Herein, polyorchidism possessing of more than the usual number of testicles, which was found in two patients, is reported. Both patients had three testes, and one presented with painful swelling of the right scrotum caused by torsion of the testis and the other revealed a non-palpable testis in the right hemiscrotum. Both patients were managed surgically with orchiopexy and an orchiectomy, respectively, followed by the insertion of an artificial testis.
Humans ; Orchiectomy ; Orchiopexy ; Scrotum ; Testis ; Urogenital Abnormalities

Injuries to the pelvic nerve plexus following major pelvic ablative surgery are commonly observed conditions in urologic field and often related to voiding difficulty with flaccid type of neurogenic bladder. The pathophysiological background for voiding difficulty is unknown and also it is difficult to investigate in human. The present study was undertaken to investigate the functional changes on the bladder and urethra in major pelvic ganglion denervated rats (experimental group). Injury to the pelvic nerve plexus was created by selective removal of bilateral major pelvic ganglions of mature Sprague-Dawley rats (male, 250-300 gm). One week after operation, urodynamic evaluation and NADPH diaphorase histochemistry were performed in each rat. The whole bladder wet weight and residual urine of experimental group significantly increased to 1.6 times and 29 times that of control group, respectively. For urodynamic investigations, the bladder and the urethra were completely disconnected by means of ligation between the bladder neck and the proximal urethra, and simultaneous recordings of the intravesical and proximal urethral pressure were performed. During simultaneous urethro-vesical filling in experimental group, vesical contraction and urethral relaxation were not induced. However, an administration of L-arginine (120 mg/kg intravenously), a nitric oxide substrate, resulted in a gradual decrease in urethral pressure when the bladder pressure was reached at submaximal level. On NADPH diaphorase histochemistry in control group, a large number of NADPH positive nerve fibers were found in the proximal urethra, whereas those were found less commonly in the bladder. In experimental group, the number of NOS positive nerve fibers in the bladder was similar to that in control group. But in the proximal urethra, the number of NOS positive nerve fibers (84.7 +/- 12.7) decreased significantly in contrast to that (185.9 +/- 56.3) in control group. These results indicate that failure to empty in neurogenic bladder may be resulted from relaxation impairment of bladder outlet, which can be explained by the reduction of neuronal NOS in the proximal urethra in experimental group.
Animals ; Arginine ; Denervation ; Ganglion Cysts* ; Humans ; Ligation ; NADP ; NADPH Dehydrogenase ; Neck ; Nerve Fibers ; Neurons* ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type I* ; Rats* ; Rats, Sprague-Dawley ; Relaxation ; Urethra* ; Urinary Bladder* ; Urinary Bladder, Neurogenic ; Urodynamics

PURPOSE: To evaluate the safety and efficacy of Hickman catheter placement via the subclavian vein under fluoroscopic guidance with intravenous contrast injection. MATERIALS AND METHODS: During an eleven-month period, 187 Hickman catheters were percutaneously placed in 167 consecutive patients in an interventional radiology suite. Subclavian venous puncture was made with injection of contrast medium into the peripheral venous line. After subclavian venous access had been obtained, a subcutaneous tunnel was created using a peel-away sheath or a tunneler. The Hickman catheters were inserted through a peel-away sheath, the distal tip of which was at the junction of the right atrium and the superior vena cava. RESULTS: One hundred and eighty-six Hickman catheters were successfully placed; the one failure was due to an atomical tortuosity of the vein(0.53%). Complications included one case of subclavian vein occlusion (0.53%); three of line occlusion by thrombus (1.6%); one of oozing at the suture site (0.53%); six of infection or inflammation (3.2%); eight of natural removal (4.2%); one case of air embolism (0.53%) and two of malposition (0.1%). Major complications such as pneumothorax or arterial puncture leading to mediastinal hemorrhage did not, however, occur. CONCLUSION: The authors concluded that radiologic Hickman catheter placement offers advantages over traditional approaches in terms of safety, convenience, and time and cost savings.
Catheters ; Cost Savings ; Embolism, Air ; Heart Atria ; Hemorrhage ; Humans ; Inflammation ; Pneumothorax ; Punctures ; Radiology, Interventional ; Subclavian Vein* ; Sutures ; Thrombosis ; Vena Cava, Superior

