Prevalence of Varicocele in Adolescents and Effect of Varicocele on the Testicular Volume / 대한비뇨기과학회지

PURPOSE: The aim of this study was to estimate the current prevalence of varicocele and their effect on the testicular volume. MATERIALS AND METHODS: The relationship between testicular volume and the degree of varicocele, as classified by Dubin-Amelar, was evaluated in 1,281 Korean school boys, between 15 and 18 years of age. All examinations were carried out by a single urologist, and the testicular volume was measured in the upright posture using a Prader's orchidometer. All the boys were assessed for their previous medical history, family history. RESULTS: There was a 12.9% prevalence of varicocele in the adolescents. The mean testicular volume in the control groups was 14.29+/-2.10ml on the left and 14.45+/-2.13ml on the right. Patients with left varicocele had a testicular volume of 13.09+/-2.34ml on the left and 13.24+/-2.32ml on the right. The testicular volume of patients with a grade I varicocele were similar to those in the control group. Patients with grade II and III varicoceles had significantly smaller testes than the control groups. CONCLUSIONS: The reduction in testicular volume due to a varicocele correlated with the severity of the varicocele grade. Careful evaluation for testicular volume loss, and early surgical intervention, should be offered to adolescent patients with varicoceles.

Prevalence of Varicocele in Adolescents and Effect of Varicocele on the Testicular Volume / 대한비뇨기과학회지

PURPOSE: The aim of this study was to estimate the current prevalence of varicocele and their effect on the testicular volume. MATERIALS AND METHODS: The relationship between testicular volume and the degree of varicocele, as classified by Dubin-Amelar, was evaluated in 1,281 Korean school boys, between 15 and 18 years of age. All examinations were carried out by a single urologist, and the testicular volume was measured in the upright posture using a Prader's orchidometer. All the boys were assessed for their previous medical history, family history. RESULTS: There was a 12.9% prevalence of varicocele in the adolescents. The mean testicular volume in the control groups was 14.29+/-2.10ml on the left and 14.45+/-2.13ml on the right. Patients with left varicocele had a testicular volume of 13.09+/-2.34ml on the left and 13.24+/-2.32ml on the right. The testicular volume of patients with a grade I varicocele were similar to those in the control group. Patients with grade II and III varicoceles had significantly smaller testes than the control groups. CONCLUSIONS: The reduction in testicular volume due to a varicocele correlated with the severity of the varicocele grade. Careful evaluation for testicular volume loss, and early surgical intervention, should be offered to adolescent patients with varicoceles.

Recurrent Priapism Associated with Splenectomy / 대한비뇨기과학회지

Priapism is a prolonged erection of the corpus cavernosum that is unaccompanied by sexual desire. It has been classified into 2 main groups: primary (idiopathic) or secondary. The common conditions associated with a secondary priapism include sickle cell anemia, trauma, leukemia, a cancerous invasion of the penis, drugs, alcohol ingestion, various venous thromboembolic diseases, intravenous fat for parenteral nutrition, and other less common disorders.1 A splenectomy has not been previously identified as a predisposing factor except for a report of 3 cases of priapism who underwent a splenectomy.2 We experienced a case of recurrent priapism following a splenectomy that developed in 30 years old man.

Recurrence According to Grade after BCG Intravesical Therapy in Stage T1 Bladder Cancer / 대한비뇨기과학회지

PURPOSE: We compared the recurrence rate and mean interval to recurrence according to tumor grade after complete transurethral resection and adjuvant intravesical instillation with bacillus Calmette-Guerin (BCG), in patients with stage T1 transitional cell carcinoma of the bladder. MATERIALS AND METHODS: Between January 1994 and May 2000, 31 patients presenting to our hospital with T1 superficial bladder cancer received adjuvant intravesical instillation with BCG after complete transurethral resection of the bladder tumor. Tumors with CIS lesion or recurrent tumors were excluded. The recurrence rates, mean interval to recurrence, tumor size and number of tumors were compared according to tumor grade. RESULTS: Of the 31 patients, 5 presented with grade I tumor, 17 with grade II tumor and 9 with grade III tumor. Mean follow-up period was 22 months (range 6-58) and mean tumor sizes according to tumor grade were 1.6, 1.6 and 1.7cm in grade I, II and III, respectively. Twelve (38.7%) patients experienced tumor recurrence. The recurrence rates according to tumor grade were 20.0%, 41.2% and 44.4% in grade I, II and III, respectively. Mean interval to recurrence were 40, 11.4 and 7.5 months, respectively. CONCLUSIONS: Our results suggest that the recurrence rates were higher in grade II and III tumors than in grade I tumor. Therefore close follow-up is necessary in both grade II and III tumors.

