PURPOSE: Extracorporeal shock wave lithotripsy (SWL) has been established as the treatment of choice for the urinary stones. But, for the treatment of staghorn calculi, the efficacy of this therapeutic procedure is controversal. We intended to study the therapeutic results and the usefulness of ureteral stent between 2 types of lithotriptor, EDAP LT-01 and Storz Modulith SLX. MATERIALS AND METHODS: Sixty cases were diagnosed as staghorn calculi from February 1990 to December 1998. Among them, 31 patients were treated with EDAP LT-01 SWL (group A) and 29 patients with Storz Modulith SLX SWL (group B). We inserted a double-J stent in 45 patients that consisted of 24 patients from group A and 21 patients from group B. The number of treatment sessions, complications and success rates were compared regarding each SWL and volume of the stone. RESULTS: The success rates of each SWL were 70.9% in group A and 75.9% in group B. The success rates, according to staghorn morphology, were 71.4% and 85.7% in partial staghorn of group A and B. The average shock wave sessions were 12.0 and 7.4 in partial staghorn of group A and B. The success rates, according to staghorn volume, were 67.8% and 88.9% in less than 60cm3 of group A and B. The average shock wave sessions were 12.6 and 9.6 in less than 60cm3 of group A and B. The findings were statistically significant between the two groups in less than 60cm3 or partial staghorn. After SWL, incidence of steinstrasse was 12.5% and 33.3% in the double-J stent inserted patients of group A and B. CONCLUSIONS: SWL could be a method of primary treatment for staghorn calculi. Storz Modulith SLX SWL was more effective than EDAP LT-01 SWL for staghorn calculi of which the volume was less than 60cm3. Placement of ureteral stents would be effective in the treatment of staghorn calculi by EDAP LT-01 SWL and not in Storz Modulith SLX.
Calculi* ; Humans ; Incidence ; Lithotripsy ; Shock ; Stents ; Ureter ; Urinary Calculi

Trauma is the important cause of death in children and adults. From May 1, 1984 to June 30, 1995, 370 patients were admitted to our hospital for genitourinary injuries. We made clinical observations and compared children with adults on incidence, cause, diagnosis and treatment of genitourinary traumatic patients. As the result, it was no significant difference between children and adults on incidence, sex ratio, cause, hospital stay, and associated injuries. The kidney was the most common organ to be injured and there was no difference in severity of renal injury between two groups. Operative treatments were more common in adults than children, and external genitalia was most common organ to get operation.
Adult* ; Cause of Death ; Child* ; Diagnosis ; Genitalia ; Humans ; Incidence ; Kidney ; Length of Stay ; Sex Ratio

Trauma is the important cause of death in children and adults. From May 1, 1984 to June 30, 1995, 370 patients were admitted to our hospital for genitourinary injuries. We made clinical observations and compared children with adults on incidence, cause, diagnosis and treatment of genitourinary traumatic patients. As the result, it was no significant difference between children and adults on incidence, sex ratio, cause, hospital stay, and associated injuries. The kidney was the most common organ to be injured and there was no difference in severity of renal injury between two groups. Operative treatments were more common in adults than children, and external genitalia was most common organ to get operation.
Adult* ; Cause of Death ; Child* ; Diagnosis ; Genitalia ; Humans ; Incidence ; Kidney ; Length of Stay ; Sex Ratio

We compared the roles of urinary cytology and flow cytometric DNA analysis in the evaluation of 26 patients with transitionsl cell carcinoma of bladder from March 1989 to April 1991. When carcinoma was present at the time of specimen collection it was detected by cytology in 65.4 percent and flow cytometric DNA analysis in 73.1 percent. Combination of flow cytemetric DNA analysis and urinary cytology increased the diagnostic yield to 88.5 percent Flow cytometric DNA analysis was slightly more sensitive than urinary cytology for the detection of abnormalities in specimen from low stage. high grade. small size. small number and recurrent cancer but no statistically significant difference was identified. When used in conjunction with urinary cytology. urine flow cytometric DNA analysis was valuable procedure in the diagnosis and follow up of patients with bladder cancer.
Diagnosis ; DNA* ; Follow-Up Studies ; Humans ; Specimen Handling ; Urinary Bladder Neoplasms ; Urinary Bladder*

