PURPOSE: The twenty-six F sized continuous running irrigation transurethral resection (TUR) system has showed a relatively high risk for inducing postoperative urethral stricture in Korean men. We evaluated the efficacy and safety of recently available 22F continuous running irrigation TUR system for treating benign prostatic hyperplasia (BPH) patients. MATERIALS AND METHODS: A total of seventy patients with severe symptomatic BPH underwent transurethral prostatectomy (TURP). The 26F system was used in 31 cases and the 22F system was used in 39 patients. The total resection weight, the resection rate, and the intraoperative and immediate postoperative complication rates were compared between the 2 groups. The patients were followed for 2 weeks, 4 weeks and 3 months postoperatively to check for the development of urethral stricture. RESULTS: The total resection weight was 14.8+/-9.5gm in the 22F group and 11.2+/-10.2gm in the 26F group (p>0.05). The resection rates were 0.24+/-0.10gm/min and 0.19+/-0.11gm/min, respectively. The rate of urethral stricture requiring any type of management was 15.4% (6/39) in the 22F group and 38.7% (12/31) in the 26F group (p<0.05). Visual internal urethrotomy was performed in 2.6% (1/39) and 9.7% (3/31) of the patients, respectively. Other complications were 1 capsular perforation, 1 TUR syndrome, 1 epididymitis and 1 delayed bleeding in the 22F group, and 1 intraoperative fever and 1 epididymitis in the 26F group. CONCLUSIONS: TURP using the 22F continuous running irrigation system enabled the surgeon to resect prostate adenoma with a similar speed and effectiveness as compared with the 26F system, and it significantly reduced the risk of urethral stricture. Performing TURP with using this system can be considered as a first line therapy for the BPH patients who require surgery.
Adenoma ; Epididymitis ; Fever ; Hemorrhage ; Humans ; Male ; Postoperative Complications ; Prostate ; Prostatic Hyperplasia ; Running* ; Transurethral Resection of Prostate* ; Urethral Stricture

A primary signet ring cell carcinoma (PSRCC) of the urinary bladder is a rare variant of a mucin-producing adenocarcinoma. The prognosis of a PSRCC is poor, as silent progression in a linitis platica fashion leads to delayed diagnosis. Herein, the case of a PSRCC of the bladder, which extended to the prostate, which was treated with a cystoprostatectomy, is reported.
Adenocarcinoma ; Carcinoma, Signet Ring Cell* ; Delayed Diagnosis ; Prognosis ; Prostate* ; Urinary Bladder*

Intratesticular varicocele is a rare entity and refers to a dilated intratesticular vein radiating from the mediastinum testis into the testicular parenchyma. A 22-year-old man was admitted to our hospital with left testicular pain. On physical examination, a grade III varicocele was noted on the left side. Gray-scale ultrasound and color Doppler ultrasound examinations revealed intratesticular and extratesticular varicocele. The patient underwent spermatic vein ligation by open modified Palomo varicocelectomy.
Humans ; Ligation ; Mediastinum ; Physical Examination ; Testis ; Varicocele ; Veins ; Young Adult

PURPOSE: This study is designed to explore the role of retrograde urethrography as a predictor of recovery of urinary continence after radical retropubic prostatectomy. MATERIALS AND METHODS: A total of 40 patients who underwent radical retropubic prostatectomy from January 2005 to April 2007 were investigated. Among them one neurogenic bladder patient and one follow up loss patient were excluded. Voiding pattern and urinary incontinence were investigated with voiding diary monthly after Foley catheter removal. Recovery of urinary continence was defined as usage of less than 1 diaper per day. Pericatheter urethrography was conducted 2 weeks after operation. If definite bladder-urethral extravasation was not detected, an retrograde urethrography was performed immediately. 30 patients with sufficient length of urethra, regular margin of urethra and beaky appearance were defined as Group A, and 8 patients without above mentioned characteristics were marked as Group B. Differences between two groups were compared in terms of age, prostate volume, prostate specific antigen, urodynamic parameters, and duration of urinary incontinence. RESULTS: No significant differences were found in age, prostate volume, PSA between two groups. In group A, recovery rates of urinary continence were 70% (21 persons), 100% (30 persons) at 1,3 months after removal of catheter, respectively. In group B, rates of urinary continence recovery were 16.6% (1 person), 37.5% (3 persons), 75% (6 persons) at 1,3,4 months, respectively and 1 person regained continence at 7 months. CONCLUSION: A catheter free retrograde urethrography can be easily added after confirmation of bladder urethra anastomosis site healing. It gives us some valuable informations about external sphincter. The characteristics of retrograde urethrography can be used as a predictor of early recovery of postoperative incontinence.
Catheters ; Follow-Up Studies ; Humans ; Prostate ; Prostate-Specific Antigen ; Prostatectomy* ; Urethra ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urinary Incontinence ; Urodynamics

