No abstract available.
Lithotripsy* ; Shock*

PURPOSE: Although double-J ureteral stents are used prophylactically to reduce morbidity and complications following shock wave lithotripsy(SWL), the efficacy is still controversial. To evaluate the efficacy of urethral stunting in SWL of medium sized(1.5-2.5cm) renal calculi, we performed a randomized study. MATERIALS AND METHODS: We analysed the outcome of SWL in 46 patients with medium sized(1.5-2.5cm) solitary renal calculi. The study population was divided Into two groups, group 1 consisting of patients who had urethral stents before SWL(n=21) and group 2 of those who did not(n=25). Several variables, including complications, operation requirements and stone free rates, were evaluated. RESULTS: There were no statistical differences between group 1 and group 2 in the incidence of ureteral obstruction or steinstrasse(19% vs 20%), hospitalization (10% vs 16%), operation requirements(10% vs 12%) and stone free rate after 3 months(81% vs 76%). Of 21 patients with stunts, 4(19%) had urinary frequency or urgency and 4(19%) had dysuria. CONCLUSIONS: Regarding our results, placement of urethral stents would not be useful in SWL of medium sized renal calculi.
Calculi ; Dysuria ; Hospitalization ; Humans ; Incidence ; Kidney ; Kidney Calculi* ; Lithotripsy* ; Shock* ; Stents* ; Ureter* ; Ureteral Obstruction

We analyzed the results of the prostate biopsies of 64 patients with elevated serum PSA (>4ng/ ml) at Kangbuk Samsung Hospital from March 1993 to February 1996. Of 64 patients, 11 patients (17%) had prostate cancer and 53 patients (83%) were diagnosed as benign prostatic hyperplasia. Among the patients with prostate cancer, 1 patient had serum PSA between 4.1 to 10.0ng/ml, 2 patients between 10.1 to 20.0ng/ml and 8 patients above 20ng/ml The detection rates of prostate cancer in each serum PSA levels were 3%, 15% and 36% respectively. Two of 17 patients with both negative DRE and TRUS were diagnosed as prostate cancer Two of 21 patients with positive TRUS and negative DRE had prostate cancer but none of 8 patients with positive DRE and negative TRUS had prostate cancer. Seven of 18 patients with both positive TRUS and DRE had prostate cancer. The sensitivity, specificity, positive predictive value and overall accuracy of DRE and TRUS in patients with elevated PSA (>4ng/m1) were 64%, 64%, 27%, 64% and 82%, 43%, 23%, 50% respectively in patients with elevated serum PSA (>4ng/ml). In conclusion, these results suggest that prostate biopsy in early diagnosis of prostate cancer would be needed for the patients with elevated serum PSA (>4ng/ml) regardless of the results of DRE and TRUS.
Biopsy* ; Early Diagnosis ; Humans ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Sensitivity and Specificity

The decline in the incidence of renal tuberculosis has not had any conclusive evidence yet in korea, and the disease has not been eradicated completely. The clinical study was made on the 11 inpatients who showed atypical clinical findings of renal tuberculosis at Korea General Hospital, Seoul, Korea, 1982 to 1985. The clear diagnosis of 11 cases was established pathologically at operation. It is suspected that atypical renal tuberculosis will be lead to difficulties in diagnosis.
Diagnosis ; Hospitals, General ; Humans ; Incidence ; Inpatients ; Korea ; Seoul ; Tuberculosis, Renal*

