A comparative study on the results according to initial managements in the patients with urethral injury / 대한비뇨기과학회지

This study was performed to compare the results according to initial managements in 130 patients with urethral injury during the period from January, 1978 to May, 1990. The following results were obtained : 1. Among the 130 patients ranged from 6 to 70 years of age with average of 35.4 years, 71 ruptures were complete and 59 were incomplete and pelvic bone fracture was associated in 40 patients(30.8%). 2. Of these patients. 44 who had mild urethral injury were managed by observation or indwelling of Foley catheter, 27 by primary realignment and 69 by suprapubic cystostomy only as a initial management. and thereafter urethral strictures were developed in 5(13.2%). 21(77.8%) and 48 (81.4%), respectively, with no statistical difference between later two groups. 3. In the cases of urethral stricture who were treated by suprapubic cystostomy as a initial management required more complicated surgical procedures such as end to end anastomosis or staged urethroplasty for the correction than primary realignment. 4. Complications other than stricture such as impotence, urinary tract infection, stone, or fistula were developed in both groups similarly.

A comparative study on the results according to initial managements in the patients with urethral injury / 대한비뇨기과학회지

This study was performed to compare the results according to initial managements in 130 patients with urethral injury during the period from January, 1978 to May, 1990. The following results were obtained : 1. Among the 130 patients ranged from 6 to 70 years of age with average of 35.4 years, 71 ruptures were complete and 59 were incomplete and pelvic bone fracture was associated in 40 patients(30.8%). 2. Of these patients. 44 who had mild urethral injury were managed by observation or indwelling of Foley catheter, 27 by primary realignment and 69 by suprapubic cystostomy only as a initial management. and thereafter urethral strictures were developed in 5(13.2%). 21(77.8%) and 48 (81.4%), respectively, with no statistical difference between later two groups. 3. In the cases of urethral stricture who were treated by suprapubic cystostomy as a initial management required more complicated surgical procedures such as end to end anastomosis or staged urethroplasty for the correction than primary realignment. 4. Complications other than stricture such as impotence, urinary tract infection, stone, or fistula were developed in both groups similarly.

Choriocarcinoma of the Bladder / 대한비뇨기과학회지

Choriocarcinoma developed in genital organ mainly. In male, choriocarcinoma developed rarely in testis but stremely rare in extragenital organ. Choriocarcinoma of the bladder was reported about 10 cases in the literature. Histogenesis of choriocarcinoma in bladder was trophoblastic differentiation from the totipotential germ cells. But Civantos et al. postulated that choriocarcinoma developed dedifferentiation from the undifferentiated carcinoma. Herein, we reported a case of choriocarcinoma with transitional cell carcinoma in the bladder.

A Clinical Observation on the Renal Pelvis and Ureteral Tumors / 대한비뇨기과학회지

A clinical observation was made on 14 cases of transitional cell carcinoma of the renal pelvis and ureter whose diagnosis was confirmed pathologically at Kyung Hee University Hospital during the period tom November, 1971 to June, 1984. The results were as follows 1. The age of patient at the time of the diagnosis ranged from 42 to 75 years (mean 57.9 years), with highest incidence during the 6th decade. 11 tumors occurred in male patients and 3 in female patients, for a ratio of 3.7 : 1. 2. Common presenting symptoms were gross hematuria (92.8 %) and pain (28.5 %). 3. IVP was performed in all patients. A filling defect in the renal pelvis or ureter was found in 6 cases, and non-visualized kidney in 6 cases. RGP was performed in 9 patients and was useful to demonstrate a filling defect. 4. Urine cytology was positive in 6 of 13 patients. 5. Nephroureterectomy including a cuff of bladder was performed in 13 patients and simple nephrectomy was done in 1 patient who was misdiagnosed as hydronephrosis due to UPJ obstruction. 6. The tumors were staged into 4 Stages postoperatively. 5 patients had Stage A tumors, 2 Stage B, 5 Stage C and 2 Stage D. 1 patient had Grade I tumor, 6 Grade II, 4 Grade III and 3 Grade IV. In 3 patients, there were synchronous tumors in renal pelvis and ureter. Three patients subsequently developed bladder tumor. 7. 7 patients were died in 3 to 18 months (average 7.8 months) after initial treatment and all were categorized into Stage C and D.

