Introduction: Aside from religious circumcisions, the indications for circumcision are few. However, in the cultural context, many patients are unnecessarily referred for circumcision for physiological phimosis (adhesions). Due to parental concerns and misperceptions by general practitioners, nonretractile prepuce is one of the most common indications for referral to a paediatric surgeon in many countries. This study aimed to determine whether preputial adhesiolysis successfully managed symptomatic non-retractile foreskin and therefore prevented the need for circumcision. Methods: A retrospective review was performed of the health records of children who presented with preputial adhesion. We included 65 symptomatic patients (ballooning of the prepuce in all cases and additional dysuria in three cases) who underwent preputial adhesiolysis. All cases were followed up for 2 years. Circumcision was subsequently carried out for patients who developed fibrous scarring resulting in difficult retraction due to the development of thick adhesions or skin fissuring with persistence of symptoms. Results: Of the 65 boys, 58 (89.2%) achieved complete retraction of the prepuce. The remaining 7 boys (10.8%) presented with recurring symptoms and thick fibrosed prepuce, and they underwent circumcision due to the dense adhesions. Histopathological examination of the circumcised prepuces revealed balanitis xerotica obliterans in two cases. Conclusion Preputial adhesiolysis is a safe and effective treatment for symptomatic preputial adhesions in boys younger than 5 years old. The procedure avoids circumcision and its associated risks. Preputial adhesiolysis should be offered as a primary treatment instead of circumcision.
Phimosis ; Circumcision, Male ; Balanitis Xerotica Obliterans

Balanitis xerotica obliterans is a condition of unknown etiology with a specific clinical and histological character. It is a condition affecting the glans penis and prepuce which Stuhmer in 1928 first reported as occurring predominantly in young men following circumcision for phimosis. We report an unusual case of balanitis xerotica obliterans which developed on penis with primary urethral stone
Balanitis Xerotica Obliterans* ; Balanitis* ; Circumcision, Male ; Female ; Humans ; Male ; Penis ; Phimosis

Preputial calculi is a very rare disease and a disease of phimosis. A case of preputial calculi associated urethral calculi, bladder-calculi and bladder transitional cell carcinoma was presented.
Calculi* ; Carcinoma, Transitional Cell* ; Female ; Phimosis ; Rare Diseases ; Urinary Bladder Calculi* ; Urinary Bladder Neoplasms ; Urinary Bladder*

Preputial calculi is a very rare disease and a disease of phimosis. A case of preputial calculi associated urethral calculi, bladder-calculi and bladder transitional cell carcinoma was presented.
Calculi* ; Carcinoma, Transitional Cell* ; Female ; Phimosis ; Rare Diseases ; Urinary Bladder Calculi* ; Urinary Bladder Neoplasms ; Urinary Bladder*

No abstract available.
Bartter Syndrome* ; Gitelman Syndrome* ; Metabolism*

No abstract available.
Adrenal Hyperplasia, Congenital* ; Adrenogenital Syndrome*

A Clinical observation was made oh the 32 cases of ureteral stricture not originated from calculi and tuberculous nature during the period from January 1960 to December 1969, and the following data were obtained: 1) There were 9 cases of stricture due to radical total hysterectomy and postoperative irradiation for cervix cancer, 5 cases of aberrant vessel, 4 cases of fibrosis of periureteral tissue and ureter itself, 2 cases of congenital ureteral stricture and 1 case due to ureteritis. 2) The ureteral stricture was noted in the upper in 10 cases, 8 cases were in the lower third of ureter. 3) The clinical manifestation included flank pain, tenderness along the course of ureter in 11 cases, mass in 8 cases and high fever, chill and general malaise in 7 cases. Hematuria, anuria, loss of weight and edema also were noted 4) Of the 32 cases, 12 cases underwent nephrectomy, 9 case, were submitted periodic dilation of ureter and 3 cases had good results with resection aberrant vessels. In 2 cases ureteroneocystostomy was performed utilizing bladder flap method. In still others, percutaneous ureterostomy was performed in 2 cases and lysis (deligation) of the ligated ureter was made in 1 cases. No manipulation was done at all in 1 cases.
Anuria ; Calculi ; Constriction, Pathologic* ; Edema ; Fever ; Fibrosis ; Flank Pain ; Hematuria ; Hysterectomy ; Nephrectomy ; Ureter* ; Ureterostomy ; Urinary Bladder ; Uterine Cervical Neoplasms

