No abstract available.
Transurethral Resection of Prostate*

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

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*

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

Apocrine sweat gland carcinoma is a very unusual malignant skin adnexal tumor and mostly occurs in areas where apocrine elands are abundant namely. axilla. upper arm. scalp. eyelid. vulva and external auditory meatus. The scrotal location is not yet reported. We report a case of apocrine sweat gland carcinoma of scrotum in a man aged 85, which was managed by local excision. The histologic finding is that of poorly differentiated adenocarcinoma. Evidence of decapitation secretion typical or apocrine glands. is present in some areas.
Adenocarcinoma ; Apocrine Glands ; Arm ; Axilla ; Decapitation ; Eyelids ; Scalp ; Scrotum* ; Skin ; Sweat Glands* ; Sweat* ; Vulva

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*

The etiology of benign prostatic hyperplasia( BPH) is multifactorial, but it is recognized that two important factors necessary for the induction of BPH in men are the testis(endocrine control) and the aging. From January 1991 to June 1992, we measured 6 hormonal factors in the serum of 129 men who were diagnosed as benign prostatic hyperplasia pathologically to determine whether endocrine factors influence the volume of benign prostatic hyperplasia. These hormonal levels were correlated with the prostatic volume measured by transrectal ultrasound(TRUS). There was no significant correlation for age with total prostatic volume(r=0.06, p=0.31l). With age there was a significant increase in serum testosterone(r=0.25, p=0.003), LH(r=0.42, p=0.000) and cortisol(r=0.25, p=0.016). The prostatic volume measured by prostatic ultrasound was correlated positively with estradiol(r=0.34, p=0.002) and cortisol(r=0.28. p =0.008). Also the prostatic volume was correlated with resected weight of prostate(r=0.38, p=0.000). We suggested that serum estrogen and cortisol levels may be the factors in persistent stimulation of benign prostatic hyperplasia.
Aging ; Estrogens ; Humans ; Hydrocortisone ; Male ; Prostatic Hyperplasia* ; Ultrasonography

No abstract available.

Medical records of 570 patients underwent transurethral prostatectomy from 1985 to 1991 were reviewed to analyze the factors affected morbidity after transurethral prostatectomy retrospectively. Transurethral prostatectomy constituted 16.9% of the urologic operation during above periods and there were benign disease in 513 patients(90%), and carcinoma in 57 patients(10%). Age of the patients ranged from 48 to 93 years old with a mean age of 68.3. Of the patients, 298 patients (52.3%) had significant pre-existing medical problems. The resected net tissue weight ranged from 3 to 73 grams, with a mean of 11.8 grams. The mean operation time was 53 minutes with a range from 25 minutes to 126 minutes. The mortality was 0.36% and the operative morbidity was 20.3%. Increased morbidity was found in patients with a resection time of more than 90 minutes, used glycine of more than 20,000ml and resected weight of more than 31 grams (P<0.05) But age greater than 80 years, azotemia, urinary tract infection, serum Na+ change and pre-existing disease did not increased the operative morbidity. Voiding symptom was improved in 551 patients(96.7%) but in 19 patients(3.3%). persistent voiding difficulty was found. postoperatively at three months The causes of voiding difficulty were as follows ; 10 incontinence patients, 8 detrusor areflexia patients and 1 urethral stricture patient. In conclusion, transurethral prostatectomy is one of the most common operations today with a very low mortality and the overall postoperative results are excellent. Further studies, such as a randomized trial, will be necessary to evaluate the long-term outcome of transurethral prostatectomy further.
Azotemia ; Glycine ; Humans ; Medical Records ; Mortality ; Preexisting Condition Coverage ; Prostatic Hyperplasia* ; Retrospective Studies ; Transurethral Resection of Prostate* ; Urethral Stricture ; Urinary Tract Infections

TURP is one of the common operations in the urologic field, and it has been well shown as a golden standard treatment modality for the patients with the BPH. Nevertheless, there was no available objective index to determine effective amount of the prostate resection. Therefore, we reviewed and evaluated the charts of 119 BPH patients more than 15 in modified Boyarsky symptom score evaluation, and who have undergone TURP from 1992 to June 1994. In addition, we excluded the cases associated with the other disease, such as neurogenic bladder, urethral stricture, or prostatic carcinoma. The volume of prostate was calculated by using of TRUS and ellipsoid formula. The maximal flow rate(MFR) was evaluated mostly on 5th post-operative volume of the day. We defined the resection rate(R.R) as the rate of the resected weight to the volume of the prostate. The results were as follows. 1. The mean resection rate of the prostate was 42.1%. 2. The average of the post-operative MFR was 20.52ml/sec. 3. The relevance between the RR and the post-operative MFR was not shown herein. 4. Distribution of the patients by the postoperative modified Boyarsky symptom score was different according to the resection rate. Statistically significant difference of the postoperative modified Boyarsky symptom score was shown between the greater than 30% resection group 1ess than 30% resection group(P=<0.05) 5. The post-operative modified Boyarsky symptom score could be predicted by the equation induced through the regression analysis. Symptom score = 5.28 - (0.04'RR) Our results suggest that resection rate of 30% is the marginal rate for the desirable voiding improvement, and, if it is practicable, the resection of more than 30% is favorable for all patients with BPH.
Humans ; Prostate ; Transurethral Resection of Prostate ; Urethral Stricture ; Urinary Bladder, Neurogenic