Risk factors for massive postpartum bleeding in pregnancies in which incomplete placenta previa are located on the posterior uterine wall

OBJECTIVE: To identify factors associated with massive postpartum bleeding in pregnancies complicated by incomplete placenta previa located on the posterior uterine wall. METHODS: A retrospective case-control study was performed. We identified 210 healthy singleton pregnancies with incomplete placenta previa located on the posterior uterine wall, who underwent elective or emergency cesarean section after 24 weeks of gestation between January 2006 and April 2016. The cases with intraoperative blood loss (≥2,000 mL) or transfusion of packed red blood cells (≥4) or uterine artery embolization or hysterectomy were defined as massive bleeding. RESULTS: Twenty-three women experienced postpartum profuse bleeding (11.0%). After multivariable analysis, 4 variables were associated with massive postpartum hemorrhage (PPH): experience of 2 or more prior uterine curettage (adjusted odds ratio [aOR], 4.47; 95% confidence interval [CI], 1.29 to 15.48; P=0.018), short cervical length before delivery (<2.0 cm) (aOR, 7.13; 95% CI, 1.01 to 50.25; P=0.049), fetal non-cephalic presentation (aOR, 12.48; 95% CI, 1.29 to 121.24; P=0.030), and uteroplacental hypervascularity (aOR, 6.23; 95% CI, 2.30 to 8.83; P=0.001). CONCLUSION: This is the first study of cases with incomplete placenta previa located on the posterior uterine wall, which were complicated by massive PPH. Our findings might be helpful to guide obstetric management and provide useful information for prediction of massive PPH in pregnancies with incomplete placenta previa located on the posterior uterine wall.

A Study on Model for Decreasing an Outpatient Waiting Time / 대한의료정보학회지

This study is tried to suggest the new model to shorten the patient's waiting time from counting department to receiving drugs from pharmacy after doctor's diagnosis. The method of this study is designed to simulate from counting time to finishing time of dispensing drugs for internal medicine outpatients. The results are as follows : First, the increasing the numbers of server at pharmacy and counting department in present model don't effect on shortening outpatient's waiting time. Second, in the case of application of OCS, the outpatient's waiting time for receiving dispensed drugs from pharmacy is rather delayed because of no waiting time for counting. Third, in the case of application OCS and ATC simultaneously, the outpatient's waiting time for receiving dispensed drugs is shortened, and in this case, the increasing the numbers of server at pharmacy effect more greatly on the changes of patient's waiting time for receiving dispensed drugs from pharmacy. From the results of this study, it is noted that the best optimal for shortening outpatient's waiting time in general hospital is to introduce the OCS and ATC simultaneously in the process between the counting department and pharmacy, and increasing the numbers of server at pharmacy.

A case of myxoid liposarcoma of paratesticular tissue / 대한비뇨기과학회지

Liposarcoma of paratesticular origin is extremely rare and preoperative diagnosis is unusual. Myxoid type or liposarcoma is in general less malignant than testicular tumor and orchiectomy with high ligation and wide excision of tumor mass are probably the treatment of choice. We are present a case of myxoid liposarcoma and reviewed literatures.

A case of myxoid liposarcoma of paratesticular tissue / 대한비뇨기과학회지

Liposarcoma of paratesticular origin is extremely rare and preoperative diagnosis is unusual. Myxoid type or liposarcoma is in general less malignant than testicular tumor and orchiectomy with high ligation and wide excision of tumor mass are probably the treatment of choice. We are present a case of myxoid liposarcoma and reviewed literatures.

Urethral reconstruction in transvaginal eversion of urinary bladder caused by hydrochloride application / 대한비뇨기과학회지

A case of massive transvaginal eversion of urinary bladder through a large vesicovaginal fistula is reported. It has developed by spillage of hyprochloride on prolapse uteri and accompanied with rectovaginal fistula. Satisfactory surgical repair of the fistula was obtained by reduction of bladder and urethral reconstruction using anterior bladder wall.

1 Case of Transverse Testicular Ectopia / 대한비뇨기과학회지

Transverse testicular ectopia is an uncommon anatomical abnormality in which both gonads migrate toward the same hemiscrotum. A case report, review of the embryology, differential diagnosis and suggested management are detailed witha brief review of literature.

A Case of Ureteritis Cystica / 대한비뇨기과학회지

Ureteritis cystica is one of the cystic diseases formed in the mucosa or submucosa of the renal pelvic, ureter and bladder by chronic inflammation or irritation. A rare case of ureteritis cystica confirmed by ureteroscopy is presented with review of the literatures.

