A male child of 9 months with bilateral Wilms tumor was admitted to our hospital. His chief complaint was abdominal mass. Clinical examination and IVP, USG and CT-scan disclosed bilateral Wilms tumor. Right nephrectomy and left partial nephrectomy were performed. Anuria was experienced to 24 hours and so exploratory-laparotomy was done. Renal autotranplantation was performed because of the thrombosis of renal artery. But six days after operation he died.
Anuria ; Child ; Humans ; Male ; Nephrectomy ; Renal Artery ; Thrombosis ; Wilms Tumor*

We performed original and modified technique of Mays' glanuloplasty in 6 and 12 cases respectively. The results were as follows: 1. 6 cases of mild from of hypospadias (2 cases of coronal, 4 cases of dist. penile) and 12 cases of severe form of hypospadias (5 cases of prox. penile, 6 cases of penoscrotal, 1 case of perineal) on pre-chordectomy but all cases became severe from of hypospadias (2 cases of prox. penile, 15 cases of penoscrotal, 1 case of perineal) on post-chordectomy. 2. The postoperative complications were 3 cases (50.0%) (1 case of meatal stenosis, 2 cases of meatal necrosis) in original technique of Mays' glanuloplasty and 2 cases of meatal stenosis (16.7%) in modified technique of Mays' glanuloplasty.
Constriction, Pathologic ; Female ; Hypospadias* ; Male ; Postoperative Complications

PURPOSE: We describe clinical assessment of visual internal urethrotomy (VIU) as primary treatment modality in 69 men who presented with complete or partial obstructed urethral stricture. MATERIALS AND METHODS: The 63 patients with partial obstructed urethral stricture were treated by typical VIU. The 6 men with complete obstructed urethral stricture were treated by VIU using sound passed through previously placed suprapubic tract as guide. RESULTS: The procedure was completed successfully in 57 of the 63 men with partial obstructed (90.5%) and 3 of 6 patients with complete obstructed urethral stricture (50%). CONCLUSIONS: VIU is a safe and effective as primary treatment plan when urethral stricture is partial obstructed and the impassable urethral segment is shorter than 1.0cm.
Humans ; Male ; Urethral Stricture*

Purpose: The ideal neurourophysiologic investigatory technique would objectively and quantitatively evaluate functional status of all parts of the neurologic network involved in obtaining and maintaining penile erection. We assessed electrical activity of the corpus cavernous smooth muscle in normal and neurogenic erectile dysfunction men using SPACE. Material and Methods: A total of 39 normal subjects and 40 neurogenic erectile dysfunction patients underwent single potential analysis of cavernous electricity(SPACE) with a 2-channel EMG amplifier and surface electrodes. The electrical potentials were processed with the cut off frequencies at 0.3 - 32 Hz, a paper speed of 0.5cm/sec, and a range of amplitude of 0.5mV. Results: In 35 of 39 normal subjects(89.7%) and 5 of 10 incomplete suprasacral spinal cord injury patients, similar single potentials of uniform shape were recorded. In patients with peripheral autonomic denervation, irregular shape potentials with higher frequency and lower amplitude were found. In 3 of 5 patients with long standing diabetes(over 15 years), SPACE shows electrical silence. Conclusion: These results suggest that SPACE test is a useful noninvasive and reproducible method for evaluating cavernous innervation in erectile dysfunction. Furthermore, the single potential means intact cavernous innervation.
Autonomic Denervation ; Electrodes ; Erectile Dysfunction ; Humans ; Male ; Muscle, Smooth* ; Penile Erection ; Spinal Cord Injuries

