No abstract available.
Carcinoma, Renal Cell* ; Humans

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.

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*

No abstract available.
Hypertrophy*

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

Management of the small lower ureteral stone has been attempted by either transurethral manipulation or expectant therapy. To date, however, the choice of proper method has depended mostly on clinician's preference, and the effectiveness of the transurethral stone manipulation has remained controversial. Herein we evaluated the effectiveness of the transurethral stone manipulation, using with the Dormia dislodger, in 37 patients with lower ureteral stone less than 10mm in greatest diameter. The results are summarized as follows. 1. The overall success rate was 68% (25 of 37 patients); Immediate delivery of the stone was observed in 16 of 37 patients. In another 5 patients the stone was removed at the time when the indwelled ureteral catheter was taken out. In the remaining 4 patients the stone passed spontaneously within a week following the procedure. 2. Higher success rate was observed in smaller stone; 79% in less than 4 mm, 58% in 46 mm, and 33% in 610 mm in it's greatest diameter, respectively. 3. The morbidity rate was 8.1% (3 of 37 patients); In one patient a broken basket was retained in the ureter, which was removed at the time of ureterolithotomy. In another patient a ureteral stricture requiring periodic dilation was complicated. And in the other patient persistent hematuria was observed, which was relieved by conservative management. These results suggest that transurethral manipulation might have to be initially applied to unremittingly painful patients with small lower ureteral stone.
Constriction, Pathologic ; Hematuria ; Humans ; Methods ; Ureter* ; Urinary Catheters

Cutaneous urinary diversion with intestinal conduits after cystectomy in bladder cancer has been popular. However, because of loss of continence and storage capacity of the lower urinary tract, the situation of patients with an ileal conduit was far from satisfactory with respect to quality of life. Recently, continent urinary diversion has begun to achieve worldwide popularity as Kock, Mainz, or Indiana pouch techniques have been more feasible and accessible, but these techniques have been known as time consuming procedures. In high risk patients with bladder carcinoma more simple techniques of urinary diversion is needed. Herein, we report the outcome of ureteroappendicocutaneostomy (appendix conduit) with radical cystectomy performed in 4 bladder carcinoma patients in whom unilateral nephroureterectomy was necessary or previously done.
Cystectomy ; Humans ; Indiana ; Quality of Life ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Diversion ; Urinary Tract

PURPOSE: It has been suggested in our previous study that the serum level of xanthine oxidise(XO) activity, glutathione(GSH), malonyldialdehyde(MDA) could be used as marker of oxidant stress in association with renal ischemia/reperfusion(I/R) injury. The present study was undertaken to establish the early marker of renal 1/R injury and to investigate the effect of deferoxamine on renal 1/R injury. MATERIALS AND METHOD: In Sprague-Dawley rats(male, 200-250gm, n=60), bilateral renal arteries were clamped for 60mins after pretreatment with deferoxamine(group A) or saline(group B). After 30min of bilateral renal recirculation, left nephrectomy and blood sampling in inferior vena cava were performed for in-vitro spectrophotometric study. Control animals(group C) did not undergo I/R operation. In-vivo renal function studies were performed in both group A and B with measurement of creatinine clearance rate(Ccr) at 7th day of experiments a%or renal ischmia for 60min. RESULTS: The levels of XO activity and XO type conversion ratio in renal tissue (RT) and serum(5) were measured. These levels were significantly high in group B, but were lower in group A compared to those of control group. The values of GSH(micrometer/g tissue), a scavenger of OFR, were decreased in group A (RT:0.183+/-0.019,5:0.201+/-0.029) and greatly decreased in group B(RT:0.159+/-0.009,5:0.164+/-0.022) compared to control group(RT:0.201+/-0.006,5:0.224+/-0.031). The values of MDA(nM/g tissue), a stable end product of lipid peroxidation, were increased in group A(RT:0.149+/-0.003, 5:0.058+/-0.004) compared to control group(RT:0.128+/-0.013, 5;0.055+/-0.005), but the values were significantly lower in group A compared to group B(RT:0.171+/-0.005, 5:0.070+/-0.003). Subsequent investigation was focused on the established renal function study after 1/R, which was determined using Ccr(ml/min). The Ccr in group A(2.06+/-0.03) was significantly higher compared to that of group 8(1.48+/-0.18), although it was slightly lower than in control group(2.18+/-0.05). CONCLUSIONS: From these results, it is suggested that renal I/R injury is highly correlated with the production of OFR. The levels of GSH and MDA in renal tissue and serum seem to be probable markers of oxidant stress in association with renal I/R injury. Furthermore, deferoxamine could reduce the degree of renal damage resulting from ameliorating the production of OFR following renal I/R injury.
Animals ; Creatinine ; Deferoxamine* ; Lipid Peroxidation ; Nephrectomy ; Rats* ; Rats, Sprague-Dawley ; Renal Artery ; Vena Cava, Inferior ; Xanthine

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