From February 8. 1990 to November 30, 1991, 25 patients with staghorn calculi were underwent extracorporeal shock wave lithotripsy(ESWL) using the EDAP LT-01 lithotriptor. We reviewed patients with staghorn calculi to evaluate the effectiveness of ESWL as monotherapy for staghorn calculi and determine the selection criteria for the treatment calculi. The results were obtained as follows : l. Ten patients had complete staghorn calculi filling the complete renal collecting system with stone of l7,635 mm3 in mean volume and l3 patients had partial staghorn calculi filling the renal pelvis and partial caliceal groups with stone of 7,017 mm3 in mean volume. 2. Of 17 patients with stone of less than 8,200 mm3 in volume. 10(83.3%)remained free of stone after an average 11.8 sessions. Of 6 patients with stone of between 8,200 to 14,200 mm3 volume, 5(83.3%) remained free of stone after an average 18.3 sessions. Of 7 patients with stone of more than l4,200 mm3 in volume, 2(28.6%) remained free of stone after an average 17.4 sessions 3. When these patients were stratified by stone burden, of 10 patients with stone filling a non-dilated renal collecting system, all(100%) patients remained free of stone. Of 15 patients with filling a dilated renal collecting system. 7 (46.7%) patients remained free of stone. Of 8 cases with residual stones. 2 patients were underwent open surgery(nephrectomy, extended pyelolithotomy), 2 patients were impossible to follow up and 4 patients still are undergoing continuous additional ESWL sessions. 5. Double J stent for the pre-ESWL additional measures were placed in 19 patients(76%); Eight of the complete staghorn calculi and 11 of the partial staghorn calculi. Percutaneous nephrostomy tube was placed in 2 patients. No general or regional anesthesia was required. 6. The post-ESWL complications were ureteral obstruction(steinstrasse) in 7 patients(28%) and high fever(over 38.5 degrees C) in 11 patients( 44.0%). We conclude that partial staghorn calculi, staghorn calculi with stone of less than 14,200 mm3 in volume and staghorn calculi with stone burden filling non-dilated collecting system are eligible for ESWL.
Anesthesia, Conduction ; Calculi* ; Follow-Up Studies ; Humans ; Kidney Pelvis ; Lithotripsy* ; Nephrostomy, Percutaneous ; Patient Selection ; Shock* ; Stents ; Ureter

We attempted to compare the result of EDAP LT-01+ lithotripsy with Modulith SLX lithotripsy for management of urinary stones. We evaluated 1,544 patients (1,731 renal units) treated with EDAP LT-01+ ESWL (Group A) and 668 patients (707 renal units) treated with Modulith SLX ESWL (Group B). The results were obtained as follows; 1. Between the group A and B, stones were located in kidney (except staghorn calculi) in 666 cases (38.5%) and 160 cases (22.6%), in staghorn calculi in 31 cases (1.8%) and 13 cases (1.8%), in ureteropelvic junction (UPJ) in 65 cases (3.8%) and 19 cases (2.7%), in upper ureter in 469 cases (27.0%) and 200 cases (28.3%), in lower ureter in 491 cases (28.4%) and 271 cases (38.3%) and in bladder in 9 cases (0.5%) and 10 cases (1.4%), respectively. 2. Success rates according to stone size were 99.4% and 99.6% in less than 1 cm:, 97.5% and 97.2% in 1 cm2 to 2 cm2, 92.4% and 91.3% in 2 cm2 to 3 cm2 and 82.2% and 78.1% more than 3 cm2 respectively in the group A and B. There. was no statistically significant difference between two groups (,p>0.05). 3. Success rates ccording to stone location were 98.8% and 100% in renal stone (except staghorn calculi) , 83.9% and 84.6% in staghorn calculi,92.3% and 94.7% in UPJ stone, 97.7% and 98.5% in upper ureteral stone, 98.4% and 98.6% in lower ureteral stone and 66.7% and 30% in bladder respectively in the group A and B. There was no statistically significant difference between two groups (p>0.05). 4. Average shock wave sessions and time (min.) were 4.0 and 1.8 and 42.1 and 28.6 respectively in the group A and B. These differences were statistically significant (p<0.05). 5. Complications were gross hematuria (>=3 days) in 1.6% and 10.7%, steinstrasse in 5.1% and 12.5%, fever (>=38 degree C) in 2.1% and 2.3% and perirenal hematoma in 0% and 0.7% respectively in the group A and B. We concluded that success rates according to location and size of urinary stone were similar between two groups. But, treatment time of the group B was significantly shorter than that of the group A. Treatment sessions of the group B were decreased compared with the group A. Gross hematuria and steinstrasse were occurred significantly more in the group B compared to the group A (p<0.05).
Calculi ; Fever ; Hematoma ; Hematuria ; Humans ; Kidney ; Lithotripsy* ; Shock ; Ureter ; Urinary Bladder ; Urinary Calculi*