The factors influencing upon stone fragmentation by extracorporeal shock wave lithotripsy (ESWL) of ureteral stones are considered to be stone size, location, component, and impaction. ESWL was performed in 322 cases with ureteral stones using the Modulith SL 20 electromagnetic lithqtripter between December 1990 and July 1992. The factors influencing upon stone fragmentation such as stone size, location, degree of hydronephrosis, shape, pain character and presence or absence of urinary tract infaction for the first and second session of ESWL were investigated. The failure rate of ESWL according to stone size was similar for stones smaller than 2.0cm(p>0.05) but was high for stones larger than 2.0cm(p<0.05). The failure rate of ESWL for upper ureteral stones was similar to midureteral stones(p>0.05) but was low for lower ureteral stones(p>0.05). The failure rate of SSWL according to degree of hydronephrosis was similar in cases without hydronephrosis and with mild hydronephrosis(p>0.05) but was high in cases with severe hydronephrosis(p<0.05). The failure rate of ESWL according to stone shape was not significantly different(p>0.05). The failure rate of ESWL in cases without pain was not significantly different from in cases with dull or colic pain(p>0.05). Urinary tract infection did not influence on the failure rate of ESWL(p>0.05). From this study it is believed that factors affecting fragmentation of ureteral stones were stone size, location, and degree of hydronephrosis, but stone shape, presence or absence of pre-ESWL pain or urinary tract infection did not influence on stone fragmentation rate.
Colic ; Hydronephrosis ; Lithotripsy* ; Magnets ; Shock* ; Ureter* ; Urinary Tract ; Urinary Tract Infections

A concealed penis is a normally developed penis that becomes camouflaged by the suprapubic fat pad. This anomally can be congenital or iatrogenic following circumcision. A special variety of this disease is a retractile concealed penis with dysgenetic band of dartos fascia which produce recurrence not infrequently after operative correction by conventional method. We herein report 2 cases of concealed penis of which one case was a recurrent one and another was a case of severe degree with concomittent obesity where a new method for operative correction was applied.
Adipose Tissue ; Circumcision, Male ; Fascia ; Female ; Male ; Obesity ; Penis* ; Recurrence

Megaureter literally means a large ureter and is not used to denote a specific disease process. In this report a classification was proposed according to International pediatric urologic seminar in 1976. Seven cases of primary obstructive megaureter were presented with literature. This diagnosis excluded infravesical obstruction, reflux and neurogenic disorders. The results were as follows; 1. 6 cases were left, 1 case was bilateral. 2. The symptom of pyuria was observed in 2 cases, flank pain and pyuria were observed in 2 cases hematuria was observed in 2 cases, abdominal distention was observed in 1 cases. 3. Histologic findings showed inflammation of mucosa and submucosa in 3 cases, submucosal fibrosis and muscular hypertrophy in 2 cases and submucosal fibrosis and inflammation in 2 cases. 4. 6 cases were treated by Politano-Leadbetter ureteroneocystostomy and 1 case of them was tailored 1 case was treated by nephrourethrectomy. 5. Follow up study was performed in 5 cases of Politano-Leadbetter ureteroneocystostomy. 4 cases of them showed improved pyuria and hydroureteronephrosis.
Classification ; Diagnosis ; Fibrosis ; Flank Pain ; Follow-Up Studies ; Hematuria ; Hypertrophy ; Inflammation ; Mucous Membrane ; Pyuria ; Ureter

Xanthogranulomatous pyelonephritis (XGP) in childhood is not common and the characteristics of the disease are different from those in adults. A 14-year-old boy was admitted to Pusan National University Hospital complaining of fever and right flank pain. An excretory ungraphy shows compressed pelvocalyceal system by extraluminal space occupying lesion in right kidney CT and ultrasonogram of the kidney shows relatively well marinated localized bulging mass on right posterior aspect and invading to the right posterior Gerota's fascia, psoas muscle and quadratus lumborum muscle. Right nephrectomy was performed under the suspicion of Wilms` tumor. Pathologic findings revealed XGP postoperatively. We report a case of focal XGP in a child with review of the literature.
Adolescent ; Adult ; Busan ; Child ; Fascia ; Fever ; Flank Pain ; Humans ; Kidney ; Male ; Nephrectomy ; Psoas Muscles ; Pyelonephritis, Xanthogranulomatous* ; Ultrasonography

