A clinical observation on the vesicovaginal repair was done on24 cases admitted to the Dep. of Urology, Keimyung University Hospital, during the period from 1971 through 1981. Vesicovaginal fistula can be surgically repaired via vaginal route or transvesical extraperitoneal or transperitoneal technique and the following results were obtained. 1. Overall success rate of vesicovaginal fistula repair was 71% and that of simplified transperitoneal transvesical approach was higher than conventional method (88%). 2. Excision of the fistulas were facilitated by continuing traction on the Foley catheter, vaginal insertion of assistant`s finger and sand bag application below hip. 3. Preoperative infection with scar tissue, short duration, large sized fistula, inadequate exposure and dissection of bladder from vagina turned out to be main factors of the operative failure. 4. Wide exposure with tension free closure of well-vascularized peritoneal flaps and the judicious interposition of pedicled omentum have produced the most encouraging results and supravesical diversion by ileal or colonic conduit can be avoided. 5. Previous attempts for surgical repair seemed to have relation with success rate.
Catheters ; Cicatrix ; Colon ; Fingers ; Fistula ; Hip ; Omentum ; Silicon Dioxide ; Traction ; Urinary Bladder ; Urology ; Vagina ; Vesicovaginal Fistula*

Malignant fibrous histiocytoma, which is interesting because of its pleomorphic nature, is a rare soft tissue sarcoma possibly arising from histiocyte. The tumors are usually situated in the skin or subcutaneous tissues, especially of the extremities, but they may also involve deeper structures, such as the retroperitoneum or genital organs. Herin we report a case of malignant fibrous histiocytoma in the retroperitoneal space and discuss the pathologic and clinical features.
Extremities ; Genitalia ; Histiocytes ; Histiocytoma, Benign Fibrous ; Histiocytoma, Malignant Fibrous* ; Retroperitoneal Space ; Sarcoma ; Skin ; Subcutaneous Tissue

Although the rates of tuberculosis cases are continuing decline with advent of newer drugs, sporadic cases of urinary tuberculosis still occur. During last 5 years, we experienced 22 cases of reconstructive surgery and 18 cases of endourologic procedures for preservation of renal function. The following results were obtained: 1. Reconstructive surgeries including ureteroneocystostomy etc. were underwent in 22 cases and improvement were noted in 18 cases. 2. In 18 endourologic cases, there has been a substantial improvement in renal function, decrease in upper tract dilatation and relief of symptom. Average indwelling duration was 2.4 months and the mean number of dilatation per patient was 1.8 time. 3. Endopyelotomy and direct ureterotomy with ureteroscope are useful modalities in multiple ureteral stricture or upper ureter stricture. 4. It should be emphasized that percutaneous antegrade stent indwelling was more easier than retrograde technique especially in failure cases.
Constriction, Pathologic ; Dilatation ; Humans ; Stents ; Tuberculosis ; Tuberculosis, Renal* ; Ureter ; Ureteroscopes

Selected number of urinary E. coli isolates from patients were subjected to the tests to characterize in vitro properties, compared with the strains of normal flora in intestinal tract or other sources. Further studies were carried out for determination of the mechanism of pathogenesis by using rabbit as an experimental animal model. Both strains of 87E1 and 87E51 which had one type of pili, were eliminated rapidly 4 or 8 days after inoculation into renal pelvis of rabbit. On the contrary, 88E18 strain which had both types of pili successfully colonized in urinary tract and the rabbit died due to urosepsis after the 8th day of experiment. The result of bacterial count colonized in the tissue by colony forming unit (CFU)per gram were similar to those in the urine.
Bacterial Load ; Colon ; Humans ; Kidney Pelvis ; Models, Animal ; Stem Cells ; Urinary Tract ; Uropathogenic Escherichia coli* ; Virulence*

In 1969 Lalli and associates introduced angioinfarction of kidney as a possible therapeutic modality. Recently Wallace and associates suggested that infarction followed by nephrectomy may activate the immune system resulting in improved survival of patients with stage IV renal cell carcinoma. From 1982 we began a study using preoperative infarction in 21 patients without evidence of metastasis as well as those with stage IV disease. Post operatively all patients were given medroxyprogesterone acetate and testosterone propionate as adjuvant therapy. The authors have collected a series of 46 cases of renal cell carcinoma during the past l0 years from April, 1975 through March, 1985. Conclusions; 1. Two year survival rate according to tumor stage was 86% in stage II 67% in stage III in stage III and 0% in stage IV. 2. The value of angioinfarction; a. Almost all patients displayed acute postembolization syndrome consisting of fever, leukocytosis and pain, which were usually resolved by conservative treatment except for 3 cases treated surgically for the displacement of stee1 coils into the hypogastric and femoral artery. b. We believe that embolization facilitated nephrectomy probably due to tissue edema, although this could not be proved by objective measurement of the length of the length of time required for the operation and blood loss. 3. The role of adjunctive nephrectomy in patients with metastatic renal cell carcinoma; a. Mean survival was 8.5 months in which radical nephrectomy was performed in comparison with 3.8 months in which simple nephrectomy was done or only symptomatic treatment was given. b. There was only one complete remission which lasted 6 months. Two patients and stable disease and markedly improved symptom for at least 3 months, but eventually all patients showed evidence of progression.
Carcinoma, Renal Cell ; Edema ; Femoral Artery ; Fever ; Humans ; Immune System ; Infarction ; Kidney ; Leukocytosis ; Medroxyprogesterone Acetate ; Neoplasm Metastasis ; Nephrectomy* ; Survival Rate ; Testosterone Propionate