PURPOSE: Renal vascular clamping during a laparoscopic partial nephrectomy is a time-consuming procedure with a risk of renal ischemia. To study the feasibility of laparoscopic partial nephrectomy without renal arterial clamping, we compared the procedure with laparoscopic partial nephrectomy with vascular clamping. MATERIALS AND METHODS: Seventeen patients underwent laparoscopic partial nephrectomy without renal arterial clamping (group 1) from February 2004 to June 2008. The operative results were reviewed retrospectively and compared with those of 16 patients who underwent laparoscopic partial nephrectomy with arterial clamping (group 2). Patient characteristics did not differ significantly between the 2 groups. However, exophytic tumors were detected in 13 patients in group 1 and 3 patients in group 2 (p=0.001). Scores on the preoperative aspects and dimensions used for an anatomical (PADUA) classification were 6.9 in group 1 and 7.7 in group 2 (p=0.037). All surgeries by the transperitoneal approach were performed by a single surgeon. RESULTS: The mean operative times were 103 and 130 minutes in groups 1 and 2, respectively (p=0.312). The mean renal arterial clamping time of group 2 was 27.6 minutes (range, 20-42 minutes). The mean estimated blood loss was 327 ml in group 1 and 315 ml in group 2 (p=0.971). The mean postoperative change in the glomerular filtration rate was 20.11 ml/min/1.73 m2 in group 1 and 18.95 ml/min/1.73 m2 in group 2 (p=0.748). The mean times to postoperative initiation of ambulation and of oral intake were 1.6 and 1.7 days (p=0.486) and 1.3 and 1.6 days (p=0.811) in groups 1 and 2, respectively. The mean length of hospital stay was 7.4 and 7.9 days in groups 1 and 2, respectively (p=0.9). The mean tumor size was 2.1 cm (range, 1-7 cm) in group 1 and 3.3 cm (range, 1.5-9 cm) in group 2. CONCLUSIONS: Laparoscopic partial nephrectomy without renal arterial clamping is feasible for a localized renal tumor. However, patients should be selected carefully, such as those with an exophytic tumor.
Constriction ; Glomerular Filtration Rate ; Humans ; Ischemia ; Kidney Neoplasms ; Laparoscopy ; Length of Stay ; Nephrectomy ; Operative Time ; Retrospective Studies ; Walking

PURPOSE: Reports of clinical findings and treatment for pediatric urinary stone have been published relatively infrequently. Extracorporeal shock-wave lithotripsy (SWL) is a minimally invasive method of treating urinary stone and has been shown to be effective in the pediatric population. We evaluated the clinical characteristics of patients with pediatric urinary stone and compared the therapeutic results of two SWLs, LT-01+ and Modulith SLX lithotriptors. MATERIALS AND METHODS: The records of 57 children treated by SWL were analyzed retrospectively. Twenty-five patients were treated by LT-01+ (group I) and 32 by Modulith SLX (group II) lithotriptor. The outcomes, including the number of treatment sessions, stone free rate and complications, were assessed. RESULTS: The average age of all 57 children, 36 male and 21 female, was 14.3 years. Chief complaints were flank pain (71.9%), gross hematuria (10.5%) and urinary tract infection (12.3%). The average stone size was 8.2mm (2-15mm). The success rates of each SWL were similar in both groups (group I: 88.0%, group II: 90.6%). However the average number of treatment sessions/patient in Group I was significantly smaller than that of Group II (group I: 2.92, group II: 1.35, p<0.05). Flank pain and gross hematuria were developed similarly after treatment in both groups, and needed only conservative therapy and was resolved within three days. CONCLUSIONS: Clinical characteristics of urinary stone in children were similar to those of adults. There was no significant difference in treatment success rate between the two types of lithotriptors but the number of treatment sessions was smaller in patients treated by Modulith SLX lithotriptor.
Adult ; Child ; Female ; Flank Pain ; Hematuria ; Humans ; Lithotripsy* ; Male ; Retrospective Studies ; Shock* ; Urinary Calculi* ; Urinary Tract Infections