PURPOSE: Although prostate specific antigen(PSA) is an excellent tumor marker, it is not prostate cancer-specific but organ-specific. The objectives of this study is to identify the correlation between the nonmalignant elevation of PSA and the characteristics of DRE, TRUS, and histologic features. MATERIALS AND METHOD: Ninety nine patients with elevated PSA were divided into 3 groups of prostatic cancer(46), benign prostatic hyperplasia(46), and infectious prostatic disease(10) according to their clinical history and histology of prostate. RESULTS: There was significant elevation of PSA in order of prostate cancer, infectious disease, prostatic intraepithelial neoplasia(PIN), and benign prostatic hyperplasia(p > 0.01). Episodes of acute urinary retention and pyuria more frequently induced nonmalignant elevation of PSA(p > 0.05). There was no specific correlation between the findings of TRUS and elevation of PSA except intraprostatic calculi and cyst. Irregularity of margin and seminal vesicle on TRUS highly suggested prostatic cancer. On microscopic examination, high grade PIN, enlarged nucleus, prominent nucleoli and perineural invasion were highly correlated with prostatic cancer. CONCLUSIONS: These results suggest that nonmalignant elevation of PSA has following clinical characteristics: episodes of urinary retention, bladder calculi, urinary tract infection, prostatic calculi or cyst, and histologically benign. And the values of PSA in nonmalignant condition is not so elevated as malignancy.
Calculi ; Communicable Diseases ; Humans ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Pyuria ; Seminal Vesicles ; Urinary Bladder Calculi ; Urinary Retention

There have been some pros and cons about the of routine intravenous pyelography in benign prostatic hyperplasia. Herein we analyzed 196 patients who underwent intravenous pyelography before prostatectomy at Dept. of Urology, Seoul National University Hospital from Jan. 1976. to Dec. 1983. Of 196 patients 140 (72%) showed normal upper tract with cystogram compatible with benign prostatic hyperplasia(Group I), 22(11%) dilated upper tract(Group II), 20(10%) incidental upper tract abnormalities including 9 urolithiasis(Group III), and 14(7%) completely normal findings(Group IV). There was a significant relationship between Group II and serum BUN value. Cystoscopy revealed evidence of prostatic enlargement in 14 cases and other abnormal findings including bladder tumor which were not shown on routine IVPs. We conclude that intravenous pyelography is not always necessary in diagnosis of benign prostatic hyperplasia when urine analysis and serum BUN are normal Instead, we recommend KUB to observe renal outline and calculi, and preoperative routine cystoscopy to evaluate prostatic enlargement and bladder neck obstruction.
Calculi ; Cystoscopy ; Diagnosis ; Humans ; Prostatectomy ; Prostatic Hyperplasia ; Seoul ; Urinary Bladder Neck Obstruction ; Urinary Bladder Neoplasms ; Urography* ; Urologic Diseases* ; Urology

Gitelman's sydnrome is a heritable renal disorder characterized by hypomagnesemia, hypokalemia and hypocalciuria. As compared to those with Bartter's syndrome, reduced urinary excretion of calcium and magesium wasting are essential features of Gitelman's syndrome. Interestingly, we have experienced a case of 32-year old man with a mixed type of Gitelman's syndrome and Bartter's syndrome, which includes normomagnesemia, normal renal magnesium excretion, and hypocalciuria. Herein we report the case of atypical Gitelman's syndrome with brief review of related literature.
Adult ; Bartter Syndrome ; Calcium ; Gitelman Syndrome* ; Humans ; Hypokalemia ; Magnesium*