We have experienced an unusual case of hemorrhagic renal cyst in the rt. kidney at 58 years old woman. The Rt. kidney was enlarged, and showed a few subcapsular ischemic areas The color of kidney was dark brown. As the cyst at lower pole of rt. kidney was dissected, hemorrhagic fluid visualized in the cystic cavity. The final pathologic finding was renal cyst associated with malignant change and renal cell carcinoma at another renal parenchyma. Herein, hemorrhagic renal cyst, a rare clinical entity, was reported with review of literatures.
Carcinoma, Renal Cell ; Female ; Humans ; Kidney ; Middle Aged

This rare venous congenital anomaly has been diagnosed preoperatively in a 35-year-old female with complaint of the right flank pain. Herein a case of retrocaval ureter is presented with brief review of literatures.
Adult ; Female ; Flank Pain ; Humans ; Retrocaval Ureter*

No abstract available.

PURPOSE: To determine the efficacy and outcome of extracorporeal shock-wave lithotripsy (SWL) compared with ureteroscopy (URS) in the treatment of lower ureteric calculi. MATERIALS AND METHODS: The records of patients treated primarily by SWL and URS were analysed retrospectively. Treatment with SWL included 198 patients (103 men and 95 women). All patients received 2500-3000 shocks waves at a mean energy setting of 16-20kV. URS was used in 194 patients (91 men and 103 women), with 7Fr, 8Fr, 9.5Fr rigid Storz ureteroscope. All ureteroscopies were performed with the patient under general or spinal anesthesia. The outcome was assessed by stone-free rates, retreatment rates, auxiliary treatment, Efficiency quotient (EQ), complications. RESULTS: SWL and URS for lower ureteric calculi resulted in a success rate 75.3% and 95.8%, respectively. Including the number of auxiliary procedures, we calculated the Efficiency Quotient (EQ) as 66.6 for SWL and 72.3 for URS. The mean treatment time for SWL was 30 minutes and for URS 38.1 minutes. General anesthesia was more frequently needed in URS patients. Complications occurred more often in the URS group. These were mostly mild, and all could be treated with a double-J stent, antibiotics, or analgesics. A lower stone-free rate was achieved in patients with larger(> OR = 10mm) stones (56.9% vs 82.9%) for smaller stones (<10mm) in the SWL group and 90.0% vs 97.9% for smaller stones in the URS group. Compared with SWL, URS was more time consuming; entailed placement of a ureteral stent and more often led to hospitalization. On the other hand, stone clearance was rapid after URS. CONCLUSIONS: The stone-free rate after URS is much higher than after SWL. Our study demonstrates that URS is highly effective treatment option for lower ureteral stones.
Analgesics ; Anesthesia, General ; Anesthesia, Spinal ; Anti-Bacterial Agents ; Calculi ; Hand ; Hospitalization ; Humans ; Lithotripsy* ; Male ; Retreatment ; Retrospective Studies ; Shock ; Stents ; Ureter* ; Ureteroscopes ; Ureteroscopy*

PURPOSE: A suprapubic approach to the suburethral polypropylene (SPARC) procedure was reported as a new technique for urethral support in the treatment of stress urinary incontinence in women. The safety and efficacy of the SPARC procedure were evaluated in women with stress urinary incontinence. MATERIALS AND METHODS: 50 women (mean age 48.6) with stress urinary incontinence underwent the SPARC procedure under general anesthesia between October 2002 and May 2004. The preoperative evaluations included: the patients history, a physical examination, urinalysis, an urodynamic test and incontinence staging for the Stamey grade. 2 and 5 women had previously experienced failed anti-incontinence surgery and pelvic surgery, respectively. The mean follow-up period was 8.01 months, with all patients assessed for the procedural outcome, subjective satisfaction and complications. RESULTS: The mean follow-up period, hospital stay and operation time were 8.01 months (3-15), 3.7 days (2-6) and 23 minutes (18-45), respectively. The success rate was 94%. There were no significant perioperative and postoperative complications. 3 patients (6%) had bladder perforation during the operation that necessitated an indwelling Foley catheter (mean period 7.3 days). 3 patients (6%) each had postoperative cystitis and immediate voiding difficulty that necessitated an indwelling Foley catheter (mean period 3.0 days) and bladder training, but without cutting or releasing of the tapes. 7 patients (14%) had postoperative de novo urge symptoms. CONCLUSIONS: The SPARC procedure is a simple, safe and effective treatment for female stress urinary incontinence in terms of the short operation time and hospital day, and low complication and relatively high success rates. However, a longer follow-up will be necessary to determine its long term effect and efficacy.
Anesthesia, General ; Catheters ; Cystitis ; Female* ; Follow-Up Studies ; Humans ; Length of Stay ; Physical Examination ; Polypropylenes ; Postoperative Complications ; Urinalysis ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urodynamics

