Change in Penile Length in Children: Preliminary Study

PURPOSE: Studies of penile length in children have been rarely conducted. In Korea, great improvements in height and weight have been observed because of economic development over the past 25 years. We investigated the current status of penile length in Korean children and compared the results with those of a previous Korean study conducted in 1987. MATERIALS AND METHODS: The subjects in this study were 233 boys aged 1 to 158 months, each of whom had been brought to outpatient clinics between April and October 2011. Penile length was measured according to the stretched penile length (SPL) technique; testicular size was measured (in ml) by using orchidometry. A comparison of penile lengths between the current study and the 1987 study was made by using Student's t-test. RESULTS: SPL increased significantly by 0.7 to 1.1 cm in most age groups (p<0.05). Current anthropometric measures of Korean children such as height, body weight, and testicular size have increased compared with those from 1987. CONCLUSIONS: Penile length has increased significantly over the last quarter century. Therefore, it is suggested that novel reference values for penile length in prepubertal Korean children be determined in studies with a larger community-based population in order to diagnose and treat size-related penile disorders.

Holmium:YAG Laser Lithotripsy as a Treatment Modality for Ureteral Calculi / 대한비뇨기과학회지

PURPOSE: We evaluated the results of Holmium:YAG laser lithotripsy according to the size and location of the ureteral stones. MATERIALS AND METHODS: Between March 1998 and April 2007, the medical records of 203 patients who were treated with ureteroscopic Holmium: YAG laser lithotripsy due to ureteral calculi were reviewed. They were subgrouped by the size and the location of the ureteral stones. The results of treatment were evaluated by the stone free rate and the mean operation time of each group. RESULTS: The stone free rates of the upper, mid and lower ureter stone groups were 73.3%, 96.1% and 100%, respectively. There was a significant difference in the upper ureter stone group compared to the other two groups, and especially for the group with stone less than 10mm. Stone migration into the renal pelvis or calyx was a major cause of failure in the patients with upper ureter stones. 8 cases showed stone migration and 2 cases showed fragment migration. CONCLUSIONS: As Holmium:YAG laser lithotripsy has a low complication rate and a high stone free rate, it is an effective treatment modality for ureteral calculi. However, such procedures should be performed carefully because the thermal effect of the Holmium:YAG laser causes ureteral perforation, and especially in the cases of impacted or large stones. Other effective alternatives such as trapping devices need to be studied for patients with upper ureteral stones to prevent stone migration.

Renal Ruptures with Active Bleeding Treated with Emergency Selective Renal Arterial Embolization / 대한비뇨기과학회지

Selection of a treatment modality for traumatized renal rupture depends on the renal injury grade, hemodynamic stability, combined organ injury, and the physician's experience. Treatment for renal injury tends to be conservative to maintain renal function and lessen the morbidity of surgery. If renal injuries were well-staged and selected by radiologic evaluation, hemodynamically stable patients with significant injuries (grades II through V) can usually be managed without surgical exploration. We report 3 cases of grade 4 renal injuries successfully treated with selective renal arterial embolization.

The Early Experience of Video-assisted Minilaparotomy Surgery (VAMS) / 대한비뇨기과학회지

PURPOSE: Video-assisted minilaparotomy surgery (VAMS) is a hybrid of conventional open and laparoscopic surgeries, which combines the benefits of both techniques. Our initial experiences with 33 cases were analyzed to assess the feasibility of VAMS. MATERIALS AND METHODS: Between May 2004 and April 2006, a total of 33 patients underwent VAMS-radical (n=20) and VAMS-live donor nephrectomies (n=13). The results of each operation were analyzed in terms of patient age, operation time, blood loss during surgery, time of oral intake and full ambulation, post operative stay period and amount of analgesic use. RESULTS: The mean age of the patients that had undergone the VAMS- radical and VAMS donor nephrectomies were 55.9 12.4 and 36.0 8.6 years, respectively. The mean results of the VAMS radical nephrectomy and VAMS donor nephrectomy with regard to the operative time, blood losses, time to oral intake, time to ambulation, postoperative length of stay and postoperative length of analgesics use were 225+/-72 / 253+/-67 minutes, 378+/-254 / 447+/-208cc, 2.1+/-0.7 / 1.4+/-0.5 days, 2.1+/-1.1 / 1.6+/-0.7 days, 6.2+/-1.1 / 6.2+/-1.0 days and 1.7+/-0.8 / 1.6+/-0.5 days, respectively. The mean warm ischemic time of VAMS donor nephrectomy was 2.4+/-0.8 minutes. The mean operation time of the 10 earliest cases of VAMS radical nephrectomy was 283 minutes; whereas, that of the last 10 cases decreased to 166 minutes. The mean operation time of the 7 earliest cases of VAMS donor nephrectomy was 299 minutes, which decreased to 206 minutes in the last 6 cases. Complications included 3 wound extensions in 5 patients experiencing massive intraoperative bleeding, 1 pneumonia, 1 wound dehiscence and 1 postoperative bleeding, all of which occurred in the 8 earliest cases. CONCLISIONS: VAMS could be a safe and feasible minimally invasive surgical procedure as experience is accumulated; when the initial learning curve has been overcome.

Solitary Fibrous Tumor as Misdiagnosed as Bladder Cancer / 대한비뇨기과학회지

Solitary fibrous tumor(SFT) was previously named localized fibrous mesothelioma, and this is a rare mesenchymal neoplasm that usually shows benign behavior. It is the most commonly recognized tumor of the pleura. These tumors have been recently reported to be found in unexpected locations. To the best of our knowledge, there have been only 2 reports of SFT arising from the urinary bladder in Koreans. We review this third case of SFT that was misdiagnosed as bladder cancer. This tumor was removed from a 40-year-old man who had a history of lower urinary tract symptoms.

Primary Malignant Melanoma of the Male Urethra / 대한비뇨기과학회지

A primary malignant melanoma occurring within the male urethra is a very rare disease, which usually shows highly malignant potential. Due to the low incidence, the clinical features of this disease remain unclear, and the mode of treatment controversial. Herein, we report a case of a malignant melanoma of the male urethra in a 77 year old man, who was managed by transurethral resection, and has remained uneventful for a 6 month follow-up period.

Testicular Tuberculosis Mimicking Testicular Malignancy / 대한비뇨기과학회지

Genitourinary tuberculosis is the most common manifestation of an extrapulmonary tuberculous infection. The most common site of genital tuberculosis is the epididymis, but testicular tuberculosis is very rare. A 30 year old patient presented with a painless right testicular mass. Under the clinical diagnosis of a right testicular tumor, a right radical inguinal orchiectomy was performed. The pathological diagnosis revealed testicular tuberculosis, without involvement of the epididymis.