419 bacterial strains in 395 specimens of urine(significant bacteriuria) were found during the period of 12 months from January 1,1979 to December 31,1979, and the following results were obtained: 1. The ratio of male to female was 1.1:1(male;210,female;185) and the most common age group was 6th decade in male and 3rd decade in female. 2. 85.4% was gram negative bacilli group,14.1 percent was Gram positive cocci group and 0.5% was fungus in 419 isolated strains the isolated organisms were E.coli(35.1%), Serratia(11.2%), Proteus(11.2%), Psuedomonas(9.8%), Streptococcus(7.2%), Staphylococcus(6.0%), Klebsiella(5.7%), alcaligencs(3.3%), Citrobacter(2.6%), Enterococcus(1.0%), fungus(0.5%), acinebacter(0.2%) and flavobacter(0.2%) . In male patient E.coli(17.4%), Serratia(14.3%), Proteus(17.0%), Psuedomonas(15.2%), Streptococcus(7.2%) were the common causative organisms and in the female patients E.coli(57.0%) was the main invader. 3. In 183 patients of urologic department, the indwelling catheter and other instrumentation was the most common cause of bacteriuria in male and the uncomplicated infection was the most common one in female./ the most common causative organism of bacteriuria in the cases of uncomplicated infection obstruction and urinary stone is E.coli but Pseudomonas, Proteus and Serratia a well as E.coli were common in indwelling catheter and instrumentation group. 4. The Gram negative bacilli were sensitive to amikacin(80.5%), colimycin(70.7%), tobramycin(64.4%), and gentamicin(56.0%) and the Gram positive cocci were sensitive to carbenicillin(76.3%) tobramycin(46.7%) amikacin(43.5%) penicillin(41.4%) TAO(40.8%) and Gentamicin(40.4%).
Anti-Bacterial Agents ; Bacteriuria ; Catheters, Indwelling ; Female ; Fungi ; Gram-Positive Cocci ; Humans ; Male ; Proteus ; Pseudomonas ; Serratia ; Urinary Calculi ; Urinary Tract Infections* ; Urinary Tract*

After ureterosoopic stone extraction, temporary ureteral catheter or stent insertion has been performed routinely in order to reduce postoperative pain and other complications even in patients without significant visible damage b the ureter endoscopically. However. it brines considerable discomfort to the patients. In this study. 67 patients with no significant damage to the ureter after ureteroscopic stone extraction were divided into two groups to evaluate the usefulness of temporary ureteral stent insertion. In 35 cases. group 1. a ureteral stent was inserted after stone extraction and in 32 cases. group 2. a stent was not inserted after stone extraction. Then the incidence of postoperative flank pain. dysuria. gross hematuria present for more than 24 hours. fever. admission du. ration. urinalysis and urine culture at postoperative 1 week and 2 weeks. and IVP at postoperative 3 months were investigated. In order to evaluate the relationship of operating time b the incidence or complications, each group divided into those taking more than one hour in operating time and those taking less than one hour. The following results were obtained ; 1. There was no significant difference in the incidence of complications between two groups, except for flank pain. The incidence of flank pain was 11.4% (4 cases) in group 1 and 40.6% (13 cases) in group 2. showing a significant difference (p<0.05). 2. In operations taking more than one hour. stented group showed a significant decrease(p<0.025) in the incidence of flank pain but in operations taking less than one hour, there was no significant difference between two groups. From the above results. it seems that a ureteral stent insertion is not necessary after ureteroscopic stone extraction in case of operating time less than 1 hour and no significant ureteral injury notified. But. ureteral stent insertion is helpful to reduce postoperative flank pain in case of operative time more than 1 hour.
Dysuria ; Fever ; Flank Pain ; Hematuria ; Humans ; Incidence ; Operative Time ; Pain, Postoperative ; Stents* ; Ureter* ; Ureteroscopy ; Urinalysis ; Urinary Catheters

We performed 113 ureteroscopies for stone removal in 110 patients between August 1989 and March 1992. The stones were removed successfully in 107 cases(94.7%) and complications occurred in l6 cases ( 14.2%). In 6 cases, we failed to remove ureteral stones due to inability to introduce ureteroscope at UVJ (one case). severe angulation of ureter (2 cases), inadequate illumination due to bleeding (one case) and upward migration of stones (2 cases). Complications consisted of tearing or ureteral mucosa (5 cases), ureteral perforation (5 cases), fever (2 cases). gross hematuria (2 cases) and infection (2 cases). There was no evidence of ureteral stricture on excretory urograms of 52 patients taken at 3 months postoperatively. Complication rate decreased according to accumulation or experience and it had no correlation with stone site or location. All complications were treated successfully with conservative measures. We conclude that ureteroscopic stone removal is a safe and effective method for treatment of mid-and lower ureteral stones.
Constriction, Pathologic ; Fever ; Hematuria ; Hemorrhage ; Humans ; Lighting ; Mucous Membrane ; Ureter ; Ureteroscopes ; Ureteroscopy