A Clinical Review of the Pyeloplasty / 대한비뇨기과학회지

Primary hydronephrosis due to UPJ obstruction is not infrequent urologic disorder. The causes of the obstruction art categorized into extrinsic, intrinsic and ureterovascular abnormalities. The most important thing is accurate evaluation of the dynamic physiology of UPJ with the X- ray findings. We have experienced 16 cases of pyeloplasty during the last 10 years. We reported the evaluations of the cases with review of the articles. Results were. 1. Of these 16 cases, 13 were male and 3 were female and 11 were left and 5 were right hydronephrosis. 4 were children and 9 were 3rd. and 4th. decades 2. IVP, RGP, Ultrasonography and diuretic renogram were done preoperatively 3. Pyeloplasty were done by the dismembered in 13, Culp spiral flap in 2 and pyelopyeloplasty in 1. 4. Indigocarmin test, AGP, fluoroscopy and Whitaker test were done postoperatively. 5. There were improvement in 12 cases but failed in 3 cases.

Primary Carcinoma of the Ureter: Report of Two Cases / 대한비뇨기과학회지

Two cases of primary carcinoma of the ureter were reported with review of the literatures.

An Experimental Study on Effects of Renal Papillectomy and Partial Ureteral Ligation on the Kidney / 대한비뇨기과학회지

Necrosis of the papilla and chronic interstitial nephritis of the renal cortex are the two renal 1esions most commonly. described in cases of analgesic nephropathy. Some authors believed that the necrosis of the papilla was secondary to the cortical changes by which fibrosis of the cortex produced ischemia of papilla and necrosis. However, other authors have suggested that the pathogenesis is, in fact, the reverse and that the cortical changes in analgesic nephropathy are caused by the medullary necrosis. An experimental study was therefore undertaken to clarify this problem and also to determine the influence of increased intrapelvic pressure on the postpapillectomy renal alterations. Followings are the results: 1. In 'the group having renal papillectomy, marked tubular dilatation and interstitial edema of the medulla are prominent changes upto two weeks after removal of the papilla. Tubules are usu. ally filled with various casts. After three weeks, there starts the tubular atrophy and interstitial fibrosis with mil infiltration of inflammatory cells. The tubular atrophy and renal scarring become much severe and diffuse six weeks after papillectomy. but glomeruli remain relatively intact. 2. The degree of tubular changes and parenchymal scarring are assumed influential to the size of removed papilla. The tubular atrophy is prominent in distal convoluted tubules and collecting tubules, and the interstitial changes extend from the medulla to the cortex in the late stage. 3. Focal or scattered depositions of amorphous calcium or calcium oxalate are found in about one fourth of cases. 4. In the group having partial ureteral ligation a week after renal papillectomy, the tubular and interstitial changes appear earlier and are more remarkable than those of papillectomy alone. The inflammatory reaction is also more prominent, and conglomeration of glomerulus is noted in some instances of the later stage. The form of the renal scarring found in this experimental study closely resembles that seen in analgesic nephropathy in man. This findings support the view that the cortical lesions in analgesic nephropathy develop as a direct consequence of papillary necrosis and additional ureteral ligation enhances interstitial nephritic process. It is possible that the tubular atrophy and interstitial edema that develop shortly after removal of the papilla may produce cortical changes.

Eosinophilic Cystitis / 대한비뇨기과학회지

Eosinophilic cystitis is a baffling rarity impossible to distinguish grossly from bladder tumor. It is characterized by vesical irritability, hematuria and eosinophilia. The etiology is unknown. Authors have found only 7 cases in the literature and present one case which was mimicking papillary carcinoma. Patient 35 years-old married man, was admitted to Seoul National University Hospital on March 13. 1967. with a one-week history of hematuria, urgency, frequency and dysuria. Physical examination was negative. Hemograms showed normal except eosinophilia of 10% to 16%. Urinalysis showed one plus proteinuria, many red cells and 5 to 6 white cells per high power field. An excretory urogram displayed essentially normal. At cystoscopy marked bullous edema on entire bladder wall and large polypoid lesion in anterior wall were noted. Punch biopsy was done and it revealed mild degree transitional cell carcinoma of the bladder. He underwent bilateral cutaneoureteroetomy and cystectomy. The surgical specimen, however, showed no malignant lesion but diffuse eosinophilic cystitis.