A clinical observation was made on the injuries of genitourinary tract of in-patient in the department of urology, catholic medical center during the period from Jan. 1972 to Dec. 1981. The results were as follows: 1. Of 4,167 cases hospitalized, 217 cases were injury of genitourinary tract, giving a ratio of 4.9%. 2. The favorable age was from 10 to 39 years for 65.0%. The sex ratio, male to female, was 3.8:1. 3. Traffic accident was the most frequent cause of the injury (35.1%)and the next were fall down, kick and blow etc. The urethra was involved most frequently in 37.2% and the next were kidney in 31.6%, bladder in 16.0%, external genitalia in 12.2% and ureter in 3.0%. 4. The fracture was the most frequent associated injury (90.4%)and the next were intestinal injury and hemothorax. The site of the fracture were pelvis, rib, skull, vertebrae and others. 5. The treatment of the renal injury was conservative treatment frequently (78.1%)and 16 cases were undergone operation (nephrectomy in 6, partial nephrectomy in 5, renorrhaphy in 3 and removal of subcapsular hematoma in 2). The posterior urethra was involved more commonly and the preferable treatment was immediate cystostomy and later reconstruction.
Accidents, Traffic ; Cystostomy ; Female ; Genitalia ; Hematoma ; Hemothorax ; Humans ; Kidney ; Male ; Nephrectomy ; Pelvis ; Ribs ; Sex Ratio ; Skull ; Spine ; Ureter ; Urethra ; Urinary Bladder ; Urology

In order to study the method of management of urethral injury, the clinical observation was made on the 81 cases of urethral injury who were treated at Department of Urology, Catholic Medical College, during the period from Jan. 1970 to Dec. 1980. The results were as follows: 1. In age distribution of the 81 cases of urethral injury, age of 59 cases ranged from 10 to 39 years. The main causes of urethral injury were traffic accident (46. 9%) and industrial accident (28. 4%). 2. The symptoms of urethral injury were urethral bleeding (61 cases, 75. 3%), acute urinary retention (26 cases, 32. 1%), inability to void(12 cases, 14.8%) and others. The associated injuries of the urethral injury were pubic bone fracture (45 cases, 55.6%), bladder rupture (8 cases. 9.9%), renal injury (2 cases. 2.5%) and others. 3. Among 69 cases of urethral injury in whom urethrography were performed, two cases (2.9%) had injury in the penile urethra, 22 (31. 9%) in the bulbar and 45 (66.2%) in the posterior. twenty four (34. 8%) had partial injury and 45 (65. 2%) complete. 4. Initial managements of urethral injury consisted of indwelling catheter (11 cases, 13. 6%), primary realignment with interlocking sound (40 cases, 49.4%), urethral anastomosis (5 cases, 6.2%) and suprapubic cystostomy (25 cases, 30. 9%). 5. Of the 11 cases of retaining catheter, no complication was noticed, while among the 40 cases of primary realignment with interlocking sound, the complications were urethral stricture (6 cases). urethral fistula (2 cases), wound infection (2 cases), incontinence (1 case) and bladder stone (1 case). Of the 5 cases having urethral anastomosis, a case developed urethral fistula. Of the 25 cases having suprapubic cystostomy, 7 (28%) were successfully treated only with cystostomy Two to five months after cystostomy. 18 cases having residual urethral stricture urethroplasty, were performed and the complications were urethral fistula (1 case), impotence (1 case) and incontinence (1 case). In urethral injury, the definitive diagnosis must be made by urethrography and the initial management which must be provided is catheterization without excessive force. If catheterization fails, the suprapubic cystostomy is the best alternative management, the definitive urethroplasty have to be followed 3 to 6 months later which remained urethral stricture.
Accidents, Occupational ; Accidents, Traffic ; Age Distribution ; Catheterization ; Catheters ; Catheters, Indwelling ; Cystostomy ; Diagnosis ; Erectile Dysfunction ; Fistula ; Hemorrhage ; Male ; Pubic Bone ; Rupture ; Urethra ; Urethral Stricture ; Urinary Bladder ; Urinary Bladder Calculi ; Urinary Retention ; Urology ; Wound Infection

Hamartoma of the bladder is quite a rare entity which is composed of a disorderly admixture of mature cellular elements normally present in the urinary bladder. There is a great controversy regarding the pathogenesis of this lesion. Whether it is a true hamartomatous lesion or metaplastic lesion developed secondary to the inflammatory process. Similar or identical lesions has often been given by other names such as florid examples of cystitis glandularis. We prefer to cell florid examples of cystitis glandularis rather than hamartoma when it was occurred in an old age higher then 50th decade. Here we report a case of hamartoma of the urinary bladder in 44 years old man. Cystoscopic examination revealed a papillary polypoid mass which was attached to the fundus of bladder by long stalk. The mass measured 1.5 cm in greatest diameter. It was composed of epithelial nests resembling von Brunn's nest, cystitis glandularis or cystitis cystica dispersed in a stroma rich in smooth muscle and fibrous tissue.
Hamartoma

