No abstract available.
Child* ; Endoscopy* ; Humans

We conducted a prospective study to compare MMC subconjunctival injection with MMC soaking for surgical outcome and postoperative complications as an adjunct to trabeculectomy in eyes with glaucoma. Eleven patients with bilateral glaucoma had undergone primary trabeculectomy with adjunctive subconjunctival mitomycin-C injection in one eye[Group I] and primary trabeculectomy with subconjunctival mitomycin-C soaking in the other eye[Group II]. Minimal follow-up period was 6 months and mean follow-up period was 12.8 months. Preoperative mean IOP was 35+/-10.9 mmHg in the group Iand 33+/-14.4 mmHg in the group II, and there was no statistical significance. Postoperative mean IOP at 1, 3, 6 months were 13+/-2.3, 13+/-3.1, 13.6+/-2.9 mmHg in the group I, and 11.3+/-3.3, 12.2+/-3.4, 12.9+/-2.7 mmHg in the group IIand no statistical significance. Each of ten eyes[91%] in both groups achieved intraocular pressure of less than 21 mmHg and good bleb formation without any medication. Postoperative complications were transient hyphema[18% in the group I, 9% in the group II], cystic bleb[9% in the group I, 27% in the group II] and shallow anterior chamber[9% in the group II]. Postoperative corneal endothelial cell density per square millimeter averaged 2, 221+/-306/mm2[mean+/-standard deviation] in the group I and 2, 195+/-272/mm2in the group II and there was no statistical significance. The rates of surgical success and postoperative complications were similiar in the two groups. Subconjunctival injection has similar effect to soaking method. This method enables us to have accurate control of concentration and amount of MMC, and thereby reduces complications and improves surgical outcomes in trabeculectomy.
Blister ; Endothelial Cells ; Filtering Surgery ; Follow-Up Studies ; Glaucoma ; Humans ; Intraocular Pressure ; Mitomycin* ; Postoperative Complications ; Prospective Studies ; Trabeculectomy*

We reviewed the result of one-stage hypospadias repair of 32 cases, from Jan. 1989 to Dec. 1994, according to the site of urethral opening after release of chordee. The following results were obtained. 1. The posterior hypospadias (posterior penile, penoscrotal) was 18 cases and the anterior & middle hypospadias was 16 cases. 2. Success rate of posterior hypospadias repair was 9/18(50%) and that of anterior & middle hypospadias was 9/16(56.3%), it was not different statistically (P<0.05). 3. Complication rate of posterior hypospadias repair was 9/18 (50%) and of anterior & middle hypospadias was 7/16(43,5%), it was not different statistically (P<0.05) and complications were managed by simple procedure and require no further treatment. In condition, one stage repair of hypospadias could be applicable in most cases of hypospadias. The complication and morbidity were minimal.
Female ; Hypospadias* ; Male

We reviewed the result of one-stage hypospadias repair of 32 cases, from Jan. 1989 to Dec. 1994, according to the site of urethral opening after release of chordee. The following results were obtained. 1. The posterior hypospadias (posterior penile, penoscrotal) was 18 cases and the anterior & middle hypospadias was 16 cases. 2. Success rate of posterior hypospadias repair was 9/18(50%) and that of anterior & middle hypospadias was 9/16(56.3%), it was not different statistically (P<0.05). 3. Complication rate of posterior hypospadias repair was 9/18 (50%) and of anterior & middle hypospadias was 7/16(43,5%), it was not different statistically (P<0.05) and complications were managed by simple procedure and require no further treatment. In condition, one stage repair of hypospadias could be applicable in most cases of hypospadias. The complication and morbidity were minimal.
Female ; Hypospadias* ; Male

