A Case of Prostatic Adenoid Cystic Carcinoma / 대한비뇨기과학회지

Adenoid cystic carcinoma occurs most commonly in the salivary glands, and also has been recognized in numerous other locations. However, it is rarely found in the prostate. We report a case of adenoid cystic c arcinoma of the prostate in a 77-year-old man whose chief complaint was urinary retention. Digital rectal examination transrectal ultrasonography revealed a markedly enlarged prostated and PSA was 4.6ng/ml. The transurethral prostatectomy was performed and the histopathological diagnosis was the adenoid cystic carcinoma. We review the clinical and pathologic feature of this disease.

Factors Influencing the Success Rate of Percutaneous Nephroureterolithotripsy / 대한비뇨기과학회지

PURPOSE: Percutaneous nephroureterolithotripsy is one of alternative methods for the treatment of upper ureteral stones which are impacted in ureter or unresponsive to repeated extracorporeal shock wave lithotripsy(SWL). We evaluated the factors influencing the success rate of percutaneous nephroureterolithotripsy based on clinical data. MATERIALS AND METHODS: 107 patients(2 with bilateral) were included in this study. We reviewed the medical records and analyzed the factors ; stone size, laterality, location, site of percutaneous puncture, presence of pyuria, body weight, previous procedure(open surgery or SWL), and the experience of operator. RESULTS: The overall success rate of percutaneous nephroureterolithotripsy was 85.3%(93 of 109 cases). The location of stone and the experience of operator influenced the success rate of operation. The stones located above the lower pole level were obviously more successful than those located below it(57/62, 91.9% versus 36/47, 76.6%, p<0.05). In the late period of the operator`s experience, the success rate was significantly increased than that in the early period(51/58, 87.9% versus 40/51, 78.4%, p<0.05). But the stone size, laterality, site of percutaneous puncture, presence of pyuria, body weight and previous procedure didn`t influence the success rate. The average operation time was 93 minutes, average radiation exposure time was 2.2 minutes, and average hospital stay was 5.4 days. Most of the complications such as bleeding, urinary tract infection and pneumothorax were managed successfully with conservative treatments. CONCLUSIONS: Upper ureteral stones, which are impacted in ureter or unresponsive to repeated SWL can be successfully managed with percutaneous procedures. The stone location and the experience of operator are considered to be the major factors influencing the success rate.

A Case of Inguinal Wilms' Tumor / 대한비뇨기과학회지

Extrarenal Wilms' tumor is extremely rare and occurs predominantly in children. There are less than 50 well-documented cases of extrarenal Wilms' tumor in the literature. Herein, a case of extrarenal Wilms' tumor, whose mass was found in the inguinal region during an operation for the cryptorchidism, is reported in a 2 year old child with a brief review of literature. This case report illustrates the importance of pathologic examination of similar soft masses, found incidentally during operations.

Bilateral Xanthogranulomatous Pyelonephritis in a Child / 대한비뇨기과학회지

Xanthogranulomatous pyelonephritis is a chronic inflammatory condition that can only be diagnosed by histological examination, and is often associated with renal calculi, obstruction and urinary tract infection. We report a case of bilateral xanthogranulomatous pyelonephritis in a child with end stage renal disease, which was misdiagnosed as renal cell carcinoma preoperatively.

The Diagnostic Usefulness of Computed Tomography of Transitional Cell Carcinoma of the Renal Pelvis and Ureter / 대한비뇨기과학회지

We evaluated the usefulness of preoperative computed tomography (CT) in 26 patients with transitional cell carcinoma (TCC) of the renal pelvis or ureter. Also we had comparative analysis between CT and conventional urography in diagnosis. The conventional imaging methods such as excretory urography and retrograde pyelography are helpful in localizing the lesions but usually cannot detect extension into the peripelvic and/or periureteral fat or metastasis to the lymph nodes. Of 17 patients who were thought localized by CT, 16 were localized in the mucosa or muscle layer and 1 was invasive to periureteral or peripelvic tissue pathologically. Of 8 patients who were thought invasive to periureteral or peripelvic tissue by CT, 5 were identical and 3 were metastatic to lymph nodes pathologically In conclusion, preoperative CT is thought to be useful tool for the diagnosis and staging in TCC of the pelvis or ureter and the sensitivity and specificity of CT were higher in localized diseases than in advanced diseases.

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.

Coincidental occurrence of renal cell carcinoma and angiomyolipoma in the same kidney : a case report / 대한비뇨기과학회지

Coincidental occurrence of the renal cell carcinoma and renal angiomyolipoma in the same kidney is exceedingly rare, and it is usually presented as separated masses or nodules in cage of its occurrence. However, our case which has occurred in a 37-year-old-man without any stigmata of tuberous sclerosis is different because the angiomyolipoma and renal cell carcinoma are admixed in the same mass. To our knowledge, only 2 cases or combination of this tumors have been reported previously.

The Pathological Anatomy of Intermittent Testicular Torsion / 대한비뇨기과학회지

Testicular torsion is the most common cause of acute scrotal pain in prepubertal and adolescent boys. The overall testicular salvage rate with acute torsion is only 20 to 50 per cent. However, up to 50 percent of the patients with acute torsion have experienced previous episodes of acute testicular pain. Intermittent testicular torsion is a separate entity that should be considered in all young males with a history of scrotal pain and swelling. interspersed with long interval without symptoms. Most males with testicular torsion have aberrant anatomy for the testes to be more susceptible to torsion. Bell-clapper deformity and long mesorchium have been typically described at exploration. On reviewing the medical records. elective orchiopexy was performed on l2 patients under the diagnosis of intermittent testicular torsion during the recent 5 years at Yonsei University Hospital. The features and pathological anatomy of intermittent testicular torsion in these l2 patients are described. Awareness of intermittent testicular torsion as a definite entity and early elective orchiopexy will improve testicular salvage rate.

Two Cases of Aldosteronoma / 대한비뇨기과학회지

Primary aldosteronism, characterized by hypertension, hypokalemia, and hyperaldosteronemia resulting from chronic oversecretion of aldosterone independent of normal renin-angiotensin regulatory system, is due mostly to aldosteronoma or to bilateral cortical nodular hyperplasia. We report two cases of primary aldosteronism due to adrenal cortical adenoma, which were diagnosed by clinical data and abdominal computed tomographic scan. Clinical symptoms and laboratory data returned to normal after surgical adrenalectomy.