PURPOSE: The clusterin expression has been associated with tumorigenesis of various malignancies, including tumors of the prostate, colon and breast. Furthermore, the expression of clusterin is modulated by many factors that are believed to regulate tumor growth and apoptosis. We studied the clusterin expression in transitional cell carcinoma (TCC) of the bladder and we investigated its correlation with apoptosis. MATERIALS AND METHODS: Eighty five bladder tumor specimens from radical cystectomy or transurethral resection were subjected to immunohistochemical clusterin staining with Ig G clusterin Ab. We examined the immunohistochemical localization of clusterin, and this was followed by TUNEL staining to detect the apoptotic cells. After double-staining with Hoechst 33258, we detected the apoptotic cells under a fluorescence microscope and we calculated the apoptotic index. RESULTS: Invasive TCC showed a stronger positive expression of clusterin as compared with superficial TCC, but the positivity of the clusterin expression was not in proportion to the tumor grade. The apoptotic indices of cancer were 0.52+/-0.28%, 0.30+/-0.16% and 0.17+/-0.11% in Grade I, Grade II and Grade III superficial TCC, respectively, and it was 0.23+/-0.13% in Grade III invasive TCC. Apoptotic cells were not detected in the cancer cells stained with clusterin. Conversely, clusterin was not expressed in the cells showing apoptosis. CONCLUSIONS: These results suggest that clusterin could be used as a marker to provide prognostic information for the TCC patients. The apoptotic index revealed that apoptosis and the clusterin expression have correlation with transitional cell cancer. Further study will be needed to clarify the role of clusterin as a therapeutic target for cancer treatment.
Apoptosis* ; Bisbenzimidazole ; Breast ; Carcinogenesis ; Carcinoma, Transitional Cell* ; Clusterin* ; Colon ; Cystectomy ; Fluorescence ; Humans ; In Situ Nick-End Labeling ; Prostate ; Urinary Bladder Neoplasms ; Urinary Bladder*

PURPOSE: The Suprapubic Arc (SPARC) procedure has recently been introduced as a new surgical treatment option for stress urinary incontinence in women. We have reported our early results of SPARC procedures. MATERIALS AND METHODS: A total of 23 patients received SPARC procedures at our hospital between November 2002 and August 2003. All the patients were evaluated with history taking, physical examination, urodynamic study and cystography preoperatively. The procedure was carried out under IV propofol or spinal anesthesia. The enrolled patients were followed-up for more than 3 months postoperatively. The cure rate was evaluated and perioperative and postoperative complications were assessed. RESULTS: The mean age of the patients was 48.8 years (ranges from 32 to 67 years) and eight patients had past history of previous abdominal or pelvic surgery. The mean hospital stay was 1.9 days (ranges from 1 to 7 days). Mean follow-up period was 7.9 months (ranges from 3.7 to 14.0 months). Nineteen of the 23 patients (82.6%) were completely cured and 2 patients (8.7%) were much improved, hence the total success rate of the procedure was 91.3%. Bladder perforation during procedure occurred in 7 patients (30.4%) but conservative management sufficed. No serious complication was occurred. CONCLUSION: Our early results show that the SPARC procedure is a effective treatment option for the management of stress urinary incontinence. But we suggest that surgeons should be careful to avoid the bladder injury especially in their early period of experience.
Anesthesia, Spinal ; Female* ; Follow-Up Studies ; Humans ; Length of Stay ; Physical Examination ; Polypropylenes ; Postoperative Complications ; Propofol ; Urinary Bladder ; Urinary Incontinence* ; Urodynamics

