No abstract available.

No abstract available.

Oncocytoma is a neoplasm consisting of oncocytes that is found in the salivary gland, kidney, and thyroid. Adrenocortical oncocytoma is particularly uncommon, and most cases reported are benign and nonfunctioning. Here, we report a 20 cm adrenal mass associated with necrosis that was identified as an oncocytic adrenocortical tumor with uncertain malignant potential through histopathological evaluation after its resection.
Adenoma, Oxyphilic ; Adrenal Gland Neoplasms ; Kidney ; Necrosis ; Oxyphil Cells ; Salivary Glands ; Thyroid Gland ; Uncertainty

Pediatric urolithiasis and calcular anuria in early infancy are rare. Cystine stones may develop in utero or during early infancy. We report the case of a female 9-month-old infant with obstructive anuria resulting from cystine stones in a single functioning unit. She presented to the emergency department owing to the absence of micturition for 3 days. Radiological investigations revealed four left ureteral stones and an atrophic right kidney resulting from a calcular obstruction. Her laboratory values were as follows: serum creatinine 6.7 mg/dl, Na 132 mEq/l, K 6 mg/dl, and hematocrit 32%. An urgent percutaneous nephrostomy tube was inserted into the left side for urinary drainage, and her serum levels of creatinine and K returned to normal within 3 days. A left ureterolithotomy was the final management. Stone analysis revealed pure cystine crystals.
Anuria ; Creatinine ; Cystine ; Drainage ; Emergencies ; Female ; Hematocrit ; Humans ; Infant ; Kidney ; Nephrostomy, Percutaneous ; Ureter ; Urination ; Urolithiasis

PURPOSE: Because low-quality trials may lead to erroneous conclusions, quality assessments are necessary. Thus, in this study, we scrutinized randomized controlled trials (RCTs) published in the Korean Journal of Urology (KJU) to assess their quantity and quality. MATERIALS AND METHODS: Upon extracting RCTs from all articles published in the KJU from 1991 to 2010, assessments were made on the basis of the Jadad scale and the adequacy of allocation concealment. The selections and assessments were performed independently by two researchers, and adjustment of the differences was done by a third-party researcher. In addition, the factors that may affect quality were analyzed. RESULTS: A total of 3,516 original articles were searched and 28 RCTs were extracted. In the 1990s, RCTs constituted only 0.27% of the total original articles, but in the 2000s, RCTs constituted 1.34%. The mean total Jadad score increased from 1.6 points in the 1990s to 1.65 points in the 2000s. However, the percentage of "good quality" trials also increased from 20% to 30.43%. As for adequate allocation concealment, one study was observed in the 2000s. The aspect most lacking was appropriate dropout and double-blinding. Studies with medical interventions or funded or examined by institutional review boards tended to receive higher quality assessments. CONCLUSIONS: Although RCTs consistently increased in both quantity and quality, in future studies, researchers should continue to strive toward achieving adequate allocation concealment and appropriate double-blinding. In addition, researchers must become more interested in receiving external funding and undergoing examination by institutional review boards.
Ethics Committees, Research ; Financial Management ; Humans ; Korea ; Patient Dropouts ; Prospective Studies ; Random Allocation ; Urology

