PURPOSE: The vaginal wall sling was introduced by Raz as a simpler and lessmorbid alternative to fascial or synthetic slings for the treatment of female stress urinary incontinence. The purpose of this study was to determine the efficacy and safety of anterior vaginal wall sling in the management of women with anatomical incontinence(Al) and intrinsic sphincteric deficiency(ISD). MATERIALS AND METHODS: We performed vaginal wall sling on 46 consecutive women with stress incontinence. Preoperative evaluation included voiding cystourethrogaphy, urodynamic study, cystocsopy and incontinence staging with SEAPI classification. Postoperative subjective SEAPI outcome measures and assessment of complications were checked on a 3-month basis. RESULTS: Of the patients 19(49%) had Al and 27(59%) had ISD. Median follow-up was 8 months (range 6 to 10). Mean operation time was 65 minutes. At follow-up all of the patients reported no stress incontinence and 15% reported urge incontinence. De novo urge incontinence did not occur. Complications included prolonged voiding difficulty(8,7%), suprapubic pain(8.7%), and pain on leg abduction(4.3%). Four patients had a prolonged time to gain complete bladder emptying, which required more than 3 weeks to resolve. Permanent urinary retention has not occurred in any patient. CONCLUSIONS: Vaginal wall sling is a safe, simple and effective procedure for the treatment of stress urinary incontinence due to Al and ISD.
Classification ; Female* ; Follow-Up Studies ; Humans ; Leg ; Outcome Assessment (Health Care) ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Urge ; Urinary Retention ; Urodynamics

No abstract available.
Allografts* ; Cadaver* ; Fascia*

Recent improvement in the understanding of the continence mechanism in women have led to the development of innovative new surgical methods. Nearly 300 procedures have been proposed for the surgical treatment of stress urinary incontinence (SUI) in women. Three groups of surgical procedures and their variants have been utilized over the past decades: urethropexy, colposuspension and the sling. Many are less invasive than previous techniques and appear to offer improved safety and shorter hospital stays, while maintaining the efficacy of traditional open anti-incontinence surgery. Burch colposuspension and sling procedures still are the main stream but recently tension-free vaginal tape procedure and its variants are developed and widely performed all over the world. Pathophysiological concepts and theories on clinical staging have changed in recent years. The importance of pressure transmission and hammock- like support has been complemented by the so-called 'integral theory'. Loosely applied polyprophylene mid-urethral sling are the new gold standard therapy for female SUI. The long-term follow-up data are comparable to previous sling procedures. Transobturator mid-urethral slings are challenging to retropubic approach and under investigation. Increasing range of available procedures allows surgical treatment of SUI to be individualized for the patient. Although surgery will continue to play an important role in the treatment of SUI for women, highly qualified study are needed. Every urologist who wants to treat SUI patients has to understand physiology and pathophysiology of SUI and urodynamics, and be well trained even though new surgical techniques are easier than previous ones. That is because every surgery has its complications and surgeons have to deal them with the knowledge and experience. The field of SUI treatment is evolving continuously and undoubtfully current technique will be surpassed by newer, better concepts in the future.
Complement System Proteins ; Female* ; Follow-Up Studies ; Humans ; Length of Stay ; Physiology ; Rivers ; Suburethral Slings ; Urinary Incontinence* ; Urodynamics

The analysis of DNA proliferation by flow cytometry was performed successfully on 93 paraffin-embedded TCC specimens. We defined the proliferation index as hyperdiploid populations on DNA histogram and divided it into two groups, low-(<35% ) and high (>35%) proliferation index. On the basis of this criteria, proliferation index was evaluated as a complementary predictor of survival of the patients with bladder tumor. Proliferation index was well correlated with T stage (p=0. 0019) and grade (p=0.0152). For high proliferation group survival of patients with bladder tumor was significantly lower than low proliferation group (p=0.0063). Proliferation index, T stage, grade and lymph node involvement were significant variables as prognostic parameters in univariate, analysis but only T stage was a significant variable in multivariate analysis. In the intermediate groups, proliferation index was a good predictor of survival of the patients with muscle invasive. bladder tumor (T2, T3a) (p=0.0131) but not with grade II bladder tumor (p=0.7107). In conclusion. proliferation index is valid as a complementary prognostic parameter in TCC of the bladder, especially in the muscle invasive group.
DNA* ; Flow Cytometry ; Humans ; Lymph Nodes ; Multivariate Analysis ; Urinary Bladder Neoplasms* ; Urinary Bladder*

