PURPOSE: Our study was designed to compare the incidence of urological complications for patients with spinal cord injury in relation to their voiding method, and then we wished to suggest a proper voiding method. MATERIALS AND METHODS: Based on their medical records, questionnaires and upper tract imaging, a total of 301 male spinal cord injury patients were retrospectively analyzed for the outcomes of their voiding method. Our study was performed on 50 patients with urethral Foley catheterization, 106 patients with clean intermittent catheterization, 67 patients with suprapubic catheterization, 51 patients within self voiding and 27 patients with condom catheters. Urological complications such as urinary infection, stone disease, urethral complications, vesicoureteral reflux, radiographic upper tract abnormality and bladder tumor were recorded for each patient. RESULTS: Of the 262 complications that were recorded, 89 developed in 24 (48.0%) patients having urethral Foley catheterization, 41 in 23 (21.7%) patients having clean interemittent catheterization, 72 in 26 (38.8%) patients having suprapubic catheterization. 36 in 15 (39.4%) patients with self voiding and 24 in 9 (33.3%) patients having condom catheters. The urethral Foley catheterization group had the highest complication rates relative to all other voiding methods, and the clean intermittent catheterization group had significantly lower complication rates except for having the highest rate of urethral stricture. CONCLUSIONS: Our study shows that clean intermittent catheterization for spinal cord injury patients significantly reduces the incidence of urological complications and it may be the optimal voiding method.
Catheterization ; Catheters ; Condoms ; Humans ; Incidence ; Intermittent Urethral Catheterization ; Male ; Medical Records ; Surveys and Questionnaires ; Retrospective Studies ; Spinal Cord Injuries* ; Spinal Cord* ; Urethral Diseases ; Urethral Stricture ; Urinary Bladder Neoplasms ; Urinary Catheterization ; Vesico-Ureteral Reflux

PURPOSE: Our study was designed to compare the incidence of urological complications for patients with spinal cord injury in relation to their voiding method, and then we wished to suggest a proper voiding method. MATERIALS AND METHODS: Based on their medical records, questionnaires and upper tract imaging, a total of 301 male spinal cord injury patients were retrospectively analyzed for the outcomes of their voiding method. Our study was performed on 50 patients with urethral Foley catheterization, 106 patients with clean intermittent catheterization, 67 patients with suprapubic catheterization, 51 patients within self voiding and 27 patients with condom catheters. Urological complications such as urinary infection, stone disease, urethral complications, vesicoureteral reflux, radiographic upper tract abnormality and bladder tumor were recorded for each patient. RESULTS: Of the 262 complications that were recorded, 89 developed in 24 (48.0%) patients having urethral Foley catheterization, 41 in 23 (21.7%) patients having clean interemittent catheterization, 72 in 26 (38.8%) patients having suprapubic catheterization. 36 in 15 (39.4%) patients with self voiding and 24 in 9 (33.3%) patients having condom catheters. The urethral Foley catheterization group had the highest complication rates relative to all other voiding methods, and the clean intermittent catheterization group had significantly lower complication rates except for having the highest rate of urethral stricture. CONCLUSIONS: Our study shows that clean intermittent catheterization for spinal cord injury patients significantly reduces the incidence of urological complications and it may be the optimal voiding method.
Catheterization ; Catheters ; Condoms ; Humans ; Incidence ; Intermittent Urethral Catheterization ; Male ; Medical Records ; Surveys and Questionnaires ; Retrospective Studies ; Spinal Cord Injuries* ; Spinal Cord* ; Urethral Diseases ; Urethral Stricture ; Urinary Bladder Neoplasms ; Urinary Catheterization ; Vesico-Ureteral Reflux

The records of 37 patients with penile cancer during the past 17 years were reviewed. 1. About 80% of patients delayed for more than 3 months to seek medical advice following initial symptoms. 2. Most common complaint was penile mass (81.1%). 3. All 37 patients were not circumcised during neonatal period. 4. Thirty five of 37 cages were squamous cell carcinoma. 5. Clinical stages were distributed as follows: 9 cases in stage I, 8 cases in stage II, 16 cases in stage III, and 4 cases in stage IV. 6. Nineteen patients (51.4%) had inguinal lymphadenopathy initially. Exploration was carried out in 14 cases and metastatic cancers were found in 8 cases (57.1%) Sentinel lymph node biopsy was done in 6 cases of non-palpable inguinal lymph node and metastatic cancer was found in 1 case. 7. Partical penectomy was performed in 33 cases, and total penectomy was done in 1 case. Two major complications were infection (29.4%) and urethral stricture (14.7%). 8. Bleomycin was administered to 17 patients after operation or biopsy. 9. Sixteen of 37 patients were followed for more than 2 years, revealing 2 year survival 83.3% in stage I, 60% in stage II. 33.3% in stage III and 0% in stage IV.
Biopsy ; Bleomycin ; Carcinoma, Squamous Cell ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Male ; Penile Neoplasms* ; Sentinel Lymph Node Biopsy ; Urethral Stricture