PURPOSE: We prospectively evaluated the surgical outcomes of single scrotal incision orchiopexy in children with a palpable undescended testis compared with the traditional two incision orchiopexy. MATERIALS AND METHODS: A total of 398 orchiopexies (292 children) were included and randomly assigned to the single scrotal incision orchiopexy group (Group I, 147 children, 201 testes) or the traditional inguinal incision orchiopexy group (Group II, 145 children, 197 testes). The final number of patients enrolled (excluding those lost to follow-up) was 107 children (146 testes) in group I and 105 children (141 testes) in group II. Success was defined as no complications, postoperative intrascrotal location of the testis, and no conversion to the traditional inguinal approach. Surgical outcomes and complications were compared between the two groups. Testicular location, complications, and subjective satisfaction rate were assessed at the follow-up evaluation at least 12 months postoperatively. RESULTS: The overall success rate in group I was 92.5% in 135 of 146 testes; the remaining 9 testes required conversion to traditional two incision orchiopexy. In group II, orchiopexy was successful in 136 of 141 testes (96.5%). The operation time and hospital stay were significantly shorter in group I (40.5+/-25.9 minutes, 2.1+/-0.8 days) than in group II (62.3+/-35.6 minutes, 2.5+/-0.7 days), respectively (p<0.001, p=0.03). Postoperative complications were found in two cases (hematoma, wound dehiscence) in group I and in one case (wound dehiscence) in group II; all cases with complications recovered with conservative care. The subjective rate of satisfaction with the cosmetic result was 96.6% in group I and 96.5% in group II (p=0.97). CONCLUSIONS: We conclude that single scrotal incision orchiopexy is a simple technique that is associated with a shorter operation time and hospital stay than the traditional method and that is more feasible cosmetically.
Child ; Cosmetics ; Cryptorchidism ; Follow-Up Studies ; Humans ; Length of Stay ; Male ; Orchiopexy ; Postoperative Complications ; Prospective Studies ; Scrotum ; Testis

PURPOSE: Sexual adverse events (AEs), a major cause for discontinuing 5alpha-reductase inhibitor (5ARI) therapy for benign prostatic hyperplasia (BPH), are known to occur most frequently early in therapy and appear to decline over time. The aim of this study was to investigate the changes in sexual function occurring with dutasteride treatment during a 1-year follow-up period in Korean men. MATERIALS AND METHODS: Using the International Index of Erectile Function, we prospectively evaluated, after 1, 3, 6, 9, and 12 months of treatment, the changes in sexual function of 55 outpatients (mean age 62.3+/-7.2 years) with BPH (mean volume 48.9+/-16.0 g) who had relatively good erectile function (EF) and were treated with dutasteride for at least 1 year. RESULTS: EF scores showed the most significant decrease at 1 month (p<0.01). Function gradually recovered thereafter but was still significantly decreased after 12 months of treatment (p<0.05). The scores for orgasmic function and sexual desire also showed the most significant reduction at 1 month but were restored to the baseline level at 6 months. No significant correlation was observed between changes in sexual function and prostate-specific antigen level, prostate volume, or International Prostate Symptom Scores. CONCLUSIONS: After 1 month of treatment, dutasteride therapy resulted in a significant reduction in all investigated sexual functions. Overall, recovery in sexual function was noted at 3 months, and orgasmic function and sexual desire were restored to baseline levels at 6 months. However, EF was still significantly reduced at 12 months.
Azasteroids ; Erectile Dysfunction ; Follow-Up Studies ; Humans ; Male ; Orgasm ; Outpatients ; Prospective Studies ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Dutasteride

PURPOSE: It is well known that fungi become predominant microorganisms in the urine of patients with long-term Foley catheters. This study was conducted to evaluate the lengths of time for fungi to cause urinary tract infection (UTI) and to identify predictors of fungal UTI in burn patients with long-term Foley catheters. MATERIALS AND METHODS: A total of 93 patients who did not have infection at the time of admission but later had fugal UTI were evaluated. Urinalysis, urine culture, and Foley catheter indwelling were done at admission. All patients were administered prophylactic antibiotics from admission. Urine cultures were run every week, and catheters were changed every 2 weeks for each patient. RESULTS: Three of the 93 patients (3.2%) displayed fungal UTI at the 1st week of catheter indwelling. However, most patients (78.5%) displayed fungal UTI from 2nd to 5th week after catheter indwelling. The most prevalent fungus identified was Candida tropicalis (60.2%). By univariate logistic regression analysis, only the total body surface area burned (TBSAB) was predictive of fungal UTI in burn patients (p=0.010). By multivariate logistic regression analysis, underlying disease (p=0.032) and TBSAB (p=0.036) were predictors of fungal UTI. Patients with higher TBSAB were more likely to display shorter intervals from Foley catheterization to fungal UTI. CONCLUSIONS: Fungal UTI was initially found at the 1st week of urinary catheter indwelling, but the majority of cases occurred after the 1st week and appeared earlier in patients with underlying disease or higher TBSAB. Underlying disease and TBSAB were predictors of early fungal UTI.
Anti-Bacterial Agents ; Body Surface Area ; Burns ; Candida tropicalis ; Catheters ; Fungi ; Humans ; Logistic Models ; Urinalysis ; Urinary Catheterization ; Urinary Catheters ; Urinary Tract ; Urinary Tract Infections

