No abstract available.
Amyloidosis*

No abstract available.
Biopsy* ; Prostate*

No abstract available.
Prostatectomy*

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.
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*

Infertility is a world wide problem affecting up to 5% of all couples and in some communities up to 30% (WHO, l975). Although it is well known that the male factor is the main cause of the infertility in 40-50% of the cases, the appropriate drugs for treating this condition have not yet been found. Androgens have been tried at different doses, the higher ones to provoke suppression of spermatogenesis and ultimate rebound phenomenon. This has led to controversy due to the high percentage of permanent oligozoospermia reported by some authors (2-8%) and to the short-lived improvement obtained with this treatment. Mesterolone, an androgen without suppressive action upon the hypothalmic-pituitary axis. is presently used, although results are not yet conclusive. The present investigation would assess the effectiveness of mestero1one currently used in the treatment of idiopathic male infertility. To assess the effectiveness of treatment with mesterolone which is alleged to improve semen quality (sperm density, motility and morphology) in idiopathic infertile selected patients, this would be a double blind study to follow prospectively men suffering from primary idiopathic testicular failure being treated with mesterolone, Proviron, Schering, a drug which is presumed to improve this condition. Results would be assessed through several sperm parameters and pregnancy rate. Participants in the study will be men with primary idiopathic oligozoospermia and asthenozoospermia. The inclusion criteria would be as follows: a) men aged 20-40 years, whose female partners are entirely normal, b) informed volunteers with primary testicular failure, c) men having vaginal intercourse at least 2 times weekly with one partner and without known psycho-sexual problems, d) men willing to enter this study and relying only on the drug administered throughout the study, e) no history of renal, liver or any other chronic physical or psychological disease, t men who can be followed up regularly, and g) men whose female partner is not using any method of family planning. The exclusion criteria would be as follows: a) azoospermic patients, b) history of recent or severe liver or renal disease, and c) history recent severe infectious disease (less than 3 months ago), d) clinically detectable chronic diseases, e) concurrent use of drugs known or suspected to interact with the drug to be administered in the study or known to affect spermatogenesis. A total of 90 subjects are divided into the fol1owing three groups: a) placebo group: consisted of 30 Korean male with 15 oligozoospermia with sperm count of less than 20 x 1,000,000/ml and 15 asthenozoospermia with sperm motility of less than 309b, b) oligozoospermia group: consisted of 30 patients with sperm counts of less than 20 x1,000,000/ml, and c) asthenozoospermia group: consisted of 30 patients with sperm motility of less than 30%. Parameters for study are as follows: history taking, physical examination (testis size), laboratory works (CBC ESR, urinalysis, fructose in seminal fluid, testicular biopsy, semen analyses (pH of semen, volume, liquefaction. density, motility, agglutination, viability, normal form, WBC), hormonal assays (FSH, LH, testosterone, prolactin). Before starting treatment, 2 semen samples will be obtained with a time interval of not less than 1 week, each preceded by 3 days of sexual abstinence. For follow-up, patients will have a semen sample taken every month each preceded by 3 days of sexual abstinence while in treatment. After treatment, and for 3 months, a monthly semen analysis will be undertaken. Treatment scheme as follows: 75mg of mesterolone (proviron) was given by mouth daily for more than 90days to be justified on the basis of general assumption that spermatogenetic cycle lasts approximately 74days. An average duration of the treatment was 6.8 months in this study. In placebo group, digestive tablets are given as mesterolone administration. Clinical characteristics of a total of 90 patients were listed in the table l. The results were considered to be effective (+), if more than 30%, of improvement being noted on the count or more than 20% of improvement being noted on motility beyond the pre-treatment level. The results of this study are presented as follows: Changes of sperm density after treatment: Oligozoospermia group: sperm counts increased in 27%, of the 15 placebo treatment patients and 37% of the 30 mesterolone treatment patients. Asthenozoospermia group: sperm counts increased in 20%, of the 15 placebo treatment patients and in 27% of the 30 mesterolone treatment patients. Changes of sperm motility after treatment: Asthenozoospermia group: sperm motility improved in 13% of placebo treatment patients and 27% of mesterolone treatment patients. Oligozoospermia group: sperm motility improved in 20%, placebo treatment patients and 30% of mesterolone treatment patients. Changes of other parameters after treatment: Volume of seminal fluid and normal shape of spermatozoa were not changed significantly before and after the treatment between placebo and mesterolone groups and also between oligozoospermia and asthenozoospermia groups. Coital frequency and body weight were tend to increase after the mesterolone treatment. Pregnancy rates after treatment: Pregnancy resulted in l3%, of placebo treatment patients and 17% of mestero1one treatment patients in oligozoospermia group. Pregnancy occurred in 7%, of placebo treatment patients and l0% of mesterolone treatment patients in asthenozoospermia group. In conclusion, the author's clinical experience confirmed that mesterolone appears to be of value particularly in the treatment of idiopathic oligozoospermia and asthenozoospermia without any noticeable adverse effects.
Agglutination ; Androgens ; Asthenozoospermia ; Axis, Cervical Vertebra ; Biopsy ; Body Weight ; Chronic Disease ; Coitus ; Communicable Diseases ; Double-Blind Method ; Family Characteristics ; Family Planning Services ; Female ; Fibrinogen ; Follow-Up Studies ; Fructose ; Humans ; Infertility ; Infertility, Male ; Liver ; Male ; Mesterolone* ; Mouth ; Oligospermia* ; Physical Examination ; Pregnancy ; Pregnancy Rate ; Prospective Studies ; Semen ; Semen Analysis ; Sexual Abstinence ; Sperm Count ; Sperm Motility ; Spermatogenesis ; Spermatozoa ; Tablets ; Testosterone ; Urinalysis ; Volunteers

