The assessment of symptomatic improvement of patients with benign prostatic hyperplasia after transurethral prostatectomy / 대한비뇨기과학회지

Although transurethral prostatectomy is the most common treatment method of benign prostatic hyperplasia, the exact indication and efficacy of this method is variable and controversial. We performed this study to determine the efficacy of transurethral prostatectomy on men with moderate symptoms or benign prostatic hyperplasia. The efficacy parameters evaluated included the change of maximal flow rate, Boyarsky symptom score and the global assessment of voiding symptom by the patient after transurethral prostatectomy. The mean maximal flow rate improved 204% after transurethral prostatectomy, and the mean obstructive and irritative symptom scores decreased 84% and 59% respectively. But the irritative symptom score of unsatisfied patients decreased only. 41%. Over all, 80% of the patients were satisfied with the result of the operations. The improvement of the irritative symptoms is not expected after a transurethral prostatectomy, and therefore, the operative procedure is not indicated. But the symptoms of the unsatisfied patients were similar to the comparative group (healthy men over 50 years of age). Although this comparative group had nocturia (11%), frequency (32%), urgency (29%), they felt no necessity for special medical attention, but hesitancy, intermittency, terminal dribbling and dysuria led the patient to seek help in a hospital.

Prevalence of calcified upper urinary tract stone disease in health clinic visitors / 대한비뇨기과학회지

No abstract available.

Acute necrotizing fascitis of the male genitalia (Fournire's gangrene) / 대한비뇨기과학회지

We reviewed 15 cases of necrotizing fascitis of the male genitalia. The clinical courses could be divided into two different types. In about one half of the patients the symptoms and signs progressed slowly within 122 weeks and in the remained they progressed rapidly. In the former, the prodromal signs were noted, usually low abdominal and inguinal pain. In 8 of fifteen patients, the locations of infectious focus were difficult to determine. The diagnosis were made after the development of scrotal necrosis in all of the cases. There were no differences in the causative pathogens comparing to 1hose of previous reports. The common underlying diseases were liver cirrhosis and diabetes. Hypoalbuminemia and leukocytosis were found in all. Of course, the strategy of treatment is same between two types, we would like to propose to use the term Fourier`s gangrene, a specific form of necrotizing fascitis, only to whose clinical course in acute and the location of primary infecious foci are obscure.

Acute necrotizing fascitis of the male genitalia (Fournire's gangrene) / 대한비뇨기과학회지

We reviewed 15 cases of necrotizing fascitis of the male genitalia. The clinical courses could be divided into two different types. In about one half of the patients the symptoms and signs progressed slowly within 122 weeks and in the remained they progressed rapidly. In the former, the prodromal signs were noted, usually low abdominal and inguinal pain. In 8 of fifteen patients, the locations of infectious focus were difficult to determine. The diagnosis were made after the development of scrotal necrosis in all of the cases. There were no differences in the causative pathogens comparing to 1hose of previous reports. The common underlying diseases were liver cirrhosis and diabetes. Hypoalbuminemia and leukocytosis were found in all. Of course, the strategy of treatment is same between two types, we would like to propose to use the term Fourier`s gangrene, a specific form of necrotizing fascitis, only to whose clinical course in acute and the location of primary infecious foci are obscure.

Leukemoid reaction with renal cell carcinoma / 대한비뇨기과학회지

Renal cell carcinoma has been recognized for several years as a relatively common cause of paraneoplastic syndromes. Fever, polycythemia, hypercalcemia, amyloidosis, abnormal liver function, Cushing's syndrome and neuropathy have been ostm frequently reported in association with renal cell carcinoma, but leukemoid reactions have been reported only rarely with this tumor. Recently we experienced a leukemoid reaction in a 64-year old female patient who presented with an advanced case of renal cell carcinoma. According to the literature the mortality is 100% with leukemoid reactions in renal cell carcinoma, and indeed this patient expired. We therefore, consider this reaction as a late manifestation of a bizzare presentation of renal cell carcinoma.

A Case of Vesico-Sigmoido-Appendiceal Fistula / 대한비뇨기과학회지

We report a case of vesico-sigmoido-appendiceal fistula from unknown origin in a 29 years old female who was presented with the chief complaints of fecaluria and bladder irritation symptoms The diagnostic procedure such as excretory urography, cystography, barium enema, cystoscopy and proctoscopy were performed, and the vesico-recto-appendiceal or vesico-sigmoido-appendiceal fistula was suspected. On operation, the tip of appendix was communicated with the sigmoid fistulous tract and opened into the bladder in a common pathway. The patient underwent appendectomy, sigmoid fistulectomy, and partial cystectomy and the postoperative course was uneventful.

Two Cases of Paratesticular Rhabdomyosarcoma / 대한비뇨기과학회지

Rhabdomyosarcoma is the most frequent cancer involving the trigone of the bladder, the proximal urethra, vagina and paratesticular tissue in children, and 15 percent of rhabdomyosarcoma in children arise in the urogenital tract. Rhabdomyosarcoma is highly malignant neoplasm with a tendency toward early infiltration of adjacent structures and metastases to regional lymphnodes and distant organs. We report tow cases of paratesticular rhabdomyosarcoma with brief review of literatures.

