No abstract available.
Transurethral Resection of Prostate*

Internal urethrotomy under direct vision was utilized in the complete urethral stricture secondary to pelvic bone fracture or other trauma Prior to operation the antegrade-retrograde cystourethrogram demonstrated a complete disruption and the length of stricture at the level of bulbar and/or membranous urethra. To seek correct channel of proximal urethra was facilitated by an antegrade metal sound guidance performed through the suprapubic tract during urethrotomy. We found this technique a simple, easy and effective method in the management of traumatic complete urethral stricture.
Constriction, Pathologic ; Pelvic Bones ; Urethra ; Urethral Stricture*

Bladder stone formation is secondarily associated with bladder outlet obstruction, such as neurogenic bladder and benign prostatic hyperplasia, and intravesical foreign body. 1. A case of unexpected giant bladder stone weighed 580gm associated with missed intravesical bullet after gun shut injury during Korean War in a 55-year-old man. 2. A case of giant bladder stone weighed 260gm associated with urinary stasis and urinary tract infection due to neurogenic bladder in a 46-year-old woman. 3. A case of multiple bladder stone, total number of 107, associated bladder outlet obstruction due to benign prostatic hyperplasia in a 63-year-old man.
Female ; Foreign Bodies ; Humans ; Korean War ; Middle Aged ; Prostatic Hyperplasia ; Urinary Bladder Calculi* ; Urinary Bladder Neck Obstruction ; Urinary Bladder* ; Urinary Bladder, Neurogenic ; Urinary Tract Infections

We reviewed our experience retrospectively with 65 patients who had post-traumatic complete urethral stricture secondary to pelvic bone fracture or other causes during last 10 years. All patients underwent delayed endoscopic internal urethrotomy (EIU) 3 to 9 months later after immediate suprapubic diversion. Prior to EIU, the antegrade-retrograde urethrogram demonstrated a complete urethral disruption, and the length of urethral obstruction was measured from 0.5cm to 3.5cm (mean 1.4cm). Of 65 patients, 61 patients (94%) had successful operations, 4 patients (6%) whose strictures were measured more than 2.5cm were failed and treated with open urethroplasty. Sixty-one patients who eventually underwent successful endoscopic internal urethrotomy; 28 patients (46%) achieved satisfactory urethral voiding after first EIU; 33 patients (54%) took operations more than twice due to recurred partial urethral stricture. After 6 to 53 months (average-21months), fifty-six (86%) of 65 patients voided satisfactorily (incontinence in 3 patients). Five patients who did not void well even after successful EIU were diagnosed to have neurogenic bladder (detrusor areflexia). Of 65 patients, 16 patients (25%) had post-traumatic impotence. After the EIUs were performed, there were no newly developed impotences. There were no serious major complications. We concluded that direct visual internal urethrotomy was useful and safe as a primary minimally invasive therapeutic modality for post-traumatic complete urethral stricture in selected patients with relatively short urethral defect (less than 2.5cm).
Constriction, Pathologic ; Erectile Dysfunction ; Humans ; Male ; Pelvic Bones ; Retrospective Studies ; Urethral Obstruction ; Urethral Stricture* ; Urinary Bladder, Neurogenic

The prostate-specific antigen is a serine protease which is found only in epithelial cells of prostatic origin. Benign and malignant primary, as well as metastatic prostate cells, elaborate this protein. Benign prostatic hyperplasia can be associated with elevated levels of PSA as determined by a monoclonal assay, and prostatic weight is the most important non-cancer factor variable of PSA elevation. We estimated the in vivo prostate gland volume and resected weight of prostate in 75 men using prolate ellipse formula ultrasound analysis from Jan. 1991 to June 1992. OF the men 43 (58 %) had a PSA value of 4ng/ml or less. The PSA value was greater than 4 but less than or equal to 10 in 19 men (25 %) and greater than 10 in 13 men (17 %). A total of 24 men (35 %) had a eland volume less then 25 cm3, 16% of whom had a PSA value greater than 4. Further analysis revealed that the incidence of a PSA value greater than 4 increased as the prostate volume increased (51 % for greater than or equal to 25 but less than or equal to 50 and 62.5 % for greater than 50). The incidence of a PSA Value greater than 10 increased as resected weight of prostate increased (25 % for greater than or equal to 21 but less than or equal to 30 and 75 % for greater than 30). We found a statistically significant association between prostate gland volume and resected specimen weight to the serum PSA concentration. The prostate gland volume can be a helpful adjunct in determining the significance of PSA value clinically.
Epithelial Cells ; Humans ; Incidence ; Male ; Phosmet ; Prostate* ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Serine Proteases ; Ultrasonography

