Antireflux Surgery Using a Ureteroenterostomized Segment of Sigmoid Colon in Vesicoureteral Reflux after Augmentation Ileocystoplasty: A Case Report / 대한비뇨기과학회지

The vesicoureteral reflux (V-U reflux) is one of the serious complication after urinary diversion and enterocystoplasty when combined with ureteroenterostomy. A 33 year-old female patient was presented with moderate hydronephrosis and V-U reflux (Grade III/V) in a single kidney on urograms. She had undergone a nephrectomy and augmentation ileocystoplasty with ureteroileostomy because of urinary tuberculosis sixteen years ago. Antireflux surgery was performed using a segment of sigmoid colon to which the ureter was anastomosed through submucosal tunnel. Follow-up urograms showed disappearance of reflux and improvement of hydronephrosis at five months postoperatively.

Preliminary results of M-VAC(methotrexate, vinblastine, doxorubicin and cisplatin) chemotherapy for advanced trasitional cell carcinoma of the urothelium / 대한비뇨기과학회지

We reviewed retrospectively 23 patients treated with M-VAC (Methotrexate. Vinblastine, Doxorubicin, Cisplatin) from October 1987 to June 1990 at our hospital to evaluate predictive variables for response to chemotherapy and long term survival free of disease. Treatment consisted of monthly cycles of 30mg. per m2 methotrexate, followed 24 hours later by 3mg. per m2. vinblastine, 30mg. per m2. doxorubicin and 70mg. per m2. cisplatin and concluded with repeat vinblastine and methotrexate on days 15 and 22. The Median number of cycles was 3 (range 2 to 5). Complete plus partial remission were observed in 13 of 23 patients (57%) with a median survival or 13 months (range 7+ to 32+ months). Stabilization occurred in 3 patients (14%) and progression in 7 patients (29%) with median survivals of 10 months (range 7+ to 11 months) and 8 months(4 to 12+ months). 1 year survival rate was 77% in complete puls partial remission and 66% in stabilization and 28% in progression. 10 patients with a complete plus partial remission are alive with a median follow up of 15 months ( range 4 to 32+ months), of whom 1 is surviving for more than 2 years. Toxicity included moderately severe myelosuppression that resulted in nadir sepsis in 1 patient mild to moderate anorexia, vomiting, alopecia and renal dysfunction. Though the number of availuable patients are limited, these preliminary results suggest that treatment with M-VAC is effective against disseminated urothelial transitional cell tumors.

Comparison of the Marshall-Marchetti and endoscopic bladder neck suspension for stress incontinence / 대한비뇨기과학회지

The MsrshaII-Marchetti and endoscopic bladder neck suspension procedure are successful procedures for the treatment of genuine stress incontinence. We experienced 32 cases of stress incontinence surgically treated by the Marshall-Marchetti procedure (7 cases) during the period from January 1973 to 1981 and endoscopic bladder neck suspension procedure (25 cases) from l982 to June l990. Following results were obtained. I. Patients' ages ranged from 15 to 63 years (average 46.6 years), and most patients were rnultiparous with an average of 3.5 deliveries. 2. On the chain cystourethrogram. 25 cases (78.1%) belonged to type I , and seven case.s (2l.9%) to type I[ according to Green`s classification. 3. The values of postoperative days on catheter, operative time and postoperative hospitalization in the Marshall-Marchetti procedure were 6.7+/-3.3 days, 112.9+/-20.6 minutes and 8.7+/-0.8 days, and in the endoscopic bladder neck suspension procedure 3.3+/-2.0, 87.9+/-22.9 and 45+/-2.0 respectively (P<0.05). 4. Postoperative complications were minimal except urinary retention in I4 out of 25 cases (56%) undergoing the endoscopic bladder neck suspension procedure, and nine of them (64.3%) were restored to normal voiding pattern within two weeks by intermittent catheterization. 5. The success rate was 85.7% in the Marshall-Marchetti, and 91.3% in the endoscopic bladder neck suspension procedure with a minimum follow up of six months. With above results. we concluded that the endoscopic bladder neck suspension procedure had advantages including operative simplicity, extensive indication, a high rate of cure, short hospitalization and postoperative catheter drainage compared with the Marshall-Marchetti procedure.

