The Treatment of Lower Ureteral Stones: A Comparison of Shock Wave Lithotripsy and Ureteroscopy / 대한비뇨기과학회지

No abstract available.

Testis tumor: A clinical experience of 20 years / 대한비뇨기과학회지

Forty-six patients with testicular tumor were treated at our hospital From 1971 to 1990. There were 25 children (13 yolk sac tumors, 10 teratomas, 1 teratocarcinoma and 1 acute lymphocytic leukemia) and 21 adults(11 seminomas, 4 non-seminomatous germ cell tumors and 6 non-germ cell tumors). Testicular lumors with clinical evidence of cryptorchidism were 4 seminomas and 2 non seminomts. Serum AFP or HCG were observed in 8 patients of 8 seminomas, 1 of 5 teratomas, 7 of 9 yolk sac tumors and 4 or 5 non-seminomatous germ cell tumors(NSGCT). Four stage 1 seminomas and 1 NSGCT were tumor free of 2 years after radical orchiectomy and 2 of 4 seminomas were received prophylactic radiotherapy. Two stage II seminomas and 1 NSGCF treated with PVB nomas and radiotherapy were tumor free of 2 years but stage III seminomas and NSGCT died during chemotherapy. All stage 1 yolk sac tumors and teratomas were tumor Free of 2 years by surveillance only following radical orchiectomy but stage II and III yolk sac tumors died during chemotherapy. We have suggested that poor result of stage III testicular tumors can be attributed to few cases with more aggressive and more toxic chemotherapy in the unfavorable prognosis disease(advanced extent) and poor compliance of patient of therapy.

The correlation of serum prostate specific antigen(PSA) and prostatic volume measured by transrectal ultrasonography in the diagnosis of benign prostatic hyperplasia / 대한비뇨기과학회지

We investigated a correlation of serum prostate specific antigen(PSA) and preoperative prostatic volume measured by transrectal ultrasonography (TRUS) in 66 patients with pathologically con- firmed benign prostatic hyperplasia (BPH), as aids in the early detection of prostate cancer and in the improvement of specificity in BPH. The preoperative serum PSA value was also measured in 18 patients with pathologically confirmed prostate cancer and 15 men without prostatic disease as normal control using Tandem-R PSA radioimmunometric assay. There was a highly significant correlation between natural logarithm transformed PSA(In PSA) and non-transformed prostatic volume by linear regression analysis(r=0.6668, p<0.0001). Given above data, we determined a volume adjusted 95th percentile upper confidence limit for n PSA as an appropriate cutoff between normal and abnormal PSA value, according to prostatic volume in BPH. In the patients with BPH and prostate cancer, sensitivity, specificity, diagnostic accuracy and positive predictive value were 94%, 72%, 68% and 48%, respectively. A statistical results by the volume-adjusted cutoff for in PSA was similar to that at 10 ng/ml as cutoff for PSA value. Above 40ml in prostatic volume, however, a false positive rate was decreased in inverse proportion to prostatic volume in BPH. In summary, the prostatic volume must be considered in BPH patients with elevated serum PSA value, negative digital rectal examination and negative TRUS of prostate. And when the volume adjusted PSA cutoff is clinically applied to BPH patients for the early detection of prostate cancer, we thought that the false positive rate can be decreased in BPH patients.

Flow cytometry of undescended testis: A comparison with histology / 대한비뇨기과학회지

To evaluate the value of flow cytometry in cryptorchidism, the results were compared with histologic findings. The study group consisted of 22 unilateral cryptorchidism(17 prepubescents and 5 postpubescents) and 18 testes 1mm patients with hydrocele, infertility and prostatic cancer. DNA histograms of all prepubertal testes demonstrated normal pattern of 85% of cells in the diploid peek. 12% of cells in the tetraploid peek and no haploid peak in spite of three distinct pattern of the histolegical finding with respect to development of germ cells and shape of seminiferous tubule and interstitium. However, in postupubertal patients with cryptorchidsm and other diseases, DNA histograme revealed characteristic ploidy patterns of relative proportions of haploid, diploid and tetaploid sells corresponding to the histological appearances of normal testicular morphology, moderately abnormal morphology and Sertoli cell only. Flow cytometricanalysis of testis is a rapid, objective and quantitative method that may ultimately replace standard wedge biopsy due to its high degree of histological correlation in postpubertal crytorchidism.

Histologic changes of contralateral scrotal testicle in theunilateral cryptorchidism / 대한비뇨기과학회지

Histomorphologic study was performed on bilaterally testicular biopsies of 30 preadolescent patient with unilateral cryptorchidism so as to understand pathophysiology of the increased incidence or infertility, seen in unilateral cryptorchidism. The results demonstrated delayed and defective transformation of gonocytes to spermatogonia, delayed or failed transformation of spermatogonia to primary spermatocyte and decreased numbers of Leydig cells. These abnormalities were present in the unilaterally cryptorchid testis and their contralateral descended partners but they were more serious and earlier onset in the cryptorchid testis. That is to say, blunted surge in gonadotropins triggers atrophy of Leydig cells leading to delayed and defective maturation of germ cells leading to decreased numbers of germ cells. These findings are compatible with the hypothesis that hypo gonadotropic hypogonadism is the cause of cryptorchidism.

Infant pyeloplasty / 대한비뇨기과학회지

The widespread use of prenatal ultrasonography has resulted in a dramatic increase in the number of hydronephrosis. Timing. safety and benefits of performing pyeloplasty in infancy currently are being questioned. to evaluate the effect of age on the pyeloplasty. the results of 9 pyeloplasties done during infancy ( including 4 pyeloplasties in neonate) were compared with those of 11 pyeloplasties in older age group. The surgical results in two groups were equally good, with all of cases having an improved or stable IVP or ultrasonogram taken 6 months postoperatively. Complications were few and were more common in the older age group. in which 5 cases required a secondary procedure. In conclusion, pyeloplasty during infancy was as safe and successful as that of older age group.

Caudal anesthesia in pediatric urology / 대한비뇨기과학회지

Caudal anesthesia has become increasingly widespread in pediatric surgery in recent years, especially for operation below the umbilicus. A prospective study was made to determine the efficacy of caudal anesthesia for pediatric urologic surgery. Seventy five patients who had analogous age and disease were entered in this study (caudal block with light general anesthesia in 47 patients and general anesthesia alone in 28 patients). The children who had caudal block were in psychologically ideal condition with reduced postoperative pain and less demand of analgesics during postoperative period. There were no toxic reactions of local anesthetics and technical faults in the caudate anesthesia. In conclusion, caudal anesthesia was notable for its simplicity, safety and effectiveness and was particularly useful in patients who have the propensity to develop bladder spasm.

Vesicovaginal fistula: 20years of experience / 대한비뇨기과학회지

A clinical observation on the vesicovaginal fistula repair was done on 46 cases admitted to the Department of Urology, Keimyung University Hospital, during the period from 1971 through 1990. The incidence rare of recent 10 years has decreased in comparison with that of the previous 10 years without change of age distribution, size and location of vesicovaginal fistula. Success rate of vesivocaginal Fistula repair was 60%. 89% and 100% with suprapubic transvesical. transperitoneal transvesical and trensvaginal repair, respectively. Although the management of vesicovaginal fistula still remains controversial in regard to the timing of repair and type of approach, transvaginal approach has the distinct advantages of simplicity, ease and less morbidity. Transvaginal repair with jackknife position can be performed successfully by better exposure and easier access.