A clinical observation was made on 90 consecutive cases of urologic in-patients with renal stones in the Department of Urology, Yonsei University College of Medicine, from January, 1975 to December, 1979. 1) This disease occurred most frequently in the fourth decade, showing 29 cases of total urologic in-patients with renal stones and the ratio of male to female was 2:1. 2) 57 cases showed acidic urine, compared with alkaline urine in 25 cases. 3) Pyuria was observed in 57,3% and microscopic hematuria in 59.8%. 4) In 35.4%, cultures of urine were positive for bacteria and the common invaders were staphylococci and E. coli. 5) In 20.7%, of all cases there were urinary stones of other sites. 6) Pyelolithotomy in 47 cases (54.4%), nephrolithotomy in 16 cases (17.8%), partial nephrectomy in 7 cases (7.8%), nephrectomy in 12 cases (13.3%) and bivalve nephrolithotomy in 8 cases (8.9%) were performed. 7) In pyelolithotomy, single stone was 70.2%, and single stone and staghorn stone in nephrolithotomy were 43.8% respectively which were fixed to the renal calyx. In bivalve nephrolithotomy, staghorn stone was 75% and multiple stone in partial nephrectomy was 85.7% and staghorn stone in nephrectomy was 41.7%. 8) Transfusion was performed in bivalve nephrolithotomy, partial nephrectomy, nephrolithotomy, pyelolithotomy and nephrectomy in decreased order, operation times were longer in order of partial nephrectomy, bivalve nephrolithotomy, nephrolithotomy, nephrectomy and pyelolithotomy, and post-operative day was longer in partial nephrectomy with 11.3 days. 9) Postoperative complications were observed in 9 cases (10%). There were in differences in operative technique and secondary operation by postoperative complication was performed in 2 cases.
Bacteria ; Bivalvia ; Female ; Hematuria ; Humans ; Male ; Nephrectomy ; Postoperative Complications ; Pyuria ; Urinary Calculi ; Urology

OBJECTIVES: To investigate the genotypes of the pathogenic gene COL4A5 and the characteristics of clinical phenotypes in children with Alport syndrome (AS). METHODS: A retrospective analysis was performed for the genetic testing results and clinical data of 19 AS children with COL4A5 gene mutations. RESULTS: Among the 19 children with AS caused by COL4A5 gene mutations, 1 (5%) carried a new mutation of the COL4A5 gene, i.e., c.3372A>G(p.P1124=) and presented with AS coexisting with IgA vasculitis nephritis; 3 children (16%) had large fragment deletion of the COL4A5 gene, among whom 2 children (case 7 had a new mutation site of loss51-53) had gross hematuria and albuminuria at the onset, and 1 child (case 13 had a new mutation site of loss3-53) only had microscopic hematuria, while the other 15 children (79%) had common clinical phenotypes of AS, among whom 7 carried new mutations of the COL4A5 gene. Among all 19 children, 3 children (16%) who carried COL4A5 gene mutations also had COL4A4 gene mutations, and 1 child (5%) had COL4A3 gene mutations. Among these children with double gene mutations, 2 had gross hematuria and proteinuria at the onset. CONCLUSIONS This study expands the genotype and phenotype spectrums of the pathogenic gene COL4A5 for AS. Children with large fragment deletion of the COL4A5 gene or double gene mutations of COL4A5 with COL4A3 or COL4A4 tend to have more serious clinical manifestations.
Humans ; Nephritis, Hereditary/pathology* ; Hematuria/complications* ; Retrospective Studies ; Collagen Type IV/genetics* ; Genotype ; Mutation

OBJECTIVETo systematically evaluate the effects of finasteride on hematuria associated with benign prostatic hyperplasia (BPH).

METHODSWe electronically searched MEDLINE (December 1966-April 2009), EMBASE (December 1974-April 2009), The Cochrane Library (Issue 1, 2009), CNKI (December 1994-April 2009), VIP (December 1989-April 2009) and CBM (December 1978-April 2009) , and handsearched several relevant journals as well. Randomized controlled trials were assessed with the methods recommended by the Cochrane Collaboration. The data were screened and systematically analyzed by at least two reviewers independently using the RevMan 5.0 software.

