No abstract available.
Amyloidosis*

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.
Biopsy* ; Prostate*

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

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

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

No abstract available.
Vesicovaginal Fistula*

PURPOSE: Renal cell carcinoma(RCC) in solitary kidney is an absolute indication for partial nephrectomy. We evaluated the renal function after partial nephrectomy for renal cell carcinoma in a solitary kidney. MATERIALS AND METHODS: Partial nephrectomy was performed in 14 patients with localized sporadic RCCs that developed in a solitary kidney between January 1993 and December 2005. In 8 patients(57%), the contralateral kidney had been surgically removed. In the remaining 6 patients, 4 had a contralateral nonfunctioning kidney(29%) and 2 had nephrolithiasis (14%). Three patients were treated with enucleation, and partial nephrectomy was done in 11 patients. The recorded variables we studied were the preoperative and postoperative serum creatinine levels, whether renal ischemia and hypothermia was used, the duration of renal ischemia and the percent of renal parenchyma that was resected. RESULTS: At mean follow-up of 55.6 months(range: 16.3-106.6), the mean serum creatinine had increased from 1.03mg/dl preoperatively to 1.26 mg/dl postoperatively(p>0.05). The mean serum creatinine had significantly increased at 3, 6 and 12 months after surgery(p<0.05). The postoperative serum creatinine after 16 months was still increased compared to the preoperative serum creatinine, but there was no statistical significance(p>0.05). None of the 14 patients required dialysis for end stage renal disease after surgery. The normal preoperative serum creatinine had increased above 1.5mg/dl in two patients, but not above 2.0mg/dl. One patient had multiple renal cell carcinoma masses and one had diabetes mellitus. The postoperative creatinine of the 9 patients who had renal warm ischemia was not significantly different from the 5 patients who had no ischemia(p>0.05). The renal ischemia time, cold ischemia and the resected percent volume of the renal parenchyma were found to have no statistically significant impact on postoperative renal function(p>0.05). CONCLUSIONS: Partial nephrectomy safely preserves renal function in patients with solitary kidney.
Carcinoma, Renal Cell* ; Cold Ischemia ; Creatinine ; Diabetes Mellitus ; Dialysis ; Follow-Up Studies ; Humans ; Hypothermia ; Ischemia ; Kidney Failure, Chronic ; Kidney* ; Nephrectomy* ; Nephrolithiasis ; Warm Ischemia

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