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

To define the practical value of prostatic needle biopsy in patients with suspicious prostatic carcinoma we studied the analysis of the clinical records of 49 patients underwent the prostatic needle biopsy at Severance Hospital during the 5 year period from 1976 through 1980. Forty-nine patients had been biopsied; carcinoma was found in 3 of 15 patients (20 per cent) not having prostatic induration, 6 of 17 (35 per cent) with minimal or equivocal induration and 12 of 17 (71 per cent) with marked induration. The results suggest that the vast majority of the patients with prostatic carcinoma has some degree of palpable induration and that a high index of suspicion appears warranted and needle biopsyshould be performed when any prostatic induration is present on digital rectal examination.
Biopsy, Needle* ; Diagnosis* ; Digital Rectal Examination ; Humans ; Needles* ; Prostatic Neoplasms

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

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

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

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