Transurethral incision of the prostate(TUIP) was designed two decades ago as a new surgical management for certain patients in whom transurethral resection of prostate( TURP) was not indicated. TUIP was performed on 24 patients in 26 months. We incised the prostate in 5 and 7 o'clock direction or 6 o'clock direction. Uroflowmetry and residual urine volume were checked preoperatively and 3 months after TUIP in 20 patients. Mean peak urine flow rate increased from 7.8+/-6.4 ml to 13.1+/-8.5 ml per second (p=0.015). Mean postvoid residual urine volume decreased from 67.2+/-l9.3 ml to 25.4+/-l2.6 ml (p<0.00l). l5 patients were interviewed or completed questionaire with mean follow-up period of 16.8 months, which demonstrated that 73.3% were satisfied with the long-term outcome. Operating time, estimated blood loss, time to catheter removal postoperatively were all significant in favor of TUIP. Based on objective and subjective criteria, TUIP is an effective treatment option for selected men with benign prostatic hyperplasia.
Catheters ; Follow-Up Studies ; Humans ; Male ; Prostate* ; Prostatic Hyperplasia*

We reviewed our experience of in situ extracorporeal shock wave lithotripsy(ESWL) for primary ureteral stones in 284 patients between March 1994 and October 1995. The second-generation lithotripter, Direx Compact, was used for stone disintegration without any manipulation of stone and only parenteral analgesics were used for pain control during ESWL. The locations of stones were upper in 140(49.3%), mid in 39(13.8%) and lower ureter in 105(36.9%) cases. Of the 284 patients, 250(88.0%) were stone free and 5(1.7%) had some residual stones, while 29(10.2%) patients were failed to respond to the treatment. The stone size was significant factor influencing the final result. Re-ESWL was necessary in 48 patients(16.9%) and auxillary procedures including percutaneous nephrostomy and double-J catheterization were required in 18 patients(6.3%). The over all efficiency quotient was 71.4. The 29 patients who were refractory to in situ ESWL were managed by ureteroscopic manipulation(10 cases) or open surgery(19 cases). The complications were mild but admission was required in 8 patients(2.8%) with colic pain or fever. Our experience shows that in situ ESWL is a noninvasive and efficient method to treat ureteral stones within whole length of ureter.
Analgesics ; Catheterization ; Catheters ; Colic ; Fever ; Humans ; Lithotripsy* ; Nephrostomy, Percutaneous ; Shock* ; Ureter*