PURPOSE: We analyzed differences in urinary stone composition according to body mass index (BMI). MATERIALS AND METHODS: Between January 2007 and December 2010, 505 ureteral or renal stones were collected from 505 patients who underwent surgical intervention. Data on patient age, gender, BMI, urinary pH, and stone composition were collected. RESULTS: The patients' mean age was 49.2 years (range, 20 to 83 years). Of the 505 patients, 196 (38.7%) had calcium oxalate (CO) stones, 172 (33.9%) had mixed calcium oxalate and calcium phosphate (COP) stones, 72 (14.2%) had calcium phosphate (CP) stones, 50 (9.8%) had uric acid (UA) stones, and 15 (2.9%) had struvite stones. We excluded struvite stones in the statistical analysis because of the small number of patients; a total of 490 patients were included in this study. In the multinomial logistic regression analysis, obesity was found to be associated with UA stones compared with COP stones (odds ratio [OR] 3.488; 95% confidence interval [CI] 1.732-7.025; p<0.001) and CP stones (OR 2.765; 95% CI 1.222-6.259; p=0.015). Similar results were observed for CO stones compared with COP stones (OR 2.682; 95% CI 1.727-4.164; p<0.001) and CP stones (OR 2.126; 95% CI 1.176-3.843; p<0.013). CONCLUSIONS: Obesity was associated with UA and CO stones compared with the occurrence of COP and CP stones.
Body Mass Index ; Calcium ; Calcium Oxalate ; Calcium Phosphates ; Humans ; Hydrogen-Ion Concentration ; Logistic Models ; Magnesium Compounds ; Obesity ; Phosphates ; Ureter ; Uric Acid ; Urinary Calculi

PURPOSE: Despite a recent surge in the performance of laparoendoscopic single-site surgery (LESS), concerns remain about performing LESS pyeloplasty (LESS-P) because of the technical difficulty in suturing. We report our techniques and initial experiences with LESS-P using additional needlescopic instruments and compare the results with conventional laparoscopic pyeloplasty (CL-P). MATERIALS AND METHODS: Nine patients undergoing LESS-P were matched 2:1 with regard to age and side of surgery to a previous cohort of 18 patients who underwent CL-P. In both groups, the operating procedures were performed equally except for the number of access points. In the LESS-P group, we made a single 2 cm incision at the umbilicus and used a homemade port. We also used additional 2 mm needlescopic instruments at the subcostal area to facilitate suturing and the ureteral stenting. RESULTS: The preoperative characteristics were comparable in both groups. Postoperatively, no significant differences were noted between the LESS-P and CL-P cases in regard to length of stay, estimated blood loss, analgesics required, and complications. But, LESS-P was associated with a shorter operative time (252.2 vs. 309.7 minutes, p=0.044) and less pain on postoperative day one (numeric rating scale 3.7 vs. 5.6, p=0.024). The success rate was 94% with CL-P (median, 23 months) and 100% with LESS-P (median, 14 months). CONCLUSIONS: Our initial experiences suggest that LESS-P is a feasible and safe procedure. The use of additional 2 mm instruments can help to overcome the difficulties associated with LESS surgery.
Analgesics ; Cohort Studies ; Humans ; Laparoscopy ; Length of Stay ; Operative Time ; Stents ; Umbilicus ; Ureter ; Ureteral Obstruction