Expression of p21(waf1/cip1) Protein in Bladder Cancer and its Prognostic Value / 대한비뇨기과학회지

No abstract available.

A case of Malignant Peripheral Nerve Sheath Tumor Near Left Inguinal Region / 대한비뇨기과학회지

No abstract available.

The Clinical Observation on 67 Cases of Renal Injury by Blunt Trauma with Conservative Treatment / 대한비뇨기과학회지

No abstract available.

The Usefulness of New Diagnostic Criteria on Color Doppler Ultrasound for Varicocele Diagnosis / 대한비뇨기과학회지

No abstract available.

A case of Renal Angiomyolipoma in a Child without Evidence of Tuberous Sclerosis / 대한비뇨기과학회지

Angiomyolipoma is a rare benign tumor and approximately 20 to 50% of patients with the diagnosis of angiomyolipoma have some or all of the other stigma of tuberous sclerosis. Patients with tuberous sclerosis tend to be younger, more likely to have multifocal and bilateral disease. Angiomyolipoma which is not associated with tuberous sclerosis mostly affects middle aged women. According to literature data, angiomyolipoma is very rare in child and almost exclusively associated with tuberous sclerosis. We report a case of 14 year-old girl who has a renal angiomyolipoma without clinical evidence of tuberous sclerosis.

Enuresis and Urine Concentration in Healthy Preschool Children / 대한비뇨기과학회지

PURPOSE: To determine if the urine specific gravity(SG) plays a role in enuresis, the first morning urine SG of the healthy preschool nocturnal enuretic was compared with that of the nonenuretic. The results of desmopressin were analyzed according to the pretreatment urine SG to know if the urine SG can predict the responsiveness of the medication. MATERIALS AND METHODS: Five hundred twenty healthy preschool children aged 3-6 years were entered in this prospective observer-blinded study. A comparison was made between SG of the first morning urine specimen and results of questionnaire concerning the bed wetting and voiding habits of children. The responsiveness to oral desmopressin(0.2-0.4mg h.s.) in 14-day treatment periods was also analyzed according to the urine SG in 28 children with enuresis. The responder group was defined as a reduction of at least 50% from the number of wet night. RESULTS: The incidence of enuresis was 8.6 percent. Stastistically significant difference was found between the bedwetter and nonbedwetter group with regard to the urine SG(p<0.05). The overall response rate of desmopressin was 68 percent. There was no significant difference between the responder and nonresponder group with respect to urine SG. CONCLUSIONS: The first morning urine of the enuretic showed higher probability of lower level of the SG than that of the nonenuretic. Treatment with desmopressin was associated with a significant decrease in the number of wet night, but clinical response was not predictable based on the first morning urine SG.

Diagnostic Value for Early Detection of Prostate Cancer of the Digital Rectal Examination, Serum Prostate Antigen and Transrectal Ultrasonography / 대한남성과학회지

PURPOSE: There diagnostic modalities have been commonly used to detect prostate cancer to date: digital rectal examination (DRE), serum prostate specific antigen (PSA) and transrectal ultrasonography(TRUS). We evaluated the diagnostic values of these three modalities in the early detection of prostate cancer. MATERIALS AND METHODS: We analysed 215 patients with low urinary tract symptoms who had pathologic diagnosis for prostatic cancer was possible by biopsy or transurethral resection. Transectal ultrasonography guided sextant biopsies were performed if the PSA level was greater than 4.0 ng/ml or DRE was suspicious, even if TRUS revealed no ateas suspicious for cancer. TURP were performed without TRUS or biopsies if the PSA level was lesser than 4.0 ng/ml and DRE was negative. RESULTS: Of the 215 patients, 36 (16.7%) revealed prostate cancer. Positive predictive value, sensitivity and specificity was 37.0%. 83.3%. 71.5% for DRE, 30.0%, 91.7%, 58.3% for PSA and 27.6% 58.3%. 43.3% for TRUS respectively. Positive findings on serum PSA or DRE or both tests detected significantly more tumors(97.2%, 35of 36 cancers) than only PSA (91.7%, 33 for 36 cancers), DRE (83.3%, 30 of 36 cancers) and TRUS (60.0%, 21 of 35 cancers) alone. CONCLUSIONS: These result shows that DRE is more valuable and cost effective method for detection of prostate cancer than serum PSA and the use of DRE in conjunction with serum PSA enhances prostate cancer detection.