Penile Epispadias: A Case Report / 대한비뇨기과학회지

Penile epispadias is extremely rare congenital anomaly. Four cases of epispadias. two of which were penile. one was penopubic and one was subsymphyseal epispadias, had been reported previously in our department. We have experienced another case of penile epispadias. Herein this case of penile epispadias have been presented. A 7-year-old boy visited this clinic for short, broad based 'tent-like' penis with complete phimosis. The glans could not be inspected due to phimosis and a gutter was palpated between the two corpora. Voiding cystourethrogram revealed dorsally displaced urethra. There was no combined urological symptoms such as dysuria, frequency in urination or urinary incontinence. Urethral reconstruction by Young's method has been performed with excellent result.

Vesicouterine Fistula: A Report of Two Cases / 대한비뇨기과학회지

Vesicouterine fistula is a rare condition, and almost of them result from surgical obstetric procedures. We have experienced two cases of vesicouterine fistulas, one of which developed menouria. Herein these two cases of vesicouterine fistulas have been presented. Case 1; A 29_year_old housewife had underwent dilatation and curettage at local clinic. Afterwards she has been noticed urinary leakage from the vagina and menturia. Cystoscopic examination revealed a small fistula at midportion of the retrotrigone and hysterosalpingography showed a fistula between the bladder and the uterus. Transperitoneal closure of the fistula was performed with excellent result. Case 2; A 32-year-old housewife had. gross hematuria after bugination and curettage for interruption of midtrimester pregnancy and noticed urinary leakage from the vagina a few days later. A fistula between the bladder and the uterus was identified with cystoscopic examination, cystography and hysterosalpingography. A 24 Fr. silastic Foley catheter has been indwelt in the bladder for 4 weeks, but resulted in failure. Transperitoneal closure of the fistula resulted in cure.

An Oral Calcium Tolerance Test for the Diagnosis of Hypercalciuria in Patients with Calcium Nephrolithiasis / 대한비뇨기과학회지

Hypercalciuria is the most common metabolic abnormality in patients with calcium nephrolithiasis and oral calcium tolerance test (OCTT) has been developed to diagnose various forms of hypercalciuria. 71 patients with calcium nephrolithiasis who had been admitted to the Dept. of Urology, Pusan National University Hospital during the period of 11/2years from Jan. 1984 to Jun. 1985, were studied for urinary calcium excretion by OCTT constituted of rigorous calcium restriction for 3 days, fasting and calcium loading. The following results were obtained. 1. Of the 71 patients, hypercalciuria was found in 43 cases (61%) and hyperuricosuria in 24 cases (33.8%). Hyperuricosuria was found more frequently in patients with hypercalciuria than patients with normocalciuria. 2. Of 43 cases with hypercalciuria, 11 cases (15%) were classified as absorptive type I, 14 cases (2O %) as absorptive type II 9 cases (13%) as renal hypercalciuria, and 3 cases (4%) as primary hyperparathyroidism. In the other 6 cases, the etiology of the hypercalciuria could not be defined by our simple OCTT. 3. In fasting, urinary Ca/Cr ratio was 0.052+/-0.025 in normocalciuria group, 0.068+/-0.018 in absorptive type I, 0.068+/-0.025 in absorptive type II group, and all these values were in normal limit. In renal hypercalciuria and primary hyperparathyroidism group, the ratios were 0.167+/-0.033 and 0.149+/-0.029, and these values were significantly higher than normal range. 4. After calcium loading, urinary Ca/Cr ratio was 0.105+/-0.041 in normocalciuria group, but in hypercalciuria groups, the ratios were markedly increased to 0.244+/-0.035 in absorptive type I, 0.288+/-0.042 in absorptive type II, 0.263+/-0.068 in renal hypercalciuria, 0.290+/-0.041 in primary hyperparathyroidism group. 5. In renal hypercalciuria, the ratio of renal calcium reabsorption was 97.8+/-O.9%, and tend to be lower than other subgroups of hypercalciuria and normocalciuria group. The ratio of renal phosphorus reabsorption did not show the difference of the values among the subgroups of hypercalciuria and normocalciuria group. OCTT using rigorous calcium restriction for 3 days is recommended as a relatively simple and reliable method of defining the etiology of hypercalciuria.

Vesicoileal Fistula Caused by Malignant Lymphoma: A Case Report / 대한비뇨기과학회지

Vesicoileal fistula develops in less than 10% of all vesicointestinal fistulas. The causative disorders were recorded as regional enteritis, bladder tumor, trauma, ileal tuberculosis and complication of radiation therapy of cervical carcinoma, but the literatures recording vesicoileal fistula caused by malignant lymphoma are surpassingly few. We report a case of vesicoileal fistula originated primarily from malignant lymphoma in a 74 years old man who was seen with the chief complaints of pneumaturia and fecaluria. The diagnostic procedures such as IVP, cystography, gastrointestinal series, barium enema and rectosigmoidoscopy were performed and the vesicoileal fistula was suspected. The diagnosis was confirmed by operation and histologic examination. The operation consisted of one stage resection of the ileal lymphoma and adhered sigmoid colon, end to end anastomosis of ileum, end to end anastomosis of sigmoid colon and partial cystectomy. The patient underwent anticancer chemotherapy and was discharged at the postop. third week.