Today, genitourinary tuberculosis as well as tuberculosis of other organs have decreased in its incidence with development of antituberculosis drugs. However, it is still very frequent in Korea. There are still great deal of difficulties in finding Mycobacterium tuberculosis from urine because of variations in method of taking urine sample and techniques of examination. For these matters, early diagnosis was difficult indeed. For this reason, we performed amplification of Mycobacterial DNA from urine by use of the Polymerase Chain Reaction, and urine AFB smear from Apr., 1993 to Feb., 1994 and achieved following results. l. In order to increase sensitivity and specificity, we performed nest PCR. and primers used each cases were a) INS1 and INS2, which amplify 245-base pair sized DNA, b) Pt3 and Pt6, which amplify 188-base pair. The sequences of primers were INS1 (5'-CGTGAGGGCATCGAGGTGGC-3'), INS2 (5'- GCGTAGGCGTCGGTGACAAA-3'), Pt3(5'-GAACGGCTGATGACCAAACT-3'), and Pt6( 5'-ACGTAGGCGAACCCTGCCCA-3') (Table l). And after 30 cycles of amplification, unique Mycobacterium tuberculosis DNA band was found ( Figure). 2. Total number of confirmed genitourinary tuberculosis were 35 cases, 19 cases were positive in both PCR and AFB smear, other 15 cases were positive only in PCR and in one case, PCR was negative but positive in AFB smear (Table 2).
DNA ; Early Diagnosis ; Incidence ; Korea ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Tuberculosis

No abstract available.
Forearm*

Eighteen experimentally induced blunt and sharp renal injury in rabbits were treated either with an alloplastic renal capsule made of Vicryl mesh or with through and through chromic catgut sutures or with no suture as controls. A simple apparatus was used to cause uniform renal injury and the device was modification of an AO Kuntscher nail extractor. The Vicryl mesh capsule was made by ourselves with #2 and #4 Vicryl. The postoperative healing course were followed up until 6 weeks and isotope renogram showed good renal function in 15 cases. However, when compared to the controls, the kidney which had been repaired with Vicryl mesh contained considerably less scar and showed neither perirenal fibrosis or atrophy of the parenchyma in the vicinity of the capsule. Our preliminary results seem to confirm that simple and rapid surgical treatment of intermediate degree renal injuries is possible using the alloplastic Vicryl mesh capsule. The method may be also suitable for reconstruction of the parenchyma following nephrotomies, such as for removal of staghorn calculi.
Atrophy ; Calculi ; Catgut ; Cicatrix ; Fibrosis ; Kidney* ; Polyglactin 910* ; Rabbits ; Sutures

The accepted treatment for significant obstruction of the ureteropelvic junction has in general been open operative surgery. However, attention has recently been drawn to the efficacy of percutaneous pyeloplasty. We experienced the twenty-eight patients of the UPJ obstruction during a 10-year period. Of these patients 20 have underwent open pyeloureteroplasty and 8 were performed percutaneous pyeloplasty. Among these 8 patients, 5 were undergone endopyelotomy only and 3 were dilated successfully by balloon dilation after endopyelotomy. The results led us to evaluate these modalities for treatment of UPJ obstruction and the initial results of percutaneous pyeloplasty were encouraging.
Humans

Stricture of the prostatomembranous urethra following pelvic fractures presents major problems in surgical management owing to their relatively inaccessible position above the urogenital diaphragm and behind the pubis. In 1973 Waterhouse and associates described transpubic approach to posterior urethral stricture, which has been usefully modified by Blandy as partial pubectomy for urethroplasty. Blandy`s method gives the extra room which needed to effect a tension-free anastomosis between bulbar and prostatic urethra and which was easily provided by taking away an arch of bone from the inferior of the symphysis. This method leaves pelvic ring intact, so avoids (a) subsequent pelvic instability and (b) the deformity that may result if an entire segment of symphysis is taken out and the penis falls into the defect. Our experience with 8 such cases has convinced us of the superiority of partial pubectomy for urethroplasty.
Congenital Abnormalities ; Constriction, Pathologic ; Diaphragm ; Male ; Penis ; Urethra ; Urethral Stricture