Bacillus Calmette-Guerin (BCG) is an attenuated strain of Mycobacterium bovis (M. bovis) that has been used to treat transitional cell carcinoma. Since the initial report by Morales and associates on the use of intravesical BCG for the treatment of recurrent superficial bladder tumors, intravesical therapy with BCG has proved to be more effective for prophylaxis and the treatment of superficial bladder tumors and carcinoma in situ than most of the standard chemotherapeutic agents. While the majority of patients tolerate BCG treatments well, a number of adverse reaction (e.g., fever, hematuria, dysuria, nausea and malaise) have been reported. More serious complications occur on rare occasions and they include pneumonitis/hepatitis, ureteral obstruction, renal abscess and sepsis. We report here on a case of ureteral obstruction that was caused by periureteral tuberculous granuloma after intravesical BCG therapy for superficial bladder tumors, and the condition required distal ureterectomy & ureteroneocystostomy.
Abscess ; Bacillus ; Carcinoma in Situ ; Carcinoma, Transitional Cell ; Dysuria ; Fever ; Granuloma* ; Hematuria ; Humans ; Morale ; Mycobacterium bovis* ; Nausea ; Sepsis ; Ureter* ; Ureteral Obstruction* ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: We attempted to identify the prostatitis in men with elevated serum prostate specific antigen (PSA) levels, and also determined whether treatment with antibiotics lowers serum PSA, resulting in decreases of the frequency of prostatic biopsies. MATERIALS AND METHODS: Men with lower urinary tract symptoms, and serum PSA greater than 4ng/ml, were evaluated for the presence of prostatitis. Prostatitis was defined as over 20 white blood cells in expressed prostatic secretions. Patients with prostatitis were treated with a 4-week course of antibiotics. Patient without signs of prostatitis underwent transrectal biopsies. PSA blood tests and prostatic massages were repeated 4 weeks later. Patients with PSA levels greater than 25ng/ml were excluded. RESULTS: Of the 49 patients with elevated PSA levels (with a mean PSA level of 9.26ng/ml), 29 (59%) had the laboratory signs of prostatitis. In 18 patients (62%) with prostatitis, the serum PSA level decreased to below 4ng/ml (mean 2.73ng/ml) after treatment. The remaining 11 patients with prostatitis, and the 20 patients without, underwent sextant transrectal ultrasound guided biopsies; which resulted in pathologic confirmation of prostate cancer in 3 out of the 11 patients with prostatitis, and in 4 (20%) out of the 20 patients without. Screening for prostatitis decreased the frequency of a prostatic biopsy by 32.7%. CONCLUSIONS: In over half of the patients with elevated serum PSA levels, the clinical evaluation revealed evidence of prostatitis. The treatment of prostatitis in this study decreased prostate biopsies by 32.7%. We suggest that screening for prostatitis in patients with elevated PSA levels, and it subsequent treatment can decrease the percentage of negative biopsies.
Anti-Bacterial Agents ; Biopsy* ; Hematologic Tests ; Humans ; Leukocytes ; Lower Urinary Tract Symptoms ; Male ; Mass Screening ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Prostatitis* ; Ultrasonography

The teratoma is made up of a variety of parenchymal cell types representative of more than one germ layer. Retroperitoneal teratoma is an uncommon neoplasm which occurs in only 10% of all retroperitoneal primary neoplasm. Primary retroperitoneal teratoma has been rarely seen in adults and 3 cases has been reported in Korea. Recently we experienced a case of retroperitoneal teratoma, which was suspected by clinical investigation and confirmed by exploration and microscopic examination. CT scan is very useful in differential diagnosis of this rare tumor. We report a case of retroperitoneal teratoma in 22 year old young woman.
Adult* ; Diagnosis, Differential ; Female ; Germ Layers ; Humans ; Korea ; Teratoma* ; Tomography, X-Ray Computed ; Young Adult

