No abstract available.
Amyloidosis*

No abstract available.
Biopsy* ; Prostate*

The stone disease of urinary tract is common and familiar to urologist. But intrascrotal calculus is a rare disease. It is believed to originate either as a fibrinous deposit in tunica vaginalis testis or as a remnant of the appendix testis or appendix epididymis that has undergone torsion and become freely movable. Herein I report a case of intrascrotal calculi in the patient who complained scrotal mass.
Appendix ; Calculi* ; Epididymis ; Fibrin ; Humans ; Male ; Rare Diseases ; Scrotum ; Testis ; Urinary Tract

No abstract available.
Prostatectomy*

No abstract available.
Recurrence* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: Although the advent of orthotopic bladder substitution in women was a major achievement in the evolution of urinary diversion, the mechanism of voiding dysfunction remains to be fully understood. This is a report on the voiding function of the ileal neobladder, based on a questionnaire survey of 6 female patients. MATERIALS AND METHODS: Between 1995 and 2002, 7 of 10 women(mean age 56.1) that underwent an orthotopic bladder substitution were evaluated using uroflowmetry, bladder diary and voiding cystourethrography. Six patients completed the questionnaire. The mean follow-up period was 24.6 months(range 1 to 72 months). RESULTS: From the uroflowmetry, the mean maximum flow rate was 12.2ml/sec, with a low average flow rate(mean 6.2ml/sec), and the voiding time was considerably prolonged(mean 68.5sec). According to the bladder diary and questionnaire responses, although the frequency and tidal volume of micturition were normal, the majority of patients were conscious of retarded, intermittent, prolonged and weak streams, with straining during voiding. Of the 7 patients, 5(71.4%) achieved excellent daytime continence, but 6(85.7%) had nighttime incontinence. One patient was unable to void and required regular intermittent catheterization. Two patients sometimes, or often, performed self-catheterization due to residual urine. According to the questionnaire responses, 4(66.7%) of the 6 patients stated that their micturition status was better or the same compared with their preoperative status, and 4(66.7%) of the patients felt satisfied. The degree of inconvenience was low for every item and the limitation on daily life was considered minimal. Cystograms revealed a descent of the pouch and urethral angulation in the 3 patients with difficulty in urination or hypercontinence. CONCLUSIONS: Orthotopic bladder substitution after a radical cystectomy in women provides relatively satisfactory functional outcomes.
Catheterization ; Catheters ; Cystectomy ; Female ; Follow-Up Studies ; Humans ; Surveys and Questionnaires* ; Rivers ; Tidal Volume ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urinary Diversion ; Urination

PURPOSE: Radical cystectomy has been a standard method in the treatment for invasive bladder cancer. Recently the orthotopic substitutions have been generally performed for urinary diversion. Ghoneim introduced a new method for orthotopic substitution which has used relatively short segment of ileum, and the method is regarded to have few complications. We performed this method for our study and analyzed the results and complications. MATERIALS AND METHODS: Among total 29 patients underwent ileal W-neobladder with serous-lined extramural tunnel, 27 patients had invasive bladder cancer and the remaining two patients had contracted bladder with vesicoureteral reflux. There were 25 male patients with the mean age of 59.2 years(45-70) and 4 female patients with 61.8 years(51-68). Mean follow-up period for the entire group was 8.4 months(3?17 month). History taking, physical examination, and complete laboratory tests were performed postoperatively and IVP or CT scan was taken at 3 month and 9 month after the operation for the evaluation of recurrence and upper tract change. RESULTS: The average operating time was 8 hours 35 minutes(420-670 min). Paralytic ileus developed in two patients and wound dehisced in 4. In all 29 patients, vesicoureteral reflux was not detected. Stricture of ureteroileal anastomosis was observed in 4 left renal units. We performed percutaneous nephrostomy and antegrade double J stenting on all the patients with stricture primarily, but one patient underwent neoureteroileostomy because of the failure of the primary management. Four patients complained enuresis, but no daytime incontinence was observed. There were no clinical symptoms of complications in all 29 patients and no metabolic acidosis was observed in laboratory tests. CONCLUSIONS: Serous-lined extramural tunnel method of orthotopic substitution showed an acceptable and safe reservoir with a large capacity at low pressure and absence of reflux with relatively short segment of ileum.
Acidosis ; Constriction, Pathologic ; Cystectomy ; Enuresis ; Female ; Follow-Up Studies ; Humans ; Ileum ; Intestinal Pseudo-Obstruction ; Male ; Nephrostomy, Percutaneous ; Physical Examination ; Recurrence ; Stents ; Tomography, X-Ray Computed ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Diversion ; Vesico-Ureteral Reflux ; Wounds and Injuries