RESULTSCompared with the placebo control group, the finasteride group showed a significantly decreased incidence of hematuria during the 12 months follow-up period (OR 0.11, 95% CI: 0.06-0.21, P < 0.05).

CONCLUSIONFinasteride has desirable therapeutic and preventive effects on BPH-associated hematuria. More well-designed multicentered randomized controlled trials of large sample size are invited to provide further evidence for this conclusion.

Finasteride ; therapeutic use ; Hematuria ; drug therapy ; etiology ; prevention & control ; Humans ; Male ; Prostatic Hyperplasia ; complications ; drug therapy ; Randomized Controlled Trials as Topic

A clinical observation was made on 31 partial nephrectomized patients in Department of Urology, Catholic Medical College, during the period from January 1976 to December 1980. The results were as follow: 1. The common age group in 3rd and 4th decades and the proportion of male to female was 1.4 : 1. 2. Among 31 cases, renal stone was 18 (58.0%). renal tuberculosis was 7 (22.6%), renal rupture was 2 (6.5%). double pelvis was 2 (6.5%), renal infarction was 1 (3.2%) and renal carbuncle was 1 (3.2%). 3. of 31 cases, partial nephrectomy was performed in 33 cases. As methods of the operation, Guillotine type with "U" shaped mattress suture was 19 cases (57.6%) and Renal Vessel Clamp type wag 14 cases (42.4%). 4. Postoperative complication were gross hematuria in 4 cases, temporary urine leakage in 4 cases, wound infection in 1 case, residual stone in 1 case, delayed bleeding in 1 case, septic condition in l case and death in 1 case.
Carbuncle ; Female ; Hematuria ; Hemorrhage ; Humans ; Infarction ; Male ; Nephrectomy ; Pelvis ; Postoperative Complications ; Rupture ; Sutures ; Tuberculosis, Renal ; Urology ; Wound Infection

We studied 60 cases of minimal change nephrotic syndrome (MCNS) with mesangial IgA deposits occurring over a 6 year period. There were 43 adults and 17 children. Hematuria occurred in 69.0% of the adults and 88.2% of the children. Two adults and six children had gross hematuria during the course of the disease. Mesangial IgA deposits were noted in 100% of the cases, and concomitant IgG or IgM deposits were found in 78.6% of adults and 73.7% of children. The fluorescent intensity of mesangial IgA deposits was trace (+/-) to 1+ in 86.1% and 70.6% of the adults and children respectively. Most of the patients showed electron microscopic findings consistent with minimal change nephrotic syndrome. We speculate that most of our cases are variants of minimal change nephrotic syndrome but are neither IgA nephropathy nor an overlapping syndrome, and that environmental or genetic factors may be related to the deposition of IgA in these MCNS patients.
Adult ; Child ; Comparative Study ; Female ; Glomerular Mesangium/immunology/*pathology ; Hematuria/etiology ; Human ; Immunoglobulin A/*analysis ; Male ; Nephrosis, Lipoid/complications/immunology/*pathology

A clinical observation was made on the 58 nephrectomized patients during the period from Jan. 1978 to Dec. 1982 and the following were obtained. 1. The nephrectomies were performed in the 58 patients of the 465 urologic operations. (12.5%) 2. The most frequent age distribution ranged from 20 years old to 49 years old and the ratio of male to female was 1.3:1. 3. The causative disease of nephrectomy were tuberculosis (22.4%), renal stone (15.5%), renal injury (13.8%), hydronephrosis (12.1%), renal tumor (12.1%) and renal infection(10.3%) in order. 4. The common symptom were flank pain (41.4%), hematuria (37.9%), and frequency (17.2%). 5. The most frequently employed surgical approach of nephrectomy was though flank (79.3%). 6. The postoperative complications were 8 cases(13.8%),of which wound infection was the highest (6.9 %) 7. 47 cases (81.0%) were discharged within 15 days after operation.
Age Distribution ; Female ; Flank Pain ; Hematuria ; Humans ; Hydronephrosis ; Male ; Middle Aged ; Nephrectomy ; Postoperative Complications ; Tuberculosis ; Wound Infection ; Young Adult

