55 consecutive anatrophic nephrolithotomies on 53 patients performed between July, 1983 and June, 1990 were reviewed. The patients (36 male and 19 female) ranged in age from 3 to 72 years. The operation time averaged 219.8 minutes with a range of 120-330 minutes, and the ischemic time ranged between 20 and 90 minutes, with a mean of 43.5 minutes. Postoperative complications developed in 18 patients, which were such as persistent urinary tract infection in 5cases (9.4%), atelectasis in 4 (7.5%), transient urine leak in 2 (3.8%), delayed bleeding in 2 (3.8%) and urinary retention in 2 (3.8%). Postoperative residual stones were identified in 15 (27.3%), but in 8 of these 15patients stones were delivered spontaneously and thus 48 of 55 cases (87.3%) became stone free. The recurrence of stone was noted in 2 out of 48 patients during the short follow up period. Anatrophic nephrolithotomy seems to be an effective method compared to other procedure because of decreasing recurrence of stone by complete stone removal and reconstruction of abnormal collecting system.
Follow-Up Studies ; Hemorrhage ; Humans ; Male ; Methods ; Postoperative Complications ; Pulmonary Atelectasis ; Recurrence ; Urinary Retention ; Urinary Tract Infections

No abstract available.

No abstract available.
Carcinoma, Renal Cell* ; Humans

Vasectomy has become a popular method for male sterilization in Korea and this, in turn, has been followed by an increase in the number of patients requesting vasectomy reversal. Recently, many authors have reported a high success rate of vasovasostomy using microsurgical techniques. However, a significant discrepancy persist between the patency and pregnancy rate despite improvements in surgical techniques. A total of 200 patients undergoing vasovasostomy from May 1983 to April 1990 were reviewed. Of these 200 patients, only 130 patients (98 patients by two-layer, 32 patients by modified two-layer technique) could be followed up and analyzed as to pregnancy rate related to age, vasal obstructive interval, gross appearance and sperm quality of the vas fluid, operative method, and presence or absence of sperm granuloma. Success rates were 90.3% for patency and 65.4% for pregnancy. With regard to factors influencing to operation, it seemed that the results were better when there was a shorter vasal obstructive interval, watery vas fluid, presence of normal morphologic sperm quality, presence of sperm granuloma, and when the operation was done using the two-layer technique. However, no statistically significant difference was found, except between the bilateral presence and absence of sperm granuloma at the vasectomy site. Thus it is suggested that the most important single factor influencing the success rate of vasovasostomy is a meticulous and skillful operative technique itself, althought other factors may affect the outcome. More effort and research are needed to find the factors affecting the success rate of vasovasostomy.
Granuloma ; Humans ; Infertility* ; Korea ; Pregnancy Rate ; Pregnancy* ; Spermatozoa ; Sterilization, Reproductive ; Vasectomy ; Vasovasostomy*

Male urethral diverticulum is uncommon lesion, furthermore calculus formation within the male urethral diverticulum is very rare. Generally, urethral diverticula are classified as congenital and acquired. The majority of male urethral diverticula are acquired and approximately 10 to 20 per cent are congenital. Acquired urethral diverticula in the male may arise from many sources, including infection (prostatic abscess, infection of periurethral glands, hematoma or schistosomiasis), obstruction (stricture, impacted stone, Cunningham clamp or condom catheter) and trauma (instrumentation, external injury and pelvic fracture). Calculi formation is more common in the acquired diverticulum owing to stagnation of urine and infection. These calculi in the diverticulum usually are solitary and may attain considerable size with predisposing factors, 1) a ureteral or bladder calculus that is lodged in the urethra 2) urethral trauma or stricture, 3) calcification around a foreign body or hair. The treatment of urethral diverticulum combined with stone is excision of the diverticula with removal of stone. We treated two cases of urethral diverticulum combined with stone in the male, and report with review of literature.
Abscess ; Calculi ; Causality ; Condoms ; Constriction, Pathologic ; Diverticulum* ; Foreign Bodies ; Hair ; Hematoma ; Humans ; Male* ; Ureter ; Urethra ; Urinary Bladder Calculi