Clinical Observation on Posterior Urethral Injury and Long Term Followup / 대한비뇨기과학회지

From January 1970 to December 1988, 114 patients underwent urethroplasty for traumatic complete disruption of posterior urethra in the Department of Urology, Catholic University Medical College and were followed for 2 to 17 years. The results were as follows : 1. In age distribution age of 73 patients (62%) ranged from 10 to 39 years. 23 patients ( 20.2%) were children and 91 (79.8%) were adults. The most common cause of posterior urethral stricture was traffic accident ( 56.1%) and the most common associated injury was pelvic bone fracture (75.4%). 2. Initial success rate in voiding after primary operation was 78.9 % (90/114 patients) and there was no significant difference of initial success rate in voiding between primary realignment group (81.6%. 31/38 patients) and delayed end-to-end anastomosis group (79.4%. 50/63 patients). 3. In cases of long stricture and multiple failure of urethroplasty, extensive urethroplasties such as skin inlay urethroplasty (17 cases), transpubic urethroplasty (9 cases) and pedicled scrotal skin substitution (3 cases) were required. 4. 111 patients were finally achieved success in voiding postoperatively ( 97.4%, 111/114 patients). 5. According to the 72 patients who have been followed up by interview and questionnaire, late complication rate ( stricture, impotence and incontinence) of the delayed end-to-end anastomosis group (20.0%, 11.1%, 15.6% ) was lower than that of the primary realignment group (27.3 %, 31.8%, 22.7%).

The Use of Ileum for the Replacement of Ureter / 대한비뇨기과학회지

In 1906, the human ureteral repair with an isolated segment of ileum was performed by Shoemaker and since 1950, the operation was reported with increasing frequency. At present time, the use of ileum for the replacement of ureter gives the best alternative. Partial or total replacement of the ureter by ileal segment was performed at the Dept. of Urology, St. Mary's hospital in 6 patients from 1971 to 1988. Herein we report our clinical investigation, in which the results were considered to be relatively successful, with brief review of literatures.

Choriocarcinoma in Kidney : A Report of Two Cases / 대한비뇨기과학회지

Choriocarcinoma is a malignant gestational trophoblastic disease that demonstrates high incidence of metastasis. The metastasis is primarily hematogenous, but may be done by lymphatic or direct extension. The frequent sites of the metastasis are lung, vagina and pelvis, but the renal involvement is rare. We report two cases of choriocarcinoma in kidney in two multiparous 29-and 35-year-old women.

Urological Complications in 200 Renal Transplantations / 대한비뇨기과학회지

We evaluated the urological complications in 200 renal transplantations performed in the Department of Urology, Catholic Medical College between March 1969 and April 1986. The following results were obtained; 1. Of 200 cases of recipient 151 cases were male and 49 cases were female. 2. The ureteroneocystostomy was performed as the method of modified Politano-Leadbetter (intravesical approach) in 66 cases and modified Mackinnon (extravesical approach) in 134 cases. 3. Our incidence of urological complications in 200 renal transplantations was 7%1l4 cases). Postoperative complications developed in Il of the 66(l6.7%) who underwent intravesical ureteroneocystostomy and 3 of the 134(2.2%) who underwent extravesical ureteroneocystomy. 4. The details of the complications were as follows: 6 were ureteral obstruction, 5 ureteral leakage, 2 urine leakage from anastomosis site and 1 was bleeding from anastomosis site. 5. Operative method for urological complications were ureteroureterostomy (10) in ureteral obstruction(6) and ureteral leakage (4), ureteroneocystostomy (1) in ureteral leakage, simple suture (2) in bleeding(1) and urine leakage from anastomosis site(2).