The increased occurrence of genitourinary tract anomalies in infants with imperforate anus is well documented. A retrospective analysis was made on 130 children with imperforate anus over the last 10 years. A 21%(27cases) incidence of associated genitourinary anomalies was found in this series. Patients with high and intermediate imperforate anus demonstrated a 30%(19/61) incidence of genitourinary anomalies. In contrast, patients with low imperforate anus revealed 12% (8/66) incidence of genitourinary anomalies. The spectrum of these anomalies were hydronephrosis. bilateral renal agenesis, bilateral polycystic kidney, bilateral VUR, unilateral renal hypoplasia, posterior urethral stricture, renal stone, cryptorchidism, hypospadias and epispadias in descending frequency of order. Hydronephrosis( 13/27, 48%) was the most frequently encountered anomaly. Patients with high imperforate anus seems to be prone to have more severe urinary anomalies. Fistulae between the rectum and urinary tract were found in 33 patients with high and intermediate type imperforate anus( rectourethral fistula; 27 cases, rectovesical fistula, 3 cases, rectocloacal fistula, 3 cases). During the posterior sagittal anorectoplasty, fistula was corrected simultaneously. In conclusion, early urological screening should be done for the early diagnosis and treatment of associated genitourinary anomalies in all children with imperforate anus.
Anus, Imperforate* ; Child ; Cryptorchidism ; Early Diagnosis ; Epispadias ; Female ; Fistula ; Humans ; Hydronephrosis ; Hypospadias ; Incidence ; Infant ; Male ; Mass Screening ; Polycystic Kidney Diseases ; Rectum ; Retrospective Studies ; Urethral Stricture ; Urinary Tract

The effectiveness of Sulfobenzylpenicillin in the treatment of urinary tract infection was evaluated in the Department of Urology, Seoul National University Hospital during the period from May to November, 1973. Our clinical study was performed on the 28 patients who visited the outpatients clinic and admitted to the ward. These patients were studied by bacterioscopy with Gram's method of staining. and culture in blood agar plate and chocolate agar plate In this studies. the causative organisms were divided into 8 groups; E. coli (5), coagulase positive staphylococcus (5), pseudomonas (2), Corynebacterium spp. (1), a-hemolytic etreptococcus (2), N. Gonorrheae (10), Proteus (2) and KIebsiella (1). The dosage schedule was 1 gm. of Sulfobenzylpenicillin at intervals of 12 hours for consecutive 5 days in gonococcal urethritis and nongonococcal urethritis. But in upper urinary tract infections and post-operative infections, it lasted for 7 to 10 days or more. And following results were obtained. Effectiveness on Urological diseases 1) Gonococcal urethritis; Satisfactory clinical results were obtained with Sulfobenzylpenicillin for five days. Results were excellent in 5 cases, good in 4 cases and negative effect in 1 case. 2) Non-gonococcal urethritis; In this group, the therapeutic results were favorable in 90% of all cases. (excellent-4, good-5, fail-l) 3) Urethral stricture and fistula (2 cases); AII cases were responded to the Sulbenicillin. 4) Cystitis including Prostatism; Two of three cases were caused by E. coli and they had a good response to sulbenicillin. 5) Two cases of pyelonephritis and two cases of postoperative infections were studied with sulbenicillin and more than 60% of cases were effective with sulbenicillin. Side effects were not remarkable but in a few cases who received intramuscular injection, pain on the injection site was noticed.In summary, this new semi-synthetic penicillin is considered to be a useful chemotherapeutic weapon against a variety of infection in the urological field including those due to Gram negative bacilli such as pseudomonas and proteus sp.
Agar ; Appointments and Schedules ; Cacao ; Coagulase ; Corynebacterium ; Cystitis ; Fistula ; Gonorrhea ; Humans ; Injections, Intramuscular ; Outpatients ; Penicillins ; Prostatism ; Proteus ; Pseudomonas ; Pyelonephritis ; Seoul ; Staphylococcus ; Sulbenicillin ; Urethral Stricture ; Urethritis ; Urinary Tract Infections* ; Urinary Tract* ; Urologic Diseases ; Urology

