A 21-year old male complained pain in his penis which has rapidly grown in its mass. We found a cystic mobile mass of about 2cm in diameter at the frenulum of the penis. A modified circumcision was performed ten years ago that an incised skin of prepuce was rolled and implanted in the operation site. The patient found an asymptomatic small nodule one month after a circumcision. We found no communication with the urethra. We performed an excision of the mass to confirm the diagnosis. Pathologic examination revealed epidermal cyst and abscess formation. We used antibiotics for treatment of infection.
Abscess ; Anti-Bacterial Agents ; Circumcision, Male ; Epidermal Cyst ; Female ; Humans ; Male ; Penis ; Skin ; Urethra

PURPOSE: To compare pre-and postoperative scrotal pain in patients with varicocele who underwent varicocelectomy with different approaches and to identify the factors that affect the outcomes. MATERIALS AND METHODS: A total of 48 patients with left-sided varicocele who had left scrotal pain was included and followed up for more than 3 months. Twenty patients underwent varicocele ligation using modified Palomo, fifteen with laparoscopic approach and thirteen with microscopic subinguinal varicocelectomy respectively. Visual pain scale was used at pre-operation and 3 months later postoperatively. We compared age, grade, a character of pain, operation time, a number of pain killer and pain score. RESULTS: Mean age of patients was 28.9 years (range 15~58 years). 45 patients described their pain as dull ache and 3 as a sharp sensation. There was complete resolution of pain in 35 patients (72.9%), while 7 (14.5%) had partial resolution. 6 (12.5%) had persistent symptoms and varicocele recurred in 3 (6.2%). There was no significant difference in pain resolution according to surgical approaches. Microsurgical approach had a prolonged operation time, but recurrence was not occurred. 3 patients that had a sharp scrotal pain were included in partial resolution or persistent pain. CONCLUSIONS: Surgical approaches were effective in the treatment of painful varicocele in selected patients and there was no significant difference in pain resolution according to surgical approaches. The sharp scrotal pain was related to the outcome of treatment.
Humans ; Ligation ; Recurrence ; Sensation ; Varicocele

We report a rare case of a metastatic tumor of the tunica vaginalis and epididymis with hydrocele from occult gastric cancer. A 72-year-old patient showed a painless scrotal swelling. Scrotal ultrasound showed a right hydrocele and a follow-up hydrocelectomy showed a mass on the epididymis. The operation was thus converted to radical orchiectomy. The tumor was revealed as an adenocarcinoma in the tunica vaginalis and epididymis. Abdominal computed tomography found gastric cancer, which was confirmed by a gastric fibroscopy biopsy. The patient was referred to the hemato-oncology department for chemotherapy but died after 3 months.
Adenocarcinoma ; Aged ; Biopsy ; Epididymis ; Follow-Up Studies ; Humans ; Male ; Orchiectomy ; Stomach ; Stomach Neoplasms ; Testicular Hydrocele

PURPOSE: This study evaluated the prognostic differences in invasive cancer that progressed from a superficial transitional cell carcinoma (TCC) compared to an already invasive TCC at the time of the initial presentation. MATERIALS AND METHODS: Seventy-one patients who had a radical cystectomy performed for an invasive TCC were enrolled in this study. They were divided into two groups. In the first group, the patients were diagnosed as a superficial TCC at initially, which progressed to an invasive tumor. The second group consisted of patients who were diagnosed with invasive TCC at the time of the initial diagnosis. Two groups were compared with regard to the TNM stage, Ash grade, presence of accompanying carcinoma in-situ and survival rate. RESULTS: The group with invasive cancer at the time of the initial presentation had a significantly higher grade than the progressed group. The five-year survival rate was lower in the progressed group. Moreover, Kaplan-Meier analysis showed it was statistically significant (p=0.04). CONCLUSIONS: The grade was higher and the five-year survival rate was lower in the group with invasive cancer at the time of the initial presentation. Therefore, the invasive TCC at the initial diagnosis might take a more aggressive nature than the progressed group.
Carcinoma, Transitional Cell ; Cystectomy ; Diagnosis* ; Humans ; Kaplan-Meier Estimate ; Prognosis ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: The objective of this study was to evaluate the Caspase 3 and p21 expression level and to understand the correlation between Caspase 3 expression and the clinical factors in renal cell carcinoma. MATERIALS AND METHODS: Forty-two patients with renal cell carcinoma were enrolled in this study. Immunohistochemical staining of Caspase 3 and p21 was performed in formalin-fixed and paraffin-embedded tissue sections using rabbit polyclonal antibody (Caspase 3) and mouse antibody (p21). The Caspase 3 and p21 expression levels were compared with the TNM stage, Fuhrman grade, pathological type and survival rates. RESULTS: The Caspase 3 expression level correlated only with the Fuhrman grade (p=0.017). There was no significant correlation between the Caspase 3 and p21 expression level. The prognostic values did not correlate with the Caspase 3 and p21 expression level. CONCLUSIONS: The prognostic value of the Caspase 3 expression level in renal cell carcinoma was insufficient. The relationship between Caspase 3 and p21 was not proven in renal cell carcinoma, and new factors may be implicated with Caspase 3.
Animals ; Apoptosis ; Carcinoma, Renal Cell* ; Caspase 3* ; Humans ; Mice ; Prognosis ; Survival Rate