False Negative of Doppler Ultrasonography During Testis Torsion in Animal Model / 대한비뇨기과학회지

PURPOSE: Our aim is to identify the false negative rate of doppler ultrasonography and to compare color doppler ultrasonography with pathologic findings during testis torsion in animal model. MATERIALS AND METHODS: Seventeen male house rabbits weighted 1.9-2.6kg were examined with doppler ultrasonography as control group and 1 rabbit was orchiectomized as pathologic control group. In 16 rabbits, right spermatic cord was torqued 720o count-clockwise and placed back into the scrotum, and 1, 3, 6, 9, 12, 18, 24, 48 hours after torsion, doppler ultrasonographic and pathologic findings were examined at twisted testicles. RESULTS: In 1 hour and 3 hours group, false negative rate of doppler ultrasonography were 100% and 6 hours after torsion false nagative rate was 63%. Nine hours after torsion false negative rate was 50%, 12 hours after torsion false negative rate was 25%. But after 18 hours group, all had decreased or disappeared blood flow. Before 9 hours after torsion, there was no pathologic changes in seminiferous tubules. In seminiferous tubules, number of spermatid decreased in 12 hours group and spermatid was absent and spermatocyte were markedly degenerated in 18 hours group. In 48 hours group, spermatid and spermatocyte were absent, number of Sertoli cell decreased markedly and diffuse infarction were seen. CONCLUSIONS: As time goes by, false negative rate of doppler ultrasonography was decreased. So if blood flow have been normal when doppler ultrasonography was done before 12 hours after torsion, doppler ultrasonography should be re-examined in suspected testis before 12 hours after torsion because of spermatocytes are degenerated after 12 hours.

A Case of Primary Amyloidosis of the Bladder / 대한비뇨기과학회지

Amyloidosis is characterized by deposition of homogenous, eosinophilic, hyaline material in various tissues. Presently, most cases occur in a generalized form as a manifestation of an underlying plasma cell neoplasm(myeloma) or plasmacytic dyscrasia. On the other hand, most cases of symptomatic amyloid disease in the urinary bladder has occurred as an apparently solitary, localized tumefactive process and mimicks invasive bladder tumor. We report a case of primary amyloidosis of the bladder which was diagnosed after transurethral resection in a 65-year-old man with chronic renal failure.

Penile Paraffinoma: 42 Cases / 대한남성과학회지

PURPOSE: Penile paraffinoma provokes many serious undesirable effects. We studied our series retrospectively to evaluate the outcome of surgical treatment according to the degree of penile skin defect after excision of the lesion. PATIENTS AND METHODS: Surgical treatment for penile paraffinoma was performed in 42 patients over 6 years. The operative methods were complete excision with primary closure (N=34) or bilateral pedicle scrotal flap (N=8). RESULT: The complications of bilateral pedicle scrotal flap were wound infection in 1 case and skin defect in 1 case. There were no complications of primary closure. CONCLUSIONS: We propose that the proper treatment of penile paraffinoma is complete excision with primary closure for a small denuded penis and bilateral pedicle scrotal flap for a large denuded penis.

Effects of Electrohydraulic Lithotripsy on the Rabbit Bladder According to the Distance / 대한비뇨기과학회지

Currently many modalities are available for intracorporeal stone fragmentation. Among them electrohydraulic lithotripsy destructs stone by the effects produced when An electric discharges occurs in a liquid medium. Though electrohydraulic lithotripsy fragments all kinds of urinary calculi effectively, the major limitation of electrohydraulic lithotripsy remains the potential for urothelial injury. The objective of the present study is to evaluate the possible acute and long-term tissue effects of this instrument on the rabbit bladder. The tissue effects produced by a electrohydraulic lithotripsy were examined and compared. In all acute animals, visible mucosal lesions were seen at the site of probe firing in the bladder except the minor of 3millimeter-distance group. No significant long-term tissue effects were noted either grossly or pathologically in the 3-week animals. This study confirms our clinical impression that electrohydraulic lithotripsy can provide an efficient and safe modality of intracorporeal lithotripsy through proper patient selection and careful attention to technique.

A Case of Eccrine Acrospiroma in Scrotum / 대한비뇨기과학회지

Acrospiroma is a rare benign tumor and a clinicopathologically distinctive neoplasm differentiating toward the distal part of the eccrine sweat gland. I experienced a case of dermal acrospiroma in a 59-year-old man who had a 7.0x6.5 x 5.3 cm sized, slowly growing, brown colored, smooth-surfaced mass on the right scrotum for 3 years. Histological examination revealed lobular structures composed of small fusiform cells and large eosinophilic polyhedral cells. Histochemically some of large polyhedral cells had PAS-positive DPAS-negative glycogen and Alcian-positive mucin in cytoplasm. Immunohistochemical stainings for vimentin, S-100, low molecule keratin, and EMA were positive in the tumor cells. During 6 months follow up period after excision, there was no recurrence. However, it is necessary to follow up for a long period because some acrospiroma may recur after a long silence period.

