Role of Transurethral Resection of the Prostate in the Diagnosis of Prostate Cancer for Patients with Lower Urinary Tract Symptoms and Serum PSA 4-10ng/ml with a Negative Repeat Transrectal Needle Biopsy of Prostat / 대한비뇨기과학회지

PURPOSE: Transrectal needle biopsy of the prostate is a definitive diagnostic procedure for prostate cancer. However, the sensitivity of a third biopsy is very low in patients with serum prostate-specific antigen(PSA) 4-10 ng/ml and negative repeat prostate biopsy. In addition, multiple prostate biopsies usually have low patient compliance due to the pain and complications associated with the procedure. The aim of this study was to evaluate the role of transurethral resection of the prostate(TURP) for the diagnosis of prostate cancer in patients with lower urinary tract symptoms and clinical suspicion but with negative repeat biopsy samples. MATERIALS AND METHODS: From January 2000 to December 2006, 51 patients less than 80 years old underwent TURP at our institution for lower urinary tract symptoms with a serum PSA 4-10ng/ml and negative repeat transrectal needle biopsy of the prostate. We examined their first serum PSA, serum PSA before the TURP, PSA density, as well as their age, prostate size and digital rectal exam findings. The probability for the detection of prostate cancer by TURP was investigated retrospectively. RESULTS: Prostate cancer was detected in seven patients(13.7%). The total Gleason score for the biopsy specimens was 5 in two patients, 6 in one patient and 7 in four patients. There were significant differences between the prostate cancer group and the benign prostate hypertrophy group with regard to the PSA density and prostate volume. However there were no significant differences between the first serum PSA and the serum PSA before TURP in the two groups. CONCLUSIONS: In case with a high suspicion for prostate cancer, the TURP helps in the diagnosis of prostate cancer in those patients with a negative repeat biopsy and a serum PSA 4-10ng/ml and improvement of their lower urinary tract symptoms.

The Expression of Interleukin-6 and Its Receptor in the Developing Rat Kidney / 체질인류학회지

Interleukin-6 (IL-6) and its receptor are presumed to play important roles in the developing nervous system. However, little is known about their potential role(s) in the developing kidney. To investigate this, we have studied the expression of IL-6 and its receptor (IL-6R) in the developing rat kidney. Kidneys from 16- (F16), 18- and 20-day-old (F20) fetuses, 1- (P1), 3- (P3), 7- (P7) and 14-day-old (P14) pups, and adult rats were extracted. Renal expressions of IL-6 and its receptors were examined by immunohistochemistry and in situ hybridization respectively. Il-6 protein already appeared in F16. The early stage of renal development before birth, IL-6 showed strong immunoreactivity in the ureteric bud, metanephric mesenchymal cells (MMC) and developing glomerulus. The expression pattern of IL-6 in nephrogenic zone are very similar even after birth. In matured nephron after birth, IL-6 immunoreactivities were detected in distal tubules strongly, and collecting ducts moderately and thick ascending limb weekly. IL-6R hybridization signals have also already appeared in 16-day old fetal kidney. Before birth, IL-6R mRNAs were expressed in ureteric bud, MMC and developing glomerulus. In the matured nephron after birth, IL-6R mRNA was expressed in the thick ascending limb, distal tubules, collecting ducts and S3 segment of proximal tubule. These results suggest that IL-6 and its receptor may be involved in regulation of nephron formation in nephrogenic zone of rat, and play a role in distal nephron including collecting duct after birth.

The Efficacy of Repeated Sclerotherapy after Percutaneous Aspiration of the Simple Renal Cyst / 대한비뇨기과학회지

PURPOSE: Percutaneous aspiration with sclerotherapy is widely used as a treatment for simple symptomatic renal cysts because percutaneous aspiration with sclerotherapy is minimally invasive and cost-effective. Sclerotherapy is usually performed in combination with aspiration due to the high recurrence rate, 30-70%, for the simple aspiration. We conducted an analysis of percutaneous aspiration with repeated sclerotherapy, and we report the results of sclerotherapy after percutaneous aspiration of simple renal cysts and we also review the results of the other previous studies. MATERIALS AND METHODS: Between January 2001 and April 2004, the results of percutaneous aspiration with repeated sclerotherapy in 39 cases of simple renal cysts were evaluated. We evaluated the operation time, the hospital stay, the success rate, the complication rate and the follow-up period. All patients were available for follow-up over a period of 3 months by conducting ultrasound exams and computed tomography (CT) scans. RESULTS: Complete collapse, partial collapse and recurrence of the renal cysts occurred in 24/39 (61.5%), 13/39 (33.3%), and 2/39 (5.1%) cases, respectively. The mean operative time was 50.3 minutes and the mean hospital stay was 4.5 days. The cost of two sessions of sclerotherapy was about 240,000 won and that of three sessions of sclerotherapy was about 300,000 won. The size of the cyst was not related to the rate of collapse. Any complication related to percutaneous aspiration with repeated sclerotherapy were not noted. CONCLUSIONS: With regard for the success rate and cost-effectiveness, percutaneous aspiration with repeated sclerotherapy is considered a primary treatment for simple symptomatic renal cysts.