Purpose: To analyze various prognostic factors and surgical outcomes in patients who underwent radical nephrectomy and thrombectomy of a renal cell carcinoma with renal vein or inferior vena caval thrombosis. Materials and Methods: Among 44 patients with confirmed renal cell carcinomas and renal vein or inferior vena caval thrombosis, between December 1993 and June 2000, 42 having undergone radical nephrectomy and thrombectomy were retrospectively studied. 2 patients were excluded due to no operation performance. The 5-year disease-specific survival rates were analyzed according to various prognostic factors, including age, gender, clinical symptoms, tumor side (Rt. vs. Lt.), thrombus position (renal vein vs. IVC), histopathological cell type, lymph node involvement, pT stage irrespective of thrombus, Fuhrmann nuclear grade and invasion to perinephric fat, vessel, renal pelvis or adrenal gland. Results: The overall 5-year disease-specific survival rate of all the patients was 55%. A univariate analysis of the 42 patients showed that the position of the tumor thrombus, histopathological cell type and invasion to the adrenal gland had a significant impact on the survival. On multivariate analysis, the tumor thrombus location and histopathological cell type were independent prognostic factors for the survival. The 5-year disease-specific survival rates of the patients with a renal vein thrombus (n=23) and with IVC (inferior vena cava, n=20) were 75 and 20%, respectively. The 5-year disease-specific survival rate of the patients with a conventional cell type (n=32) was 68%, and patients with other pathologic cell types had no significant follow-up periods. Conclusions: The tumor thrombosis position, histopathological cell type and invasion to the adrenal gland are considered as clinically significant prognostic factors in patients with a renal cell carcinoma with vein thrombosis after radical nephrectomy with a thrombectomy. Meticulous radical nephrectomy with thrombectomy will be beneficial to the survival of patients with a renal cell carcinoma and vein thrombus.
Adrenal Glands ; Carcinoma, Renal Cell* ; Follow-Up Studies ; Humans ; Kidney Pelvis ; Lymph Nodes ; Multivariate Analysis ; Nephrectomy ; Prognosis ; Renal Veins ; Retrospective Studies ; Survival Rate ; Thrombectomy ; Thrombosis* ; Veins