PURPOSE: The pathophysiological role of detrusor overactivity (DO) in the bladder, which is commonly observed in various bladder diseases, is not well understood. DO appears in bladder outlet obstruction (BOO), and may continue even after subsequent deobstruction. DO therefore provides an excellent opportunity to observe molecular biological changes. METHODS: In this study, to understand the molecular effects of persistent DO after BOO induction and deobstruction, we performed awake cystometry on female Sprague-Dawley rats divided into 4 groups: a sham group, a BOO group, a deobstructed group with DO after BOO (DDO), and a deobstructed group without DO after BOO (non-DDO). Total RNA was extracted from the bladder samples, and gene expression profiles were compared between the sham and model groups. RESULTS: DO was observed in 5 of the 6 rats (83%) in the BOO group, and in 6 of the 13 rats (46%) in the deobstructed group. The non-DDO group showed a significantly greater residual volume than the DDO group. Through a clustering analysis of gene expression profiles, we identified 7,532 common upregulated and downregulated genes, the expression of which changed by more than 2 fold. In the BOO group, 898 upregulated and 2,911 downregulated genes were identified. The non-DDO group showed 3,472 upregulated and 4,025 downregulated genes, whereas in the DDO group, only 145 and 72 genes were upregulated and downregulated, respectively. CONCLUSIONS: Abnormal function and gene expression profiles in bladders after BOO were normalized in the BOO rats with DO after deobstruction, whereas in those without DO, abnormal function persisted and the gene expression profile became more abnormal. DO may play a protective role against the stress to the bladder induced by BOO and deobstruction as a form of adaptive neuroplasticity.
Animals ; DNA ; Female ; Gene Expression Profiling ; Gene Expression* ; Humans ; Microarray Analysis ; Neuronal Plasticity ; Rats* ; Rats, Sprague-Dawley ; Residual Volume ; RNA ; Transcriptome* ; Urethral Obstruction ; Urinary Bladder Diseases ; Urinary Bladder Neck Obstruction* ; Urinary Bladder* ; Urinary Bladder, Overactive

We have experienced the female urethral syndrome in many patients, but we are embarrassed in identifying the exact cause of each case and searching for the treatment modalities. Until now there have been many explanations on the causes of the female urethral syndrome without effective treatment methods. I thought there was a possibility of lower urinary tract dysfunction as an evoking factor of this syndrome and so we conducted this study with urodynamic examination on the cause of female urethral syndrome. We took urodynamic studies in female urethral syndrome at Yonsei University Hospital tom April 1984 till March, 1985 and have come to the conclusion as follows; 1: Among the 49 patients of female urethral syndrome, normal urodynamic findings was revealed in 13 cases (26.5%). 2. There were single abnormal finding in 22 cases (44.9%) which were composed of 10 cases (20.4%) of hypersensitive bladder findings, 1 case (2%) of unstable detrusor, 9 cases (18.3%) of high maximum urethral closure pressure and 2 cases (4%) of detrusor-sphincter dyssynergia. 3. The combined abnormal findings were noticed in 14 cases (28.6%), 12 cases (24.4%) of combined hypersensitive bladder and high maximum urethral closure pressure and 2 cases (4%) of combined hypersensitive bladder and detrusor-sphincter dyssynergia. 4. Hypersensitive bladder finding, which was main abnormal one was found in 24 cases (49.9%),while high maximum urethral closure pressure in 21 cases (42.9%) among 49 patients of female urethral syndrome. The urodynamic abnormalities must be considered as the causes of female urethral syndrome when we cannot find the exact cause of such as infection, gynecologic disease, urethral stricture and so. And I consider the further studies of treatment in female urethral syndrome are needed.
Ataxia ; Female* ; Genital Diseases, Female ; Humans ; Urethral Stricture ; Urinary Bladder ; Urinary Tract ; Urodynamics*