ESWL monotherapy has been considered a valid initial treatment for staghorn calculi. In an effort to reduce post-ESWL obstruction, many urologists place ureteral stents before ESWL. The use of ureteral stents has proved to contribute to successful stone passage and to reduce post- ESWL morbidity but there also have been reports of complications that might have been caused by indwelling ureteral stents. From January 1989 to December 1995, we reviewed 29 patients with ureteral obstruction after ESWL (EDAP LT-01 & 02) monotherapy without ureteral stenting in 47 patients with staghorn calculi. Ureteral obstruction was occurred in 29 patients (61.7%); 16 (55.2%) in the upper ureter, 11 (37.9%) in the lower ureter, and 2 (6.9%) in the mid-ureter. Steinstrasse was occurred in 13 patients (13/29, 44.8%); 8 (61.5%) in the lower ureter, 4 (30.7%) in the upper ureter, and 1 (7.7%) in the mid-ureter. Ureteral obstruction was occurred regardless of the size of the staghorn calculi(length, breadth, volume). The method of resolving ureteral obstruction was additional ESWL (21 patients, 72.4%), and auxillary procedures including PCN (4 patients, 13.8%), push up procedure (1 patient, 3.4%), push up & double J stenting (1 patient, 3.4%), and ureterolithotomy (2 patient, 6.9%). Mean number of session of ESWL resolving ureteral obstruction was 3.27. Overall complete stone-free rate of staghorn calculi was 55.3%(26 patients). Our results indicate that postoperative ureteral obstruction is easily relieved without major complication by additional ESWL or auxillary procedures. Therefore, ie believe that ESWL monotherapy without ureteral stenting may be adequate treatment modality of staghorn calculi.
Calculi* ; Humans ; Pregnenolone Carbonitrile ; Stents* ; Ureter* ; Ureteral Obstruction*

Endoscopic suspension of bladder neck by Stamey's procedure is a successful technique of correcting female stress urinary incontinence. We treated 27 patients complaining of urinary incontinence with Stamey operation from February, 1988 to March, 1994. The results was as follows l. Patients was distributed in age from 31 to 63 (mean; 48.8) years. All patients except one were multiparous, average 3.6(2-6)times of deliveries 2. Severities of incontinence were Grade I in 2 patients, Grade II in 20, Grade III in 5. 3. On preoperative lateral cystourethrogram, bladder base was descended about 1.1+/-0.57cm in resting, 2.63+/-1.24cm in straining from SCIPP(Sacrococcygeal-inferior point of pubic bone) line. Preoperative average PUVA(Posterior urethrovesical angle) was 142.2+/-53.27 degree, and average functional urethral length was 2.84+/-l.36cm. 4. Postoperative times of catheterization was 5.8 days, the amount of residual urine was lO5+/-10.3cc after removal of catheter. 5. Incontinence was completely disappeared in 24 patients(88.9%), but 3 patients were recurred due to break of suture material.
Catheterization ; Catheters ; Female ; Humans ; Neck ; Sutures ; Urinary Bladder ; Urinary Incontinence*

PURPOSE: Diabetic autonomic neuropathy can cause organic sexual dysfunction in men. The possibilities of preventing or inhibiting erection-related nerve damage by early administration of insulin and testosterone were investigated in the streptozotocin(STZ)-induced diabetic rat model. MATERIALS AND METHODS: Forty Sprague-Dawley rats were divided into normal control and four experimental diabetic groups(untreated, insulin treated, testosterone treated, and insulin and testosterone treated). The pathologic effects were evaluated by nicotinamide adenine dinucleotide phosphate diaphorase staining of nitric oxide synthase(NOS)-containing nerve fibers and neurons of the corpus cavernosum, the dorsal nerve, and the pelvic ganglion. RESULTS: The NOS-containing nerve fibers and neurons in the corpus cavernosum, dorsal nerves, and pelvic ganglia were decreased significantly in untreated diabetic rats. In the insulin- and/or testosterone-treated diabetic rats, a significant increase was observed compared with the untreated diabetic rats. In the number of axons in the dorsal nerves, the same results were demonstrated as for the NOS-containing nerve fibers. In all groups, there was a significant correlation between the ratio of NOS-containing neurons in the pelvic ganglia and the numbers of NOS-containing nerve fibers in the corpus cavernosum(r=0.641, p<0.05). CONCLUSIONS: Early administration of insulin, testosterone, or both may prevent or ameliorate neural damage related to sexual dysfunction in a STZ-induced diabetic animal model.
Animals ; Axons ; Diabetic Neuropathies ; Ganglia ; Ganglion Cysts ; Humans ; Insulin* ; Male ; Models, Animal ; NADP ; Nerve Fibers ; Nervous System* ; Neurons ; Nitric Oxide ; Rats* ; Rats, Sprague-Dawley ; Testosterone*

