Recently prostatic carcinoma has been considered as an important disease in urologic field, because its occurrence rate is increasing year by year. A clinical study was made on the 30 patients of prostatic carcinoma. The results were as follows: 1. The incidence was 11.4% of all male patients who had G-U tract tumors. The patients age ranged from 52 to 87 years (mean age 69.9 years). 2. The major symptoms were prostatism (70.0%), acute retention, hematuria and pain. 3. On the transrectal palpation of prostate, 23 patients (76.7%) had hard nodules. 4. The clinical stage were stage A 3,B 4, C 1 and : D22; and the grade I 4, II 16 and III 18, respectively. 5. Among 15 patients of bone metastasis, 6 patients (40.0%) had no pain, 6 patients (40.0%) had normal acid phosphatase level and 5 patients (33.3%) had normal alkaline phosphatase level. No one had bone pain, elevated acid or alkaline phosphatase level in 5 patients who had no bone metastatic lesion. 6. The site of metastasis in stage D patients (22 cases) was bone 14, lymph node 9, lung 2 and testicle 1 case. 7. For the relief of infravesical obstruction (17 cases), open prostatectomy, TURP and suprapubic cystostomy were performed in 3, 8 and 6 cases, respectively. For the treatment of stage D patients (22 cases), orchiectomy only, DES, DES +orchiectomy and irradiation were performed in 1, 5, 15 and 5 cases, respectively. 8. Among the 18 patients who could be followed, 11 patients had survived more than 3 years. Four patients were proved to be dead. The causes of death were metastasis, myocardiac infarction and common bile duct cancer.
Acid Phosphatase ; Alkaline Phosphatase ; Cause of Death ; Common Bile Duct ; Cystostomy ; Hematuria ; Humans ; Incidence ; Infarction ; Lung ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Orchiectomy ; Palpation ; Prostate ; Prostatectomy ; Prostatism ; Testis ; Transurethral Resection of Prostate

Eighteen patients with ureterovaginal fistula were managed at Seoul National University Hospital during the recent 8 years. The operations which led to the formation of the fistula were for cervical cancer in 10 and for the benign pelvic disease in 8. All patients experienced sudden increase of drain amount or incontinence during the postoperative period. Diagnosis was established readily by IVP, cystoscopy and RGP. Six patients were managed primarily by percutaneous nephrostomy, 4 of whom received corrective surgery 6 months later. Four patients received corrective surgery primarily. Two patients were under surve-illence only and 6 patients received nephrectomy. Current trend of management of ureteral injury was discussed.
Cystoscopy ; Diagnosis ; Fistula* ; Humans ; Nephrectomy ; Nephrostomy, Percutaneous ; Postoperative Period ; Seoul ; Ureter ; Uterine Cervical Neoplasms

Of the 443 patients who underwent percutaneous renal surgery at our hospital, 24 patients(5.4% ) required open surgery. We evaluated the causes of open surgery and their operative methods in those patients. The most common cause of open surgery was inadequate puncture(10 patients)into the posterior calyx. The remainders were severe bleeding(5 patients), difficulties in fragmentation (4 patients), embedded stones( 3 patients), downward migration of stone(1 patient) and poor renal function(1 patient). Their operative methods were pyelolithotomy(9 patients),ureterolithotomy(9 patients), nephrolithotomy(1 patient), nephrectomy(3 patients) and partial nephrectomy(2 patients). Two patients who showed delayed bleeding underwent nephrectomy, because bleeding was continued in spite of conservative management or selective angioinfarction. We believe that problems and complications may occur at any point in the percutaneous renal surgery and as with other open surgery, knowledge of what complications may occur and which method is the best way to solve them will assist in their prevention and awareness of how to manage suck complicatioins will minimize their impact.
Hemorrhage ; Humans ; Nephrectomy ; Nephrostomy, Percutaneous

Objectives: to investigate the effectiveness and reliability of the combination of optical cystolithotripsy (OC) and transurethral prostatectomy (TURP) for the treatment of bladder calculi and obstructive benign prostates enlargement (BPE). Patients and methods: from September 1999 to December 2003, 63 patients who had bladder stones and BPE were treated with combined OC and TURP; 45 patients who had bladder stones with no infravesical obstruction were treated with OC alone. In the same period, the records of random selection of 561 patients with BPE were treated by TURP. The operative duration time, the length of hospital stay, the duration of urethral catheterization, outcome and complication of the procedures for each patient were reviewed. Results: The mean duration of surgery were significantly longer with combined OC and TURP than with OC or TURP alone (p<0.05), but not of hospital stay and urethral catheterization. Stones free rates were 100% after OC alone and combined OC and TURP. The postoperative average mean peak flow rates were 13.2 ml/s in the combined OC and TURP group and were 13.7 in the TURP alone group. The complication rates were 13.6% for the TURP procedure, 5% for the OC alone and 21% for the combined OC and TURP (p<0.05). Conclusion: Simultaneous treatment with OC and TURP did not change the effectiveness of these procedures, but caused additional morbidity.
Prostatectomy ; Transurethral Resection of Prostate

