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.
Carcinoma, Renal Cell* ; Humans

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*

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

BACKGROUND: Matrix metalloproteinases (MMPs) are involved in the degradation of the extracellular matrix, which is an important step in tumor invasion and metastasis. A positive correlation between the expression of MMP-9 and aggressive behavior of renal cell carcinomas (RCCs) has been reported. MMP-9 expression in RCCs and adjacent normal kidney tissues were examined in this study. MATERILAS AND METHODS: Twenty-five patients pathologically diagnosed as clear cell RCCs, from specimens obtained at radical nephrectomy, between May 2003 and December 2004 were enrolled in this study. MMP-9 activity was estimated using gelatin zymography, and quantified using a laser densitometer. The results were compared with clinicopathological characteristics. RESULTS: The expression of MMP-9 was significantly elevated in the RCC compared with non-tumor kidney specimens (p<0.01). The levels of MMP-9 expression in the RCC patients with large tumors (>4 cm) or vascular invasion were significantly higher than in those without these clinical manifestations (p<0.01). There were also significant differences in the expression of MMP-9 among T stages (p<0.01). The tissue MMP-9 level was the highest in nuclear grade 4, but there was no statistical significance between the histological grades (p=0.17). CONCLUSIONS: These results suggest that enhanced MMP-9 expression contributes to carcinogenesis and tumor progression in the later stages of RCC.
Carcinogenesis ; Carcinoma, Renal Cell* ; Extracellular Matrix ; Gelatin ; Humans ; Kidney ; Matrix Metalloproteinase 9* ; Matrix Metalloproteinases ; Neoplasm Metastasis ; Nephrectomy

The subcapsular orchiectomy is far more acceptable than a total orchiectomy to patients with prostatic carcinoma. To data, however, it has not been widely used clinically, because its effectiveness in reducing serum androgen levels has remained controversial. We designed this study, to determine if a subcapsular orchiectomy might be as effective as the total orchiectomy in lowering serum testosterone levels, with a controlled rat model. The results support that the subcapsular orchiectomy is as hormonally complete as a total orchiectomy in lowering serum testosterone, and provide us with a basic guideline to be applied to clinical management for prostatic carcinoma.
Animals ; Humans ; Models, Animal ; Orchiectomy* ; Rats* ; Testosterone*

Recently, it is well established that nitric oxide synthase (NOS) produces nitric oxide (NO), which is known to act as an important neural mediator of smooth muscle relaxation in various organs. The present study was undertaken to investigate the role played by NO in relaxing bladder outlet by correlating its action with the existence, distribution and activity of NOS. The experiments consisted of nicotinamide adenine dinucleotide phosphate (NADPH) diaphorase staining for the identification of NOS containing nerve fibers, NADPH diaphorase activity with spectrophotometric assay for NOS catalytic activity, Western blot analysis with polyclonal antibrain NOS antibody for the expression of neuronal NOS, and in vivo isovolumetric bladder contraction (IBC) and reflex urethral .relaxation (RUR) for the physiologic role of NO. On NADPH diaphorase histochemistry in the rat, NADPH positive staining was localized in neurons innervating the lower genitourinary tract including the urinary bladder and the proximal urethra. NADPH positive nerve fibers were mainly found in urethral area, whereas they were less common in detrusor. In assay of NADPH diaphorase activity on various organs of the rat, the NOS activity regionally predominated in the cerebellum, proximal urethra, and urinary bladder in the order of frequency, which were correlated with the RESULTS of Western blot. Subsequent investigations were focused on the physiologic role of NO in the reflex changes in bladder outlet activity during micturition in the rat. During IBC, the urethra exhibited reflex responses characterized by a decrease in RUR in conjunction with a rise in IBC. Administration of NOS inhibitor, Nw-nitro-L-arginine, reversibly decreased the magnitude and duration of RUR, and this effect was reversed by administration of L-arginine. From these RESULTS, it is suggested that the neuronal form of constitutive NOS in the bladder outlet synthesizes NO by its catalytic action, which mediates relaxation of bladder outlet during micturition.
Animals ; Arginine ; Blotting, Western ; Cerebellum ; Muscle, Smooth ; NADP ; NADPH Dehydrogenase ; Nerve Fibers ; Neurons ; Nitric Oxide Synthase ; Nitric Oxide* ; Rats* ; Reflex ; Relaxation* ; Urethra ; Urinary Bladder ; Urination