Pelvic Hematoma following a Transobturator Vaginal Tape Surgery for Treating Stress Urinary Incontinence

The transobturator tape surgery is the most recent minimally invasive midurethral sling procedure. This technique is introduced with the expect of decreasing some of the complications such as bladder, bowel and blood vessel injury that is associated with retropubic passage of needles. Reported is a 48-year-old woman who underwent a transobturator tape(TVT-O) procedure and who developed a retropubic hematoma at the pelvic cavity.

Difference of Brain Activation by Visual Erotic Stimuli in Young and Middle-aged Healthy Males / 대한비뇨기과학회지

PURPOSE: The objectives of this study are to identify the brain centers whose activity changes are related to sexually arousing visual stimuli and to identify the difference between young and middle-aged males by mapping the brain activity with using blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI). MATERIALS AND METHODS: Ten young heterosexual, right handed males with normal sexual function (mean age: 27 years, age range: 24 to 31) and ten middle-aged heterosexual, right handed males with normal sexual function (mean age: 52 years, age range: 46 to 55) were enrolled into this study. Real-time visual stimulation was performed with the subjects alternatively viewing erotic and non-erotic films to identify the activated brain regions associated with sexual response. Assessments with using a five-point scale were determined after visual stimulation to evaluate the subjective sexual arousal. Brain activity was mapped by performing BOLD-fMRI on a 1.5T MR scanner. After functional scanning, the high-resolution data was analyzed with the SPM analyzing program; the significance of activation was set at p<0.01 or p<0.001. RESULTS: The parietal lobe, frontal lobe, cingulate gyrus, caudate nucleus, thalamus and hypothalamus were noted as the areas of activation specifically associated with viewing the erotic film segments by the young males. For the middle-aged males, these areas were the parietal lobe, frontal lobe, right temporal lobe, cingulate gyrus and caudate nucleus. The thalamus and hypothalamus were activated in only the young males. CONCLUSIONS: We suggest that the non-activation of the hypothalamus and thalamus in middle-aged males may be associated with the lesser physiological arousal in response to the erotic visual stimuli. The non-invasive visualization of the central nervous system by functional MRI in healthy males has shown the possibility for evaluating the neuroanatomy of the brain that is associated with sexual arousal and its clinical application by comparing young and middle-aged males.

Clinical Trial of SPARC Procedure in Female Stress Urinary Incontinence / 대한비뇨기과학회지

PURPOSE: A suprapubic approach to the suburethral polypropylene (SPARC) procedure was reported as a new technique for urethral support in the treatment of stress urinary incontinence in women. The safety and efficacy of the SPARC procedure were evaluated in women with stress urinary incontinence. MATERIALS AND METHODS: 50 women (mean age 48.6) with stress urinary incontinence underwent the SPARC procedure under general anesthesia between October 2002 and May 2004. The preoperative evaluations included: the patients history, a physical examination, urinalysis, an urodynamic test and incontinence staging for the Stamey grade. 2 and 5 women had previously experienced failed anti-incontinence surgery and pelvic surgery, respectively. The mean follow-up period was 8.01 months, with all patients assessed for the procedural outcome, subjective satisfaction and complications. RESULTS: The mean follow-up period, hospital stay and operation time were 8.01 months (3-15), 3.7 days (2-6) and 23 minutes (18-45), respectively. The success rate was 94%. There were no significant perioperative and postoperative complications. 3 patients (6%) had bladder perforation during the operation that necessitated an indwelling Foley catheter (mean period 7.3 days). 3 patients (6%) each had postoperative cystitis and immediate voiding difficulty that necessitated an indwelling Foley catheter (mean period 3.0 days) and bladder training, but without cutting or releasing of the tapes. 7 patients (14%) had postoperative de novo urge symptoms. CONCLUSIONS: The SPARC procedure is a simple, safe and effective treatment for female stress urinary incontinence in terms of the short operation time and hospital day, and low complication and relatively high success rates. However, a longer follow-up will be necessary to determine its long term effect and efficacy.

