley indwelling in 2 cases (6.7%), puncture site closed to the pubic bone in 2 cases (6.7%), spontaneous bladder rupture in 1 case (3.3%) and bowel injury in 1 case (3.3%). But, the complication in 19 patients with preliminary ultrasonographic examination was only 1 retried case (5.3%) because of extravesical Foley indwelling. As above results, the brief preliminary ultrasonographic examination of the bladder is a very useful method with minimal risk during suprapubic cystostomy by trocar.

The Role of Ultrasonography in Blunt Testicular Trauma / 대한비뇨기과학회지

The ultrasonographic features in 26 cases of blunt testicular trauma were reviewed. Ultrasonography diagnosed correctly in 11 surgically proven cases of testicular rupture. There were three false-positive cases, two with a large scrotal hematocele and one with epididymis rupture. there were no false-negative cases. The sensitivity and specificity of ultrasonographic diagnosis were 100% and 80% respectively. The positive and negative predictive values were 78. 6% and 100% respectively. Therefore, the negative diagnosis by ultrasonography can warrant conservative therapy.

Effect of Adenosine on Penile Erection in Rats / 대한비뇨기과학회지

We designed this study to investigate the effects of adenosine on penile erection in Sprague- Dawley rats, in vivo. This was performed by simultaneous monitoring intracavernosal pressure( ICP) and systemic blood pressure with UROCOMPACT 6000 plus( WIEST, Germany) after intracavernosal injection of adenosine, papaverine and adenosine plus papaverine. Increment of maximal ICP was observed in the adenosine treated-group (0.015 to 0.15mg, n=30) in dose dependent manner, i.e., 15.8+/-0.95cmH2O with 0.015mg adenosine to 44.6+/-2.72cmH2O with 0.15mg adenosine, in mean ICP(n=l0, P<0.05). A similar finding was observed in the papaverine treated-group (0.015 to 0.15mg, n =30) in dose dependent manner. i.e., 28.1+/-2.88cmH2O with 0.015mg papaverine to 62.3+/-4.93cmH2O with 0.15mg papaverine, in mean ICP (n=10, P<0.05). The additive effect of adenosine plus papaverine treated-group( 0.015 + 0.015 to 0.15 +0.l5mg, n=30) was to enhance the results obtained by adenosine or papaverine alone in dose dependent manner. i.e., 50.7+/-1.71cmH2O with 0.015mg + 0.015mg papaverine to 79.5+/-5.63cmH2O with 0.15mg adenosine + 0.15mg papaverine. in mean ICP(n= 10, P<0.05). These results suggest that adenosine plays an important role on penile erection in rats. Adenosine may be useful for the future management of impotence, although the clinical effect remains to be investigated.

A Case of Nephrogenic Adenoma of the Ureter / 대한비뇨기과학회지

Nephrogenic adenoma is rare, especially in the ureter. It is thought to represent a metaplastic phenomenon forming the tubules which resemble renal tubules. The cause is unknown but may be associated with chronic irritations such as surgical trauma, incarcerated calculi and infection. We report a case of nephrogenic adenoma of the ureter in a 44-year-old woman who bad been suffered from the left flank pain due to left ureteral stone with giant hydronephrosis.

A Case of Intrascrotal Hemangioma with Spontaneous Bleeding / 대한비뇨기과학회지

Hemangiomas of the skin are common, but intrascrotal hemangioma is a rare Complications include hemorrhage, ulceration, skin infection, thromboses and phlebitis. We report a case of intrascrotal hemangioma with spontaneous bleeding.

A case of chlorpromazine induced priapism / 대한비뇨기과학회지

Priapism is a well recognized complication of some oral medications. Those most commonly cited are: antipsychotic drugs, especially the phenolhiazine: trazodone and chlorpromazine :and the antihyperlensive drugs hydralazine, guanethidine and prazocin. We report a case or priapism associated with the use of chlorpromazine who experienced 2 episodes or priapism and never experience priapism after cessation of the drug.

