Arteriovenous malformation (AVM) of the scrotum is a rare vascular lesion, which is distinguished histologically by ambiguous vessels displaying both arterial and venous characteristics and abnormal muscularization of variable sized ectatic vessels. Complete excision is recommended as a definitive treatment. Here, a case of arteriovenous malformation involving the scrotal vessels is reported.
Arteriovenous Malformations* ; Scrotum

Xanthogranulomatous pyelonephritis (XGP) is a rare, severe, chronic infection of the kidney resulting in the normal renal parenchyma being replaced by characteristic lipid-laden macrophages (foam cells). It may occur at any age but is extremely rare in children. Correct pre-operative diagnosis is essential for appropriate surgical approach. We report a case of diffuse XGP in a 6-year-old boy which was pre-operatively diagnosed as XGP.
Child* ; Diagnosis ; Humans ; Kidney ; Macrophages ; Male ; Pyelonephritis, Xanthogranulomatous*

Purpose: The serum prostate-specific antigen (PSA) level is increased after needle biopsy (Bx) of the prostate. This study tested the hypothesis that the prostate that harbors malignant lesions demonstrates less leakage of PSA after transrectal prostate Bx, and this phenomenon can be helpful in discriminating benign protrates from cancer ous prostrates. Materials and Methods: Eighty three patients were included in this prospective study because they had an increase PSA level (from 4 to 30ng/ml) and/or an abnormal digital rectal examination, and the serum PSA level was checked 60 minutes later after biopsy. We checked the pre-Bx total serum PSA, the post-Bx total serum PSA and the PSA ratio (post-Bx total serum PSA to pre-Bx total serum PSA), and we analyzed the sensitivity, specificity, positive predictive value, negative predictive value and the statistical differences. Results: Of the 31 men whose PSA ratio was less than 2.0, 27 (87%) men were proven to have prostate cancer. Of the 52 men whose PSA ratio was greater than 2.0, 49 (94%) were proven to have benign lesions. When setting 2.0 as the cutoff value, the difference was statistically significant (p<0.001); the sensitivity was 90.0%, the specificity 92.4%, the positive predictive value (PPV) 87.0% and the negative predictive value (NPV) 94.2%. Conclusions: Evaluating the 1-hour PSA ratio might be helpful for clinicians to diagnosis the high risk patients who might have cancer in their prostate glands. Repeat biopsy should be considered for patients who initially had negative biopsy results with a smaller PSA ratio.
Biopsy* ; Biopsy, Needle ; Diagnosis ; Digital Rectal Examination ; Humans ; Male ; Neoplasms ; Prospective Studies ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Sensitivity and Specificity

PURPOSE: Prostate biopsy is used to confirm the prostate cancer. Although first biopsy result was benign, repeat biopsy is recommended for the patient who has higher risk of prostate cancer. In this study, we investigated the PSA change ratio (post-biopsy PSA to baseline PSA) whether it could be predictive factor of prostate cancer and helpful when decided to perform repeat biopsy. MATERIALS AND METHODS: 151 patients, first diagnosed as benign, but underwent repeat biopsy due to clinical suspicion of prostate cancer were included. Post-biopsy PSA was checked 60 minutes later after biopsy. PSA change ratio was defined as post-biopsy PSA to baseline PSA. According to results of repeat biopsy, patients were divided into benign group (group A) and cancer groups (group B). Between two group baseline PSA, PSA density, post-biopsy PSA and PSA change ratio were compared, and most effective cut-off value was analyzed using receiver operating characteristic (ROC). RESULTS: 129 men were benign, 22 men were prostate cancer according to results of repeat biopsy. Between two groups, post-biopsy PSA and PSA change ratio were statically significant differences. (p<0.001, <0.001) The effective cut-off value was 3.0, 3.5 and 4.0 according to ROC. At ROC curve, PSA change ratio was statistically significant for diagnosis of prostate cancer. (AUC 0.800, p<0.001). CONCLUSIONS: PSA change ratio is thought be a predictive factor for prostate cancer. If the PSA change ratio was less than 3.0-4.0, repeat biopsy should be considered to confirm the diagnosis.
Biopsy ; Humans ; Male ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatic Neoplasms ; ROC Curve

PURPOSE: The purpose of this study was to investigate the risk factors for urethrocutaneous fistula development after hypospadias repair. MATERIALS AND METHODS: Between January 1990 and May 2010, 348 patients underwent hypospadias repair. This study included 294 patients who were followed up for more than 6 months. Potential risk factors for the development of fistula after operation included age, location of hypospadias, type of hypospadias repair, suture materials and methods, methods and duration of catheterization, combined congenital urologic disorders, timing of presentation and repair of fistula, and location of fistula. Data were analyzed retrospectively. Binary logistic regression analysis was used for univariate and multivariate analysis. RESULTS: Out of 294 patients, 63 patients (21.4%, 63/294) developed urethrocutaneous fistulas after hypospadias repair. In the univariate analysis, fistula formation was statistically related with type of hypospadias and type of hypospadias repair. In the multivariate analysis with stratification by hypospadias site, however, only the location of hypospadias was a significant independent risk factor in urethrocutaneous fistula development after hypospadias repair (p<0.001). CONCLUSIONS: Our results suggest that the risk of developing urethrocutaneous fistula after hypospadias repair is associated with the location of hypospadias (more proximal-type hypospadias). Type of hypospadias repair, suture materials, suture techniques, and number of other combined urologic disorders were not related to the development of urethrocutaneous fistulas.
Catheterization ; Catheters ; Female ; Fistula ; Humans ; Hypospadias ; Logistic Models ; Male ; Multivariate Analysis ; Retrospective Studies ; Risk Factors ; Suture Techniques ; Sutures

