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*

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*

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: 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

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

A total of 92 men with impotence underwent a trial of intracavernous injection of papaverine 30mg. Underlying causes of impotence were psychogenic (26 Pts.), posterior urethral injury (28 Pts.), spinal cord injury (15 Pts.), pelvic surgery (14 Pts.) and eldly (9 Pts.). The results were as follows 1. The underlying causes of impotence in papaverine responders were psychogenic 23 (88.5%), posterior urethral injury 19 (67.9%), spinal cord injury 13(86.7%), Pelvic surgery 5 (35.7%) and eldly 3 (33.3%). 2. Fourteen patients of the moderate papaverine responders underwent intracavernous injection of papaverine 30mg with phentolamine 1mg and 8 of them attained full erection. 3. After injection, the erection started in an average of 2.6 minutes, rigidity of penis attained in an average of 7.3 minutes, and erection status sustained for an average of 42.6 minutes in 60 patients. 4. Normal nocturnal penile tumescence monitoring (NPTM) or stamp test was found in 19 of 40 patient and 18 of them (94.7%) were papaverine responders, while 21 had an abnormal NPTM or stamp test and 11 of them were papaverine non-respoders. 5. A penile brachial index (PBI) of 0.6 or more was found in 62 of 73 patients and 53 of them(85.5 %) were papaverine responders, while 11 had an index of less then 0.6 and all of them were papaverine non-responders. 6. Thitry patients had sexual intercourse. Twenty-seven of them had a satisfactory result and 23 of them had ejaculation. 7. Papaverine induced prolonged erection occurred as major complicatiun in 4 patients after trial injection. Erection was subsided after intracavernous phenylepinephrine injection. There were minor complications such as ecchymosis at the injected site on the prepuce but subsided spontaneously in a few days. We conclude that intracavernous papaverine injectiun currently is a good screening technique for the differential diagnosis of severe vasculosenic impotence and is a useful chemical prosthesis of non-vasculogenic impotence.
Coitus ; Diagnosis, Differential ; Ecchymosis ; Ejaculation ; Erectile Dysfunction ; Humans ; Male ; Mass Screening ; Papaverine* ; Penile Erection ; Penis ; Phentolamine ; Prostheses and Implants ; Spinal Cord Injuries

Two hundred cases of surgically repaired hypospadias at Pusan University Hospital in the past sixteen half years were surveyed and analyzed. Of 200 patients, 99(49.5%) were corrected in their preschool age. The number of patients with the distal type and proximal type of hypospadias performed in 134(67%) of 200 and the success rate was 84.3 per cent(113 of 134). One stage repair was performed in 66(33.0%) of 200 and the success rate are as follows : King, 100%(7 of 7), MAGPI, 100.0% (4 of 4), Mathieu, 100.0%(5 of 5), Hodgson ( I , III), 75%(12 of 16), and preputial island flap including Duckett, Hodgson XX and double faced technique, 67.6% (23 of 34). The most common postoperative complication was fistula.
Busan ; Female ; Fistula ; Humans ; Hypospadias* ; Male ; Postoperative Complications

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*

PURPOSE: As growth hormone was reported to improve cavernosal nerve regeneration, we studied the action mechanism of growth hormone(GH) on the regeneration of nitric oxide synthase(NOS)-containing penile nerves after unilateral cavernous nerve neurotomy in rats. MATERIALS AND METHODS: Male rats were divided into three groups: sham operation(n=10); unilateral neurotomy of a 5mm segment of the cavernous nerve(n=10) and unilateral neurotomy with GH injection(n=10). Electrostimulation of the intact cavernous nerve was performed at 1 and 3 months after operation. Nicotinamide adenine dinucleotide phosphate(NADPH) diaphorase staining was used to identify nNOS in penile nerve fibers of the mid-shaft segment. The gene expression for nNOS, insulin like growth factor(IGF)-I and nerve growth factor(NGF) were investigated in corporal tissue by reverse transcriptase-polymerase chain reaction(RT-PCR) using specific oligonucleotide primers. RESULTS: Electrostimulation in the GH-treated group revealed a greater maximal intracavernosal pressure and a shorter latency period than in those given neurotomy alone at 3 months after operation. One month after unilateral neurotomy, both neurotomy alone and the GH-treated groups showed a significant decrease in NOS-containing nerve fibers in the dorsal and intracavernosal nerves on the side of neurotomy, however mRNA expression of nNOS and IGF-I showed a significant increase in GH-treated group. At 3 months, the number of NOS-containing nerve fibers in the neurotomy alone group did not increase while the GH-treated group showed a significant increase. CONCLUSIONS: These results show that GH significantly enhances the regeneration of NOS-containing fibers in the dorsal and intracavernosal nerves after unilateral cavernous nerve injury via IGF-I.
Animals ; DNA Primers ; Gene Expression ; Growth Hormone* ; Humans ; Insulin ; Insulin-Like Growth Factor I ; Latency Period (Psychology) ; Male ; NAD ; Nerve Fibers ; Nerve Regeneration ; Nitric Oxide ; Rats* ; Regeneration* ; RNA, Messenger

Relaxation of penile cavernous smooth muscle is controlled by nerve and endothelium derived substances. Externally applied acetylcholine in human corpus cavernosum has been shown to cause endothelium dependent smooth muscle relaxation and nitric oxide(NO) is known as an endothelium derived relaxing factor(EDRF). NO has been identified as an endothelium derived relaxing factor in blood vessels. We tried to determine whether it is involved in the relaxation of the corpus cavernosum that allows penile erection. The changes of isometric tension in rabbit cavernous smooth muscle strips mounted in organ bath chambers after the addition of drugs were monitored on the biophysical recording system. Acetylcholine induced a dose-dependent relaxation and atropine at 5 x 10(-5) M almost abolished the effects of acetylcholine. N(c)-nitro-L-arginine (L-NOARG) at 5 x 10(-5) M almost abolished the effects of acetylcholine. The subsequent addition of L-arginine at 5 x 10(-5) M further restored to the effect of acetylcholine, but these effect did not occur if D -arginine was substituted for L-arginine. Methylene blue at 10-5 M markedly inhibited effects of acetylcholine. These data suggest that acetylcholine endothelial formation of NO via muscarinic receptor and NO from L-arginine leads to the relaxation of cavernous smooth muscle via activation of guanylate cyclase in rabbit.
Acetylcholine ; Arginine ; Atropine ; Baths ; Blood Vessels ; Endothelium ; Endothelium-Dependent Relaxing Factors ; Guanylate Cyclase ; Humans ; Male ; Methylene Blue ; Muscle, Smooth* ; Nitric Oxide* ; Penile Erection ; Receptors, Muscarinic ; Relaxation*