Vocal fold scarring is an intractable phonosurgical condition. The number of patients with vocal fold scars is increasing with the aging of society and with the increasing application of laryngeal microsurgery. Many methods are available to treat these, including voice therapy, stem cells, regenerative scaffolds, and growth factors. However, no standard treatment strategy has yet been established, and novel techniques are required. Basic fibroblast growth factor has been shown to be effective for the treatment of mild chronic vocal fold scarring. The combined use of basic fibroblast growth factor and regenerative scaffolds is currently under investigation. Here, we report a female patient in whom vocal fold scarring developed after two laryngeal microsurgeries. We performed laryngeal microsurgery to remove the scar tissue and used basic fibroblast growth factor and a collagen scaffold to promote healing. The patient's voice quality was greatly increased, and she was content with her voice after 2 years of follow-up. This is the first report of this methodology in Korea and is presented along with a review of the literature.

BACKGROUND AND OBJECTIVES: Inlay butterfly cartilage tympanoplasty makes the graft easy, and reduces operating time. The present study aimed to investigate the outcomes of microscopic versus endoscopic inlay butterfly cartilage tympanoplasty. SUBJECTS AND METHODS: In this retrospective study, the outcomes of 63 patients who underwent inlay butterfly cartilage tympanoplasty with small to medium chronic tympanic membrane perforation were evaluated. Twenty-four patients underwent conventional microscopic tympanoplasty and 39 underwent endoscopic tympanoplasty. The outcomes were analyzed in terms of the hearing gain and graft success rate. RESULTS: The surgical success rate was 95.8% in the patients who underwent conventional microscopic tympanoplasty and 92.3% in those who underwent endoscopic tympanoplasty. In both groups of patients, the postoperative air-bone gap (ABG) was significantly lower than the preoperative ABG. There were no significant differences between the preoperative and postoperative ABG values in either group. CONCLUSIONS: Endoscopic inlay tympanoplasty using the butterfly cartilage technique appears to be an effective alternative to microscopic tympanoplasty and results in excellent hearing.
Butterflies ; Cartilage ; Endoscopy ; Hearing ; Humans ; Inlays ; Microscopy ; Retrospective Studies ; Transplants ; Tympanic Membrane Perforation ; Tympanoplasty

Catathrenia is a rare sleep disease characterized by monotonous groaning sounds that appear to be related with prolonged expiration, commonly experienced during rapid eye movement (REM) sleep. Catathrenia is also known as nocturnal groaning or sleep-related groaning and is currently categorized as a sleep-related breathing disorder. We present a rare case of a 19-year-old male with nocturnal groaning during non-REM sleep. We suggest that if catathrenia is suspected, polysomnography should be utilized to differentiate it from various sleep disorders such as snoring, central sleep apnea, sleep talking, parasomnia, and sleep-related movement disorders.
Humans ; Male ; Movement Disorders ; Parasomnias ; Polysomnography ; Respiration ; Sleep Apnea, Central ; Sleep Wake Disorders ; Sleep, REM ; Sleep-Wake Transition Disorders ; Snoring ; Young Adult

Background and Objectives: Neck stab wounds should be managed properly as they can result in life-threatening complications and death. However, guns are prohibited in South Korea and many previous studies conducted in other countries are thus inapplicable. Also, most of the existing case reports deal mostly with profound neck injury and might lead to misunderstanding regarding the severity of injuries when considering neck stab wounds. This study analyzed the clinical characteristics of neck stab wounds according to the cause of trauma.Subjects and Method A total of 89 patients with neck stab wounds who visited the emergency room between January 2005 and June 2017 were enrolled. Medical records and radiological findings were reviewed retrospectively. The patients were divided into two groups according to the cause of trauma (suicide attempt or assault by another person). A comparative analysis of the two groups was conducted. Results: The patients consisted of 41 cases of (46.1%) attempted suicides and 26 cases of (29.2%) psychiatric disorders. Of these, more than half had superficial wounds above the platysma, and multiple anatomical lacerations were found in 40 cases (45%). Psychiatric diagnoses were identified only in the attempted-suicide group (p<0.001), and injuries to the posterior neck triangle were observed only in the assault-by-another-person group (p=0.029). There were 11 cases (12.4%) of profound injury, but there was no significant difference between the two groups. One patient with injury by another person died due to the cutting of the common carotid artery. Conclusion Superficial injuries were more common while profound injuries were relatively uncommon in this study. However, physicians should pay attention to proper evaluation and management comprehensively in cases of neck stab wounds.