PURPOSE: Angiogenin is involved in tumor angiogenesis, an important process for the growth and metastatic potential of solid tumors. This study was performed to evaluate the expression of angiogenin in the tumor tissues of patients with bladder tumors. The correlations of angiogenin with the tumor grade and stage were also evaluated. MATERIALS AND METHODS: The quantification for the expression of angiogenin mRNA was assessed in 106 human bladder tumor tissues, 19 normal mucosae surrounding the bladder tumor and 17 normal bladder mucosae, using a quantitative competitive polymerase chain reaction (QC-PCR). We compared the levels of angiogenin mRNA expression between the bladder tumors and the normal bladder mucosae of the controls, the bladder tumors and the normal bladder mucosae surrounding the tumors, and with regard to the tumor grades and stages. RESULTS: The levels of angiogenin mRNA expression in the bladder tumor tissues were significantly higher than in the normal bladder mucosae of the controls and the normal bladder mucosae surrounding the tumors. The angiogenin expression levels in the bladder tumors at stages T1 or above T2 were significantly higher than in the bladder tumors at stage Ta. There was no significant difference in angiogenin expressions with regard to the tumor grade. CONCLUSIONS: These data suggest that angiogenesis, mediated by angiogenin, may be involved in the tumorigenesis of the urinary bladder and the invasiveness of bladder tumors.
Carcinogenesis ; Humans* ; Mucous Membrane ; Polymerase Chain Reaction ; RNA, Messenger ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Ever since Pereyra described needle suspension of the bladder neck as a form of surgical therapy for the treatment of stress urinary incontinence in women numerous modifications have been presented. Each of these modifications has helped to found healthy anatomical and surgical principles that ensure patient safety, decrease morbidity and improve effectiveness. We had treated 8 patients of stress urinary incontinence with or without cystocele by transvaginal Burch procedure. By fixing suspension sutures to the Cooper`s ligament we expected to achieve a static suspension independent of everyday patients` activities. The duration of follow up was 3 months to 6 months. Them were no serious operative complications. Incontinence was completely disappeared in 6 patients (75%) and significantly improved in 1 patient (12.5%), and failed in 1 patients (12.5%). Although the small number of patients and limited follow up, we believe that fixation of suspension sutures to the Cooper`s ligament can favorably influence long-term results of treatment for female stress urinary incontinence.
Cystocele ; Female* ; Follow-Up Studies ; Humans ; Ligaments ; Neck* ; Needles ; Patient Safety ; Sutures ; Urinary Bladder* ; Urinary Incontinence*

PURPOSE: It is known that size of the prostate increases with age, but there is no guideline of size of the prostate to be applied to Korean men. This study reports the size change of prostate with age in Korean men. MATERIALS AND METHODS: To determine the prostatic size, 645 volunteers(539 normal group and 106 BPH group) from Chungbuk province underwent transrectal ultrasonography (Scanner 200, Pie Medical, Netherlands). Size of the prostate was estimated as a weight by the elliptical method. RESULTS: The mean prostate weight was 22.4+/-8.4gm(range 7~83gm). The relationship between prostate volume and age was statistically significant in 645 volunteers(r=0.17, p<0.0005). Also, between normal group and benign prostatic hyperplasia group, there was significant correlation with age(r=0.16, P<0.0005), while results were insignificant with size(r=0.13, p>0.1). CONCLUSIONS: Size and rate of growth of the prostate were smaller compared to the western society, nevertheless, prostate size increased with age. For accurate and reasonable age-specific size of the prostate of Korean male, community based multicenter study will be needed with more accurate measurement techniques such as step-section planimetry for the prostatic volume estimation.
Chungcheongbuk-do* ; Humans ; Male ; Prostate ; Prostatic Hyperplasia ; Ultrasonography

PURPOSE: Both the development and progression of a tumor are angiogenesis dependent, the induction of which is mediated by several angiogenic factors, such as vascular endothelial growth factor (VEGF). This study was performed to evaluate the expression of VEGF in the tumor tissues of patients with bladder tumors. The correlation of VEGF with the tumor grade and stage was also evaluated. MATERIALS AND METHODS: The quantification for the VEGF mRNA expression was assessed in 117 human bladder tumor tissues and 17 normal bladder mucosae of controls, using a quantitative competitive polymerase chain reaction (QC-PCR). We compared the levels of VEGF mRNA expression between the bladder tumors and the normal bladder mucosae of the controls, the bladder tumors and the surrounding normal bladder mucosae, and according to tumor grades and stages. RESULTS: The VEGF mRNA expression in the bladder tumor tissues was significantly higher than in the normal bladder mucosae of the controls and the surrounding normal bladder mucosae. The VEGF expression was significantly higher in the grade III than the grade I bladder tumors. There was no significant difference in VEGF expression with regard to the tumor stage. CONCLUSIONS: These data suggest that angiogenesis, mediated by VEGF, may be involved in the neoplastic growth of bladder tumors and the tumor's aggressiveness.
Angiogenesis Inducing Agents ; Carcinoma, Transitional Cell* ; Humans* ; Mucous Membrane ; Polymerase Chain Reaction ; RNA, Messenger ; Urinary Bladder ; Urinary Bladder Neoplasms ; Vascular Endothelial Growth Factor A*

