No abstract available.
Transurethral Resection of Prostate*

Internal urethrotomy under direct vision was utilized in the complete urethral stricture secondary to pelvic bone fracture or other trauma Prior to operation the antegrade-retrograde cystourethrogram demonstrated a complete disruption and the length of stricture at the level of bulbar and/or membranous urethra. To seek correct channel of proximal urethra was facilitated by an antegrade metal sound guidance performed through the suprapubic tract during urethrotomy. We found this technique a simple, easy and effective method in the management of traumatic complete urethral stricture.
Constriction, Pathologic ; Pelvic Bones ; Urethra ; Urethral Stricture*

Bladder stone formation is secondarily associated with bladder outlet obstruction, such as neurogenic bladder and benign prostatic hyperplasia, and intravesical foreign body. 1. A case of unexpected giant bladder stone weighed 580gm associated with missed intravesical bullet after gun shut injury during Korean War in a 55-year-old man. 2. A case of giant bladder stone weighed 260gm associated with urinary stasis and urinary tract infection due to neurogenic bladder in a 46-year-old woman. 3. A case of multiple bladder stone, total number of 107, associated bladder outlet obstruction due to benign prostatic hyperplasia in a 63-year-old man.
Female ; Foreign Bodies ; Humans ; Korean War ; Middle Aged ; Prostatic Hyperplasia ; Urinary Bladder Calculi* ; Urinary Bladder Neck Obstruction ; Urinary Bladder* ; Urinary Bladder, Neurogenic ; Urinary Tract Infections

We reviewed our experience retrospectively with 65 patients who had post-traumatic complete urethral stricture secondary to pelvic bone fracture or other causes during last 10 years. All patients underwent delayed endoscopic internal urethrotomy (EIU) 3 to 9 months later after immediate suprapubic diversion. Prior to EIU, the antegrade-retrograde urethrogram demonstrated a complete urethral disruption, and the length of urethral obstruction was measured from 0.5cm to 3.5cm (mean 1.4cm). Of 65 patients, 61 patients (94%) had successful operations, 4 patients (6%) whose strictures were measured more than 2.5cm were failed and treated with open urethroplasty. Sixty-one patients who eventually underwent successful endoscopic internal urethrotomy; 28 patients (46%) achieved satisfactory urethral voiding after first EIU; 33 patients (54%) took operations more than twice due to recurred partial urethral stricture. After 6 to 53 months (average-21months), fifty-six (86%) of 65 patients voided satisfactorily (incontinence in 3 patients). Five patients who did not void well even after successful EIU were diagnosed to have neurogenic bladder (detrusor areflexia). Of 65 patients, 16 patients (25%) had post-traumatic impotence. After the EIUs were performed, there were no newly developed impotences. There were no serious major complications. We concluded that direct visual internal urethrotomy was useful and safe as a primary minimally invasive therapeutic modality for post-traumatic complete urethral stricture in selected patients with relatively short urethral defect (less than 2.5cm).
Constriction, Pathologic ; Erectile Dysfunction ; Humans ; Male ; Pelvic Bones ; Retrospective Studies ; Urethral Obstruction ; Urethral Stricture* ; Urinary Bladder, Neurogenic

Patients with bilateral aplasia of the vas deferens have been considered sterile. In such patients many investigators have tried to create a successful sperm bank with various materials such as saphenous vein, tunica vaginalis, silicone prosthesis, monofilament knitted polypropylene and etc. and to offer hope for fertility. We performed to create an artificial spermatocele in a 32 year old male patient with bilateral vas aplasia by using a segment of great saphenous vein, anastomosed to the globus major to store spermatozoa. Aspirations of the venous cap of the patient at 2.3.4. and 5 months revealed numerous sperm with normal morphology and poor motility. Attempted insemination to his wife with this sperm was unsatisfactory.
Adult ; Aspirations (Psychology) ; Fertility ; Hope ; Humans ; Insemination ; Male ; Polypropylenes ; Prostheses and Implants ; Research Personnel ; Saphenous Vein ; Silicones ; Sperm Banks ; Spermatocele* ; Spermatozoa ; Spouses ; Vas Deferens*

A 29 year old male patients had long pendulous and bulbous urethral stricture after trauma. Patient was treated with modified Orandi vasculized island skin flap urethroplasty for pendulous urethra and Blandy-Singh vasculized island skin flap urethroplasty for bulbous urethra simultaneously. The result was relatively good for follow up on month.
Adult ; Follow-Up Studies ; Humans ; Male ; Skin* ; Urethra ; Urethral Stricture*

We investigated whether early catheter removal after operation could affect the result and morbidity or TURP. We reviewed 99 charts of 118 consecutive BPH patients who underwent TURP during 1991. Since August 1991 we changed our philosophy and started to remove the catheter on postoperative day 1. Prior to that time catheter was removed three to five days postoperatively. There were 42 patients in early catheter removal group and 57 patients in traditional group. Nine- teen cases were ruled out due to the protocol violation or loss during follow-up. All operations were performed by the same surgeon. There was no significant differences between two groups in terms of patient`s age, symptom scores, operation time, resected specimen weight and the amount of used irrigating solution. No statistical differences between the complications of both groups was seen. Of the early removal group 6(14%) required reinsertion of the catheter following initial removal and 4 (10%) required blood transfusions. In conventional group 5(9%) required recatheterization and 5 (9%) required transfusion. Other complications were not remarkable. The average hospital stay postoperatively was 2.2 days in early removal group and 6.2 days in traditional group. The average costs saving for patients in early removal group was about won 140,000(about dollers 200). These results suggest that early removal of the catheter could be allowed as a routine postoperative management following TURP, thereby reducing the length of hospital stay and costs.
Adolescent ; Blood Transfusion ; Catheters* ; Catheters, Indwelling ; Follow-Up Studies ; Humans ; Length of Stay ; Philosophy ; Prostate* ; Prostatic Hyperplasia ; Transurethral Resection of Prostate

