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: 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*

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: The aim of this study was to evaluate the results of performing the suprapubic arc (SPARC) procedure during 14 months at our hospital for treating female stress urinary incontinence. MATERIALS AND METHODS: Between October 2002 and December 2003, 114 consecutive women who suffered with stress urinary incontinence underwent the SPARC procedure. All the patients were followed up for at least 1 year. The patients were preoperatively evaluated via taking their medical history, physical examinations, and conducting urinalysis and voiding cystourethrography and urodynamic studies, including determining the Valsalva leak point pressure (VLPP). Evaluations were conducted by questionnaires and interviews for determining the surgical outcome and the patients' satisfaction. RESULTS: The mean age was 48.6 years (30-70), the mean follow-up period was 16.4 months (12-25), the mean hospital stay was 3.8 days (2-10) and the mean operation time was 38.7 minutes. For 114 patients, 92 (80.7%) were cured and 17 (14.9%) were significantly improved. 99 patients (86.8%) were satisfied with the SPARC procedure, and 95 patients (83.3%) would like to recommend the SPARC procedure to others. Intraoperative complications included 9 (7.9%) bladder perforations and 1 (0.9%) urethral injury. Postoperative complications showed 14 cases (12.3%) of urinary retention, 2 cases (1.8%) of vaginal wound infections and 1 case (0.9%) of vaginal erosion due to tape. De novo urge incontinence was noted in 3 patients (2.6%). CONCLUSIONS: Favorable results were obtained from the SPARC procedure. This procedure is an effective and safe technique for the treatment of female stress urinary incontinence in terms of the low morbidity and the high success rate.
Female* ; Follow-Up Studies ; Humans ; Intraoperative Complications ; Length of Stay ; Physical Examination ; Postoperative Complications ; Surveys and Questionnaires ; Treatment Outcome ; Urinalysis ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urinary Incontinence, Urge ; Urinary Retention ; Urodynamics ; Wound Infection

PURPOSE: To estimate the incidence and risk of significant renal injury quantitatively in the admitted patients with abdominal trauma. MATERIALS AND METHODS: From January 1992 to July 1997, 511 patients who admitted to departments of urology and general surgery due to major abdominal trauma with and without renal injury were included in this study. The risk of renal injury was defined as the percentage of square of Abbreviated Injury Scale of kidney in the Injury Severity Score(ISS) per each patient. The patients were classified to 5 groups according to the causes of trauma as traffic accident, falls, assault, other blunt and stab Injury, then compared the incidence and risk of renal injury each other. RESULTS: The overall incidence of significant renal injury was 14.9%, and the incidence according to the causes was 27.0%,20.8%, 16.1%, 14.3% and 10.7% in falls, assault, stab injury, other blunt and traffic accident, respectively. The overall risk of significant renal injury estimated by ISS was 15.7% and the risk according to the causes was 26.7%,24.9%, 11.9%,9.9% and 4.9% in assault, falls, traffic accident, other blunt and stab injury, respectively Mean ISS in the patients with renal injury was markedly higher than that of the patients without renal injury(27.5 vs 13.6)(p < 0.01). CONCLUSIONS: Our study shows that both the incidence and risk of significant renal injury in the admitted patients with abdominal trauma can be expected in the probability of 15% or so, and according to the causes, those in the traumatized patients by the assault and falls mark high.
Abbreviated Injury Scale ; Accidents, Traffic ; Humans ; Incidence* ; Injury Severity Score ; Kidney ; Urology

PURPOSE: To evaluate the usefulness and safety of unified technique of vascular control before renal exposure in reconstructive surgery of renal trauma. MATERIALS AND METHODS: From July 1995 to June 1997, 10 patients with major renal trauma who operated by unified approach technique were included in this study. Blunt trauma was the mechanism of injury in 8 patients and 2 were resulted from penetrating(stab) injury. Of the injuries 2 were grade 3, 7 grade 4, 1 grade 5. RESULTS: Of the 10 patients, 8(80%) were performed kidney preserving surgery and 2(20%) resulted in nephrectomy. Partial nephrectomy was underwent in 6 patients(with vascular repair in 2 cases) and renorrhaphy in 2 patients. Pedicle flap of omentum was used mainly and polyglycolic acid mesh also used in 2 cases as coverage material of parenchymal defect. Complications occurred in 2 cases(20%) but none resulted in renal loss with the mean followup of 10 months(1 to 15 months). CONCLUSIONS: Unified approach technique of vascular control before renal exposure seems to be a safe and effective method for reconstructive surgery in renal trauma. To confirm this result, studies with more cases and longer followup are needed.
Follow-Up Studies ; Humans ; Kidney* ; Nephrectomy ; Omentum ; Polyglycolic Acid