No abstract available.

No abstract available.

No abstract available.
Fascia* ; Female* ; Humans ; Urinary Incontinence*

PURPOSE: Penile fracture is a traumatic injury of the tunica albuginea of the corpus cavernosum during the erectile state. The aims of this study were to evaluate whether the differences of clinical manifestations according to age is present or not in the patients with penile fracture. MATERIALS AND METHODS: This study included 52 patients that were admitted to the department of urology after being diagnosed with penile fracture. History taking, physical examination, radiographic study, and operation were performed as needed. We divided patients into two groups on the basis of 40 years old, and we compared clinical manifestations and operative findings between the two groups. RESULTS: The mean age of patients was 41.4, and the most common cause of injury was sexual intercourse in both groups, but the elapsed time from the injury to arrival at hospital was longer in the young age group than the middle age group (p<0.05). In the aspect of the rupture of tunica albuginea, injury to the right and proximal part of the penis was most common in both groups. Transverse rupture was more prevalent, and the length of the rupture line was also longer in the middle and old age group (p<0.05). CONCLUSIONS: This study supports that sexual intercourse is the most common cause of penile fracture in our country, and the majority of both groups have rupture of tunica albuginea at the right proximal part of the penis. However, the degree of rupture is severe, and elapsed time from the injury to arrival at hospital was relatively shorter in the middle and old age group than the young age group.
Adult ; Coitus ; Humans ; Male ; Middle Aged ; Penis ; Physical Examination ; Rupture ; Urology

PURPOSE: This study was performed to determine whether pediatric patients are more susceptible for major renal injury than adults, and the reasons evaluated. MATERIALS AND METHODS: The medical records of 209 consecutive patients (47 children and 162 adults) with a blunt renal injury were retrospectively reviewed. The renal injuries were graded on a five point scale based on the results of computerized tomography. The causes of the blunt renal injury were classified into three groups; traffic accidents, falls and other blunt trauma. The degree of renal injury was compared according to the cause, and whether there were differences in the causes of renal injury and the number of patients with major renal injury between children and adults determined. RESULTS: The main cause of the renal injuries was traffic accidents in adult, but falls in pediatric patients. Overall 21 of the 47 children (44.7%) and 45 of the 162 adults (27.8%) had major renal injuries (p<0.05). 38 (52.8%) of the 72 patients were injured by falls, as opposed to traffic accidents, so there were significantly more fall induced major renal injuries (p<0.05). CONCLUSIONS: Children are more likely to sustain major renal injury from a blunt abdominal trauma, and the patients injured by falls have more severe renal injuries than those of other causes. Also, the main cause of a renal injury was traffic accidents in adult, but falls in pediatric patients. From the different origins of the causes of injury, as well as the unique pediatric anatomic structures, pediatric patients are more susceptible to major renal injury than adults.
Accidents, Traffic ; Adult* ; Child* ; Humans ; Kidney ; Medical Records ; Pediatrics ; Retrospective Studies

PURPOSE: We retrospectively evaluated and compared the success rate, and satisfaction with the operation, in patients who had undergone the modified fascial sling procedure using autologous and allograft fascia. MATERIALS AND METHODS: We compared 65 consecutive women (44%), having undergone the modified fascial sling procedure using allograft cadaveric fascia lata between September 1999 and April 2002 (group 1), with 82 consecutive women (56%), having undergone the procedure using autologous rectus fascia between December 1996 and August 1999 (group 2). The surgical outcomes, and the satisfaction of patients, were assessed by questionnaire. RESULTS: In group 1 the mean follow-up was 26 months (range 12-32), and 59 (91%) of the patients were cured, and 4 (6%) improved. In group 2, the mean follow-up was 51 months (range 32-64), and 73 (90%) of the patients were cured, and 6 (7%) improved. From the questionnaires, there was no difference in the satisfaction with the operation between the groups, but was somewhat lower than the success rate. The mean operation time for group 1 was significantly shorter than for group 2, and postoperative pain control in group 1 was significantly less than in group 2. De novo urge incontinence developed in 2 (3.1%) and 3 (3.7%) patients from groups 1 and 2, respectively. CONCLUSIONS: The modified fascial sling procedure, using allograft fascia, was more advantageous because of the decreased operation time and the reduction in pain control, although there were no significant differences in the success rates and satisfaction between the two groups. Therefore, the modified fascial sling procedure, using allograft fascia, is an effective treatment for all types of stress urinary incontinence, with a high cure rate and an acceptable low morbidity. A longer follow-up period will be required to confirm our results.
Allografts* ; Cadaver ; Fascia Lata ; Fascia* ; Female ; Follow-Up Studies ; Humans ; Pain, Postoperative ; Surveys and Questionnaires ; Retrospective Studies ; Urinary Incontinence* ; Urinary Incontinence, Urge