Effect of Testosterone Replacement on Penile Erection in Castrated Rat / 대한남성과학회지

PURPOSE: This study examined the changes in intracavernous pressure, expression of nitric oxide synthase(NOS), and content of penile smooth muscle in castrated rats and testosterone-supplied castrated rats. MATERIALS AND METHODS: Sprague Dawley rats were used for this study and divided into control, castrated, and testosterone-supplied castrated groups. Castration was performed by bilateral orchietomy under general anesthesia, and testosterone propionate 3 mg/kg was injected subcutaneously daily for a week beginning 4 weeks after orchiectomy. Intracavernous pressure was measured by stimulating the cavernous nerve at 10 volts, 2.4 mA. Expression of NOS was measured by immunohistochemical staining for NADPH diaphorase, and content of penile smooth muscle was measured by H&E staining of the corpus cavernosum. The stained area-to-tissue ratio was calculated by computer scanning for each case. RESULTS: Compared with the control group(3.45+/-0.25 ng/ml), the serum testosterone level of the castrated group (0.78+/-0.34 ng/ml) was lower. Serum testosterone level was restored in the testosterone-supplied castrated group. Compared with the(67.2+/-14.3 cmH2O) was decreased (p <0.05). There was no significant difference between the testosterone-supplied group(94.7+/-11.4 cmH2O) and control group, so intracavernosal pressure was restored by testosterone treatment. Immunohistochemical staining for NOS showed that NADPH diaphorase was stained as brown nerve fiber. Compared with the control group(37.5+/-2.8%), the NOS activity of the castrated group(7.5+/-2.1%) was significantly decreased(p <0.05). NOS activity was slightly increased in the testosterone-supplied group(47.5+/-2.4%) compared with the control group, but the difference was not statistically significant. Thus, testosterone treatment restored NOS activity after castration. By H&E staining, the content of penile smooth muscle was 76.5+/-2.8% in the control group, but significantly lower in the castrated group(46.2+/-3.4% p <0.05). Smooth muscle content was slightly decreased in the testosterone-supplied group(63.8+/-4.7%) compared with control group, but the difference was not statistically significant. Thus, smooth muscle content was restored by testosterone treatment after castration. CONCLUSIONS: Decline of factors involved in erectile function can be restored by testosterone replacement after castration.

Bioadhesive Drug Delivery System for the Intravesical Administration of Paclitaxel in Rabbits / 대한비뇨기과학회지

PURPOSE: Many reports have shown that the efficacy of intravesical therapy for bladder cancer is, in part, limited by the poor penetration of drugs into the urothelium. The present study evaluated the effect of glyceryl monooleate (GMO) on the delivery and penetration of paclitaxel into the bladder of rabbits, when given as an intravesical dose. MATERIALS AND METHODS: The urine, plasma, and tissue pharmacokinetics were determined in rabbits treated for 120min with paclitaxel (500g/20ml) by an intravesical instillation. Two formulation of GMO/paclitaxel were evaluated, according to the proportion of water, 15% and 30%, with Taxol was used as a control. The animals were observed for clinical signs of toxicity, and necropsy performed. RESULTS: At 120min post-instillation, the bladders were emptied and excised. The urine paclitaxel concentrations were decreased by 39.6 and 41.2% in the two experimental groups, and by 25.2% in the control group. The paclitaxel concentrations in the urothelium were 53 and 56% of the urine concentration in the two experimental groups, respectively, but by only 11% in the control group. The concentration then declined exponentially in the underlying capillary perfused tissues, reaching equilibrium at a depth of 1,400-1,700um. The plasma concentrations were extremely low compared with those in the urine and bladder tissues, and were not associated with clinical toxicity. CONCLUSIONS: These results indicate that GMO improves the delivery of paclitaxel and increases the concentration in the bladder tissue. These results suggest that the intravesical delivery of GMO/paclitaxel/water provide a significant bladder tissue targeting advantage, and that paclitaxel represents a viable candidate drug for intravesical bladder cancer therapy.