Protective Effect of Several Metals Against Cadmium Injury to Mouse Testicle / 대한비뇨기과학회지

One of the most obvious effects of cadmium poisoning in experimental animals is induction of testicular necrosis. Many studies have been conducted, but the mechanism of the disturbance, which is peculiar to the testicle, has not been elucidated. Testicular damage due to cadmium exposure greatly differs depending upon strains of mice and methods of administration. As a preventive measure against testicular necrosis due to cadmium, pretreatment of small doses of cadmium and several kinds of metals have been found to be effective. In order to examine testicular damage by cadmium doses and protective effects by small doses of metals (Cd, Cu, Se, Mn) and phenobarbital which were administered before single challenge dose of cadmium, mature male I. C. R. mice, 16 weeks of age, weighing approximately 40g were used in this study. The weights of the body and the testicle, cadmium concentration in the testicle and results of histopathological findings of the experimental groups were as follows. 1. With regard to the body weight of each group that was injected intraperitoneally with single cadmium doses of 0.5, 1.O, 2.O and 3.Omg/kg the last two groups showed a significant decrease in one week. 2. Relative testicular weight (testicular weight ,body weight) one week after cadmium administration decreased significantly in the group of more than 1.Omg/kg administration. However, in the pretreatment groups, it was found that the group pretreated with cadmium did not decrease. 3. Cadmium concentration in the testicle in each group increased with the amount of cadmium doses. However, in the pretreatment group, the groups pretreated with cadmium and manganese did not increase. 4. In histopathological findings of the testicle on the 7the day after cadmium administration, the minimum dose of cadmium that induced edema in the interstitial tissue and inactive spermatogenesis in a few germinal epithelia was O.5 mg/kg, but the changes seemed to be due to inhibitory effect for spermatogenesis rather than direct injury to the testicular tissue. Necrosis was observed in the spermatogenic epithelium in the 2.O mg/kg group and severe necroses were extended to the interstitial tissue in the 3.O mg/kg group. The critical concentrations of cadmium for the histopathological change in the testicular tissue was 0.32ug/g and that for necrotic change was 0.60ug/g. 5. Protective effect in the pretreatment groups was noticeable in the cadmium pretreated group and moderate effect in the manganese group; however, in the other metal groups and the phenobarbital group little effect was observed. 6. Comparison of the histopathological findings between the group of pretreatment showing effect.

Two Cases of Xanthogranulomatous Pyelonephritis / 대한비뇨기과학회지

Xanthogranulomatous pyelonephritis is an atypical form of severe chronic parenchymal infection and usually occurs in associated with urinary tract infection, obstruction and/or calculi. An accurate preoperative diagnosis is difficult because of its clinical and radiological similarities to various other renal lesions. We experienced two cases of xanthogranulomatous pyelonephritis, so we report with review of some literatures.

Review of 28 Cases of Testicular Tumor / 대한비뇨기과학회지

We reviewed 28 pts. with testicular tumors admitted to the department of urology, Catholic medical college during last 12 yrs. The results are summarized as follows; 1. Age distribution ranged from 4 months to 59 years old, showing the highest incidence below 10 yrs old (39%). 2. There were 28 cases of testis tumor, and all cases were germ cell tumors which consisted of 9 cases of seminoma, 10 cases of teratoma, 5 cases of embryonal carcinoma, 2 cases of teratocarcinoma. 1 case of seminoma and embryonal carcinoma, and 1 case of choriocarcinoma and seminoma. 3. Serum HCG and AFP were evaluated in 13 cases. All seminoma and teratoma, 1 case of seminoma and embryonal ca. ranged within normal limit. But, among 4 cases of embryonal ca. 2 had elevated serum HCG, and 3 had elevated serum AFP. 1 case of teratocarcinoma and 1 case of seminoma and teratoma had elevated serum AFP and HCG. 4 The clinical stage was A in 21, B in 6, C in 3. 5. Radical orchiectomy was done in all cases, and retroperitoneal lymph node dissection was given for 9 cases. Radiation therapy and chemotherapy with PVB regimen were performed in 10 and 3 cases. 6. On 12 cases follow up study was made. Of them 3 (1 of teratocarcinoma, 1 of embryonal carcinoma, 1 of seminoma and embryonal carcinoma) in stage C were died at 3.3 yrs, 1.2 yrs and 15 days after orchiectomy. And 1 case(teratocarcinoma) in stage A were died at 1.5 yrs. after orchiectomy due to pulmonary metastasis. Remaining 8 cases are alive without evidence of relapse for mean follow up 39.7 months.

Congenital Arteriovenous Malformation of the Kidney: A Case Report / 대한비뇨기과학회지

We report a case of congenital renal arteriovenous malformation in which painless gross hematuria was the only clinical manifestation.

