A Case of Renal Angiomyolipoma Extending into the Renal Cyst Which was Confused with Renal Pelvis Tumor / 대한비뇨기과학회지

Renal angiomyolipoma is composed of mature fats, smooth muscles and abnormal blood vessels which arises mainly from renal parenchyme and compresses the calyx or protrudes the renal cortex, but which extends into the renal cyst is rare. Recently it can be easily diagnosed preoperatively by several diagnostic modalities such as ultrasonography, computed tomography and several clinical signs associated with tuberous sclerosis, although it`s clinical and radiological features are similar with renal cell carcinoma. We report a case of renal angiomyolipoma without tuberous sclerosis, extending into the renalcyst, which was confused with renal pelvis tumor in a 73 years old male.

Immunohistochemical Study of Ras and Epidermal Growth Factor Receptor Expression in BBN Induced Bladder Tumor of Rat / 대한비뇨기과학회지

There is increasing evidence that genes encoding for signal transduction pathway, including ras and epidermal growth factor receptor( EGFR), are involved not only in normal cellular growth and differentiation but also in development and progression of malignant tumors. N-butyl-N- (4-hydroxybutyl) nitrosamine (BBN)-induced rat bladder tumor is an ideal model to study the time related gene expression in stepwise bladder epithelial carcinogenesis. We herein investigated the roles of ras and EGFR by immunohistochemical study in bladder tissues of Sprague-Dawley rats after administration of BBN. Sequential epithelial changes consisting of normal, simple hyperplasia, nodular or papillary hyperplasia, papilloma and superficial transitional cell carcinoma(TCC) were observed in rat bladders in parallel with the duration of BBN administration. The expressions of both ras and EGFR were weak in bladder epithelia of non-BBN-administered rats, whereas, immunoreactivity and number of reactive cell layer were increased in bladder epithelia of BBN-administered rats in parallel with the duration of BBN administration and progression of bladder epithelial changes. These results further support the hypothesis that ras and EGFR may have important roles in development of bladder TCC.

A case of ureteral ectopia draining into seminal vesicle / 대한비뇨기과학회지

Ectopic ureter entering into the seminal vesicle associated with ipsilateral renal dysplasia is a very rare developmental abnormality. Clinical manifestations consists of dysuria, hematuria, recurrent epididymitis. ejaculatory pain and perineal discomfort and the diagnosis is made by seminal vesiculogram through vas deference. Surgical excision of the seminal vesicle and the ectopic ureter is the best choice or treatment in this entity. We present a case of 34 year old infertile man with ectopic ureter entering into the seminal vesicle associated with ipsilateral renal dysplasia and contralateral cryptorchidism.

Ultrastructural changes of human testis after vasectomy / 대한비뇨기과학회지

Vasectomy is one of the most common forms of male contraception throughout the world. However, more vasectomy reversals are sought each year because of the increasing number of second marriages and other causes. Before recommending vasectomy, urologists may wish to resolve in their own mind the conflict between reports that maintain the testis is harmed by vasectomy and those that slate is not. We studied a group of patients undergoing vasectomy reversal to determine whether histopathologic change on light and electron microscopy would be detected. Only one testis specimen from post-vasectomy patients showed an abnormality correlated with spermatogenesis and five cases showed mild focal interstitial fibrosis without abnormality of spermatogenesis on light and electron microscopy. We found that vasectomy has some influence to the spermatogenesis and pathologic change.

A case of perinephric cyst / 대한비뇨기과학회지

The perinephric cyst in which cystic structures are in close relation to the kidney and renal pelvis is rare in occurrence. The causes may be obscure but most perinephric cysts around the kidney are a result of trauma, either accidental or an operative complication and doubtful origin, in which there is an encysted collection of urine or serous fluid lying beside and sometimes compressingthe kidney, and sometimes communicating with the pelvis. Clinical presentation is characterized by palpable flank mass and history of trauma. The diagnosis is made by excretory urography, ultrasonogram and CT scan. The treatment is aspiration or encleation of the cyst, or rarely nephrectomy. We report a case of perinephric cyst with hypertension developed in a 58-year-old woman presented with a child-fist sized palpable mass on right upper abdomen.