PURPOSE: Forkhead transcription factor FKHR (FOXO1) is one member of the Forkhead transcription factor family, and it is thought to regulate the glucose metabolism in human and to be related to both cell cycle progression and cell apoptosis. Herein, we investigated the expression level of FOXO1 and its clinical implications in bladder cancer. MATERIALS AND METHODS: From June 1992 to June 2005, 145 specimens were harvested from primary bladder cancer and 102 specimens were harvested from normal-looking tissue surrounding the tumor mass; these specimens were investigated for determining the mRNA expression levels of FOXO1 with using the real-time PCR method. The expression levels of FOXO1 were compared statistically with such clinical variables as stage, grade, recurrence and progression. Survival analysis was performed using the Kaplan-Meier model. RESULTS: The expression levels of FOXO1 in the bladder cancer specimens (28.19pg/ml) were significantly higher than those of the corresponding normal bladder tissues (8.87pg/ml) that surrounded the tumor mass (p<0.001), and the expression levels of FOXO1 were significantly correlated with stage and the progression of superficial disease (p<0.05 each). Also, the expressions of FOXO1 of the patients who remained alive during the study period were higher than those of the nonsurviving patients (p<0.001). A higher expression of FOXO1 in the patients with superficial bladder tumor showed more survival benefit than a lower expression (p=0.004). But the recurrence and differentiation of bladder cancer were not correlated with the expression level of FOXO1. CONCLUSIONS: This data indicate that the expression level of FOXO1 can be recommended as a useful marker to predict disease occurrence as well as the progression and survival of patients with superficial bladder cancer.
Apoptosis ; Cell Cycle ; Glucose ; Humans* ; Metabolism ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; Recurrence ; RNA, Messenger ; Transcription Factors ; Urinary Bladder Neoplasms* ; Urinary Bladder*

We experienced a case of extensive urinary extravasation by rupture of renal pelvis in 61-year old male with no predisposing factors or any prior clues. He was managed by primary closure and followed up for 6 months without any problem.
Causality ; Humans ; Kidney Pelvis* ; Male ; Middle Aged ; Rupture ; Rupture, Spontaneous*

PURPOSE: This study was performed to evaluate whether the overexpression of p53 and Ki-67, and loss or overexpression of Rb were associated with clinical parameters of bladder tumor. MATERIALS AND METHODS: Fifty-two archival tumor specimens from transitional cell carcinoma of the urinary bladder in 42 male and 10 female patients ranging from 30 to 83 years old (mean age : 63.5 years old) were investigated for the expression of mutant p53, Rb and Ki-67 immunohistochemically. They were divided into 36 superficial and 16 invasive bladder tumors, and grade I in 10, II in 25 and III in 17. RESULTS: p53 positivity and Ki-67 LI were significantly associated with tumor stage and grade(p<0.05 in each), but not with tumor recurrence. Loss of Rb gene expression or Rb overexpression was only correlated with stage. All specimens with p53 positivity and overexpression or loss of Rb protein simultaneously expressed higher Ki-67 compared to other bladder tumors. CONCLUSIONS: p53 positivity, loss or overexpression of Rb and the level of Ki-67 LI were significantly correlated with tumor stage and grade, but not with bladder tumor recurrence. Also, correlations existed among them, especially p53 positivity was tightly connected with Ki-67 LI(r=0.778) in linear regression analysis. These results suggest that changes of p53 and Rb expression may have an important role in aggressiveness of human bladder tumor.
Aged, 80 and over ; Carcinoma, Transitional Cell ; Female ; Genes, Retinoblastoma ; Humans ; Linear Models ; Male ; Recurrence ; Retinoblastoma Protein ; Urinary Bladder Neoplasms* ; Urinary Bladder*