Varicocele is a abnormal dilation of entire venous circulation of testis. The etiology of varicocele subfertility is not clear, but at least contributory to its development is a valvular insufficiency at the internal spermatic-left renal vein confluence. The aims of phlebography of the spermatic vein are to confirm the venous anatomy of varicocele, to establish the selection of treatment approach, and to prove the cause of postoperatively persistent varicocele. The transfemoral phlebography of internal spermatic vein was performed in 26 cases. passive reflux from the left renal vein to internal spermatic vein was observed in all cases. Distal nutcracker phenomenon(DNP) was observed in 6 cases, proximal nutcracker phenomenon(PNP) in 4 cases and suspicious PNP in 2 cases. The treatment of the varicocele was performed by Palomo`s procedure in 22 cases and by stainless steel spring coil occlusion in 4 cases. The persistent varicocele was found in 3 cases of Palomo`s procedure and 1 cases of coil occlusion.
Infertility ; Phlebography* ; Renal Veins ; Stainless Steel ; Testis ; Varicocele* ; Veins

Spontaneous rupture of the kidney is rare. It usually occurs secondary to various kinds of underlying disease such as infection, hydronephrosis, calculous disease, benign or malignant tumor, renal artery aneurysm and arteriosclerosis. In most instances, it is an acute abdominal process which requires early diagnosis and immediate surgical exploration. We report a case of spontaneous rupture of the kidney secondary to renal cell carcinoma in a 44 year-old female.
Adult ; Aneurysm ; Arteriosclerosis ; Carcinoma, Renal Cell* ; Early Diagnosis ; Female ; Humans ; Hydronephrosis ; Kidney* ; Renal Artery ; Rupture, Spontaneous*

Transvenous embolization of the internal spermatic vein appears to be at least as effective as open surgical correction in treating men with varicocele and it has several advantages ; (1) it requires only local anesthesia and a short hospital stay ; (2) there is no risk of damage to the spermatic artery : (3) the veins can be occluded accurately whatever the arrangement of any collateral vessels. We reported a technique for non-operative management of varicocele by a occlusion of the internal spermatic vein using stainless steel spring coil.
Anesthesia, Local ; Arteries ; Humans ; Length of Stay ; Male ; Stainless Steel* ; Varicocele* ; Veins*

Benign tumors of the testis are rare, accounting for one percent of all testicular tumors including epidermoid cyst of the testis. Herein we report one case of epidermoid cyst of the testis and discuss the pathological criteria for diagnosis and clinical management of the lesion.
Diagnosis ; Epidermal Cyst* ; Testicular Neoplasms ; Testis*

The aims of this study were to analyze lymphocyte and eosinophil counts in consecutive peripheral blood samples taken during immunotherapy for metastatic renal cell carcinoma (mRCC) and to correlate the findings with objective response and survival. A total of 40 patients with mRCC who received immunotherapy with interleukin-2, interferon-alpha, and 5-fluorouracil were analyzed. Objective responses were observed in 14 patients, including 2 (5%) who showed a complete response (CR) and 12 (30%) who showed a partial response (PR). Eleven patients (27%) achieved stable disease (SD), and 15 patients (38%) had progressive disease (PD). Changes from baseline in the total lymphocyte counts were significantly higher in the responding patients (CR+PR+SD) than in the non-responding patients (PD) (p=0.017), but no difference was seen in the total eosinophil counts (p=0.275). Univariate analysis identified the Eastern Cooperative Oncology Group (ECOG) performance status (p=0.017), the presence of a primary renal tumor (p<0.001) and the peripheral lymphocyte counts at week 4 (p=0.034) as prognostic factors, but a low ECOG performance status (p=0.003) and the presence of a primary renal tumor (p=0.001) were identified as independent poor prognostic factors by multivariate analysis. This study provides further evidence that changes in blood lymphocyte counts may serve as an objective indicator of objective responses.
Adult ; Aged ; Carcinoma, Renal Cell/blood/*immunology/secondary/*therapy ; Eosinophils ; Female ; Fluorouracil/administration & dosage ; Humans ; *Immunotherapy ; Interferon Type I, Recombinant/administration & dosage ; Interleukin-2/administration & dosage ; Kidney Neoplasms/blood/*immunology/*therapy ; Leukocyte Count ; *Lymphocyte Count ; Male ; Middle Aged ; Prognosis ; Survival Rate