The causes of urethrorectal fistula are multiple such as trauma, open prostatectomy, radiation therapy, infection and congenital anomaly and so forth. In considering the injured area, length and the condition or periurethral tissue, numerous approaches have been advocated for the treatment of the traumatic urethrorectal fistula. Herein we report the experience of successful transsacral repair of traumatic urethrorectal fistula in a 14 year-old male patient 3 months after cystostomy and colostomy installed.
Adolescent ; Colostomy ; Cystostomy ; Fistula* ; Humans ; Male ; Prostatectomy

OBJECTIVE: To evaluate the role of adjuvant surgical procedures in the management of gestational trophoblastic neoplasia (GTN). METHODS: In a retrospective review of medical records at the Severance Hospital, we identified 174 patients diagnosed with GTN between 1986 and 2006. Of the 174 patients, 129 (74%) were assigned to the nonmetastatic group, and 45 (26%) to the metastatic group; of the metastatic group patients, 6 were in the low-risk group and 39 were in the high-risk group. Thirty-two patients underwent 35 surgical procedures as part of the GTN treatment. The procedures included hysterectomy, lung resection, craniotomy, uterine wedge resection, uterine suturing for bleeding, salpingo-oophorectomy, pretherapy dilatation and curettage, adrenalectomy, nephrectomy, and uterine artery embolization. RESULTS: Of the 32 patients who underwent surgical procedures, 28 (87%) survived. Eleven patients underwent surgery for chemoresistant disease after receiving one or more chemotherapy regimens. Twelve patients underwent procedures to control tumor hemorrhage. Nine (81%) of 11 patients with chemoresistant disease survived, and 8 patients who underwent salvage surgery for chemoresistant disease received further chemotherapy. Of 21 patients who underwent hysterectomy, 19 (90%) achieved remission. All of three patients who had resistant foci of choriocarcinoma in the lung achieved remission through pulmonary resection. CONCLUSION: Adjuvant surgical procedures, especially hysterectomy and pulmonary resection for chemoresistant disease, as well as procedures to control hemorrhage, are pivotal in the management of GTN.
Adrenalectomy ; Choriocarcinoma ; Craniotomy ; Dilatation and Curettage ; Drug Therapy ; Female ; Gestational Trophoblastic Disease* ; Hemorrhage ; Humans ; Hysterectomy ; Lung ; Medical Records ; Nephrectomy ; Pregnancy ; Retrospective Studies ; Uterine Artery Embolization

A clinical observation was made on 178 cases of benign prostatic hyperplasia, admitted to the Department of Urology, Chonnam University Medical School during the period of January 1979 to December 1983. 1. There was no remarkable increasing tendency of annual distribution from 26 patients in 1979 to 38patients in 1983. 2. Major of the patients were in the 6th and 7th decades (81.4%) with average age of 70.5years. 3. One hundred patients(56.2%) suffered from acute urinary retention prior to admission 4. Amount of residual urine ranged from 80 to 1,200 with average of 404,6 ml. 5. Pyuria was revealed in 60 cases(33.7 %), hematuria in 116(65.2%) and azotemia in 59(33.1%). 6. Associated conditions present were respiratory disorders in 44 cases, cardiovascular in 41, urologic in 25 and miscellaneous in 14. The most common associated conditions were pulmonary tuberculosis in 22 cases and hypertension in 16 7. Patients were managed with transurethral resection (TURP) in 75 cases, suprapubic prostatectomy (SP) in 72, retropubic prostatectomy(RP) in 8, cystostomy in 8 and indwelling catheterization in 24. 8. Prostatectomy was not performed in 32 cases because of patient`s refusal (19 cases) and associated conditions (13 cases). 9. Average operating time was 96.9 minutes in SP, 113.8 minutes in RP and 64.7 minutes in TURP 1O. Average weight of prostatic tissue resected was 40.5gm in SP, 49.1 gm in RP and 3.9gm in TURP 11. Average amount of blood transfused was 500ml in SP, 800ml in RP and 72ml in TURP 12. Average postoperative catheter drainage was 12.7 days in SP,7.1 days in RP and 5days in TURP. 13. Average postoperative hospital stay was 18 days in SP, 13.8 days in RP and 11.3 days in TURP. 14. Postoperative complications of SP were delayed healing with suprapubic urine leakage and rebleeding in 2 cases respectively and wound infection in 1 case. Those of RP was acute epididymitis in 2 cases. Those of TURP were rebleeding in 9 cases, acute epididymitis in 3 cases, and inability to void with urinary retention, cerebral hematoma and urethrocutaneous fistula in 1 case respectively.
Azotemia ; Catheters ; Catheters, Indwelling ; Cystostomy ; Disulfiram ; Drainage ; Epididymitis ; Fistula ; Hematoma ; Hematuria ; Humans ; Hypertension ; Jeollanam-do ; Length of Stay ; Male ; Postoperative Complications ; Prostatectomy ; Prostatic Hyperplasia* ; Pyuria ; Schools, Medical ; Transurethral Resection of Prostate ; Tuberculosis, Pulmonary ; Urinary Retention ; Urology ; Wound Infection