A Case of Ectopic Ureterocele Associated with Reflux into the Ureterocele / 대한비뇨기과학회지

Ureterocele is a cystic dilatation of the intravesical segment of the ureter. In the ectopic ureterocele the ureteral orifice opens at a point other than its normal upper pole position, usually at the bladder neck or in the urethra, and is commonly associated with the upper moiety of a duplicated collecting system. Reflux into the ipsilateral lower pole ureter occurs in almost 50 per cent of ectopic ureterocele. But reflux into the ureterocele is rare. Recently we experienced a case of ectopic ureterocele associated with reflux into the ureterocele and treated successfully by heminephrectomy and total ureterectomy.

Serum Prostate Specific Antigen. Clinical Assessment as a Tumor Marker for the Prostate Cancer / 대한비뇨기과학회지

We evaluated a clinical usefulness of prostate specific antigen (PSA) as a tumor marker for prostate cancer. Serum PSA values were obtained from 32 patients with prostatic adenocarcinoma(group I ),81 with histologically diagnosed BPH(group II ) and 147 with clinically diagnosed BPH(group III). Mean PSA values were 121.5, 9.3 and 3.6ng/ml, respectively. To enhance the accuracy of serum PSA, we have used the quotient of serum PSA and prostatic volume, PSA density. In group I, 31 patients(97%) had PSA values over 10ng/ml and PSA density over 0.15. In group II, 27 patients(33%) had PSA values over 10ng/ml and 35(43%) had PSA density over 0.15. The PSA values of extraprostatic cancer were higher than that of organ-confined cancer in group I (p 0.05). Of 18 patients with stage D2 prostate cancer treated with orchiectomy, 11 had PSA values decreased to normal range within 6 months. Serum PSA values of 2 patients who have clinically progressive disease were increased after 6 months. In 3 of 4 patients treated with radiotherapy during follow-up of 18 months, post irradiation PSA values were 2.4, 5.6 and 11.2ng/ml, respectively. Only 1 patient who have a positive bone scan had an elevated PSA value of more than 100ng/ml. We suggest that serum PSA is not a excellent marker on screening test for prostate cancer because of a high false positive rate. However, PSA is useful for following disease progression, response to therapy and determining indication of bone scan.

Significant Issues Derived from the Choice of a PSA Test for Measuring PSA in Serum: Comparison of IMx Enzyme immunoassay and ELSA Immunoradiometric Assay / 대한비뇨기과학회지

Prostate specific antigen (PSA) has become established as the most useful serological marker for monitoring patients with prostate cancer. However, the benefits of serum PSA values are controversial in screening procedures for prostate cancer due to the rather low specificity of PSA test. To determine if different assays yield comparable results, we compared the IMx PSA enzyme immunoassay and the ELSA PSA monoclonal immunoradiometric assay. We analyzed 72 serum specimens from 68 patients with prostatic disease (12 patients with cancer, 47 benign hyperplasia and 9 prostatitis) and 13 from normal controls by both assays. Results from the assays revealed close linear correlation but the ELSA PSA assay yielded values 1.5 times those of the IMx PSA assay In 13 patients with histologically diagnosed benign prostatic hyperplasia, number of patient with PSA value over l0 ng/ml measured by IMx and ELSA assay were 2(15% ) and 4(31%), respectively. We conclude that the proportional bias between assays demonstrates a need for improved standardization of PSA assays.

Cohen Ureteral Reimplantation: Outcome of 58 Ureters in 34 Children / 대한비뇨기과학회지

Surgical results of 34 children (68 ureters) who underwent Cohen ureteral reimplantation in the last 6 years were evaluated. All children were followed at least 4 months after the operation. Indication for the repair consisted of vesicoureteral reflux in 22 children, obstructive megaureter in 8 children and ureterocele in 4 children. The underlying problems in 55 ureters ( 94.8% ) were successfully corrected. Surgical failures were persistent reflux in 2 ureters, new ipsilateral reflux in 1 ureter and contralateral reflux in 1 ureter. However, no ureteral obstruction was noticed in this series. In conclusion, the Cohen cross trigonal technique was a safe and effective method of ureteral reimplantation in children.