The use of artificial urinary sphincter (AUS) for the treatment of stress urinary incontinence has become more prevalent, especially in the "prostate-specific antigen (PSA)-era", when more patients are treated for localized prostate cancer. The first widely accepted device was the AMS 800, but since then, other devices have also entered the market. While efficacy has increased with improvements in technology and technique, and patient satisfaction is high, AUS implantation still has inherent risks and complications of any implant surgery, in addition to the unique challenges of urethral complications that may be associated with the cuff. Furthermore, the unique nature of the AUS, with a control pump, reservoir, balloon cuff, and connecting tubing, means that mechanical complications can also arise from these individual parts. This article aims to present and summarize the current literature on the management of complications of AUS, especially urethral atrophy. We conducted a literature search on PubMed from January 1990 to December 2018 on AUS complications and their management. We review the various potential complications and their management. AUS complications are either mechanical or nonmechanical complications. Mechanical complications usually involve malfunction of the AUS. Nonmechanical complications include infection, urethral atrophy, cuff erosion, and stricture. Challenges exist especially in the management of urethral atrophy, with both tandem implants, transcorporal cuffs, and cuff downsizing all postulated as potential remedies. Although complications from AUS implants are not common, knowledge of the management of these issues are crucial to ensure care for patients with these implants. Further studies are needed to further evaluate these techniques.
Atrophy ; Humans ; Postoperative Complications/therapy* ; Prosthesis Failure ; Prosthesis Implantation ; Prosthesis-Related Infections/therapy* ; Urethra/pathology* ; Urethral Diseases/therapy* ; Urethral Stricture/surgery* ; Urinary Incontinence, Stress/surgery* ; Urinary Sphincter, Artificial

PURPOSE: To evaluate the efficacy and safety of the Holmium: yttrium-aluminium-garnet (YAG) laser for the treatment of urethral/bladder neck strictures after high-intensity focused ultrasound for prostate cancer. METHODS: Between February 2007 and July 2010, Holmium: YAG laser urethrotomies were performed in eleven patients for bladder neck strictures or prostatic urethral strictures. The laser was used with a 550-microm fiber at 2 J and frequency 30 to 50 Hz. The medical records were retrospectively reviewed for medical history, perioperative and postoperative data, uroflowmetry, International Prostate Symptoms Score/quality of life, and stricture recurrence. RESULTS: At a median follow-up of 12.0 months (range, 4 to 35 months), the mean postoperative maximal flow rate and residual volume were improved significantly (P<0.05). The mean postoperative total, voiding and quality of life of international prostate symptom score were improved significantly (P<0.05). Of the 11 patients, 7 patients required one treatment, 4 patients two treatment, and 1 patients three treatment. 2 patients who had a documented urinary incontinence prior to the laser treatment subsequently required artificial urinary sphincter implantation and reported satisfaction without developing any recurrent strictures or artificial urinary sphincter erosion. All patients exhibited well-healed strictures and could void without difficulty. CONCLUSIONS: Holmium: YAG laser therapy represents a safe, effective and minimally invasive treatment for urethral/bladder neck strictures occurring secondary to high-intensity focused ultrasound for prostate cancer.
Constriction, Pathologic ; Follow-Up Studies ; Holmium ; Humans ; Lasers, Solid-State ; Medical Records ; Neck ; Prostate ; Prostatic Neoplasms ; Quality of Life ; Residual Volume ; Retrospective Studies ; Ultrasound, High-Intensity Focused, Transrectal ; Urethral Stricture ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Incontinence ; Urinary Sphincter, Artificial

Male genital lichen sclerosus (MGLSc) is a chronically relapsing disease characterized by a long course, gradual aggravation, and a tendency towards malignancy. Once called balanitis xerotica obliterans, MGLSc has a distinct predilection for the prepuce and glans, involving the urethra when aggravating, forming scarring tissues, and causing urethral stricture, which may seriously affect the patients'quality of life with such symptoms as urinary stream narrowing, dysuria, and painful penile erection. The etiology and pathogenesis of MGLSc have not yet been adequately explained though it is generally thought to be associated with autoimmune mechanism, genetic factors, infections, local trauma, and chronic urinary irritation. MGLSc can be fairly easily diagnosed according to its clinical manifestations and histopathological results, but can be hardly cured. Early diagnosis and prompt treatment are the most important approaches, which may relieve its symptoms, check its progression, and prevent its long-term sequelae. Ultrapotent topical corticosteroids are the choice for the treatment of MGLSc. For those who fail to respond to expectant medication or have dysuria due to urethral stricture and painful erection, rational surgery may be resorted to, with importance attached to long-term follow-up. This article presents an update of the diagnosis and treatment of MGLSc and MGLSc-induced urethral stricture.
Genital Diseases, Male ; diagnosis ; etiology ; therapy ; Humans ; Lichen Sclerosus et Atrophicus ; complications ; diagnosis ; therapy ; Male ; Urethral Stricture ; etiology