The Outcome of Endourologic Treatment for Benign Ureteral Strictures / 대한비뇨기과학회지

PURPOSE: We reviewed the results of endoureterotomy and balloon dilation for benign ureteral strictures to determine the efficacy of these procedures. MATERIALS AND METHODS: We treated 19 patients who had benign ureteral stricture by retrograde endoureterotomy or balloon dilation followed by placement of a 6-8Fr stent for 6 weeks. Mean follow up period was 14 months (6-27 months). Eight patients were treated by endoureterotomy using cold knife under direct vision and 11 patients were treated by balloon dilation. The causes of ureteral strictures were abdominal surgery in 8 patients, urinary tuberculosis in 6 patients, radiation therapy in 2 patients, rigid ureteroscopy in 2 patients and periureteral abscess in 1 patient. The length of strictures was shorter than 1cm in 14 patients and over 1cm in 5 patients. The etiology of strictures was ischemic origin in 11 patients and nonischemic in 8 patients. One patient had poor ipsilateral renal function (<25%). RESULTS: The overall success rate was 78.9% (15/19). The success rate of balloon dilation was 81.8% (9/11) and that of endoureterotomy was 75% (6/8). No significant complication such as high fever or sepsis was observed. Strictures shorter than 1cm had 92.9% (13/14) success rate while strictures over 1cm had 40% (2/5) success rate (p <0.05). The nonischemic strictures had better success rate (87.5%) compared to ischemic strictures (72.7%) without statistical significance. CONCLUSIONS: We would suggest the use of balloon dilation or endoureterotomy as the initial treatment of benign ureteral stricture regarding the safety and efficiency. The better outcome would be expected in the strictures shorter than 1cm in length.

Significance of Expressions of bcl-2 and p53 Protein as the Prognostic Factor in Metastatic Prostate Adenocarcinoma / 대한비뇨기과학회지

PURPOSE: We investigated the significance of bcl-2 and p53 protein expressions as the prognostic factor in metastatic prostate adenocarcinoma. MATERIALS AND METHODS: Nineteen paraffin-embedded prostatic cancer tissues were examined using immunohistochemical staining for bcl-2 and p53 protein. We evaluated correlation of bcl-2 and p53 protein expressions with cancer progression free interval, pretreatment PSA and Gleason score. RESULTS: Seven out of 19 cases (36.9%) were positive for p53 and 3 cases (15.8%) were positive for bcl-2 protein. Mean disease progression free interval in positive patients for bcl-2 and p53 protein expressions was 8.7 months and 10.3 months, respectively. However, it was 18.3 months and 21 months in negative expressions, respectively. The difference of mean disease progression free interval between positive and negative groups for p53 protein expression was statistically significant (p<0.05) but not in bcl-2 protein groups. The rates of positive staining for bcl-2 and p53 protein were 0% (0/8) and 37.5% (3/8), respectively, in Geason score 5-7 groups, 27.3% (3/11) and 36.4% (4/11) in 8-10 groups. Neither of proteins had significant correlation with Gleason score and pretreatment PSA. CONCLUSIONS: The expression of p53 protein was correlated with significant short disease progression free interval but bcl-2 overexpression had relative short disease progression interval without statistical significance. These results suggest that expressions of bcl-2 and p53 have considerable prognostic impact and these gene products would provide useful information about prognosis of metastatic prostate adenocarcinoma.

Massive Inguinal Bladder Hernia into the Scrotum / 대한비뇨기과학회지

It is generally accepted that 1-3% of all inguinal hernias involve the bladder. However herniation of the bladder deep into the scrotum is rare. We report a case of massive bladder hernia of paraperitoneal type in a 58-year-old male with scrotal pain and palpable scrotal mass. Treatment consisted of partial cystectomy and herniorrhaphy. The postoperative result was good without complications.