PURPOSE: Recently, in assisted reproductive technologies(ART) programs theme Is an increasing Interest in the use of agents for the enhancement of sperm motility for assisted fertilization. In an attempt to improve the motility at the cryopreserved human semen and hence the fertilizing capacity of asthenospermic semen samples, different semen preparation techniques have been attempted and the effects of chemical stimulants as nitric oxide(NO) have been studied extensively. Superoxide anions cause lipid peroxidative damage to cell membrane phospholipids, and sperm are known to be particularly susceptible to lipid peroxidation. Such sperm with damaged membranes are impaired functionally. Recently, peroxynitrite, an anion and a potent oxidant, generated by the interaction of nitric oxide and superoxide anions has been demonstrated In macrophages and other cellular systems. Also this anion cause lipid peroxidative damage to cell membrane phospholiplds. We therefore Investigated whether NO and peroxynitrite have the roles to modulate sperm motility and to affect Its viability. MATERIALS AND METHODS: Normal human semen samples(as per World health Organization (WHO) criteria) were obtained after 3day period of abstinence by donors. The samples(n=5) were incubated with either sodium nitroprusside(SNP; 0.1, 05, 1 or 2mM) or peroxynitrite (10, 50 or 100 micrometer ) and the percent viability and motility were assessed at various time inteval up to 4hr. The human semen samples were treated with N-acetyl-L-cystein(NAC;10mM), SNP (0.5mM), phorbol myristate acetate(PMA; 100nM), of SNF plus PMA. Both superoxide and peroxynitrite release were measured directly by chemiluminometer. Percent viability and motility were assessed at 4hr of Incubation. A sample of each aliquot was placed in a Mauler chamber for videomicrography Percent motility were analyzed by using the sperm analysis imaging system. The sperm vlability was assessed by flow cytometer using LIVE/DEAD sperm viability kIt. The production of superoxide and peroxynitrite were measured by the method of chemiluminescence assay. Result : All results represent a mean +/-SEM, n=5. Treatment of human semen samples for 4hr with SNP, a NO generating agent, significantly decreased sperm motility and viability in high concentration [relative motility(% of control); 38 +/-4 and 30 +/-5, relative viability; 42 +/-4 and 30 +/-3 by 1 and 2mM of SNP]. In the presence of low concentration SNP(0.5mM), the sperm viability was not significantly affected(82 +/-3), whereas the sperm motility was affected(64 2). SNP(0.5mM) also decreased sperm motility(80 +/-2 at 2hr 64 +/-3 at 4hr, 44 +/-3 at 6hr, and 38 +/-4 at 8hr) in a time dependent manner. Since it was demonstrated that superoxide anions are one of the common source of lipid peroxidation, we investigated whether superoxide anions produced by human semens could Interact wlth NO to generate peroxynitrite. Adding N-acetyl-L-cystein(NAC) to the human semen samples partially blocked spontaneous release of superoxide, whereas PMA augmented the release of superoxide from human semen samples (control:0.9 106 0.3, NAC: 0.5 106 +/-0.4, and PMA: 2.5 106 +/-0.4photons/60min). The production of superoxide was corresponded with the production of peroxynltrite(control: 1.0 104CPM, SNP: 3.8 106CPM, SNP plus PMA. 12chi106CPM). In addition, SNP in combination with PMA(65 +/-3) markedly decreased sperm motility than that of SNP alone(77 +/-2.5) at 4hr, implying that nitric oxide might inhibit sperm motility via the formation of peroxynitrite In human semen samples. Exogenous peroxynitrite also decreased sperm motility in a dose dependent manner(10 micrometer : 64 +/-2, 50rM: 53 +/-3, and 1 0 micrometer of peroxynitrite: 23 4). CONCLUSIONS: These results suggest that NO inhibits sperm motility via the formation of peroxynltrite and further demonstrate that NO-induced inhibition of sperm motility is depended on the production of superoxide from human semens because peroxynitrite is generated by the interaction of NO and superoxide.
Cell Membrane ; Fertilization ; Humans ; Lipid Peroxidation ; Luminescence ; Macrophages ; Membranes ; Microscopy, Video ; Myristic Acid ; Nitric Oxide* ; Peroxynitrous Acid* ; Phospholipids ; Semen ; Sodium ; Sperm Motility* ; Spermatozoa* ; Superoxides ; Tissue Donors ; World Health Organization

PURPOSE: Condyloma acuminatum is a common lesion of the external genitalia and anus. However, its involvement of the urethra is uncommonly, but when it does the lesions are difficult to eradicate. Treatments have included excision, electrical fulguration and laser therapy. Laser therapy causes minimal damage to the urethral mucosa, and stricture formation seems less likely when use. The results of intraurethral condyloma acuminatum, treated with Nd:YAG laser therapy, are reported. MATERIALS AND METHODS: Between June, 2000 and May, 2002, 13 men, with intraurethral condyloma, were treated by Nd:YAG laser therapy at our institution. All patients underwent cystourethroscopy to rule out concomitant urethral and vesicle disease. Biopsies of all lesions were performed, with the specimens sent for DNA viral typing. After removal of the condyloma, cystourethroscopy was used on follow-up at three-month intervals. RESULTS: All the patients were found to have condyloma acuminatum. Of these, 3 (23.1%) had concomitant distal urethral lesions and 7 (53.8%) had an associated cutaneous condyloma. All the patients were found to have type 6/11 human papillomavirus disease, as confirmed by their viral typing. A recurrence was observed in only 1 patient, and no complications were reported. CONCLUSIONS: For intraurethral condyloma acuminatum, Nd:YAG laser therapy is successful, and cystourethroscopy is required for the diagnosis and at follow-up.
Anal Canal ; Biopsy ; Condylomata Acuminata ; Constriction, Pathologic ; Diagnosis ; DNA ; Follow-Up Studies ; Genitalia ; Humans ; Laser Therapy* ; Male ; Mucous Membrane ; Neodymium ; Recurrence ; Urethra