The cell proliferation of 29 human transitional cell carcinomas of the bladder was assessed immunohistochemically using the monoclonal antibody Ki-67. Normal mucosa had a mean value of 0.67+/-0.20% cells positive for Ki-67, whereas the average of grade 1. 2, 3 was 5.2+/-1.8%. 12.2: 5.0%, 18.0+/-4.6%. respectively. Significant differences were noted between grade 1 and grade 2 (p intermediate Nde (grade 2) showed wide range of Ki-67 labeling index (from 6.5 to 23.5%) compared with ether grades. The labeling indices of Ki-67 were 5.5+/-2.1% for stage Ta. 11.9+/-4.2% for T1 and 17.4+/-5.8% for stages equal to or higher than T2. Significant difference was noted between stage Ta and T1 (p<0.001 ), suggesting that tumor invasion to lamina propria is a important indicator of cell proliferation. Significant difference was also noted between stage T1 and T2 or higher (p<0.01). In recurrent tumors, Ki-67 indices did not show significant difference between the tumors with short recurrent intervals(men duration of recurrence <6 months) and long(>6 months). In conclusion. we suggest that Ki-67 may be a useful monoclonal antibody for easy evaluation of proliferating cells in transitional cell carcinomas of the bladder and Ki-67 labeling indices may serves as a additional prognostic factor to the current histologic grade of the bladder tumor, especially in the tumors with the intermediate grade.
Carcinoma, Transitional Cell* ; Cell Proliferation* ; Ether ; Humans ; Mucous Membrane ; Recurrence ; Urinary Bladder Neoplasms ; Urinary Bladder*

Iatrogenic ureteral injury is a complication that can occur during a variety of pelvic or abdominal surgeries. The most frequent causes are gynecological ones, followed by colon and vascular surgeries. Management of ureteric injury depends on the time of diagnosis and the severity of organ damage. Injuries diagnosed intraoperatively should be treated immediately. Occasionally, intraoperative ureteral injury is overlooked, and symptoms of the late diagnosis of ureteral injury are usually nonspecific; therefore, the diagnosis is delayed for days or weeks postoperatively. Management of injuries diagnosed postoperatively is more complex. There are differing opinions on whether an initial conservative or immediate operative intervention is the best line of action. Delayed repair is suggested on the grounds that it will reduce inflammation and tissue edema. However, many authors are in favor of early repair, perhaps because tissue planes are easier to find before fibrosis becomes too dense. Ureteral injuries occurring at the level of the pelvic brim should be best managed with an end-to-end anastomosis, preferably around a ureteric stent. More distal injuries also should be ideally managed with an end-to-end anastomosis, after excision of the crushed or compromised segments. However, if the remaining distal segment is short, ureteral reimplantation is the procedure of choice. The Boari flap technique for ureteral reimplantation is invaluable in cases with a short proximal segment. Delayed recognition of iatrogenic ureteral injury may be associated with serious complications, so prompt recognition of ureteral injuries is important. Recognition of the injury before closure is the key to easy, successful, and complications-free repair. Increased awareness of the risk for ureteral damage during certain operative maneuvers is vital to prevent injury, and to decrease the incidence of iatrogenic injury. A sound knowledge of abdominal and pelvic anatomy is the best prevention.
Colon ; Delayed Diagnosis ; Edema ; Fibrosis ; Iatrogenic Disease ; Incidence ; Inflammation ; Replantation ; Stents ; Ureter

Traumatic injuries are the leading cause of death in young people, and the renal injury is one of the major abdominal trauma. Hematuria is the most common sign of renal trauma, however the degree of hematuria and the severity of renal injury do not correlate consistently. Criteria for radiographic investigation is somewhat different according to the injury mechanism and an age. Excellent imaging modality such as computerized tomograph has made it possible to delineate not only detailed anatomic configuration for renal laceration itself but the presence of associated intra- abdominal organ injury. Renal injury may be presented as one of the multiple trauma, thus full evaluation for the overall injury severity of the patient is mandatory. Advanced supportive care techniques and awareness of the kidney's capacity for healing have facilitated non-operative management. Nowadays, operative exploration is indicated only in selected patients with major renal injury even in the patients with penetrating trauma, and high rates of renal reconstruction is possible through early vascular control. Urologic surgeon, as a major member of the trauma team, should be expertized in the surgical skills for reconstruction as well as acquiring up-to-date knowledge on diagnosis and management of renal trauma.
Cause of Death ; Diagnosis ; Hematuria ; Humans ; Kidney ; Lacerations ; Multiple Trauma

PURPOSE: This study was performed to analyze the clinical characteristics of urologic patients who visited emergency center and provide a fundamental data for further study, and to add some help in the management of the patients. Materials and Methods: Among the total 99,935 patients who visited the emergency center from July 1, 1993 to June 30, 1995, the clinical data of 3,063 urologic patients was reviewed retrospectively. RESULTS: The most common group of age was 4th decade, and male predominated over female by 2.6 : 1. The peak time of patient's entrance to emergency center was between 20 : 00 and 24 : 00 (24.4%) and second peak was 00 : 00 and 04 : 00 (18.5%). Flank pain (57.5%) was the most common symptom and urinary retention (10.3%), gross hematuria (9.7%), irritative voiding symptoms (7.5%) followed that. The common diseases or injury were urinary stone (56.4%) and benign prostatic hyperplasia (8.0%), renal injury (4.0%), acute cystitis (3.7%) respectively. The admission rate was 23.3% and the ratio between urologic department and other departments was 4 : 1. Trauma was occupied 12.5% in all urologic patients and common disease or injuries that needed emergent operation were bladder rupture (23.5%), testicular torsion (18.5%), and renal trauma (16.0%). 7 patients with multiple injury were expired due to 1 urologic cause (renal trauma) and 6 non-urologic causes. CONCLUSIONS: The most common cause that brings the urologic patients to the emergency center is flank pain associated with urinary stone and the factors related to increased occurrence are male, age of 4th decades and midnight.
Cystitis ; Emergencies* ; Female ; Flank Pain ; Hematuria ; Humans ; Male ; Multiple Trauma ; Prostatic Hyperplasia ; Retrospective Studies ; Rupture ; Spermatic Cord Torsion ; Urinary Bladder ; Urinary Calculi ; Urinary Retention