It is well known that nitric oxide (NO) mediates smooth muscle relaxation via an increase in cyclic GMP (cGMP) 1evels. Acetylcholine (ACh) and nitroprusside (SNP) are known to mediate relaxation of cavernous smooth muscle via increasing the levels of NO. In recent years, the role of K+ channels in the hyperpolarization induced by nitrates and ACh in smooth muscle have been investigated. In this study, we attempted to characterize the role of K+ channel in rabbit cavernous smooth muscle relaxation by ACh and SNP under organ bath. Changes in isometric tension of corporal strips were monitored. The results were as follows; 1. The relaxant effects of ACh and SNP on contracted smooth muscle induced by 80 mM K' were less than those by phenylephrine. The ACh-induced relaxation was almost abolished in rabbit cavernous smooth muscle which endothelium was denuded, but the that of SNP was not affected by removal of endothelium. 2. Ng-nitro-L-arginine(L-NOARG) (3x0.00001M) and methylene blue (3x0.00001M) significantly inhibited the relaxant effect of ACh in cavernous smooth muscle, but that of SNP was not influenced by these drugs. The inhibition of L-NOARG on the relaxant effect of Ach was reversed by the addition of L-arginine(3x0.0001M). 3. Charybdotoxin (ChTx, 0.0000001M), significantly inhibited the relaxant effects of ACh,SNP and 8-Br-cGMP, but glibenclamide (0.00001M) and apamin (0.00001M) did not influence those of ACh and SNP 4. ACh (0.0001M} and SNP (0.0001M) increased the tissue content of cGMP The effect of ACh on the tissue content of cGMP was significantly affected by L-NOARG (3x0.00001M) and methylene blue (3x0.0000lM), but that of SNP was not influenced by these drugs. ChTx (0.000000lM) did not attenuate the accumulation of cGMP induced by ACh and SNP. Above results suggest that the relaxing effect of Ach and SNP on the isolated rabbit cavernous smooth muscle is associated with an increase in the tissue content of cGMP. Furthermore, ChTx sensitive-K+ channel-mediated hyperpolarization by increased cGMP may play a part in the relaxation of rabbit cavernous smooth muscle by ACh and SNP
Acetylcholine* ; Apamin ; Baths ; Charybdotoxin ; Cyclic GMP ; Endothelium ; Glyburide ; Methylene Blue ; Muscle, Smooth* ; Nitrates ; Nitric Oxide ; Nitroprusside* ; Phenylephrine ; Relaxation*

PURPOSE: Vasectomy has become a popular method for male sterilization in Korea and this, in turn, has been followed by an increase in the number of patient requiring vasectomy reversal. Recently, many authors have reported high success rates of vasovasostomy using microsurgical techniques. The purpose of this study was to compare patency and pregnancy rates and operation time of a new method for vasovasostomy developed at the Department of Urology, Dong-A University Hospital with those of other methods, and to find out other factors influencing patency and pregnancy rates. MATERIALS AND METHODS: Microscopic vasovasostomy was performed in 149 patients from June 1990 to September 1997 at our department. Among 89 patients who could be followed up post-operatively, standard two layer vasovasostomy was performed in 22 patients, modified one layer vasovasostomy with 4 full thickness sutures in 32 patients and modified one layer vasovasostomy with 5 full thickness sutures developed at our department in 35 patients. We compared mean operation times and patency and pregnancy rates between the techniques and examined patency and pregnancy rates according to age, vasal obstruction interval, presence of sperm in vas fluid and sperm granuloma. RESULTS: Success rates were 95.5% for patency and 68.2% for pregnancy in standard two layer vasovasostomy, 87.5% for patency and 59.42% for pregnancy in modified one layer vasovasostomy with 4 full thickness sutures and 97.1% for patency and 65.7% for pregnancy in modified one layer vasovasostomy with 5 full thickness sutures and there was statistical significance in the patency rates between each method (p<0.05). Mean operation times were 136.6+/-19.2 minutes in standard two layer vasovasostomy, 86.6+/-16.8 minutes in modified one layer vasovasostomy with 4 full thickness sutures and 96.7+/-18.4 minutes in modified one layer vasovasostomy with 5 full thickness sutures (p<0.001). With regard to factors influencing operation, the pregnancy rates were slightly higher in cases of younger patients, presence of sperm in vas fluid and presence of sperm granuloma (p>0.05) and significantly lower in case of longer vasal obstruction interval (p<0.0005). CONCLUSIONS: We found little difference in success rates between standard double layer vasovasostomy and modified one layer vasovasostomy with 5 full thikness sutures and the latter was easier and more time saving technique.
Granuloma ; Humans ; Korea ; Pregnancy ; Pregnancy Rate ; Spermatozoa ; Sterilization, Reproductive ; Sutures ; Urology ; Vasectomy ; Vasovasostomy*