The Quality of Life after Tension-Free Vaginal Tape and Transobturator Vaginal Tape Inside-Out for the Surgical Treatment of Female Stress Urinary Incontinence

PURPOSE: The change of quality of life following a tension-free vaginal tape (TVT) and transobturator vaginal tape (TVT-O) procedure was investigated in patients with stress urinary incontinence. MATERIALS AND METHODS: We included 86 women with stress urinary incontinence who underwent the TVT or TVT-O procedure and followed up for at least 1 year. Preoperatively, the patients were evaluated with history taking, physical examination, urodynamics to determine abdominal leak point pressure (ALPP) and pre- and postoperative quality of life was evaluated by incontinence quality of life questionnaire (I-QoL). The success after operation was defined as the absence of any subjective complaint of leakage. RESULTS: The rate of cure of TVT and TVT-O procedure were 84%, 92% and the rate of improvement of them were 16%, 8%, respectively. Preoperative patient characteristics including uroflowmetric parameters and ALPP were comparable in the two groups. The I-QoL parameters one year after surgery were statistically significant increase in I-QoL scores in each groups. There were no serious or long-term complications related to both procedures. CONCLUSIONS: These data suggest that the TVT and TVT-O procedure are effective for treating female stress incontinence and also in the aspect of improving quality.

The Prognostic Significance of Elevated Serum Creatinine for the Recurrence and Progression in Superficial Bladder Tumors / 대한비뇨기과학회지

PURPOSE: There are many prognostic indicators of bladder tumors including clinical, pathological and molecular markers based on tumor-related factors. This study was performed to evaluate the significance of an elevated level of serum creatinine for predicting progression and recurrence of superficial bladder tumors. MATERIALS AND METHODS: One hundred forty-seven patients that initially presented with a superficial bladder tumor(pTa or pT1) except for a carcinoma in situ were retrospectively analyzed according to several factors such as tumor stage, grade, size, multiplicity and serum creatinine for tumor recurrence and progression after a primary transurethral resection. RESULTS: The elevated serum creatinine group consisted of 20 patients 11 patients experienced recurrence(55.0%) and 3 patients experienced progression(15.0%). The control group consisted of 127 patients 39 patients experienced recurrence(30.7%) and 13 patients experienced progression (10.2%). The presence of an elevated level of serum creatinine and tumor multiplicity were statistically significant prognostic factors for tumor recurrence. CONCLUSIONS: These results can be helpful for predicting the prognosis of transitional cell carcinoma of the bladder and for planning therapeutic and follow-up strategies.

Solitary Metastatic Renal Tumor from Breast Cancer / 대한비뇨기과학회지

We report a case of a metastatic renal tumor secondary to breast cancer 9 years postmastectomy. This is the first case report of solitary renal metastasis from breast cancer with no other evidence of metastasis. A 47-year-old woman underwent a modified radical mastectomy and 6 cycles of CEF chemotherapy (Cyclophosphamide, Epirubicin, 5-FU) for cancer of the left breast. She was followed closely, but no recurrence or metastases were detected on either a physical or radiological examination. 9 years later, on a routine follow-up examination for metastatic breast cancer, abdomen ultrasound revealed a solid mass (4cm in diameter) in the upper portion of the right kidney. Computed tomography (CT) was used to further evaluate the solitary renal mass, which had become moderately enhanced. No regional lymph node, visceral or pulmonary metastases were found. A radionuclide bone scan confirmed no bony involvement. A laparoscopic radical nephrectomy was performed for a right renal tumor. The histopathological features were identical to those for cancer of the right breast. The patient was treated with adjuvant combination chemotherapy (docetaxel and adriamycin), and is still alive 9 months after a right radical nephrectomy, with no evidence of recurrence.

The Effect of Long-term Immobilization Stress on Spermatogenesis and Testosterone Production / 대한비뇨기과학회지

Purpose: The aim of this study was to investigate the effects of long-term immobilization stress on spermatogenesis and testosterone production in a rat model. Materials and Methods: Thirty randomly selected adult male rats were divided into 6 groups: immobilization stress groups (I, III, V) and control groups (II, IV, VI). In the immobilization stress groups, 15 rats were immobilized in a steel cage for 6 hours per day for 14 days. Groups I and II were sacrificed just after finishing the immobilization session. Groups III and IV were sacrificed after a 1 week resting period. Groups V and VI were sacrificed after a 2 week resting period. The serum concentrations of corticosterone, luteinising hormone (LH), follicle stimulating hormone (FSH) and testosterone were measured. Specimens of the testis were stained with hematoxylin-eosin and Masson's trichrome. Results: Following 2 weeks of immobilization, the serum concentration of corticosterone was significantly increased; whereas, the serum concentrations of LH and testosterone were decreased. However, the serum FSH concentration remained unchanged. After the 1 week resting period, there were significant recoveries in the serum concentrations of corticosterone, LH and testosterone. From the histology of the immobilization group, the mean testicular biopsy score (Johnsen score) was significantly decreased, but the mean value of the seminiferous tubule luminal diameter was significantly increased; whereas, that of the seminiferous tubule diameter remained unchanged. These changes slowly recovered after the resting period. Conclusions: These results suggest that the exposure to long-term immobilization impairs spermatogenesis and androgenic testicular functions in rats.

A Short-term Comparative Study on Efficacy and Safety of Standard Transurethral Resection and High Power (80W) Potassium-Titanyl-Phosphate Laser Vaporization of the Prostate / 대한비뇨기과학회지

PURPOSE: Transurethral resection of the prostate (TURP) is the gold standard treatment for symptomatic benign prostate hyperplasia, but significant complications are associated with this procedure. The aim of this study was to compare the standard TURP with the high power (80W) potassium-titanyl-phosphate laser (KTP/532; Greenlights PVTM laser system; Laserscope, San Jose, USA) to elucidate the efficacy and safety of laser treatment. MATERIALS AND METHODS: We performed comparative trials of 40 patients suffering with symptomatic bladder outlet obstruction due to benign prostatic hyperplasia from February 2005 to June 2005. Twenty patients were treated with TURP (Group I) and 20 patients were treated with KTP (Group II). All patients were assessed preoperatively and at an interval of 3 months postoperatively based on the International Prostate Symptom Score (IPSS), the quality of life (QoL) index, changes in maximum urinary flow rate (Qmax), and the postvoid residual urine (ml). The safety parameters we evaluated included the operative time (minutes), the postoperative catheterization time (day) and the blood loss (ml). The Kolmogorov- Smirnov & Shapiro-Wilk test, Student's t-test, Student's t-test (paired), and Fisher's Exact test were performed for statistical analysis. RESULTS: The mean age of each group was 68.9+/-9.9 years (group 1) and 63.9+/-9.7 years (group II), and the prostate weight was 49.5+/-15.4cc and 45.0+/-17.3cc, respectively. The mean operation time was shorter for group II (27.7+/-13.6min) than for group I (48.1+/-22.6min) (p<0.05). The mean catheterization time was 5.6+/-1.82 and 1.36+/-1.64 days, respectively, (p<0.001). The blood loss was lower in group II (11.7+/-11.4ml) than in group I (181.9+/-168.17ml, respectively) (p<0.001). CONCLUSIONS: In this preliminary short-term study, KTP Laser enucleation of the prostate was shown to be an effective alternative for treating benign prostate hyperplasia as compared with standard TURP.