Three cases of the emphysematous pyelonephritis / 대한비뇨기과학회지

Emphysematous pyelonephritis is a rare complication of acute pyelonephritis that occurs in diabetics or urinary obstruction and spontaneous gas formation around renal parenchyme. Diagnosis. in appropriate clinical setting. is confirmed radiographically. Plain film demonstrates a surprising pneumonephrogram, mottled gas shadow in the renal parenchyme as well as perirenal gas. Surgical intervention after unsuccessful antibiotics and conventional medical measurement is necessary. We experienced 3 cases of emphysematous pyelonephritis which occurred in diabetic women with brief review of the literature.

Clinical evaluation of urethral strictures following urethral catheterization / 대한비뇨기과학회지

A clinical evaluation was made on 19 patients with urethral stricture following urethral catheterization in 155 urethral stricture patients during 12 years from January. 1979 to December. 1990. The following results were obtained. I. In 155 cases of urethral stricture, iatrogenic urethral stricture was 24 cases (15.4%) of which the most common cause was urethral catheterization(19 cases) and followed by instrumentation (2 cases). 2. In 19 cases of urethral stricture following urethral catheterization. the most common site was the anterior urethra (bulbous 10 cases. pendulous 7 cases) and multiple strictures showed 5 of 17 anterior urethral strictures. 3. In 19 cases, 16 cases (84.2%) occurred in patients who have kept the urethral catheter within seven days and 18 cases (94.7%) were inserted and cared the urethral catheter by non-urologist. 4. Treatment was performed internal urethrotomy in 16, dilatation in 2 and catheter indwelling during 1 week in 1. 5. In 24 cases of iatrogenic urethral stricture. mean number of dilation to recurrent strictures after primary procedure had required O.5 time. From our results. we suggest that education for the careful insertion and method of care for the urethral catheter to non-urologist is least likely to induce urethral stricture formation.

A case of the renal medullary fibroma / 대한비뇨기과학회지

Renal medullary fibromas which are arisen from the interstitial cell of the renal medulla show small, multiple nodules on autopsy Findings over age 50, but they are very rare clinically. thus several cases have been reported until 1982. When the tumors are large. their clinical presentation is characterized by loin pain, hematuria and palpable mass. The preoperative diagnosis with radiologic studies is very difficult and the confirmative diagnosis was made with pathologic finding. Nephrectomy has been the most common useful treatment and local excision can be used. We report a case of renal medullary interstitial cell fibroma in a 17-year-old girl presented with a child-head sized palpable mass on the left upper quadrant.

Relationship of the patterns of pelvic bone fracture and bladder rupture / 대한비뇨기과학회지

A clinical observation was made on 64 cases of the bladder rupture who were admitted to our hospital during the period from June, 1979 to February, 1991. The results are as following ; 1. Of 355 cases of the genitourinary tract injury, the bladder rupture were 64 cases (18.0%), which were composed of 40 cases (62.5%) of bladder rupture without pelvic bone fracture and 24 cases (37.5%) of bladder rupture with pelvic bone fracture. The bladder rupture without pelvic bone fracture were composed of 35 cases (87.5%) with intraperitoneal bladder rupture and 5 cases (12.5%) with extraperitoneal bladder rupture, the bladder rupture with pelvic bone fracture were composed of 13 cases (12.5%) with intra and extraperitoneal bladder rupture. 2. In 24 patients with pelvic bone fracture, the most common site of bladder ruptures were found on the lateral wall in 12 cases (50%), and followed by the dome in 9 cases (37.5%), multiple areas in 3 cases (12.5%). In 40 patients without pelvic bone fracture, the most common site of bladder ruptures were found on the dome in 33 cases (82.5%), and followed by the multiple areas in 4 cases (10%), lateral wall in 3 cases (7.5%). 3. The average size of the bladder rupture was 6.5cm in cases without pelvic bone fracture, 6. 8cm in cases with pelvic bone fracture, especially comminuted pelvic ring fracture had most severed bladder rupture (average; 8.3cm). 4. Of 24 pelvic bone fractures, pubic rami fractures were most common (41.6%), and followed by comminuted pelvic ring fracture (25%), anterior and posterior pelvic ring fractures (12.5%), acetabulum and isolated fractures (8.3%), symphyseal separation fractures (4.1%) in order of frequency. 5. 5 cases (20%) of pelvic bone fractures were associated with posterior urethral injury, especially 60% in The pubic rami fracture. There was no significant relation between the type of pelvic fracture and the type of bladder rupture, but the fractures involving pubic arch were more often associated with posterior urethral injury.

