Ileal W-Neobladder in Women with Bladder Cancer: Early Experience / 대한비뇨기과학회지

PURPOSE: The anatomical and voiding functional outcomes of orthotopic neobladders in women with bladder cancer were investigated. MATERIALS AND METHODS: Since July, 1998, 5 women (median age 64.8) underwent an orthotopic bladder substitution following a radical cystectomy for bladder cancer. The median follow-up was 19.6 months (range 12 to 35). After urethral sparing cystectomy, an ileal W-neobladder was constructed and supported by an omental flap. Both the early and late complications were analyzed. A pressure flow study was performed to evaluate the voiding function, and a radiologic study including a MRI was performed to observe the anatomy. RESULTS: There were no perioperative deaths and no early and late complications related to the surgery except for acute pyelonephritis, which occurred in one patient 22 months after surgery. Four patients were continent day and night and one patient had nighttime incontinence. MRI showed that the urethra was connected to the dependent portion of the neobladder, which was supported by an omental flap in all patients. No recurrence of cancer in the native urethra was noted. All patients were satisfied postoperatively. CONCLUSIONS: Orthotopic bladder substitution after a standard radical cystectomy in women provides satisfactory anatomical and functional outcomes. An omental flap could improve the voiding function by supporting the neobladder and making a urethroneobladder junction located in the dependent portion of the neobladder.

The Comparison of the Effects of Oral Antibiotic Ingestion and Intraprostatic Antibiotic Injection in a Rat Model of Chronic Bacterial Prostatitis / 대한비뇨기과학회지

PURPOSE: An in vivo study compared the effect of oral antibiotic ingestion to that of intraprostatic antibiotic injection in a rat model of chronic bacterial prostatitis. MATERIALS AND METHODS: Wistar rats were divided into four experimental groups: oral phosphate buffered saline (PBS) ingestion group (Op group), oral antibiotic ingestion group (Oa group), intraprostatic PBS injection group (Ip group) and intraprostatic antibiotic injection group (Ia group). Escherichia coli Z17 (O2:K1:H ) was inoculated to the prostatic urethra of the 4 experimental groups to develop the chronic bacterial prostatitis rat model. To confirm the chronic bacterial prostatitis, urine bacterial culture, tissue bacterial culture and histopathologic examinations were conducted 4 weeks after inoculation of E. coli. PBS and oral ciprofloxacin were administered orally twice a day for 1 week to the Op and Oa groups, respectively, and were injected into the prostate in the Ip and Ia groups, respectively. Urine bacterial culture, tissue bacterial culture and histopathologic examinations were conducted with specimens obtained 5 weeks after inoculation of E. coli. RESULTS: Microbiological culture of urine demonstrated that there was no significant difference among any of the four experimental groups (p>0.05). Microbiological culture of the prostate demonstrated that the mean Log10cfu/g of the Ia group was significantly lower than that of the other three experimental groups (p<0.05). The histopathology showed resolving prostatitis in the intraprostatic antibiotic injected groups compared with the other experimental groups. CONCLUSIONS: This study indicates that the effect of intraprostatic antibiotic injection for chronic bacterial prostatitis was more positive than oral antibiotic ingestion. This result suggests that intraprostatic antibiotic injection would be a treatment modality to overcome the difficulty of passage of antibiotics across blood-prostate barrier into the prostatic tissue.

A Case of Primary Carcinoid Tumor of the Urinary Bladder / 대한비뇨기과학회지

Primary carcinoid tumor of the urinary bladder is extremely rare. We report a case of primary carcinoid tumor of the urinary bladder in a 45-year-old man who presented with frequency, dysuria and urinary tenesmus for 6 months with clinicopathologic, immunohistochemical and ultrastructural findings.

A Case of Arteriovenous Hemangioma of the Scrotum and the Urethra / 대한비뇨기과학회지

Hemangioma is the most common congenital anomaly in the human. It represents a proliferation of endothelial cells and has been characterized as a benign neoplasm. Hemangiomas involving the genitalia comprise 2% of all such masses. Arteriovenous hemangioma is a benign congenital lesion that rarely involves the scrotum or urethra and primarily presents during childhood. We report a case of subcutaneous scrotal and urethral hemangioma that has caused persistent urethral bleeding in a 14-year-old boy who was treated by en bloc excision.