No abstract available.
Hypertrophy*

Nitric oxide(NO) is known to act as an important neural mediator of penile erection. Nitric oxide synthase(NOS), which produces NO, has been recently identified in autonomic neurons supplying genitourinary organs including penis. The present study was undertaken to investigate the role played by NO in erectile physiology by correlating its action with the existence and activity of NOS. Initial experiments were performed to elucidate NOS expression in the human and rat penis. Western blotting analysis identified a protein of 155KDa molecular weight identical to neural form of NOS. The NOS blot density in the human and rat penis was similar each other, which was lower than that in the cerebellum. Additional studies of NOS using assay of NADPH diaphorase activity and nitrite measurement were performed in various organs of the rat. NOS activity regionally predominated in the cerebellum, urethra, penis, and urinary bladder in the order Subsequent investigations focused on the physiologic role of NO, which was determined using an in vivo electroerection model in the rat. ntracavernous injections of NOS inhibitor (L-NOARG or L-NAME from 0.000001M to 0.001M) were found to suppress the nerve-induced erection in concentration dependent manner. Subsequent intracavernous injection of L-arginine(0.01M) partially restored penile erection suppressed by L-NOARG or L-NAME(0.001M). These results indicate that the neural form of constitutive NOS in the corpora cavernosa of the penis synthesizes NO by its catalytic action, which mediates penile erection. Furthermore, determination of cavernosal NOS expression and/or activity may allow to characterize certain pathological conditions which cause neurogenic impotence.
Animals ; Blotting, Western ; Cerebellum ; Erectile Dysfunction ; Humans ; Male ; Molecular Weight ; NADPH Dehydrogenase ; Neurons ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase* ; Nitric Oxide* ; Penile Erection* ; Penis ; Physiology ; Rats ; Urethra ; Urinary Bladder

Nocturnal penile tumescence has been proposed as a source of objective data in the evaluation of erectile capacity and clinically important in differentiating between psychogenic and organic impotence. However, the absence of sleep information and difficult differentiation of movement artifact leads to false positive or false negative reaction when portable home monitor is used. This can be overcome by polysomnographic monitoring. In addition, sleep disorders affecting nocturnal penile tumescence also could be screened. Herein, we conducted a study to investigate the significance of polysomnographic nocturnal penile tumescence monitoring in 45 men with erectile dysfunction. The nocturnal penile tumescence data from polysomnographic method were compared with those from portable method, based on the results from standard method. The results obtained were summarized 1. Polysomnographic method showed higher sensitivity(82%), lower false positive(20%) and false negative rate(16%) than portable method (71%, 30%, 28%, respectively) in the differential diagnosis of impotence. 2. Among 10 patients, with measuring of air flow monitoring and anterior tibialis EMG one patient had periodic leg movement. 3. Statistically, parameters of total REM time, total tumescence time/total sleep time, number of maximum tumescence episodes, amount of maximum tumescence episodes, T-up and T-max phase in maximum tumescence episodes, circumferential changes in maximum tumescence episodes, and rigidity in maximum tumescence episodes were found to be significantly decreased in organic impotence group. These results reflect that polysomnographic NPTM provides more validity than portable NPTM on the outcome of the differential diagnosis of impotence, and it would contribute to screening of occult sleep disorders and to study for their characteristics in association with impotence.
Artifacts ; Diagnosis* ; Diagnosis, Differential ; Erectile Dysfunction* ; False Negative Reactions ; Humans ; Leg ; Male ; Mass Screening ; Penile Erection* ; Sleep Wake Disorders

Vasectomy has become a popular method for family planning in Korea and this has been followed by an increase in the number of patients requesting vasectomy reversal. Recently, microsurgical 2-layer vasovasostomy has been in vogue throughout the world. From May 1983 to December 1986, 56 men underwent bilateral microscopic 2-layer vasovasostomy at the Department of Urology, Yeungnam University Hospital. of those patients for whom follow-up information was available, 88.9% revealed normal sperm densities in ejaculates and 62.9% of their partners have conceived. Besides the microsurgical technique of operator, interval between vasectomy and its reversal, presence or absence of sperm in vas fluid, and of sperm granuloma at the time of vasovasostomy were important factors in determining the outcome of vasectomy reversal.
Family Planning Services ; Follow-Up Studies ; Granuloma ; Humans ; Infertility ; Korea ; Male ; Spermatozoa ; Urology ; Vasectomy ; Vasovasostomy*

Ureteroscopic removal of the stone is now popular for the management of the lower ureteral stone. A clinical study was performed on our 75 patients with lower ureteral stone treated with ureteroscopy. Of the 75 stone manipulations 62 (83%) were immediately successful and the final success rate including spontaneous delivery of stone or fragment after the procedure was 87 percents (65 cases). Of 57 smaller calculi than 1 cm (radiographic largest diameter) 50 (88%) were removed successfully. Mean duration of postoperative hospitalization was 5.6 days. There were no interrelations between the success rate and anesthetic methods. Significant complications during or after procedure were not identified. We conclude that ureteroscopic removal of stones under direct vision can be done safely and be the first choice of procedure for the lower ureteral stones.
Calculi ; Clinical Study ; Hospitalization ; Humans ; Ureter* ; Ureteroscopy