Intratumoral Injection of Holmium-Chitosan Complex in Prostate Cancer / 대한비뇨기과학회지

PURPOSE: The aim of this study was to pathologically evaluate the therapeutic and toxic effects of the 166Ho-chitosan complex(166HC) on prostatic cancer. MATERIALS AND METHODS: The DU-145 cell line was subcutaneously heterotransplanted into 30 nude mice, resulting in 24 prostatic cancers. The 24 nude mice with prostatic cancer were divided into four groups. Group I(n=6) received 0.5ml normal saline, group II(n=6) 0.5ml chitosan, group III(n=6) 370 MBq of 166HC and group IV(n=6) 740 MBq of 166HC per 1cm3, intratumorally. The tumor sizes were measured at 1 and 2 weeks after injection. The 24 mice were sacrificed and pathological examination performed: Haematoxylin & Eosin(H & E) staining and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling(TUNEL) staining. RESULTS: Two weeks after injection of 166HC, the tumor volumes in groups III and IV were smaller than those in groups I and II(p<0.05). H & E staining of the tumors showed wide central necrosis in groups III and IV, but not in groups I and II. TUNEL staining showed false positive reactions along the peripheral margins in all groups. No toxic changes were found in the liver, kidney, peripheral blood and bone marrow. CONCLUSIONS: An intratumoral injection of 166HC appears to be a new, safe and promising alternative radiotherapeutic modality for the local control of prostatic cancer, with minimized toxicities as the administered 166HC is retained at the injection site.

Efficacy of Paclitaxel-Loaded Bioadhesive Drug Deliver System Based on Glyceryl Monooleate Nanoparticle in an Orthotopic Murine Bladder Cancer Model / 대한비뇨기과학회지

Purpose: The purpose of this study was to evaluate the efficacy of paclitaxel-loaded glyceryl monooleate (GMO) in the intravesical treatment of superficial transitional cell carcinomas of the bladder by enhancing the bioadhesiveness and bioavailability. Materials and Methods: A mucoadhesive oily paclitaxel formulation was prepared using GMO, tricaprylin, Tween(8) 80 and paclitaxel. The bioactivity of the GMO/paclitaxel formulation was confirmed by assessing its cytotoxicity on MBT-2, a bladder cancer cell line. An in vivo study was performed in C3H2 mice after induction of bladder cancer by an intravesical bladder tumor implantation. The efficacy of the intravesical administration of the GMO/paclitaxel was assessed by the histology and bladder weight. Results: The average particle size of the GMO/paclitaxel was 600nm. Only 2.6% of the MBT-2 cells were viable after 24 hours of treatment with GMO/paclitaxel at a paclitaxel concentration of 10microgram/ml. In the orthotopic bladder cancer model the tumor incidence rate was significantly decreased by intravesical administration of the GMO/paclitaxel compared to the controls. The average bladder weight of the GMO/paclitaxel group was significantly lower than that of controls. No toxicity was observed in either of the groups. Conclusions: Intravesical administration of the GMO/paclitaxel formulation had an inhibitory effect on the bladder tumor in an orthotopic bladder cancer model. This formulation may be a promising approach for intravesical chemotherapy of superficial bladder cancer.

Crossed Renal Ectopia Accompanied with VUR without Fusion / 대한비뇨기과학회지

Crossed renal ectopia, without fusion, is a very rare congenital anomaly of the urinary tract, and can be frequently accompanied with hydronephrosis due to vesico-ureteral reflux (VUR) or ureteropelvic junction stenosis, renal atrophy, or ectopic ureterocele. We report a case of vesicoureteral reflux is reported in an infant with crossed renal ectopia without fusion.

Efficacy and Toxicity of Gemcitabine Plus Cisplatin Chemotherapy in Advanced Urothelial Cancer / 대한비뇨기과학회지

PURPOSE: To assess the response to, and toxicity of, combination chemotherapy, with gemcitabine and cisplatin, in patients with advanced transitional cell carcinoma of the urothelial tract. MATERIALS AND METHODS: Thirty-seven patients with advanced transitional cell carcinomas were treated with gemcitabine, 1,000mg/m2, intravenously for 30 minutes, on days 1, 8 and 15 and cisplatin, 70mg/m2, for 1 hour on day 2 of each 28-day cycle. Twenty-four that completed more than 3 cycles were evaluated for their response, but all patients were evaluated for the toxicity. The full dose of the drugs was administered to all patients. RESULTS: Three(12.5%) of the 24 patients achieved a complete response and 2 (37.5%) achieved a partial response, showing an overall response rate of 50%. The main toxicities were myelosupression, with an incidence of 34% thrombocytopenia, 40% leukopenia and 28% anemia, but only 6% of grades 3 to 4. Non-hematological toxicity was mild, with a low incidence of 46% nausea and vomiting, and only 6% of grades 3 to 4. CONCLUSIONS: Combination chemotherapy, with gemcitabine and cisplatin, exhibits significant activity and favorable toxicity in advanced transitional carcinomas, although long-term follow-up and further studies are warranted.