From January 1988 to January 1996, 42 infants and children (44 renal units) had undergone surgical management to correct ureteropelvic junction obstruction. Median patient age was 8.5 years (range from 2 months to 17 years) and 11 patients were less than 1 year old at operation. Of 44 renal units surgically managed, 30 were on the left side and 10 were right side. 2 patients had undergone bilateral surgical management. Presenting symptoms were febrile urinary tract infection in 14 cases, abdominal pain in 14 cases, abdominal mass in 5 cases, gross hematuria in 3 cases and 3 cases were detected prenatally. We used imaging antegrade pyelography (AGP) in 15 cases, additional retrograde pyelography (RGP) in 12 cases and both AGP and RGP were performed in 1 case. To correct ureteropelvic junction obstruction, we performed dismembered pyeloplasty in 33 renal units, ureterolysis in 2 renal units, ureterocalycostomy in 1 renal unit, endopyelotomy in 1 renal unit and nephrectomy in 7 renal units. To diverge the urinary flow, we used nephrostomy in 19 renal units, ureteral stenting in 6 renal units and both nephrostomy and ureteral stenting were used in 10 renal units. As postoperative complications, restenosis was developed in 5 renal units, delayed open in 5 renal units, urinary tract infection in 2 renal units and wound infection, prolonged urine leakage, ureteral stone in each 1 renal unit. Postoperative success rate in followed-up patients, who had undergone pyeloplasty, was 91.6%. The success rate in children, who was less than 1 year old, was 100% and in children, who was more than 1 year old, was 88.4%. Finally we suggest that the surgical correction is safe and proper method for ureteropelvic junction obstruction in children. Additionally early operation of ureteropelvic junction obstruction is recommendable.
Abdominal Pain ; Child* ; Hematuria ; Humans ; Infant ; Nephrectomy ; Postoperative Complications ; Stents ; Ureter ; Urinary Tract Infections ; Urography ; Wound Infection

OBJECTIVETo study the clinical characteristics of children with an initial onset of IgA nephropathy with nephrotic syndrome and compare them with children with primary nephrotic syndrome, in order to provide a theoretical basis for the differential diagnosis of the two diseases.

METHODSFifty children diagnosed with an initial onset of IgA nephropathy with nephrotic syndrome were included in this study. Seventy-two children diagnosed with an initial onset of primary nephrotic syndrome served as the control group. The clinical and laboratory examination characteristics were compared between the two groups.

RESULTSThe IgA nephropathy group had significantly higher incidence rates of gross haematuria, microscopic haematuria, hypertension, acute kidney injury, low serum high-density lipoprotein cholesterol, anemia, low serum complement C4, steroid resistance, and nephritis-type nephrotic syndrome and a significantly lower incidence of elevated serum IgE compared with the control group (P<0.05). There were significant differences in serum creatinine, serum uric acid, serum total cholesterol, serum high-density lipoprotein cholesterol, serum IgE, serum complement C4, and hemoglobin levels between the IgA nephropathy and the control groups (P<0.05). The thresholds of serum IgE (<131.2 IU/mL) and high-density lipoprotein cholesterol (<1.35 mmol/L) were reference parameters in the differential diagnosis of IgA nephropathy with nephrotic syndrome and primary nephrotic syndrome.

CONCLUSIONSChildren with IgA nephropathy presenting nephrotic syndrome manifest mainly as nephritis type and steroid-resistant type in the clinical classification. Cinical manifestations accompanied by serum levels of high-density lipoprotein cholesterol and IgE are helpful for differential diagnosis of IgA nephropathy presenting nephrotic syndrome and primary nephrotic syndrome.