Stromal sarcoma of the prostate is very rare and shows rapid growth, which consequently is related to poor prognosis. Recently, we treated two cases of prostatic stromal sarcoma: one with robot-assisted laparoscopic radical prostatectomy and the other with open radical cysto-prostatectomy with an ileal conduit. To the best of our knowledge, this is the first case report of a prostatic stromal sarcoma managed by use of a robotic procedure. Here, we report of our experiences in the treatment of prostatic stromal sarcoma by use of two different methods.
Adult ; Humans ; Laparoscopy/*methods ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Prostate/surgery ; Prostatectomy/*methods ; Prostatic Neoplasms/diagnosis/*surgery ; Rectum/surgery ; *Robotics ; Sarcoma/diagnosis/*surgery ; Seminal Vesicles/surgery ; Tomography, X-Ray Computed ; Treatment Outcome ; Urinary Bladder/surgery ; Urinary Diversion/*methods

Stromal sarcoma of the prostate is very rare and shows rapid growth, which consequently is related to poor prognosis. Recently, we treated two cases of prostatic stromal sarcoma: one with robot-assisted laparoscopic radical prostatectomy and the other with open radical cysto-prostatectomy with an ileal conduit. To the best of our knowledge, this is the first case report of a prostatic stromal sarcoma managed by use of a robotic procedure. Here, we report of our experiences in the treatment of prostatic stromal sarcoma by use of two different methods.
Adult ; Humans ; Laparoscopy/*methods ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Prostate/surgery ; Prostatectomy/*methods ; Prostatic Neoplasms/diagnosis/*surgery ; Rectum/surgery ; *Robotics ; Sarcoma/diagnosis/*surgery ; Seminal Vesicles/surgery ; Tomography, X-Ray Computed ; Treatment Outcome ; Urinary Bladder/surgery ; Urinary Diversion/*methods

PURPOSE: Laparoscopic radical nephrectomy (LRN) is more challenging with increases in body mass index (BMI). Several recent studies have shown, however, that LRN can be safely performed even in obese patients. The influence of obesity on the perioperative outcomes of LRN has not been well elucidated for large renal tumors (>7 cm), however. We estimated the impact of obesity on LRN for stage T1 and T2 renal cell carcinoma (RCC). MATERIALS AND METHODS: From January 2004 to March 2011, 266 patients underwent LRN (T1: 195, T2: 71). These patients were subdivided into the following two groups according to BMI: the nonobese group (BMI less than 25 kg/m2) and the obese group (BMI greater than 25 kg/m2). Perioperative outcomes were retrospectively compared between these two groups in T1 and T2 RCC patients. RESULTS: There were no significant differences in perioperative outcomes between the obese and nonobese groups of T1 RCC patients. However, in T2 RCC patients, operative time and complication rate were significantly increased in the obese group. CONCLUSIONS: Our results suggest that LRN can be safely performed in Korean patients with T1 RCC regardless of obesity. In T2 RCC patients, however, LRN may become more difficult with increasing BMI considering a longer operation time as well as a higher complication rate. We suggest that LRN for obese patients with T2 RCC be carefully considered.
Body Mass Index ; Carcinoma, Renal Cell ; Humans ; Nephrectomy ; Obesity ; Operative Time ; Retrospective Studies

We report a rare case of testicular metastasis from prostate cancer. A 68-year-old patient presented with a right testicular mass with discomfort. He had a history of robot-assisted laparoscopic radical prostatectomy and had received adjuvant radiation therapy and had been treated with androgen deprivation therapy continuously at another institution. We performed a right inguinal orchiectomy. The testicular mass was diagnosed as a metastasis from prostate carcinoma.
Aged ; Humans ; Neoplasm Metastasis ; Orchiectomy ; Prostate ; Prostatectomy ; Prostatic Neoplasms ; Testicular Neoplasms

PURPOSE: To evaluate the efficacy and tolerability of tamsulosin 0.4 mg once daily in Korean patients with symptomatic benign prostatic hyperplasia (BPH) and investigate whether tamsulosin 0.4 mg can improve symptoms in patients with refractory lower urinary tract symptoms (LUTS) who were previously receiving tamsulosin 0.2 mg once daily. MATERIALS AND METHODS: A total of 116 patients from 3 urology centers participated. All study subjects entered a nonblind phase consisting of 8 weeks of tamsulosin 0.2 mg monotherapy followed by an additional 8 weeks of tamsulosin 0.2 mg (0.2 mg group) or 8 weeks of tamsulosin 0.4 mg (0.4 mg group). At week 8, we chose the 0.4 mg group on the basis of International Prostate Symptom Score (IPSS), quality of life (QoL), maximal urinary flow rate (Qmax), and adverse effects. At week 16, we compared the efficacy and tolerability of tamsulosin between the 0.2 and 0.4 mg groups. RESULTS: A total of 26 patients (22.4%) were escalated to tamsulosin 0.4 mg at week 8. There were significant differences in IPSS, QoL, and Qmax at week 8 in both groups. There were significant differences in improvement in IPSS, QoL, Qmax, and postvoid residual urine volume from baseline to week 16 in both groups. There were no significant differences in efficacy or tolerability between the groups at week 16. CONCLUSIONS: Our trial demonstrated that tamsulosin 0.4 mg has favorable efficacy and tolerability in Korean patients with symptomatic BPH refractory to tamsulosin 0.2 mg. No patients experienced any serious adverse effects when we escalated the dose of tamsulosin to 0.4 mg.
Humans ; Lower Urinary Tract Symptoms ; Prostate ; Prostatic Hyperplasia ; Quality of Life ; Sulfonamides ; Urology