A Case of Surgical Management of Bilateral Staghorn Calculi / 대한비뇨기과학회지

One patient with bilateral staghorn calculi was managed by partial nephrectomy of lower pole in one kidney and nephrolithotomy combined with partial nephrectomy in the other kidney.

Urologic Complications in 125 Renal Transplantations and Comparison between Intravesical and Extravesical Uretero Neocystostomy / 대한비뇨기과학회지

We evaluated the complications of intravesical and extravesical ureteroneocystostomy in 125 renal transplantations performed in the Department of Urology, Catholic Medical College between March 1969 and July 1982. The following results were obtained: 1. Of 125 cases of the recipient 105 cases were male and 20 cases were female. 2. Intravesical ureteroneocystostomy was performed by Politano-Leadbetter method in 66 cases and extravesical ureteroneocystostomy by the similar ones reported by MacKinnon in 59 cases. 3. Our incidence of urological complications in the 125 renal transplantations was 9.7% (12 cases). 4. Postoperative complications developed in 11 of the 66 who underwent intravesical ureteroneocystostomy and in 1 of the 59 who underwent extravesical ureteroneocystostomy. 5. The details of the complications were as follows: 6 were ureteral obstruction, 4 ureteral leakage, 1 bleeding from anastomosis site and 1 was urine leakage from anastomosis site. 6. Operative methods for urological complications were ureteroureterostomy in ureteral obstruction 161 and ureteral leakage (3), ureteroneocystostomy in ureteral leakage (1), simple suture in bleeding (1) and urine leakage (1) from anastomosis site. 7. This method of extravesical ureteroneocystostomy in renal transplantation was easy and fast and has a low complication.

Antibody Dependent Cell-Mediated Cytotoxicity in Patients with Urologic Cancers: A Change by Surgical Operation, Histologic Grades and Clinical Stages / 대한비뇨기과학회지

In an attempt to evaluate the immune competence of urologic cancer patients, antibody-dependent cell-mediated cytotoxicity (ADCC) were performed in thirty-four patients and same numbers of age and sex matched normal controls. Also we compared of the level of ADCC before and after the operation. Concomittantly the values of ADCC were examined by histological grading and clinical staging. We used 51Cr-labelled chicken erythrocytes sensitized with 7s rabbit anti-chicken erythrocytes antibody as target cells and patient peripheral mononuclear cells as effector cells. 1. Effector cells of the patients with the urologic cancer showed significantly lower ADCC than those of normal controls. 1) All urologic cancer. Controls 41.4+/-6.0% (n=34) Preoperation 22.1+/-6.8% (n=34) 2) Transitional cell carcinoma of the renal pelvis and the bladder. Controls 41.7+/-6.1% (n=28) Preoperation 22.5+/-6.3% (n=28) 3)Non-transitional cell carcinoma(renal cell Ca. prostate ca. penis ca. seminoma). Controls 40.2+/-5.9% (n=6) Preoperation 20.6+/-4.6% (n=6) 2. In the patients with the transitional cell carcinoma of the bladder and the renal pelvis, highly graded patients had tendency to have lower response of ADCC. Grade I 27.3+/-4.0% (n=14) Grade II 19.9+/-4.l% (n=7) Grade III 15.5+/-3.2% (n=7) 3. In the patients with bladder carcinoma highly staged patients had tendency have lower response of ADDC. Stage T

A Clinical Observation on 69 Cases of Hypospadias / 대한비뇨기과학회지

The author has made a clinical observation on 60 cases of hypospadias which were tented at the Department of Urology, St. Mary's Hospital during the 11 + 1/2 years from 1970 to June, 1981. 1. The ages were distributed from 1 year to 27 years and most of the cases (33. 3%) was found in the age group of 6 to 10 years old. 2. Most of the types of hypospadias (76. 7%) was penoscrotal type. 3. Cryptorchism was the most frequent associated anomalies with 13 cases (61. 9%). 4. 60 cases were treated surgically but of these, chordee removal only was done in 19 cases and urethroplasty was done in 41 cases with 35 cases of success. 5. Urinary fistulas were complicated in 10 cases (24.4%) during urethroplasty. 6. Of 41 urethroplasties, 28 cases (84.8%) were succeeded by modified Denis-Browne-Crawford method and 6 cases (100%). Cecil method and one case (50%), Tiersch-Duplay method.