We aim to reassess the safety of the monopolar transurethral resection of the prostate (M-TURP) without suprapubic cystostomy at our institution over the past decade. This retrospective study was conducted in patients who underwent M-TURP at Peking University First Hospital between 2003 and 2013. A total of 1680 patients who had undergone M-TURP were identified, including 539 patients in the noncystostomy group and 1141 patients in the cystostomy group. After propensity score matching, the number of patients in each group was 456. Smaller reductions in hemoglobin and hematocrit (10.9 g vs 17.6 g and 3.6% vs 4.7%, respectively) were found in the noncystostomy group. In addition, patients undergoing surgery without cystostomy had their catheters removed earlier (4.6 days vs 5.2 days), required shorter postoperative stays in the hospital (5.1 days vs 6.0 days), and were at lower risk of operative complications (5.7% vs 9.2%), especially bleeding requiring blood transfusion (2.9% vs 6.1%). Similar findings were observed in cohorts of prostates of 30-80 ml and prostates >80 ml. Furthermore, among patients with a resection weight >42.5 g or surgical time >90 min, or even propensity-matched patients based on surgical time, those with cystostomy seemed to be at a higher risk of operative complications. These results suggest that M-TURP without suprapubic cystostomy is a safe and effective method, even among patients with larger prostates, heavier estimated resection weights, and longer surgical times.
Aged ; Blood Transfusion ; Cystostomy/methods* ; Hematocrit ; Hemoglobins/analysis* ; Hemorrhage/epidemiology* ; Humans ; Intraoperative Complications/epidemiology* ; Male ; Middle Aged ; Postoperative Complications/epidemiology* ; Propensity Score ; Prostatectomy/methods* ; Prostatic Neoplasms/surgery* ; Retrospective Studies ; Transurethral Resection of Prostate/methods* ; Treatment Outcome

Percutaneous nephrolithotomy (PNL) is a safe and effective procedure commonly performed to remove renal stones. Although PNL is associated with low morbidity, unexpected complications may occur. We describe here a 44-year-old male patient with recurrent renal stones who experienced a renal rupture and massive bleeding following PNL. Left nephrectomy and intensive treatment did not improve the patient's condition, and he died 14 days later as a result of multi-organ failure.
Adult ; Hemorrhage ; Humans ; Male ; Nephrectomy ; Nephrostomy, Percutaneous ; Rupture

We treated 19 patients with ureteral injuries during the recent 7 years. Gynecologic operations were the most common antecedent surgical procedures(89%). The diagnosis of ureteral injuries was made immediately in 3 patients and was delayed 3 to 78 days in 16 patients. All of the 3 injuries recognized during an operation were repaired at the time of injury. Of the 16 patients with injuries recognized in the postoperative period, 1 patient was managed with percutaneous nephrostomy. 14 patients received corrective surgery successfully, but the corrective surgery in remaining patient was railed and ultimately resulted in a nephrectomy because of avascular necrosis of ureter during operation. Therefore, it is better to do corrective surgery primarily in patients with ureteral injuries recognized postoperatively in order to decrease percutaneous nephrostomy associated morbidity and hospital admission period.
Diagnosis ; Humans ; Necrosis ; Nephrectomy ; Nephrostomy, Percutaneous ; Postoperative Period ; Ureter*