PURPOSE: Delirium in the elderly is common in the postoperative period but there are only few reports on detailed studies of this condition. Number of urologic patients with postoperative delirium was increas ed in our hospital for recent 24 months. The clinical characteristics of patients with postoperative delirium was analyzed retrospectively. MATERIALS AND METHODS: We selected the patients with postoperative delirium from 1010 patients who had undergone urological surgery under general or spinal anesthesia in the period from Jan. 1997 to Dec. 1999. Diagnosis of postoperative delirium was established with Diagnostic and Statistical Manual of Mental Disorders(DAM-III-R) by psychiatric clinicians. Onset and recovery of symptoms, risk factors, previous psychiatric clinicians. Onset and recovery of symptoms, risk factors, previous psychiatric disorder, relationship with anesthesia, drugs, and surgical procedures, concomittant medical conditions, and complications were retrospectively reviewed. RESULTS: Postoperative delirium was observed in 13 patients (1.3%). All patients were male and mean age was 70.4 years (46-86 years). Surgical procedures included TURP(8 patients), cystectomy (3 patients), nephroureterectomy (1 patient), and bladder rupture repair (1 patient). Delirium became apparent between one day and two days after the operation (mean 32.2 hours) and lasted for up to 7 days (mean 53 hours). Several factors such as older age (>65 years), male patient, longterm medication, past history of CVA, memory impairment, hearing difficulty, traumatic brain contusion, and obsessive personality were thought to be risk factors of postoperative delirium. Treatment with Haloperidol(R) intramuscular injection (2.5-5mg, every 30 minutes, 2-4 times until symptom resolution was achieved) with or without Ativan(R) intravenous injection (2mg) were effective. Complete symptom recovery was seen in 92.3% (12/13) of patients. One patient (7.7%) with previous history of dementia had persistent memory disturbance and disorientation during follow-up periods. CONCLUSIONS: Generally, postoperative delirium is an acute transient confusional state without considerable sequeles. Treatment is sedation and prevention of inadvertent accident associated with confusional state. Urologic surgeon must be attentive to the development of this illness especially when high risk factors were present.
Aged ; Anesthesia ; Anesthesia, Spinal ; Brain Injuries ; Cystectomy ; Delirium* ; Dementia ; Diagnosis ; Follow-Up Studies ; Hearing ; Humans ; Injections, Intramuscular ; Injections, Intravenous ; Male ; Memory ; Postoperative Period ; Retrospective Studies ; Risk Factors ; Rupture ; Urinary Bladder

Superficial bladder tumors are usually treated by TUR and the result of this treatment was known to have good prognosis. However, recurrence of the tumor after complete resection occurs in about 40-70% of the patients, a significant percentage of these recurrences showing a higher degree of malignancy. There are many factors affecting the recurrence and progression. Understanding the aspect of recurrence will help in the management of patients. So we studied to evaluate the relationship in 43 cases with superficial bladder tumors admitted to the Department of Urology, Inje college of Medicine, Pusan Baik Hospital during the period from April, l981 through March, l986. Thirty three patients were followed up for more than 3 Months. Following results were obtained: 1. No. of patients with recurrence was l8 (54.5 %). 2. Nine cases (50%) were recurred within 1 year and these patients had poor prognosis than patients recurred after 1 year. 3. The recurrence around the initial tumor site were 6 cases (33.3 %) and these patients had poor prognosis than recurrence at other site. 4. There was more significant increase of malignant progression and recurrence in multiple tumor or large tumor than solitary or small one. 5. There was significant increase of malignant progression and recurrence in initial high grade tumor than low grade tumor. 6. The recurrence rate was decreased in patients instilled adriamycin more than 4 times (45.5%, than less than 4 times (75%).
Busan ; Doxorubicin ; Humans ; Prognosis ; Recurrence* ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urology

Ectopic ureter entering into the seminal vesicle associated with ipsilateral renal dysplasia is a very rare developmental abnormality. Clinical manifestations consists of dysuria, hematuria, recurrent epididymitis. ejaculatory pain and perineal discomfort and the diagnosis is made by seminal vesiculogram through vas deference. Surgical excision of the seminal vesicle and the ectopic ureter is the best choice or treatment in this entity. We present a case of 34 year old infertile man with ectopic ureter entering into the seminal vesicle associated with ipsilateral renal dysplasia and contralateral cryptorchidism.
Adult ; Cryptorchidism ; Diagnosis ; Dysuria ; Epididymitis ; Hematuria ; Humans ; Male ; Seminal Vesicles* ; Ureter*

The renal oncocytoma is a rare benign tumor arising from the proximal tubular cells and has recently become a recognized clinical and pathologic entity. The feature of this tumor includes the tendency to (1) be incidental finding, (2) be large in size, (3) have well defined borders, (4) exhibit benign clinical behaviors. Here, we report a case of renal oncocytoma which was found incidentally due to pelvic inflammatory disease of a 37-years-old woman, who was treated with the radical nephrectomy.
Adenoma, Oxyphilic* ; Female ; Humans ; Incidental Findings ; Kidney ; Nephrectomy ; Pelvic Inflammatory Disease

Congenital anterior urethral diverticulum is presented as a cause of urinary tract obstruction and is rate in young male. We report a case of congenital anterior urethral diverticulum developed in 3 year old male child.
Child ; Child, Preschool ; Diverticulum* ; Humans ; Male ; Urinary Tract

Primary carcinoma of the urethra is quite rare. The causes of the disease are poorly understood. It is the only urologic malignancy. known to be less common in males than females, despite of the greater length and complexity of the urethra in the male. We report a case of carcinoma of the urethra in 81 years old male patient.
Aged, 80 and over ; Female ; Humans ; Male* ; Urethra*

Stamey endoscopic suspension of bladder neck is a reliable technique among various surgical techniques with high success rate and little morbidity. We treated 8 patients complaining of urinary incontinence with Stamey operation from February 1988 to May 1990 and Follow-up for over 6 months. The results as follows; 1. Patients varied in age from 31 to 63 (mean;45) years. All patients were multiparous average 2.87 (2-4) times of previous deliveries 2. All patients showed frequency and nocturia. Severities of incontinence were Grade I in2 patients, Grade II in 5, Grade III in 1 3. No significant changes were identified between preoperative and postoperative urethral pressure profiles. 4. On preoperative lateral cystourethrograms, bladder base was descended about -2.10+-0.74cm from SCIPP line and elevated about +1.2 cm+/-0.49 cm from SCIPP line on postoperative lateral cystourethrograms. 5. Incontinence was disappeared in 7 patients, but 1 patients was recurred due to rupture of suture material during lifting heavy material.
Female* ; Follow-Up Studies ; Humans ; Lifting ; Neck ; Nocturia ; Rupture ; Sutures ; Urinary Bladder ; Urinary Incontinence*

The vaginal stone associated with vesico-vaginal fistula is quite rare and its cause, frequency, composition and others are poorly understood. We report a case of huge vaginal stone associated with vesico-vaginal fistula in 57 years old woman. considering of the possible causes of stone formation in the vagina and its composition, prevention, treatment complication and others. A stone, 6 x 7 x 5cm in size, was removed by litholapaxy. The stone was composed of uric acid, magnesium ammonium phosphate and carbonate appetite.
Ammonium Compounds ; Appetite ; Carbon ; Female ; Fistula* ; Humans ; Lithotripsy ; Magnesium ; Middle Aged ; Uric Acid ; Vagina ; Vesicovaginal Fistula

No abstract available.

No abstract available.