PURPOSE: To assess whether the prostate volume and two types of lower urinary tract symptoms independently affect erectile function. MATERIALS AND MATHODS: One hundred and fifty two men, who visited outpatient department of Urology and health examination center, were investigated using validated symptom scales, including International Prostatic Symptom Score (IPSS) and International Index of Erectile Function-5 (IIEF-5). The Prostate volume was measured by one examiner using transrectal ultrasonography (TRUS). The correlations between the IIEF-5, emptying and storage symptoms of IPSS, prostate volume and age were subjected to univariate and multivariate analyses. RESULTS: The mean age, prostate volume, and IPSS and IIEF-5 scores were 54.0+/-10.6 years (31-77), 29.1+/-20.4cm(3) (7.9-170.0), and 15.1+/-9.4 (1-35) and 14.6+/-7.1 (1-25), respectively. From the univariate analysis, significant correlations were found between the IPSS and IIEF-5 scores, and the prostate volume and IIEF-5 score, and the age and IIEF-5. When the data were subjected to a multivariate analysis, statistically significant correlations were still observed between the IPSS and IIEF-5 scores and the age and IIEF-5 score, but not between the prostate volume and IIEF-5 score. Furthermore, the storage symptoms of IPSS affected erectile function, with statistical significance, whereas the emptying symptoms did not. CONCLUSIONS: In patients with benign prostatic hyperplasia, lower urinary tract symptoms, especially storage symptoms and age, caused decreases in erectile function. However, the prostate volume itself did not reduce erectile function.
Humans ; Lower Urinary Tract Symptoms* ; Male ; Multivariate Analysis ; Outpatients ; Prostate* ; Prostatic Hyperplasia ; Ultrasonography ; Urinary Tract ; Urology ; Weights and Measures

PURPOSE: The aim of this study was to evaluate the effects of the single administration of the anticholonergics, trospium chloride, in the nocturic patients without bladder outlet obstruction for mid-term. MATERIALS AND METHODS: We included the 22 male and 102 female patients with nocturia over 3 times and without bladder outlet obstruction. Exclusion criteria was under 15 ml/sec in maximal flow rate, over 30 ml in post-void residual urine, nocturnal polyuria and medication affecting lower urinary tract symptoms including alpha-blockers, sedatives, muscle relaxants. Based on voiding diary for 3 days, frequency of the nocturia, daytime frequency and frequency of the urgency and urge incontinence were measured at pretreatment, post-treatment 1st month, 3rd month and 6th month. Additionally maximal flow rate and post-void residual urine were also recorded at the same periods. Anticholinergics was administered in flexible dose. RESULTS: In frequency of nocturia, single administration of the anticholonergics improved significantly at post-treatment 1st, 3rd and 6th month compared to pre-treatment level. The more severe the frequency of the nocturia was, the more it was improved by medication but there is no significant difference. Daytime frequency is significantly improved 3 month and 6 month after medication. In urgency and urge incontinence, the significant improvement was also observed at post-treatment 3rd month and 6th month. The significant differences between pre-treatment and post-treatment were not demonstrated in maximal flow rate and post-void residual urine. Dry mouth was the most common side effect but mild and tolerable. CONCLUSION: The single administration of the trospium chloride demonstrated a clinically significant improvement in nocturia as well as symptoms of the overactive bladder and did not affect negatively on bladder contractility.
Cholinergic Antagonists ; Female ; Humans ; Hypnotics and Sedatives ; Lower Urinary Tract Symptoms ; Male ; Mouth ; Nocturia* ; Polyuria ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Bladder, Overactive ; Urinary Incontinence, Urge

The Ehlers-Danlos syndrome is a congenital anomaly having collagen metabolism with clinical and genetic heterogeneity. It has been classified into ten distinct clinical forms. Urinary bladder diverticula associated with Ehlers-Danlos syndrome appear to be relatively rare and all of the reported cases were male. A 7 years old female patient with Ehlers-Danlos syndrome visited to our hospital because of gross hematuria after blunt trauma to lower abdomen. Markedly distended urinary bladder with diverticulum was found on abdominopelvic computed tomography. Upper tract was unremarkable. We report a 7 years old female patient with Ehlers-Danlos syndrome associated with megabladder and bladder diverticulum.
Abdomen ; Child ; Collagen ; Diverticulum* ; Ehlers-Danlos Syndrome* ; Female* ; Genetic Heterogeneity ; Hematuria ; Humans ; Male ; Metabolism ; Urinary Bladder*