During the last 9 years, 6 patients of renal angiomyolipoma were managed at Catholic University Medical College. All were unilateral and were not associated with tuberous sclerosis. Preoperative diagnosis were hypernephroma (4), angiomyolipoma and renal stone. All patients were treated with nephrectomy. 17 patients were reported in Korean literature previously. In the review of the 26 cases (23 pts.), 16 cases were diagnosed as angiomyolipoma preoperatively and other as hypernephroma(9) and renal stone(1). Almost all cases(22) were managed with nephrectomy and only 4 cases were managed with conservative treatment (arterial embolization or observation).
Angiomyolipoma* ; Carcinoma, Renal Cell ; Diagnosis ; Humans ; Nephrectomy ; Tuberous Sclerosis

Involvement of the vena cava by direct vascular extension of renal cell carcinoma occurs in approximately 5% of patients undergoing nephrectomy for this neoplasm. While successful, removal of caval neoplastic thrombi has been reported occasionally, it has been general impression that renal cell carcinoma extending into the vena cava carried an extremely poor prognosis. A 45 years-old male patient was admitted with painless gross hematuria and palpable mass on fight upper quadrant. Surgical exploration was done through 10th thoracoabdominal incision. A right nephrectomy and retroperitoneal lymph node dissection were done for renal cell carcinoma. It was evident on palpation that the tumor was in the It was evident on palpation that the tumor was in the inferior vena cava Partial resection of the inferior vena cava and removal of intra vena cava thrombus were performed. This patient has led a normal life for 18 months following surgery without clinical evidence of tumor. And so, we were presented with review of the literature.
Carcinoma, Renal Cell* ; Hematuria ; Humans ; Lymph Node Excision ; Male ; Middle Aged ; Nephrectomy ; Palpation ; Prognosis ; Thrombosis ; Vena Cava, Inferior*

One patient with bilateral staghorn calculi was managed by partial nephrectomy of lower pole in one kidney and nephrolithotomy combined with partial nephrectomy in the other kidney.
Calculi* ; Humans ; Kidney ; Nephrectomy

OBJECTIVE: We analyzed the degree of behavioral and psychic masculinization as well as factors influencing the masculinization in female patients with CAH caused by 21-hydroxylase deficiency. METHODS: We studied 26 patients with salt-wasting (SW) type, 29 patients with simple virilizing (SV) type and 30 control patients, who were older than 10 years of age. Study participants were given a questionnaire containing 55 items (20 masculine items, 20 feminine items, 15 neutral items) in order to evaluate the degree of feminity and masculinity. RESULTS: SW and SV girls revealed significantly higher masculine scores and lower feminine scores than the control groups (P<0.05). Feminine scores were lower in the SW group compared to those in the SV group (P<0.05). Neutral scores showed no significant difference among three groups. Masculine, feminine, bisexual and undifferentiated personality characteristics exhibit 57.6%, 3.8%, 7.6%, and 30.7% in SW group, respectively; 31%, 17.2%, 20.6%, and 30%, respectively in SV group; 3.3%, 50.0%, 20.0% and 26.6%, respectively in control group. Masculine scores were negatively correlated with age at diagnosis and treatment (r=-0.516, P<0.05), but not with the levels of 17-hydroxyprogesterone at the time of diagnosis and study, advancement of bone age, age at clitoplasty, age at onset of puberty and age at menarche. CONCLUSIONS: Female patients with 21-hydroxylase deficiency, who reveal high masculinizing score, should be closely monitored for the adverse effects of high degree of masculinization, such as polycystic ovarian syndrome. Additionally, it is important to treat adequately after early diagnosis to minimize the degree of masculinization and to develop the prenatal mode of treatment to interrupt the secretion of adrenal androgen.
17-alpha-Hydroxyprogesterone ; Adolescent ; Adrenal Hyperplasia, Congenital* ; Bisexuality ; Diagnosis ; Early Diagnosis ; Female* ; Humans ; Masculinity ; Menarche ; Polycystic Ovary Syndrome ; Puberty ; Surveys and Questionnaires ; Steroid 21-Hydroxylase*

A statistical observation was made on 525 in-patients in the Department of Urology Catholic Medical College, during the period from the January 1. 1978 to December 31, 1979.
Urolithiasis ; Urology

The most common cause of stress urinary incontinence in the women is the characteristic abnormality of the anatomic supports of the vesical neck and proximal urethra. For the successful surgical management of stress urinary incontinence, these abnormal anatomic defects should be corrected adequately. Herine, we report 5 cases of Marshall-Marchetti operation and 2 cases of modified Pereyra procedure for stress urinary incontinence. The follow-up periods of 7 cases range from 6 months to 4 years. The mean length of catheter drainage postoperatively was 9.4 days, with a range of 5 to 15 days. All cases had excellent results without postoperative urinary retention or urinary tract infection. But, only one case undergoing Marshall-Marchetti operation recurred urinary incontinence 3 months later.
Catheters ; Drainage ; Female ; Follow-Up Studies ; Humans ; Neck ; Urethra ; Urinary Incontinence* ; Urinary Retention ; Urinary Tract Infections

A review is presented in 4 patients with major renal injury seen in our hospital. All patients underwent conservative surgical management. A conservative surgical management to major renal injury is emphasized.
Humans