No abstract available.
Lymphoma* ; Testis*

Immunoperoxidase method was used to study carcinoembryonic antigen in tissue sections of 75 patients with transitional cell carcinoma, inflammation and normal mucosa of the bladder. Transitional cell carcinomas were divided into 3 grades by the degree of cellular differentiation and 4 groups (A: superficial tumors without recurrence, B: superficial tumors with recurrence, C: superficial tumors with recurrence and up-staging and D: initially invasive tumors) according to recurrence and invasiveness. Overall positive rate of CEA for transitional cell carcinomas was 38% and 5 normal and 5 inflammatory vesical mucosas were negative for CEA in the cytoplasm of the cell. The positive rates of A, B, C and D were 25%, 57%, 30% and 50%, respectively and those of grade I, II and III were l9%, 34 % and 73%, respectively. The positive rate of CEA was well correlated with the grade but not with the recurrence or invasiveness. These conflicting data suggest that further extensive study will be necessary whether immunoperoxidase detection of CEA in tissue sections could be of prognostic value in patients with transitional cell carcinoma of the bladder.
Carcinoembryonic Antigen* ; Carcinoma, Transitional Cell* ; Cytoplasm ; Humans ; Inflammation ; Mucous Membrane ; Recurrence ; Urinary Bladder*

Herein we analyze retrospectively 65 patients with prostatic adenocarcinoma managed at Seoul National University Hospital during a 9 year period from January 1975 to January 1984. Major presentations are prostatism (60%), bone pain and urinary retention. Thirteen patients were diagnosed as B.P H. initially and in 18 patients, hard nodules were palpable by rectal examination. Hydronephrotic changes were found on I.V.P in 15 patients and the causes of those were identified in 4 patients by cystoscopy and, or CT scan. There were direct invasion by the primary tumor in 2 patients and metastasis to pelvic lymph nodes in 2 patients. Perineal needle biopsy was performed in 38 patients and adenocarcinoma was confirmed in 35 patients. In 42 patients, distant metastases were found by various diagnostic procedures including bone survey, bone scan and CT scan. According to the VAUORG staging system, 65 patients were classified as stage A (8), stage B (5) stage C (3) and stage D (49). In 49 stage D patients, endocrine therapy was done in 42 patients and 17 patients of them underwent additional T.U.R. of prostate. Only 26 patients were followed properly. Three patients with stage A survived more than 2 years and 9 patients with stage D died within 2 years while 14 patients with stage D survived more than 2 years. The causes of death in 9 stage D patients were wide spread metastasis in 6 and uncertain in 3 patients. Two year survival rate of the stage D patients was 60% (14/ 23) and the mean survival time of the dead within 2 years was 16.1 months. 35 of 65 patients had elevated level of serum acid phosphates prior to therapy, which fell to less than 50% of initial value or to normal within 1 month after endocrine therapy in 9 of 12 patients.
Adenocarcinoma* ; Biopsy, Needle ; Cause of Death ; Cystoscopy ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Phosphates ; Prostate ; Prostatism ; Retrospective Studies ; Seoul ; Survival Rate ; Tomography, X-Ray Computed ; Urinary Retention

In recent years there are so many medical informations that urologists should know. Computer systems offer new opportunities for the storage and manipulation of hospital informations. A computer-based system for urologic patient data management has been designed and developed by the authors. This program was written in dBASE IV language and could be used in IBM PC/AT (16 Bit) with at least 20MB hard disk drive. The main features of this program include storage and retrieval of data easily by pull-down menus using automatic coding system for diagnoses and operation names. Searching a case or a group of cases could be performed by name, chart number and filters (date of input, diagnosis code, operation code, urology number). And they are easily printed out by two different print forms. The automatic coding system is that after diagnoses and operation named are typed, their codes are automatically registered. The urologic code system for automatic coding was also designed by the authors. In our experience this computer-based urologic patient data management system by automatic coding is very useful, easy to handle, and minimizing input errors.
Clinical Coding* ; Computer Systems ; Diagnosis ; Humans ; Microcomputers* ; Urology

No abstract available.
Sinusitis*

No abstract available.
Angiotensin II ; Angiotensins ; Endothelial Cells ; Endothelins ; Epoprostenol ; Thrombin ; Umbilical Veins