PURPOSE: This study was undertaken to investigate the outcomes associated with docetaxel treatment of Korean patients with hormone-refractory prostate cancer (HRPC) and to compare its clinical efficacies in 1st and 2nd-line settings. PATIENTS AND METHODS: This study was retrospectively performed and included 47 patients with HRPC. The 1st-line group consisted of 19 patients who had not undergone prior chemotherapy, and the 2nd-line group consisted of 28 patients who underwent prior chemotherapy. All patients were treated with 75mg/m2 IV docetaxel every 3 weeks and 5mg of prednisone twice daily with a continuous androgen blockade. RESULTS: Of 47 study subjects, 14 patients (29.8%) had > or = 50% PSA decline from baseline. PSA response was more common in the 1st-line group, but this was not statistically different (42.1% vs. 21.4%, p = 0.114). After a median follow up of 11 months (range, 6-24 months), the 1st-line group showed a longer time to PSA progression (4 vs. 2 months, p = 0.015) and survival (17 vs. 10 months, p = 0.037) than the 2nd-line group. In terms of toxicities, no difference was apparent between the 2 groups. CONCLUSION: In a 1st-line setting, docetaxel is an effective and tolerable agent for Korean HRPC patients, and that its efficacy is limited, although 2nd-line docetaxel is tolerable.
Aged ; Antineoplastic Agents/administration & dosage/adverse effects/*therapeutic use ; Humans ; Male ; Middle Aged ; Prostate-Specific Antigen/blood ; Prostatic Neoplasms/*drug therapy/mortality ; Retrospective Studies ; Taxoids/administration & dosage/adverse effects/*therapeutic use ; Treatment Outcome

PURPOSE: The hemostasis and closure of the collecting system are still problems to be overcome during a partial nephrectomy. Herein, our initial experience of a parenchymal compression technique, without clamping of the renal pedicle during an open partial nephrectomy, is reported. MATERIALS AND METHODS: Between May 2000 and August 2005, 10 patients underwent an open partial nephrectomy, without pedicle clamping, for a renal mass. The open partial nephrectomy was performed under regional ischemia, which was achieved by parenchymal compression using a long curved vascular clamp. Several parameters were retrospectively assessed, including the tumor size, location, pathology, estimated blood loss, preoperative and postoperative serum creatinine, complications, and tumor recurrence. RESULTS: The mean mass size was 23.8mm, ranging between 12 and 55mm, and the tumors were located in the upper, mid and lower poles in 2, 3 and 4 cases, respectively. Pathological examinations revealed renal cell carcinomas in 6, an angiomyolipoma in 1, and complicated renal cysts in 3 patients. In all the patients with renal cell carcinoma, the frozen and permanent sections analyses confirmed negative margins. There were no differences between the preoperative and postoperative creatinine levels, with no significant complications observed, including urinary leak and bleeding, during the recovery period. No patient developed a local recurrence or distant metastasis during the mean follow-up period of 17.2 months. CONCLUSIONS: This technique is simple, and can be easily practiced by any urological surgeon, without concerns relating to the ischemic time and complications. It is suggested that the regional parenchymal compression is an efficient technique for hemostasis and repair of the collecting system during an open partial nephrectomy.
Angiomyolipoma ; Carcinoma, Renal Cell ; Constriction* ; Creatinine ; Follow-Up Studies ; Hemorrhage ; Hemostasis ; Humans ; Ischemia ; Kidney Neoplasms ; Neoplasm Metastasis ; Nephrectomy* ; Pathology ; Recurrence ; Retrospective Studies

Wilms' tumor is a rare malignant renal tumor in adults and it usually presents as a parenchymal mass that resembles renal cell carcinoma. The authors observed one case of adults Wilms' tumor developing in the renal pelvis and the initial diagnosis was renal pelvis tumor. The patient underwent radical nephroureterectomy with bladder cuff excision and adjuvant chemotherapy with the combination of vincristine and actinomycin. The patient has remained healthy and was without evidence of tumor recurrence on a follow-up CT scan at 18 months postoperatively.
Adult ; Carcinoma, Renal Cell ; Chemotherapy, Adjuvant ; Dactinomycin ; Diagnosis ; Follow-Up Studies ; Humans ; Kidney Pelvis* ; Recurrence ; Tomography, X-Ray Computed ; Urinary Bladder ; Vincristine ; Wilms Tumor*

Idiopathic retroperitoneal fibrosis is a fibrotic process of the retroperitoneum that frequently produces ureteral obstruction. We report a case of idiopathic retroperitoneal fibrosis in a 22 year-old male patient with brief review of literatures.
Humans ; Male ; Retroperitoneal Fibrosis* ; Ureteral Obstruction ; Young Adult