Experience of Stamey operation for female stress urinary incontinence / 대한비뇨기과학회지

Stamey endoscopic suspension of bladder neck is a reliable technique among various surgical techniques with high success rate and little morbidity. We treated 8 patients complaining of urinary incontinence with Stamey operation from February 1988 to May 1990 and Follow-up for over 6 months. The results as follows; 1. Patients varied in age from 31 to 63 (mean;45) years. All patients were multiparous average 2.87 (2-4) times of previous deliveries 2. All patients showed frequency and nocturia. Severities of incontinence were Grade I in2 patients, Grade II in 5, Grade III in 1 3. No significant changes were identified between preoperative and postoperative urethral pressure profiles. 4. On preoperative lateral cystourethrograms, bladder base was descended about -2.10+-0.74cm from SCIPP line and elevated about +1.2 cm+/-0.49 cm from SCIPP line on postoperative lateral cystourethrograms. 5. Incontinence was disappeared in 7 patients, but 1 patients was recurred due to rupture of suture material during lifting heavy material.

A Case of Seminal Vesicle Cyst / 대한비뇨기과학회지

Seminal vesicle cysts are rare. Since the first case of a seminal vesicle cyst was reported by Zinner in 1914, about 20 cases have been reported in literature up to 1976. They are presented at the age of high sexual activity. They may be asymptomatic and discovered by rectal examination or may manifest with symptoms of bladder irritation, perineal or testicular pain, pain on ejaculation, etc. Here, we report a case of seminal vesicle cyst in a 38 years-old-man who was admitted under the impression of pelvic abscess.

ESWL of Caliceal Diverticula Calculi / 대한비뇨기과학회지

Caliceal diverticula are eventrations of the upper collecting system lying within the renal parenchyma and communicating with renal pelvis or a calyx through a narrow channel. The incidence on a routine IVP is approximately 0.21 to 0.45 percent and stone formation in a caliceal diverticulum has arised from 9.5 to 50 percent. Traditionally, treatment has included nephrotomy with extraction of the calculi and percutaneous nephrolithotripsy, but more recently ESWL has been challenged due to less invasive and safer procedure. We report the results of 11 patients with calculi in caliceal diverticula treated with EDAP LT-01 lithotriptor. All patients were followed during 2-11 months (average in 6.6) The results were obtained as follows ; 1. The symptoms were included chronic vague flank pain in seven, acute renal colic in two, epigastric discomfort in one and incidentally diagnosed in one. 2. The location of diverticula were upper third in seven, mid third in three and lower third of kidney in one. The stone size showed under 10mm in seven, 11-20mm in three and over 21mm in one. 3. The average numbers of treatment were 2.2 sessions and average storage was 102. 4. The complete success rate in 63.6 % (stone free rate in 45.5 %) and partial success rate in 27.2% were showed. 5. The complete relief of symptom was in eight (72.7% ), partial in one (9.1%) and persistent symptom in two (18.2 9t ). 6. Complication was showed only gross hematuria for 1 day in 63.6 %, but all patients recovered with conservative treatment. Therefore, the possibility of producing a satisfactory result (relief of symptom in 81.1%) and the low morbidity of ESWL suggest that this treatment may be appropriate for calculi in caliceal diverticuli.

A Case of Bilateral Ectopic Ureteral Orifices associated with Bilateral Complete Ureteral Duplication / 대한비뇨기과학회지

An ectopic ureteral orifice inserts at a point other than the trigone of the bladder. Ectopic ureteral orifices in a girl commonly are associated with complete ureteral duplication comprises only 10 to 12 per cent of such patients. Continuous incontinence in a girl with an otherwise normal voiding pattern after toilet training is the classic sign of an ectopic ureteral orifice. Here, we report a 3-years-old girl who was admitted to our hospital due to continuous urinary incontinence and managed with the diagnosis of bilateral ectopic ureteral orifices associated with bilateral complete ureteral duplication.