Adolescent ; Child ; Child, Preschool ; Cholesterol, HDL ; blood ; Complement C4 ; analysis ; Female ; Glomerulonephritis, IGA ; blood ; complications ; Hematuria ; etiology ; Humans ; Immunoglobulin E ; blood ; Male ; Nephrotic Syndrome ; blood ; complications

OBJECTIVETo assess whether primary hypertension affects the occurrence and progression of benign prostatic hyperplasia (BPH).

METHODSA total of 423 cases of BPH, undergoing transurethral resection of prostate (TURP) or open surgery due to severe low urinary tract symptoms, were reviewed and analyzed. All cases were verified to be BPH postoperatively following histopathological examination.

RESULTSOf 423 patients, 295 cases (69.7%) were simple BPH (group BPH-NT); 128 cases (30.3%) were BPH with hypertension (group BPH-HT). The mean age and the incidence of haematuria were significantly higher in group BPH-HT than those in group BPH-NT (P < 0.05). The time of BPH occurrence and surgical treatment in group BPH-HT with mean diastolic blood pressure >/= 90 mmHg was significantly earlier than those with diastolic blood pressure < 90 mmHg (P < 0.05; P < 0.01). As compared with group BPH-NT, the time of BPH occurrence was significantly earlier in group BPH-HT with more than 10 years hypertension; the rate of urinary retention and haematuria was significantly higher and prostatic volume was significantly greater in group BPH-HT with more than 20 years hypertension; (all P < 0.05). Additionally, prostatic volume was positively correlated with the years of hypertension in group BPH-HT (Rsq = 0.056, P = 0.009).

CONCLUSIONSThe present results demonstrate that BPH may be frequently accompanied by the disease of hypertension. A long-term hypertension, particularly the condition of high diastolic blood pressure may improve the occurrence and clinical progression of BPH.

Aged ; Aged, 80 and over ; Hematuria ; etiology ; Humans ; Hypertension ; complications ; Male ; Middle Aged ; Prostate ; pathology ; Prostatic Hyperplasia ; complications ; pathology ; Retrospective Studies ; Severity of Illness Index ; Urinary Retention ; etiology

PURPOSE: To examine the efficacy and safety of holmium laser enucleation of the prostate (HoLEP) for the surgical treatment of benign prostatic hyperplasia and to estimate the time to overcome the learning curve. MATERIALS AND METHODS: From May 2008 to October 2009, 164 consecutive patients treated with HoLEP were enrolled in this study. International Prostate Symptom Score (IPSS), peak urinary flow rate (Qmax), and postvoid residual urine (PVR) were documented preoperatively and at 6 weeks and 3, 6, 12, and 18 months postoperatively. The 164 study subjects were divided into 3 groups (group 1 the first 50 patients treated, group 2 the second 50, and group 3 the third 64), and perioperative data and complications were analyzed in these groups to determine the learning curve. In addition, the inverse and upward techniques were compared in terms of the effects and the stability of morcellation. RESULTS: The mean patient age was 69 years, and the average operation time was 62 minutes (range, 20-208 minutes). Mean prostate volume was 54.2 ml and mean resected tissue weight was 18.6 g. Postoperatively, IPSS and PVR decreased and Qmax increased significantly. Postoperative complications were transient incontinence (8.5%), urinary retention (4.3%), hematuria (3.0%), urinary tract infection (1.2%), and urethral stricture (0.6%), and intraoperative complications were minor capsular perforation (4%) and bladder injury (8%). CONCLUSIONS: HoLEP was found to be effective and safe regardless of prostate size. We recommend that a systematic educational program be established to reduce the learning curve.
Hematuria ; Holmium ; Humans ; Intraoperative Complications ; Lasers, Solid-State ; Learning ; Learning Curve ; Postoperative Complications ; Prostate ; Prostatic Hyperplasia ; Urethral Stricture ; Urinary Bladder ; Urinary Retention ; Urinary Tract Infections