Clinical Observation on Ureteroscopy / 대한비뇨기과학회지

Rigid ureteroscopy is now an established technique for the management of ureteral stones and the diagnostic procedure of ureteral lesions. From July 1987 to August 1988, 23 patients underwent transurethral ureteroscopic procedure. The following results were obtained. 1. The success rates of ureteral stone removal were 84.6 %(11 among 13 cases) in lower ureter, 66 % (2 among 3 cases) in mid ureter and 50 % (2 among 4 cases) in upper ureter. In diagnostic procedure, the success rate was 100 % (3 among 3 cases). Overall success rate was 78.3 % (18 among 23 cases). 2. The success rates were 70 % (7 among 10 cases) of smaller than 1 cm and 80 % (8 among 10 cases) of larger than 1 cm. 3. Anesthetic methods were general(47.8 %), spinal (21.7 %) and epidural (30.8 %). 4. Average operating time was 118 minutes(from 40 minutes to 240 minutes) and mean hospitalization was 5.2 days. 5. Operative failure occurred in 4 cases : a case of false instrumental handling, a case of upward migration, a case of ureteral perforation and a case of severe ureteral kinking. 6. Complications occurred in 4 cases : a case of ureteral avulsion, a case of stone migration, a case ofureteral perforation and a case of flank pain for 2 weeks.

Percutaneous Nephrolithotomy in a Child / 대한비뇨기과학회지

Percutaneous removal of renal and ureteral calculi has become an established and successful procedure in adults. We have performed percutaneous extraction of renal stone, in 4-year-old girl. She was discharged without specific complication and IVP was checked postoperatively at 3 months later. We report a case of renal stone treated by percutaneous nephrolithotomy.

Ileal Ureter with Cecocystoplasty in a Patient of Massive Ureteral Stricture and Contracted Bladder Following Instillation of Formalin into the Bladder: Report of a Case / 대한비뇨기과학회지

Intravesical instillation of formalin has become an accepted therapeutic measure for control of intractable bladder hemorrhage. But the complication rate of formalin instillation is high and severe, including vesicoureteral reflux and hydronephrosis and acute tubular necrosis. We report a case of bilateral ureteral stricture following instillation of formalin into the bladder with unknown cause of massive hematuria, who was treated by ileal ureter with cecocystoplasty.

Clinical Observation on Female Urethral Injury / 대한비뇨기과학회지

Female urethral injury are very uncommon and encountered during traffic accident, trauma, instrumentation, operation and delivery. Treatment modalities are determined by the level of urethral injury. The result was better in the cases of rapid operative treatment than delayed one. In this report the clinical findings, patterns of injury and surgical managementof 4 cases were reviewed.

Values of Urine Cytology in the Diagnosis of Urothelial Carcinomas / 대한비뇨기과학회지

In order to determine its accuracy the authors conducted cytologic examination on patients found to have urothelial carcinoma by cystoscopy, histopathologic and radiological examinations at the Department of Urology, Catholic Medical College, from January 1971 to August 1981. The results were as follows: 1. Age distribution of the urothelial carcinomas is from 33 to 80 years age and the most frequent age group is 40 to 59 years age. The male: female ratio is 4.3:1. 2. Of the 32 patients, 4 cases (12.4%) were negative, 14 (43.8%) suspicious and 14 (43.8%) positive reports. 3. No significant correlations were found between the urine cytology and histologic grade, but the higher cytologic class had tendency to have the higher histologic grade. 4. In the aspect of the tumor size and cytology, large sized tumor had showed positive findings more frequently than that of, smaller one, but it showed high accuracy rate (77.8%) when small sized tumors were multiple.

A Case of Retroperitoneal Neurilemmoma / 대한비뇨기과학회지

Neurilemmoma is a relatively rare, which was first described by Stout in 1935. Neurilemmoma is a neoplasm arising from Schwann cells. It is usually solitary and may be benign or malignant, solid or cystic, encapsulated or diffuse. We report one case of retroperitoneal neurilemmoma with review of literature.

A Case of Calyceal Diverticulum Treated by Partial Nephrectomy / 대한비뇨기과학회지

Calyceal diverticula are eventrations of the upper collecting system, lying within the renal parenchyma, communicating with the main collecting system via a narrow channel and lining by transitional tell epithelium. Most are asyptomatic and rarely require any form of treatment but complicated one needs surgical correction. We experienced one case of calyceal diverticulum associated with stone in 47 year old man. This calyceal diverticulum was removed by partial nephrectomy.