Four Cases of Conservative Surgical Management in Major Renal Injury / 대한비뇨기과학회지

A review is presented in 4 patients with major renal injury seen in our hospital. All patients underwent conservative surgical management. A conservative surgical management to major renal injury is emphasized.

Clinical Observation on Ureteral Tailoring in 13 Cases / 대한비뇨기과학회지

A clinical observation was made on 13 cases (15 ureters) who were performed ureteral tailoring at the Department of Urology, Catholic Medical College, from 1968 to 1981. Clinical observation was included age and sex distribution, indication for operation, methods of operation, duration of indwelling ureteral splint catheter and complications. The results were as follows: 1. Ureteral tailoring was performed in the case of severe dilated ureter due to ureteral obstruction, V-U refiuxand/or megaloureter. 2. Most case had undergone antirefiux procedures except 2 cases: 12 ureters of 10 cases underwent antirefiuxprocedure of Politano-Leadbetter technic and the other one was Paquin technic. 3. Mean duration of keeping splint catheter was 11 days. 4. Temporary nephrostomy was performed in 4 cases due to poor renal function. 5. Complications had been observed in 6 cases, which included septicemia, ureteral stricture, uremia, urineleakage and urinary infection.

A Clinical Observation on 31 Partial Nephrectomized Patients / 대한비뇨기과학회지

A clinical observation was made on 31 partial nephrectomized patients in Department of Urology, Catholic Medical College, during the period from January 1976 to December 1980. The results were as follow: 1. The common age group in 3rd and 4th decades and the proportion of male to female was 1.4 : 1. 2. Among 31 cases, renal stone was 18 (58.0%). renal tuberculosis was 7 (22.6%), renal rupture was 2 (6.5%). double pelvis was 2 (6.5%), renal infarction was 1 (3.2%) and renal carbuncle was 1 (3.2%). 3. of 31 cases, partial nephrectomy was performed in 33 cases. As methods of the operation, Guillotine type with "U" shaped mattress suture was 19 cases (57.6%) and Renal Vessel Clamp type wag 14 cases (42.4%). 4. Postoperative complication were gross hematuria in 4 cases, temporary urine leakage in 4 cases, wound infection in 1 case, residual stone in 1 case, delayed bleeding in 1 case, septic condition in l case and death in 1 case.

Clinical Observation on Renal Tuberculosis and Its Urinary Tract Complications Treated by Surgery / 대한비뇨기과학회지

The clinical observation was made on 117 operated cases of renal tuberculosis in Department of Urology, Catholic Medical College, during the period from 1970 to l979. The results were as follows: 1. Among 117 cases of the renal tuberculosis, 91 (77.8%) were unilateral and 26 (22.2%) were bilateral renal tuberculosis. Among 81 cases of the ureteral stricture complicated by renal tuberculosis, 55 (60.4%) were unilateral and 26 (39.6%) were bilateral renal tuberculosis. Contracted bladder was represented in 42 cases (35.9%). 2. Ureteral reimplantation was performed in 13 cases. Among 7 cases of the anti-reflux method, 2 cases were failed, 1 case of Boari operation was dead, but 5 cases of direct method were all successful. 3. Among 5 cases of the ileocystoplasty, 4 were in good result but 1 case had small amount of residual urine. Among 6 cases of the ureteroileocystoplasy, 1 case was dead and 1 case was performed secondary nephrectomy after previous operation. One of 2 cases of the ileal substitution of the ureter was dead. 4. There was no complication in 65 cases of simple nephrectomy and 2 cases of partial nephrectomy. 5. Of 50 cases of the total patients, except 65 cases of simple nephrectomy only and 2 cases of partial nephrectomy, 5 cases were complicated and 1 cases were dead. The complications were ureteral strictures at the site of reimplantation in 6, urinary fistulas in 2 and wound infection in 1. The causes of death were sepsis in 2, uremia with sepsis in 1 and acute renal failure in 1.

Statistical Observation on In-patient in the Past 2 Years / 대한비뇨기과학회지

A statistical observation was made on 525 in-patients in the Department of Urology Catholic Medical College, during the period from the January 1. 1978 to December 31, 1979.