The Comparison of Erectile Function Tests in Patients Complaining of Impotence after Trauma / 대한비뇨기과학회지

We studied 16 male patients complaining of impotence after trauma. Underlying causes of injury were posterior urethral injury (9 patients), pevic bone fracture (3 patients), perineal burn (2 patients), penile fracture (1 patient) and spinal cord injury (1 patient). Rigiscan was used for diagnostic test and compared with other erectile function tests (Papaverine injection test, Snap Gauge test, PBI(penile brachial index) and PDI (penile digital index) test, AVS (audiovisual stimulation) and Erectiometer tests. The results obtained were as follows: 1. In 9 patients shown normal rigiscan, the number of erection was 1.56+/-0.87 times per night, duration was 14.2+/-7.54 minutes at tip and 20.1+/-9.42 minutes at base, tumescence change was 2.30+/-1.64 cm at tip and 3.40+/-0.73 cm at base, rigidity was 66.28+/-13.33% at tip and 78.86+/-21.43% at base. 2. Among 9 patients shown normal rigiscan, 8 patients showed partial to full rigid erection in intracavernous Papaverine injection test. 3. In 7 patients shown abnormal rigiscan, the findings of Snap Gauge test, AVS test and Erectiometer test showed slight to absent responses, but 9 patients shown normal rigiscan presented variable findings. 4. 13 patients with PBI > or=0.75 and 15 patients with PDI > or =0.77 showed normal rigiscan. but patients shown abnormal rigiscan presented variable findings of PBI and PDI tests. Conclusively, rigiscan and intracavernous Papaverine injection test showed high corresponding rate, but other erectile function tests presented variable findings in patients complaining of impotence after trauma.

The Comparison of Erectile Function Tests in Patients Complaining of Impotence after Trauma / 대한비뇨기과학회지

We studied 16 male patients complaining of impotence after trauma. Underlying causes of injury were posterior urethral injury (9 patients), pevic bone fracture (3 patients), perineal burn (2 patients), penile fracture (1 patient) and spinal cord injury (1 patient). Rigiscan was used for diagnostic test and compared with other erectile function tests (Papaverine injection test, Snap Gauge test, PBI(penile brachial index) and PDI (penile digital index) test, AVS (audiovisual stimulation) and Erectiometer tests. The results obtained were as follows: 1. In 9 patients shown normal rigiscan, the number of erection was 1.56+/-0.87 times per night, duration was 14.2+/-7.54 minutes at tip and 20.1+/-9.42 minutes at base, tumescence change was 2.30+/-1.64 cm at tip and 3.40+/-0.73 cm at base, rigidity was 66.28+/-13.33% at tip and 78.86+/-21.43% at base. 2. Among 9 patients shown normal rigiscan, 8 patients showed partial to full rigid erection in intracavernous Papaverine injection test. 3. In 7 patients shown abnormal rigiscan, the findings of Snap Gauge test, AVS test and Erectiometer test showed slight to absent responses, but 9 patients shown normal rigiscan presented variable findings. 4. 13 patients with PBI > or=0.75 and 15 patients with PDI > or =0.77 showed normal rigiscan. but patients shown abnormal rigiscan presented variable findings of PBI and PDI tests. Conclusively, rigiscan and intracavernous Papaverine injection test showed high corresponding rate, but other erectile function tests presented variable findings in patients complaining of impotence after trauma.

6 Cases of Primary Obstructive Megaureter / 대한비뇨기과학회지

The massively dilated ureter is one of major therapeutic challenges that face the urologists. The goals of reconstructive procedures are the elimination of residual urine, effective ureteral peristalsis, efficient and/or urgent drainage. 6 cases of primary obstructive megaureter were presented with review of literatures. The results obtained were as follows ; 1. 6 cases were divided into 2 groups according to etiology with 4 adynamic segments and 2 intrinsic stenosis. 2. The underlying histopathologic features included 1 submucosal inflammation,2 submucosal fibrosis with inflammation and 2 submucosal fibrosis. 3. 5 cases were treated with Hendren's technique and 1 case treated by ureteral meatotomy. 4. All cases showed obvious improvement of upper tract without complication during follow-up period from 5 to 26 months.

A Case of Cystic Lymphangioma of the Scrotum and Retroperitoneum / 대한비뇨기과학회지

The lymphangioma of the scrotum and retroperitoneum is a rare benign tumor secondary to congenital abnormal development of the local lymphatic communications, and about thirty cases have been reported in the literature. The majority of the patients are observed in the third to fifth decades, but this neoplasm has been reported even in the newborn. The frequent site of the lymphangioma occurs in the neck and axilla. Other sites are uncommon and one of the least frequent site is the scrotum and retroperitoneum. Treatment is complete surgical excision, unless completely removed, recurrences are common. Here, we report a case of cystic lymphangioma of the scrotum and retroperitoneum of a 26-years-old man.