PURPOSE: We investigated the predictive factors in patient with prostate cancer diagnosed by repeat prostate biopsy, where initial prostate biopsy results were negative for malignancy. MATERIALS AND METHODS: Between March 2000 and June 2007, 1280 men with suspected prostatic cancer underwent transrectal ultrasound guided needle biopsy of the prostate, with 148 (11.6%) diagnosed as having prostate cancer. Of 1132 men whose biopsy results were negative for malignancy, 655 whose prostate specific antigen (PSA) was elevated persistently underwent second biopsy, and 462 underwent third biopsy as the same course. Twelve core biopsies were performed in the majority of patients. To determine predictive factors, we evaluated prostate volume, serum PSA, percent free PSA, PSA density (PSAD), transition zone PSAD, PSA velocity (PSAV) and pathological report of previous biopsy between the men with cancer detection and the men with negative biopsy in second and third biopsy. RESULTS: Overall cancer detection rate was 16.3% (208/1280). From the first, second and third biopsies, the cancer detection rate were 11.6, 5.5 and 5.2%, respectively. There were significant differences in percent free PSA, transition zone PSAD, PSAV between cancer and negative biopsy groups after serial repeat biopsies (p<0.05). Multivariate logistic regression analysis revealed that the transition zone PSAD, PSAV, and presence of either atypical small acinar proliferation (ASAP) or high grade prostatic intraepithelial neoplasia (HGPIN) in initial biopsy specimen were significant predictors for prostate cancer diagnosed by repeat biopsy. CONCLUSIONS: Of the men with negative results on the first biopsy, 60 (5.4%) were diagnosed prostate cancer after serial biopsies. The transition zone PSAD, PSAV, and presence of either ASAP or HGPIN in initial biopsy specimen are predictable factors for prostate cancer detection on repeat biopsy.
Biopsy ; Biopsy, Needle ; Humans ; Logistic Models ; Male ; Prostate ; Prostate-Specific Antigen ; Prostatic Intraepithelial Neoplasia ; Prostatic Neoplasms

For recent 3 years, l8 GSI patients were followed for more than 6 months after surgical treatment with Raz procedure. Posterior urethrovesical angle(PUVA), urethral inclination angle (UIA), and bladder neck descent below the upper border of symphysis pubis(BN) on voiding chain cystourethrogram were measured preoperatively and postoperatively with respect to the grade of preoperative incontinence and postoperative period of voiding difficulty. UIA and BN in Stamey grade II group(N=9) were 57+/-14.6 degrees and 5.4+/-l.1cm, which were significantly higher than 39+/-7.6 degrees and 4.3+/-0.9cm in Stamey grade I group(N= 9) (P <0.05). Normal values of PUVA and UIA were defined as 90-l00 and 0-45. Depending on the duration of postoperative voiding difficulty, mean values of postoperative PUVA and UIA were normal(90+/-18.9' and 8+/-16.9') in the 1st week group(N=9), but lower than normal values(ie, overcorrected) in l-2 week group( 64+/-2l.3 and -l0+/-8.9 ) and in over 2 week group( 50+/-l0.0' and -11+/-2.2' ). Duration of postoperative voiding difficulty was 3.5+/-1.6 days in properly corrected Green type I group(N=6) and 8.3+/-l.2 days in properly corrected Green type II group(N=3), but it was much longer in overcorrected groups. From the above results, it is inferred that chain cystourethrography can be used as a useful means to predict the duration of postoperative voiding difficulty in GSI patients and prolonged postoperative voiding difficulty can be prevented by taking care not to overcorrect the bladder neck during Raz procedure.
Humans ; Neck ; Postoperative Period ; Reference Values ; Urinary Bladder

From January 1991 to June 1993, serum PSA according to age were tested by monoclonal radioimmunometric assay using ELSA-PSA 2 kit of CIS industry in 380 healthy men between 30 and 79 years of age who had normal urinalysis, no history of prostate disease and normal prostates on digital rectal examination and transrectal ultrasonography. The mean PSA values according to age were 0.775+/-0.462ng/ml in the 30 to 39-year group, 0.908+/-0.704ng/ml in the 40 to 49-year group, 0.842+/-0.468ng/ml in the 50 to 59-year group, l.393+/-0.942ng/ml in the 60 to 69-year group and 1.737+/-0.937ng/ml in the 70 to 79-year group. The upper limits of PSA (mean+2S.D.) according to age were 1.7ng/ml in the 30 to 39-year group, 2.3ng/ml in the 40 to 49-year group, 1.8ng/ml in the 50 to 59-year group, 3.3ng/ml in the 60 to 69-year group and 3.6ng/ml in the 70 to 79-year group. These results showed that mean PSA and upper limits of PSA increased significantly after 60 years of age(P values<0.01).
Digital Rectal Examination ; Humans ; Male ; Prostate ; Prostatic Diseases* ; Reference Values ; Ultrasonography ; Urinalysis