Prognostic Factors in Renal Cell Carcinoma / 대한비뇨기과학회지

PURPOSE: The prognostic factors influencing the survival rate in patients with renal cell carcinoma were evaluated. MATERIALS AND METHODS: An analysis was performed on 102 patients with renal cell carcinoma who underwent a radical nephrectomy from January 1995 to June 1999. The survival rate according to each prognostic factor such as the 1997 TNM stage, the size, cell type and nuclear grade of the tumor and the presence of symptoms at the point of diagnosis, age and gender, and tumor location was analyzed using the Kaplan-Meier method. The statistics was determined by the log-rank test of a univariate analysis and the Cox proportional hazards model of multivariate analysis. RESULTS: Univariate analysis showed that the TNM stage, size and nuclear grade of tumor, and the presence of symptoms at the point of diagnosis had a significant influence on survival rate of patients with renal cell carcinoma. The tumor cell type, age and gender, the location of the tumors had little statistical significance. Multivariate analysis showed that a distant metastasis was the most significant prognostic factor followed by nuclear grade of the tumor cell, T stage, the presence of symptoms at the point of diagnosis, and lymph node metastasis in this order. CONCLUSIONS: The TNM stage, nuclear grade of the tumor and the presence of symptoms at diagnosis are important prognostic factors in renal cell carcinoma. Analyzing these prognostic factors will be useful as a treatment modality, follow up and prognosis of patients with renal cell carcinoma.

Antibacterial Effect of an Intraprostatic Zinc Injection in a Rat Model of Chronic Bacterial Prostatitis / 대한비뇨기과학회지

PURPOSE: High levels of prostatic zinc are associated with prostatic antimicrobial activity and are depressed in patients with chronic prostatitis. We investigated the inhibition of bacterial growth in the rat prostate with chronic prostatitis after an intraprostatic injection of zinc and compared the two different types of zinc delivery. MATERIALS AND MTHODS: Ninety male Wistar rats were used in the study. Experimental chronic bacterial prostatitis was induced by the instillation of a bacterial suspension (Escherichia coli 108/ml) into the prostatic urethra. The animals were followed-up for 4 weeks and then injected intraprostatically with either 0.2ml of a zinc liposome or a zinc solution (0.04M zinc sulfate). Animals were sacrificed 4, 6, and 8 weeks after the injection. The inhibition of inflammation and its consequences were analyzed both microbiologically and histologically. The prostatic zinc concentrations were measured by inductively coupled plasma atomic emission spectrometry. RESULTS: The average infection rates and mean Log10cfu/g of the zinc-treated groups were significantly lower than the controls. The histopathology showed resolving prostatitis in the zinc-treated groups compared with the controls. The prostatic zinc levels were higher in the zinc-treated groups than in the controls 4 and 6 weeks after the zinc injection (p<0.05). However, the zinc liposome and zinc solution groups were found to be effectively identical. CONCLUSIONS: An intraprostatic injection of zinc inhibited bacterial growth by increasing the zinc levels in the rat prostatitis model. These results suggest that a local application of zinc to the prostate presents a new treatment modality for chronic bacterial prostatitis at the point of its pathogenesis.

Antibacterial Effect of an Intraprostatic Zinc Injection in a Rat Model of Chronic Bacterial Prostatitis / 대한비뇨기과학회지

PURPOSE: High levels of prostatic zinc are associated with prostatic antimicrobial activity and are depressed in patients with chronic prostatitis. We investigated the inhibition of bacterial growth in the rat prostate with chronic prostatitis after an intraprostatic injection of zinc and compared the two different types of zinc delivery. MATERIALS AND MTHODS: Ninety male Wistar rats were used in the study. Experimental chronic bacterial prostatitis was induced by the instillation of a bacterial suspension (Escherichia coli 108/ml) into the prostatic urethra. The animals were followed-up for 4 weeks and then injected intraprostatically with either 0.2ml of a zinc liposome or a zinc solution (0.04M zinc sulfate). Animals were sacrificed 4, 6, and 8 weeks after the injection. The inhibition of inflammation and its consequences were analyzed both microbiologically and histologically. The prostatic zinc concentrations were measured by inductively coupled plasma atomic emission spectrometry. RESULTS: The average infection rates and mean Log10cfu/g of the zinc-treated groups were significantly lower than the controls. The histopathology showed resolving prostatitis in the zinc-treated groups compared with the controls. The prostatic zinc levels were higher in the zinc-treated groups than in the controls 4 and 6 weeks after the zinc injection (p<0.05). However, the zinc liposome and zinc solution groups were found to be effectively identical. CONCLUSIONS: An intraprostatic injection of zinc inhibited bacterial growth by increasing the zinc levels in the rat prostatitis model. These results suggest that a local application of zinc to the prostate presents a new treatment modality for chronic bacterial prostatitis at the point of its pathogenesis.

