Valsalva Leak Point Pressure in Female Stress Urinary Incontinence: Reproducibility and Correlation with Maximum Urethral Closure Pressure / 대한비뇨기과학회지

PURPOSE: The valsalva leak point pressure(VLPP), a quantitative measure of sphincteric function, is used widely to diagnose intrinsic sphincteric deficiency. The purpose of this study was to assess the reproducibility of VLPP and to evaluate the correlation between VLPP and maximum urethral closure pressure(MUCP) in patients with stress urinary incontinence. MATERIALS AND METHODS: Thirty consecutive women with urodynamically confirmed genuine stress urinary incontinence underwent duplicate VLPP measurements. Inter-personal reproducibility of VLPP recording was obtained by two urologists in fifteen women. Intra-personal reproducibility of VLPP recording was obtained by one urologist in fifteen women. Each test was performed with two weeks interval, and was blinded to the previous results. Two hundred sixty two women with stress urinary incontinence were evaluated prospectively, comparing MUCP with VLPP to evaluate their correlation. RESULTS: Repeated measurements of VLPP were reproducible. Intra-personal agreement was excellent with a correlation coefficient of 0.95(p=0.0001) between the first and second examination. Inter-personal correlation coefficient was 0.85(p=0.0001). The difference between repeated measurement was not statistically significant. There was a statistically significant relationship between VLPP and MUCP(p=0.0001), however a correlation coefficient of 0.29 demonstrated poor clinical relationship. CONCLUSIONS: The VLPP is a simple and reproducible methods for evaluating urethral resistance in stress urinary incontinence. The MUCP has statistically significant relationship with VLPP, however it is not clinically useful to evaluate urethral sphincter function because women with normal or high MUCP had leakage at low VLPP and vice versa.

Transurethral approach to collagen injection in the female stress incontinence; Procedure of choice?

No abstract available.

Clinical Results Comparing Transurethral Needle Ablation with Transurethral Resection of Prostate for the Treatment of Benign Prostatic Hyperplasia / 대한비뇨기과학회지

PURPOSE: We compared the outcome of transurethral resection of the prostate (TURP) with that of transurethral needle ablation(TUNA) of the prostate in patient with BPH. MATERIALS AND METHODS: From May 1996 to April 1997, 21 patients were treated with TURP and 25 with TUNA. In TURP group, the mean age was 67.2 years and mean prostatic volume was 52.7ml. In TUNA group, the mean age was 67.2 years and mean prostatic volume was 32.1ml. Assessment parameters were International Prostate Symptom Score(1-PSS), quality of life question, uroflowmetry and complications. Post-treatment morbidity was noted if the patients experienced erectile dysfunction, retrograde ejaculation or urinary incontinence. Patients were examined at 3 months from the day of treatment. RESULTS: At 3 months, the maximum flow rate improved from the mean of 10.2+/- 3.2m1/sec to 20.5+/-10.7m1/sec for the TURP group and 9.3+/-1.9m1/sec to 12.5+/-4.3 for the TUNA group. 1-PSS improved from the mean 22.0+/-7.6 to 6.4+/-4.6 for the TURP group and 21.2+/-6.6 to 13.1+/-6.8 for the TUNA group. Quality of life improved from the mean 3.8)1.6 to 1.3+/-1.0 for the TURP group and 4.3+/-0.9 to 2.9+/-1.1 for the TUNA group. Erectile dysfunction was reported in 43% (9/21) of TURP and 5%(1/20) of TUNA. Retrograde ejaculation was reported in 57%(12/21) and urinary incontinence was in 5%(1/21) of TURP. Retrograde ejaculation and urinary incontinence was not reported with TUNA. The mean operation time, hospital stay and a catheterization time in the TUNA group were 45.4min, 1.2days, 4.4days in comparison with 58.7min, 7.0days, 3.6days in the TURP group. CONCLUSIONS: After TURP and TUNA, there was significant improvement in all clinical parameters. But TURP was more effective in improving maximum flow rate, 1-PSS and quality of life. TUNA, however, produced minimal morbidity with no serious complication. With acceptable low morbidity, TUNA appears to be a safe and effective procedure in the treatment of BPH.

Mutations of p53 gene and Its Significance for Renal Cell Carcinoma / 대한비뇨기과학회지

PURPOSE: Mutation of the p53 gene seem to be the most common genetic changes in human malignancies. Recent studies have also shown p53 gene mutations in several premalignant conditions and preliminary data have suggested that p53 gene mutations may be involved in tumor progression. There is wide variation in reported incidence of p53 gene mutation in renal cell carcinoma, and its prognostic significance for this tumor is unknown. MATERIALS AND METHODS: This retrospective PCR-SSCP(the polymerase chain reaction of the single-strand conformation polymorphism) analysis and immunohistochemical study were designed to investigate the role of p53 gene mutation in renal cell carcinoma and to examine association between p53 gene mutation and tumor grade, clinical behavior and DNA ploidy. RESULTS: Forty eight renal cell carcinoma(RCC) specimens were analyzed. Mutations of p53 gene were detected in 8.3%(4/48) of tumors. There were significant correlation between the presence of the mutation of p53 gene and high tumor grade and DNA aneuploidy(p-value=0.016. 0.019). But no significant correlation between the presence of the mutations of p53 gene and sex, symptom and tumor stage. CONCLUSIONS: These results suggest that the mutations of p53 gene may not be significant in development of RCC but may be related to its progression or malignant transformation.

Comparison of Ambulatory Surgery and Inpatient Surgery for Children / 대한비뇨기과학회지

Ambulatory surgery is an established surgical system that all the procedures which are visiting hospital, undergoing surgery and recovery and returning home, performed on the same day. We evaluated our initial experiences to find out if there are any differences between ambulatory surgery and inpatient surgery especially during the perioperative period. We assessed the following 6 items: the degree of perioperative anxiety in parents, observation time in the recovery room, hospital charge, length of time to return to usual activities, postoperative complications and degree of postoperative satisfaction in parents. Between April 1995 and August 1996, we reviewed 30 patients who underwent ambulatory surgery (age: 1 mo-15.2 yrs, mean 5.8 yrs) - hydrocelectomy (16 cases), orchiopexy (10 cases), varicocelectomy (1 case), excision of cyst at urethral meatus (1 case) and circumcision (2 case). Then we compared the same parameters with those of 30 inpatient children who underwent similar surgical procedures (age: 7 mo-12 yrs, mean 3.8 yrs) - hydrocelectomy (15 cases) and orchiopexy (15 cases). The results were as follows: 1. There was no significant difference among the two groups in observation time at recovery room (p=0.381) and the time to return to normal activities (p=0.202).2. Ambulatory surgery group is more economical than the inpatient surgery group (p<0.05). 3. In ambulatory surgery group, the degree of perioperative anxiety in parents was higher than inpatient surgery group (p=0.001). However, postoperative satisfaction was higher than inpatient surgery group (p=0.001) with negligible complications, In conclusion, ambulatory surgery in pediatric urology was more advantageous than inpatient surgery with regards to postoperative satisfaction and alleviation of parental burden on time and money.