PURPOSE: Cryoablation has been used successfully for the local treatment of renal cell carcinoma. Besides local destruction, Cryoablation has an immunogenic nature. In this study, we evaluated the anti-tumor immune response induced by cryoablation in renal cell carcinoma murine model. MATERIALS AND METHODS: Renal cell carcinoma was produced in BALB/c mice by the subcutaneous inoculation of Renca cells in the thigh. After 7 days, the tumors were removed using liquid nitrogen in cryoablation group and bipolar electrocoagulation in electrocautery group. For twelve days after re-inoculation of Renca cells at contralateral thigh, tumor volumes were measured daily to assess the effect against the growth of tumor. The immunocyte levels (T4, T8, B and NK cell) were determined to evaluate immune activity by FACS (Fluorescence activated cell sorter) analysis. The effect of cryoablation to induce apoptosis of tumor was evaluated by TUNEL (Terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-digoxigenin nick end-labeling) assay. RESULTS: The tumor volume of cryoablation group was significantly smaller than that of electrocautery group and control (p<0.05). Comparing with control, T cell level was significantly increased after cryoablation (p<0.05), but no group had a significant difference in the levels of B cell and NK cell by FACS analysis. The apoptosis index % of cryoablation group was significantly increased than that of control group (p<0.05) by TUNEL. CONCLUSIONS: Cryoablation could result in the inhibition of re-inoculated tumor growth and induce T cell mediated immune response. The active immune response may be attributed to the apoptosis of tumor after cryoablation.
Allergy and Immunology ; Animals ; Apoptosis ; Carcinoma, Renal Cell* ; Cryosurgery* ; DNA Nucleotidylexotransferase ; Electrocoagulation ; Immunity, Active ; In Situ Nick-End Labeling ; Killer Cells, Natural ; Mice ; Nitrogen ; Thigh ; Tumor Burden

The clinical practice guidelines (CPGs) is made step by step. The evidences that have been published were searched and a group of experts make a consensus based in the evidences. The CPGs in the medical field, where utilizations and interests are increasing, must be confirmed in the management of quality. The Korean Appraisal of Guidelines for Research & Evaluation II (K-AGREE II) tool that helps to manage the quality of CPGs and to develop CPGs was translated by the Steering Committee for Clinical Practice Guideline. It is divided into 6 domains and each domains are independent. It is consisted of 23 items as detail and 2 items for the overall evaluation. Only fifteen CPGs are successfully certified using the K-AGREE II tool in the Korean Medical Guideline Information Center from 2013 and 3 CPGs made by the Korea Urological Association and the associated societies are certified successfully. With the level of certification of CPGs is higher, the Korea Urological Association and the associated societies are also try to develop CPGs that meet their level of certification. The Korean clinical practice guideline for the treatment of prostate cancer developed recently is the evidence of effort.
Certification ; Consensus ; Information Centers ; Korea ; Prostatic Neoplasms ; Quality Improvement ; Urology

No abstract available.
Dipyridamole* ; Tomography, Emission-Computed, Single-Photon*

Cystic dysplasia of the rete testis (CDT) is a very rare congenital benign testicular tumor that is often associated with ipsilateral genitourinary anomalies. It is usually found in the pediatric population and must be differentially diagnosed from a malignant lesion. Here we report the case of a 63-year-old man with a left inguinal hernia who visited our urologic outpatient clinic. Scrotal ultrasonography showed a left direct inguinal hernia in the inguinal area and a well-circumscribed cystic lesion containing multiple minute cysts with echogenic foci occupying almost one-third of the left testicular parenchyma. Testicular tumor markers were within the normal range and a computed tomography scan of the abdomen showed no genitourinary abnormalities. We presumed that the left testicular lesion was malignant, and the patient underwent radical orchiectomy. However, the pathologic examination revealed a CDT. Here we present this case of a 63-year-old man with an inguinal hernia accompanied by multiple cystic lesions on the left testis.
Abdomen ; Adult ; Ambulatory Care Facilities ; Hernia, Inguinal ; Humans ; Middle Aged ; Orchiectomy ; Reference Values ; Rete Testis ; Testicular Neoplasms ; Testis ; Biomarkers, Tumor ; Urogenital Abnormalities

PURPOSE: The aim of this study was to evaluate the efficacy of periprostatic lidocaine injection according to lidocaine dose during transrectal ultrasound-guided prostate biopsy. MATERIALS AND METHODS: The subjects of this study were 92 patients who had undergone transrectal ultrasound-guided 12-core biopsy of the prostate. The patients were randomly assigned to three groups: group 1 (n=31, no lidocaine injection), group 2 (n=30, periprostatic injection of 10 ml 1% lidocaine), and group 3 (n=31, periprostatic injection of 20 ml 1% lidocaine). The patients were assessed for pain by use of a 10-point visual analogue scale (VAS) and for other complications after the procedure. RESULTS: The mean VAS scores of groups 1 through 3 were 0.93+/-0.89, 1.32+/-1.37, and 1.13+/-1.10, respectively. There were no statistically significant differences between the three groups. However, the mean VAS score of the biopsy pain was 5.0+/-1.48, 3.93+/-1.94, and 3.60+/-2.15, in the same groups, respectively, with statistically significant differences between group 1 and the other groups. Patients in groups 2 and 3 reported significantly less biopsy pain than did group 1 patients (p=0.004, 0.021), with no statistically significant difference in VAS score between groups 2 and 3 (p=0.533). With respect to post-biopsy complications, there were no significant differences in the incidence of hematuria, hematospermia, rectal bleeding, or infection among the three groups. CONCLUSIONS: Periprostatic injection of local anesthesia with lidocaine was associated with significantly less pain than in the absence of anesthesia. Furthermore, a 20-ml dose of lidocaine produced no better pain control than did a 10-ml lidocaine dose for prostate biopsy.
Anesthesia ; Anesthesia, Local ; Biopsy ; Hematuria ; Hemorrhage ; Hemospermia ; Humans ; Incidence ; Lidocaine ; Prostate