No abstract available.
Rhabdomyosarcoma, Embryonal*

No abstract available.
Lithotripsy* ; Ureter*

PURPOSE: Extracorporeal shock wave lithotripsy(SWL) is currently prorposed for the first line treatment of most renal and ureteral stones. In general, SWL is very effective and non-invasive method than open surgery or endoscopic lithotripsy. We experienced 350 cases of SWL for 46 months and announced it. MATERIALS AND METHODS: We retrospectively reviewed the data of 324 patients(350 stones) who had been diagnosed as renal or ureteral stones and underwent SWL using Tripter Compact(R) lithotriptor from September 1994 to July 1998. Male to female ratio was 1.9:1 and patient`s ages ranged from 18 to 82 years(mean 43.7 years). We underwent SWL only with parenteral analgesics for pain control. RESULTS: In 350 stones, renal stones were 90 cases(25.7%) and ureteral stones were 260 cases(74.3%). In 90 renal stones, calyceal stones(include 1 staghorn stone) were 62 cases(68.9%) and renal pelvic stones were 28 cases(31.1%). In 260 ureteral stones, upper ureteral stones were 209 cases(80.4%), mid ureteral stones were 10 cases(3.8%), and lower ureteral stones were 41 cases(15.8%). The stones from 10 to 19mm in diameter were the majority of renal stones(53.3%), whereas in ureter, the stones smaller than 10mm in diameter were most common(41.5%). Less than 3 treatment sessions were needed for 147 cases(93.0%) of stones smaller than 10mm and for 146cases(76.0%) stones larger than 10mm. Less than 3 sessions were needed for 68 cases(75.6%) of renal stones and for 225 cases(86.5%) of ureteral stones. All renal stones were fragmented and the success rate for upper ureteral stones was 93.3%(195/209), for mid ureteral stones was 80.0%(8/10), and for lower ureteral stones was 80.5%(33/41). According to the size of stone, the success rate for the stones smaller than 10mm in diameter was 96.2%(152/158) and for the stones larger than 10mm was 90.6%(174/192). Total success rate was 93.1%(326/350). The complications after SWL were gross hematuria over 24hours(64 cases, 18.3%), flank pain(52 cases, 14.9%), gastrointestinal disturbances(7 cases, 2%), and Steinstrasse(31 cases, 8.9%). The causes of failure were incomplete fragmentation(21 cases, 87.5%) and mucosal impact(3 cases, 12.5%) of stones. Re-treatment rate was 59.7% and auxiliary procedure rate was 8.0%(efficiency quotient was 0.56). CONCLUSIONS: Our experiences shows extracorporeal shock wave lithotripsy is a safe and effective method for the treatment of renal and ureteral stones, and we expect the better outcome by development of techniques and equipments.
Analgesics ; Female ; Hematuria ; Humans ; Lithotripsy* ; Male ; Retrospective Studies ; Shock* ; Ureter ; Urinary Calculi

Retroperitoneal teratoma is a rare tumor composed of tissues from all three germ cell layers - endoderm, mesoderm, ectoderm. It is generally known as a disease of baby or children and as 10% of retroperitoneal tumor. Recently, we experienced a case of retroperitoneal teratoma in adult.
Adult ; Child ; Ectoderm ; Endoderm ; Germ Cells ; Humans ; Mesoderm ; Teratoma*

PURPOSE: This study examined the efficacy of ureteroscopic stone manipulation with comparing the success rates and complications rates. MATERIALS AND METHODS: The manipulation of calculi can be done under the direct vision of ureteroscope using dormia baskets with increasing safety and efficacy. The results of ureteroscopic removal of stones were reviewed in 636 cases. From January 1992 to October 1997, 636 patients underwent ureteroscopic removal of stones. RESULTS: There were 236 female and 400 male patients between 16 and 75 years old. The success rates of ureteroscopic removal of stones were related to location of the calculus: 95.8% in lower ureter, 87.7% in mid ureter and 90% in upper ureter(overall success rate was 95%). 35 cases(5.8%) of complication occurred in 604 cases of success: Severe ureteral mucosal injury in 25 patients, gross hematuria(>48hours) in 4 patients, ureteral mucosal prolapse in 3 patients, flank pain(>48hours) in 2 patients, ureteral perforation in 1 patient. CONCLUSIONS: Ureteroscopic removal of stones can be successful and safe treatment modality for lower urethral stones, especially with plentiful experience and good surgical skill.
Aged ; Calculi ; Female ; Humans ; Male ; Prolapse ; Ureter ; Ureteroscopes ; Ureteroscopy

Pheochromocytoma is one of the surgically curable hypertensive diseases and can arise wherever chromaffin cells are located. Herein, a case of extra-adrenal pheochromocytoma developed in a 51 year-old male is presented with brief review of literatures.
Chromaffin Cells ; Humans ; Male ; Middle Aged ; Pheochromocytoma*

Benign Prostatic Hyperplasia is one of the most important desease with a high frequency in urology. There is no doubt that the main stream of treatment is transurethral resection. of the prostate, however, marked improvement in drug therapy has been observed in recent years. Allylestrenol is a synthetic gestagen which was known to act directly on the prostate to exhibit its effect of reducing the size of the prostate by inhibiting the selective uptake of serum testosterone, inhibition of metabolism of testosterone to 5a-DHT (dihydrotestosterone) reductase, inhibition of 5a-DHT receptor binding. Our present study was carried out on 108 patients with benign prostatic hyperplasia to evaluate the efficacy and safety of antiandrogen therapy with allylestrenol. Allylestrenol was administered in a dose of 25 mg twice a day in the morning and evening after meal for 12 weeks to the patients and its efficacy was evaluated with peak urinary flow rate, Madsen Symptom Score at 4, 12 weeks after treatment and prostate volume at 12 weeks after treatment. Of these patients 46 completed the study and only 2 patients withdrew from the study owing to side effects. However,these side effects were not serious. At baseline (mean +SD) the mean peak urinary flow rate was 11.0+/-3.7 ml/sec, mean symptom score 10.2+4.0 and mean ultrasonic assessment of prostatic volume 36.8 +/-9.6 gm. At 4 weeks after treatment(mean + SD) mean peak urinary flow rate was 12+/-3.5 ml/sec, mean symptom score 7.7+/-4.2 (p > .0.05, p < 0.05). At 12 weeks after treatment (mean +SD) mean peak urinary flow rate was 12.8+4.7 ml/sec, mean symptom score 7.0+4.2 and mean ultrasonic assessment of prostatic volume 36.6+/-9.3 gm (p < 0.05, p < 0.05, p > 0.05).
Allylestrenol* ; Drug Therapy ; Humans ; Meals ; Metabolism ; Oxidoreductases ; Prostate ; Prostatic Hyperplasia* ; Rivers ; Testosterone ; Ultrasonics ; Urology