Expression of M llerian Inhibiting Substance in Cryptorchidism at the Descending Level of Testis / 대한비뇨기과학회지

PURPOSE: To investigate the relationship of MIS and cryptorchidism according to the descending level of testis into scrotum, we studied expression degree of MIS by immunohistochemical analysis using anti-human MIS polyclonal antibody in testicular specimen. MATERIALS AND METHODS: MIS were stained in excised testis by trauma on each 8 patients as control group and age-matched abdominal, inguinal and prepubic cryptorchidism. The expression were classified as score 1, 2, 3 and 4 according to stained degree of percentage in randomized 16 fields(x400) under the light microscope. RESULTS: Of the degree of MIS expression in control group, 87.5% were category 3 or more. The mean score was 3.13+/-0.62. 2. Of the degree of MIS expression in abdominal type cryptorchid testis group that underwent orchiectomies, 68.7% were category 1. The mean score, 1.31 +/- 0.48, showed significant difference compared to control group(p0.05). 4. Of the degree of MIS expression in prepubic type, 75.0% were category 3 or more. And the mean score, 2.88+/-0.62, showed no significant difference compared to control group(p>0.05). CONCLUSIONS: Expression of MIS is different according to descending level of testis and may play a role in physiologic changes of testicular descent.

A Case of Extra-adrenal Paraganglioma of the Scrotum / 대한비뇨기과학회지

Extra-adrenal paragangliomas are rare tumors of neural crest origin, usually arising from the carotid bodies, the glomus jugulare, or the retroperitoneum. And, though ten percents of cases are presented with malignancy, it`s prognosis is relatively good. In genitourinary area, there are a few reported cases of extra-adrenal paragangliomas of the urinary bladder and the spermatic cord. Herein, we report a case of paraganglioma arising in the scrotum, which is an extremely rare location.

A case of retroperitoneal neurilemmoma / 대한비뇨기과학회지

Neurilemmoma is wel1 encapsulated tumor of Schwann cell origin. It is more often solid than cystic and. usually solitary and may be benign. The treatment is surgical excision. We report a 42-year-old man hospitalized with complaints of RUQ pain and palpable mass. There was no endocrinological abnormality. Ultrasonography, computerized tomography and angiography revealed right huge extrarenal mass without metastatic evidence. The patient underwent surgical excision.

A case of ureteral stump metastasis from renal adenocarcinoma / 대한비뇨기과학회지

The metastasis of renal cell carcinoma to the ureteral stump is very rare and only a Few cases were reported. In most cases ureteral metastasis appeared after nephrectomy. We are presenting a case of metastatic renal cell carcinoma to the ureteral stump after radical nephrectomy in a 14 years old male with brief review and literature.

Endoscopic surgery for management in stricture of ureteropelvic junction, ureter or caliceal neck / 대한비뇨기과학회지

Recently. the endopyelotomy has been used as a first choice of treatment in selected cases of ureteropelvic or ureteral strictures. 24 consecutive cages of endourologic-tomy procedure including 12 cases of endopyelotomy. 8 cases of endoureterotomy and 4 cases of endocalicotomy were performed from Nov. '89 to May '91. The causes of stricture were previous operation (7 cases), congenital (6 cases). tuberculosis (5 cases) and others. They were all followed more than 3 months. The overall success rete was 83.3%. The success means improvement of clinical symptoms and radiographic findings. The complications were upward migration of stent (1 case), granuloma (1 case) and re-stricture (2 cases). Especially in 1 cases of caliceal stricture the success rate was 100% with no complication. Our experience indicates that endourologic-tomy procedure has relatively good success rate, low morbidity, Low complication and a shorter recovery time. Especially endocalicotomy is one of the best method to treat caliceal stricture.