No abstract available.
Vesicovaginal Fistula*

PURPOSE: Recent studies report that up to 40 to 50% of patients who were thought to have clinically localized disease were found to be understaged subsequent to radical surgery. Clearly, development of more sensitive means to identify patients with micrometastatic, locally invasive disease is warranted. With the development of molecular biology, we can apply reverse transcriptase-polymerase chain reaction (RT-PCR) that allows us to identify PSA-synthesizing cells in peripheral blood even when they are highly diluted in a population of peripheral lymphocytes. In this study, we will evaluate the role of RT-PCR in molecular staging of prostate cancer to apply it to clinical situations. MATERIALS AND METHODS: Peripheral blood was obtained from a wide variety of patients with and without prostate cancer before radical prostatectomy. After ribonucleic acid isolation, complementary deoxyribonucleic acid was generated and amplified with a hot-start technique. RT-PCR results were compared with pathologic stage, Gleason score, serum PSA and tumor volume. RESULTS: The RT-PCR test was positive in 0 of 20 controls without suspicion of prostate cancer. Before radical prostatectomy a positive test was obtained in 2 of 9(22.2%) with pT2 disease versus 3 of 5(60%) with pT3 disease. A positive test was obtained in 5 of 6(83.3%) with overt lymph node or bone metastatic disease. We obtained intermittent RT-PCR positive results in serial procedures with two overt bone metastatic cancer patients. There was no significant difference in serum PSA, Gleason score or tumor volume between the men with positive or negative results. CONCLUSIONS: The PSA RT-PCR test in our laboratory cannot be used preoperatively to predict accurate pathological stage of prostate cancer who have undertaken radical prostatectomy. But there is a tendency that PSA mRNA was more frequently detected with higher stage. If the methodology of RT-PCR is refined and improved and sample size increased, RT-PCR for PSA mRNA will become a valuable tool for the evaluation of prostate cancer patients.
DNA ; Humans ; Lymph Nodes ; Lymphocytes ; Male ; Molecular Biology ; Neoplasm Grading ; Prostate* ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms* ; RNA ; RNA, Messenger ; Sample Size ; Tumor Burden

PURPOSE: Since the first description of multiple primary malignant neoplasms(MPNs) by Billroth, numerous studies concerning MPNs have been reported. We analyzed variable characteristics of MPNs in urologic tumor patients and try to offer useful clinical informations. MATERIALS AND METHODS: From January 1994 to September 1998, we have treated 1,230 patients who had at least one primary urologic cancer; 459 transitional cell carcinomas, 366 renal cell carcinomas, 325 prostatic cancers, 128 others. Among those patients, 99 patients(8.0%) had genitourinary multiple primary neoplasms(GU-MPNs). We reviewed the medical and pathologic records of these 99 patients with GU-MPNs. RESULTS: The incidence of MPNs was especially high in patients with renal cell carcinoma and bladder cancer than any other GU tract cancers. Renal cell carcinoma plus gastrointestinal malignancy and urothelial cancer plus cervix cancer were common combinations of MPNs in this study. Incidences of counterpart cancers were similar to the ranks of relative frequency of cancers in Korea except genitourinary cancers that were more common than the relative frequency of their own. 55 cases were synchronous and mean diagnostic interval was one month and eleven days. 36 cases of 44 metachronous MPNs developed within 5 years after the diagnosis of the first tumor. In synchronous MPNs, 29 second tumors(52.7%) were diagnosed by staging workup or during operation of the first tumor and 34 second tumors(77.3%) of metachronous MPNs were diagnosed by their own symptoms. CONCLUSIONS: Due to the improvements in the techniques for diagnosis and treatment of cancer and the prolonged average life span, occurrence of MPNs is no longer rare. Therefore importance of early diagnosis of MPNs is increasing. We recommend to keep in mind the possibility of MPNs especially in RCC and bladder cancers. We think further study is needed to delimitate the risk factors of MPNs.
Carcinoma, Renal Cell ; Carcinoma, Transitional Cell ; Diagnosis ; Early Diagnosis ; Humans ; Incidence ; Korea ; Neoplasms, Multiple Primary* ; Prostatic Neoplasms ; Risk Factors ; Urinary Bladder Neoplasms ; Urogenital Neoplasms ; Urologic Neoplasms ; Uterine Cervical Neoplasms