PURPOSE: Although the gold standard treatment for muscle invasive bladder cancer, radical cystectomy does not guarantee a high survival rate even without the natural bladder. We evaluated the survival rate and prognostic factors in patients with muscle invasive transitional cell carcinoma of the bladder, performed with the combined modality of transurethral resection and chemotherapy. MATERIALS AND METHODS: A total of 72 patients with clinical stage T2-T4 N0M0 bladder cancer diagnosed/treated/admitted between 1991 and 2002 were included in the study. They were treated with transurethral resection followed by 6 cycles of methotrexate, vinblastine, epirubicin, and cisplatin chemotherapy. The patients were evaluated with cystoscopy, urine cytology, abdominal-pelvic CT scan, whole body bone scan, and chest radiography. The prognostic factors such as age, the presence of hydronephrosis, and tumor stage, size, grade, and morphology were analyzed using log-rank test, while the 5-year overall survival rate was estimated using Kaplan-Meier method. RESULTS: The 5-year overall survival rate was 48%(stage T2, 83%; stage T3, 60%; stage T4, 0%). Age, T stage, tumor grade and tumor size were significant predictors for an increased probability of bladder preservation. Tumor morphology and the presence of hydronephrosis were not associated with survival rate in bladder preservation management. CONCLUSIONS: Our RESULTS showed that bladder preservation managed with transurethral resection and chemotherapy for muscle invasive bladder cancer demonstrates a good response rate in selected patients. Therefore, muscle invasive bladder cancer with T2-3 stage, low grade, small size(less than 4 cm), and solitary in patients less than 65 years old may be considered as a candidate for bladder preservation management.
Aged ; Carcinoma, Transitional Cell ; Cisplatin ; Cystectomy ; Cystoscopy ; Drug Therapy ; Epirubicin ; Humans ; Hydronephrosis ; Methotrexate ; Organ Preservation ; Radiography ; Survival Rate ; Thorax ; Tomography, X-Ray Computed ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Vinblastine

PURPOSE: Bladder cancer can be induced by many chemicals, of which smoking was confirmed by Burch et al to be one well known risk factor. In our study, we evaluate the effect of smoking on bladder cancer as a single risk factor. MATERIALS AND METHODS: A total of 156 patients were enrolled in this study from March 1999 to April 2003. A survey soliciting smoking pattern, and duration and dose of smoking was mailed to each patient. We classified all patients into current smokers, ex-smokers and never-smokers on the basis of their smoking history. ANOVA and Chi-square tests were performed to evaluate the differences of stage, grade, tumor size and recurrence rate. The Kaplan-Meier technique was used to plot recurrence free survival and the log-rank test was used to compare the survival curves. RESULTS: There was no significant difference among current smokers, ex-smokers and never-smokers in terms of stage, grade and tumor size. However there was an obvious difference of recurrence rate among these groups. No significant difference of recurrence-free survival rate between ex-smokers and current smokers was noted, while never-smokers showed a better recurrence-survival rate than ex-smokers and current smokers. CONCLUSIONS: These data suggest that stage, grade, tumor size and tumor character can not represent the effect of smoking on bladder cancer progression. More accurate and prospectively determined assessment of smoking status by molecular investigation and indirect smoking would be required.
Humans ; Postal Service ; Recurrence ; Risk Factors* ; Smoke* ; Smoking* ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Flow cytometric nuclear deoxyribonucleic acid (DNA) ploidy analysis was done successfully on 35 specimens of stage T1 bladder carcinoma treated with Bacillus Calmette-Guerin(BCG) between June 1986 and June 1993. The histologic tumor grading was done by the same pathologist. Of the specimens 16(46%) were DNA diploidy, 14(40%) were aneuploidy and 5(14%) were tetraploidy. In the relationship between tumor grade and ploidy, diploidy was seen in all (100%) of 5 patients with grade 1, in 13(48%) of 27 patients with grade 2. On the other hand, non-diploidy in 14(52%) of 27 patients with grade 2, and in all(100%) of 5 patients with grade 3. Mean followup period was 29 months(12-97 months). None of the patients died of tumor during the followup period. None(0%) of 16 patients with diploidy had tumor recurrence, in contrast 8(42%) of 19 patients with non-diploidy tumors recurred(p<0.05). None of the 16 patients with diploidy had progression. but 5(36%) in 14 patients with aneuploidy (5 patients(26%) in 19 patients with non-diploidy) progressed to an advanced stage(p<0.05). The DNA ploidy analysis appears to significantly contribute in the elucidation of possible future recurrence and progression in patients with stage T1 bladder carcinoma.
Aneuploidy ; Bacillus ; Diploidy ; DNA* ; Flow Cytometry ; Follow-Up Studies ; Hand ; Humans ; Neoplasm Grading ; Ploidies ; Recurrence ; Tetraploidy ; Urinary Bladder*