Diabetes is known to induce autonomic dysfunction and most experiments have been focused on the smooth muscle dysfunctions of the urinary bladder and corpus cavernosum in the genitourinary tract. The contractile response of the vas deferens is also decreased in diabetic rats and this effect may cause impairment of sperm transportation. However, few studies have been investigated the changes of contractility of the vas deferens in diabetic animals and little attention has been given to the differences between the contractilities of the prostatic and epididymal ends of the vas deferens in diabetic rats. In this study, the whole vas deferens was divided into two portions, prostatic and epididymal ends, and we examined the contractility of both segments to field stimulation at various frequencies from 4 to 64 Hz for 30 sec with pulses of 1 msec duration at 80 V in organ bath containing modified Tyrode's solution. Both initial twitch and the last contraction after 30 sec elicited by field stimulation were compared to clarify which component was more susceptible to field stimulation in control and diabetic rats. In the prostatic end, initial twitch was more impaired than the last contraction, which is believed that in diabetic rats, ATP(adenosine triphosphate) is more affected than NA(noradrenaline). In contrast, in the epididymal and the last contraction was more impaired than the initial twitch. In 64 Hz, initial twitch and the secondary contractions were not distinguished in the epididymal end of control rats, but in diabetic rats both phases were distinct. This means that the release of NA to field stimulation in the epididymal end is delayed in diabetic rats.
Animals ; Baths ; Muscle, Smooth ; Rats* ; Sperm Transport ; Urinary Bladder ; Vas Deferens*

PURPOSE: To investigate the relationship of MIS and cryptorchidism according to the descending level of testis into scrotum, we studied expression degree of MIS by immunohistochemical analysis using anti-human MIS polyclonal antibody in testicular specimen. MATERIALS AND METHODS: MIS were stained in excised testis by trauma on each 8 patients as control group and age-matched abdominal, inguinal and prepubic cryptorchidism. The expression were classified as score 1, 2, 3 and 4 according to stained degree of percentage in randomized 16 fields(x400) under the light microscope. RESULTS: Of the degree of MIS expression in control group, 87.5% were category 3 or more. The mean score was 3.13+/-0.62. 2. Of the degree of MIS expression in abdominal type cryptorchid testis group that underwent orchiectomies, 68.7% were category 1. The mean score, 1.31 +/- 0.48, showed significant difference compared to control group(p<0.05). 3. Of the degree of MIS expression in inguinal type,56.2% were category 3 or more. The mean score, 2.63+/- 0.81, showed no significant difference compared to control group(p>0.05). 4. Of the degree of MIS expression in prepubic type, 75.0% were category 3 or more. And the mean score, 2.88+/-0.62, showed no significant difference compared to control group(p>0.05). CONCLUSIONS: Expression of MIS is different according to descending level of testis and may play a role in physiologic changes of testicular descent.
Cryptorchidism* ; Humans ; Male ; Orchiectomy ; Scrotum ; Testis*

PURPOSE: High levels of prostatic zinc are associated with prostatic antimicrobial activity and are depressed in patients with chronic prostatitis. We investigated the inhibition of bacterial growth in the rat prostate with chronic prostatitis after an intraprostatic injection of zinc and compared the two different types of zinc delivery. MATERIALS AND MTHODS: Ninety male Wistar rats were used in the study. Experimental chronic bacterial prostatitis was induced by the instillation of a bacterial suspension (Escherichia coli 108/ml) into the prostatic urethra. The animals were followed-up for 4 weeks and then injected intraprostatically with either 0.2ml of a zinc liposome or a zinc solution (0.04M zinc sulfate). Animals were sacrificed 4, 6, and 8 weeks after the injection. The inhibition of inflammation and its consequences were analyzed both microbiologically and histologically. The prostatic zinc concentrations were measured by inductively coupled plasma atomic emission spectrometry. RESULTS: The average infection rates and mean Log10cfu/g of the zinc-treated groups were significantly lower than the controls. The histopathology showed resolving prostatitis in the zinc-treated groups compared with the controls. The prostatic zinc levels were higher in the zinc-treated groups than in the controls 4 and 6 weeks after the zinc injection (p<0.05). However, the zinc liposome and zinc solution groups were found to be effectively identical. CONCLUSIONS: An intraprostatic injection of zinc inhibited bacterial growth by increasing the zinc levels in the rat prostatitis model. These results suggest that a local application of zinc to the prostate presents a new treatment modality for chronic bacterial prostatitis at the point of its pathogenesis.
Animals ; Humans ; Inflammation ; Liposomes ; Male ; Models, Animal* ; Plasma ; Prostate ; Prostatitis* ; Rats* ; Rats, Wistar ; Spectrum Analysis ; Urethra ; Zinc*