Patients with bilateral aplasia of the vas deferens have been considered sterile. In such patients many investigators have tried to create a successful sperm bank with various materials such as saphenous vein, tunica vaginalis, silicone prosthesis, monofilament knitted polypropylene and etc. and to offer hope for fertility. We performed to create an artificial spermatocele in a 32 year old male patient with bilateral vas aplasia by using a segment of great saphenous vein, anastomosed to the globus major to store spermatozoa. Aspirations of the venous cap of the patient at 2.3.4. and 5 months revealed numerous sperm with normal morphology and poor motility. Attempted insemination to his wife with this sperm was unsatisfactory.
Adult ; Aspirations (Psychology) ; Fertility ; Hope ; Humans ; Insemination ; Male ; Polypropylenes ; Prostheses and Implants ; Research Personnel ; Saphenous Vein ; Silicones ; Sperm Banks ; Spermatocele* ; Spermatozoa ; Spouses ; Vas Deferens*

No abstract available.

The etiology of benign prostatic hyperplasia( BPH) is multifactorial, but it is recognized that two important factors necessary for the induction of BPH in men are the testis(endocrine control) and the aging. From January 1991 to June 1992, we measured 6 hormonal factors in the serum of 129 men who were diagnosed as benign prostatic hyperplasia pathologically to determine whether endocrine factors influence the volume of benign prostatic hyperplasia. These hormonal levels were correlated with the prostatic volume measured by transrectal ultrasound(TRUS). There was no significant correlation for age with total prostatic volume(r=0.06, p=0.31l). With age there was a significant increase in serum testosterone(r=0.25, p=0.003), LH(r=0.42, p=0.000) and cortisol(r=0.25, p=0.016). The prostatic volume measured by prostatic ultrasound was correlated positively with estradiol(r=0.34, p=0.002) and cortisol(r=0.28. p =0.008). Also the prostatic volume was correlated with resected weight of prostate(r=0.38, p=0.000). We suggested that serum estrogen and cortisol levels may be the factors in persistent stimulation of benign prostatic hyperplasia.
Aging ; Estrogens ; Humans ; Hydrocortisone ; Male ; Prostatic Hyperplasia* ; Ultrasonography

Flow cytometric nuclear deoxyribonucleic acid (DNA) ploidy analysis was done successfully on 35 specimens of stage T1 bladder carcinoma treated with Bacillus Calmette-Guerin(BCG) between June 1986 and June 1993. The histologic tumor grading was done by the same pathologist. Of the specimens 16(46%) were DNA diploidy, 14(40%) were aneuploidy and 5(14%) were tetraploidy. In the relationship between tumor grade and ploidy, diploidy was seen in all (100%) of 5 patients with grade 1, in 13(48%) of 27 patients with grade 2. On the other hand, non-diploidy in 14(52%) of 27 patients with grade 2, and in all(100%) of 5 patients with grade 3. Mean followup period was 29 months(12-97 months). None of the patients died of tumor during the followup period. None(0%) of 16 patients with diploidy had tumor recurrence, in contrast 8(42%) of 19 patients with non-diploidy tumors recurred(p<0.05). None of the 16 patients with diploidy had progression. but 5(36%) in 14 patients with aneuploidy (5 patients(26%) in 19 patients with non-diploidy) progressed to an advanced stage(p<0.05). The DNA ploidy analysis appears to significantly contribute in the elucidation of possible future recurrence and progression in patients with stage T1 bladder carcinoma.
Aneuploidy ; Bacillus ; Diploidy ; DNA* ; Flow Cytometry ; Follow-Up Studies ; Hand ; Humans ; Neoplasm Grading ; Ploidies ; Recurrence ; Tetraploidy ; Urinary Bladder*

Apocrine sweat gland carcinoma is a very unusual malignant skin adnexal tumor and mostly occurs in areas where apocrine elands are abundant namely. axilla. upper arm. scalp. eyelid. vulva and external auditory meatus. The scrotal location is not yet reported. We report a case of apocrine sweat gland carcinoma of scrotum in a man aged 85, which was managed by local excision. The histologic finding is that of poorly differentiated adenocarcinoma. Evidence of decapitation secretion typical or apocrine glands. is present in some areas.
Adenocarcinoma ; Apocrine Glands ; Arm ; Axilla ; Decapitation ; Eyelids ; Scalp ; Scrotum* ; Skin ; Sweat Glands* ; Sweat* ; Vulva