Problems with interpretation of primary diagnostic tests for impotence / 대한비뇨기과학회지

We analyzed the practical problems and factors which affect making the correct differential diagnosis in the interpretation or test results from the nocturnal penile tumescence (NPT) test and erotic stimulation test (EST). This was done to provide better information for higher diagnostic accuracy in the clinical application of these tests. The followings are the results of NPT tests and EST identifying the factors affecting correct differential diagnosis by comparison the other differential diagnostic methods. The overall sensitivity of NPT test (Number: 114 total patients) was 82%. 21 cases (18%) could not be diagnosed correctly due to traction of the sensor (12 cases, 10%) and sleep disturbance (9 cases, 8%). The overall sensitivity of EST (Number: 174 total patients) without considering the degree of patient`s sexual drive to erotic stimulation was 77%. 40 cases (23%) could not be diagnosed correctly due to tolerance to pornographic film (17 cases, 10 %), discomfort by the body attachments (14 cases, 8%) and traction of the sensor (9 cases, 5%). However, higher sensitivity (90%) and lower rate of incorrect diagnosis (10% ) were observed in 119 patients who showed Grade II or III (moderate to good) sexual drive to erotic stimulation. The results suggest that undesirable factors in the primary screening methods, traction of sensor, sleep disturbance in NPT test, and tolerance to pornographic film, discomfort by the body attachments, traction of sensor in EST must be taken into consideration when interpretation of test results is being performed.

Effect of acetylcholine in vivo penile erection in rat / 대한비뇨기과학회지

An in vivo study was conducted on Sprague-Dawley rat to investigate the role of acetylcholine (AChl on penile erectionAn in vivo study was conducted on Sprague-Dawley rat to investigate the role of acetylcholine (AChl on penile erection. This was performed by simultaneously monitoring intracavernosal pressure (ICP) and systemic blood pressure after intracavernosal injection of ACh. anticholinesterase (anti-ChE) or atropine. with and without cavernosal nerve stimulation. Increase of basal ICP was not observed in the group with ACh (0.01 to 0.05ug) treatment alone (n=9). However, the synergic effect of ACh (0.01 to 0.05 ug) on nerve induced erection (NIE) was to enhance the results obtained by NIE alone. i.e., 55 mmHg with NIE alone to 77 mmHg with ACh pretreatment plus NIE. in mean ICP (n=9, P<0.05). A similar finding was observed in the group with anti-ChE pretreatment (0.01 to 1.Oug). i.e., 56 mmHg with NIE along to 84 mmHg with anti-ChE pretreatment plus NIE, in mean ICP (n=14, P<0.05). Conversely, NIE was markedly reduced in the group with atropine pretreatment (0.01 to 1.0ug) in dose dependent manner, i.e., 58mmHg with NIE along to 38mmHg with atropine pretreatment plus NIE, in mean ICP (n=13, P These results indicate that ACh does play a significant role in penile erection and it may require a cooperative action of other neurotransmitter to induce in vivo penile erection.

Significant parameters of the bulbocavernosus reflex latency testing for the diagnosis of neurogenic impotence / 대한비뇨기과학회지

Measurement of the bulbocavernosus reflex is widely used to diagnose underlying neurologic disorders in erectile dysfunction. Because this single parameter of latency time in BCRL(bulbocavernosus reflex latency) testing has been used as the sole guideline to diagnose neurogenic impotence, problems in discriminating neurological disturbance from nonneurogenic impotence are frequently encountered especially when the value of latency time is within the borderline range, or when the outcome is difficult to interpret. In order to assess the useful parameters of conventional BCRL testing for the differential diagnosis of neurogenic impotence, we performed BCRL testing in 100 patients who compliance of poor erection. We compared these patients with a previously controlled group of 45 adult males without any erectile or neuronal disturbance. The results obtained were summarized as follows. . 1)Of 100 patients, 24 were diagnosed as neurogenic impotence. 2) In this neurogenic impotence group, as compared to the normal and non-neurogenic impotence group, there was a significant difference(P<0.05) in the values of sensory, pain, reflex threshold and bulbocavernosus reflex latency time. 3) The BCR measurement allowed to find lateralized neurologic disturbance. These results show that in BCRL testing the evaluated values of sensory, pain and reflex threshold, in addition to latency time, can be useful parameters for the differential diagnosis of neurogenic impotence.