Epidemiology of mumps, mumps complications, and mumps orchitis in Korea using the National Health Insurance Service database.

PURPOSE: To analyze the presentation of mumps and mumps orchitis using the National Health Insurance Service Database (NHISD). MATERIALS AND METHODS: Using information from the NHISD representing all cases of mumps in Korea, data regarding mumps orchitis were analyzed. The International Classification of Diseases, Tenth Revision, and Clinical Modification codes were used for diagnosis. The incidence estimates of the number of mumps cases were analyzed using the Statistical Analysis System (SAS) software. RESULTS: Based on the NHISD, 199,186 people were diagnosed with mumps, and males accounted for 62.3% cases. Teen males accounted for 69,870 cases, the largest number of patients diagnosed with mumps. The annual incidence of mumps increased every year (poisson regression, hazard ratio [HR] 1.026, 95% confidence interval [CI] 1.024-1.027; p<0.025). The risk of mumps was lower in females than that in males (poisson regression, HR 0.594, 95% CI 0.589-0.599; p<0.001). Of the 199,186 patients diagnosed with mumps, 3,872 patients (1.9%) had related complications. Among the mumps complications, the most diagnosed complication was mumps orchitis, which was seen in 41.8% of the males. Mumps orchitis cases accounted for less than 1.5% of the patients with mumps in minors under the age of 20 years and was somewhat higher in 2009 and 2013-2015. CONCLUSIONS: Among the complications related to mumps, meningitis was most common in females, while orchitis was dominant in males. Mumps orchitis also shows periodic outbreaks but is particularly prevalent in adults, which suggests the potential need for additional vaccination against mumps.

Late occurrence of bilateral tuberculous-like epididymo-orchitis after intravesical bacille Calmette-Guérin therapy for superficial bladder carcinoma.

We report a case of bilateral tuberculous-like epididymo-orchitis occurring 3 years after intravesical bacille Calmette-Guérin instillation therapy in an 83-year-old patient with proven superficial bladder carcinoma. The patient had no previous history of tuberculosis. Because of persistent inflammation and painful swelling of the epididymides and testes, the patient underwent bilateral orchiectomy. This case demonstrates the late adverse effects that can occur after intravesical BCG therapy, which in our patient ended in surgical removal of both gonads.

La herniorrafia de Shouldice en el tratamiento de la hernia inguinal primaria. Estudioprospectivo sobre 775 pacientes / Shouldice herniorrhaphy in the treatment of primary inguinal hernia. A prospective study of 775 patients

Introducción. La irrupción de los materiales protésicos en la reparación de los defectos inguinales ha permitido simplificar las técnicas, conseguir una mayor reproducibilidad y mejorar la comodidad postoperatoria. A pesar de ello, las técnicas de reparación anatómica siguen teniendo vigencia y algunas, como la herniorrafia de Shouldice, pueden competir en los aspectos anteriormente comentados. Pacientes y método. Entre 1987 y junio de 2000, 775 pacientes fueron intervenidos quirúrgicamente de hernia inguinal mediante la técnica de Shouldice.Todas las herniorrafias fueron realizadas por el mismo cirujano (J.L. Porrero). Se han analizado la edad, el sexo, la localización de la hernia, la clasificación de Gilbert, los factores de riesgo, el tipo de anestesia, la tolerancia a la anestesia local, las complicaciones postoperatorias, la estancia media, la valoración del dolor, el porcentaje de recidiva y la reincorporación a la actividad social y laboral. Resultados. La edad media de los pacientes era de 52 años y el 93 por ciento eran varones. En el 83 por ciento de casos se realizó anestesia local con sedación; en el 13 por ciento, anestesia raquídea y sólo en el 4 por ciento, anestesia general. La tolerancia a la anestesia local por parte del paciente fue buena en el 83 por ciento y mala en el 7 por ciento; la valoración del cirujano fue buena en el 80 por ciento y mala en el 7 por ciento. Las complicaciones postoperatorias fueron: un 6 por ciento de equimosis, un 3 por ciento de orquitis, un 1 por ciento de atrofia testicular, un 7 por ciento de cefaleas y un 8 por ciento de retenciones urinarias (siempre asociadas a anestesia raquídea o general). El 20 por ciento de los pacientes fueron intervenidos en régimen ambulatorio y el 76 por ciento pasó una noche en el hospital. La reincorporación a la actividad laboral se produjo a los 20 días de media y el porcentaje de recidiva a los 7 años de seguimiento medio fue del 2 por ciento. Conclusiones. La herniorrafia de Shouldice con anestesia local sigue siendo una técnica de reparación anatómica válida para el tratamiento de la hernia inguinal (AU)

High-energy microwave thermotherapy in patients in urinary retention.

PURPOSE: To study the outcome of high-energy transurethral microwave thermotherapy (TUMT) in patients with obstructive benign prostatic hyperplasia (BPH). PATIENT AND METHODS: Between September 1995 and March 1998, patients presenting with urinary retention secondary to BPH were recruited into the study. Their mean age was 67.2 years (range 50-85 years). The mean catheterization time prior to treatment was 3 months (range 15 days-1 year). Among the 200 patients treated during this period, 30 were high anesthesia risk (American Society of Anesthesiologists Class III/IV). The patients were treated in a single 1-hour session using high-energy (Prostatron 2.5) software, the range of energy transmitted being 111.9 to 214.2 kJ (mean 196.3 kJ). Symptoms were scored according to the International Prostatic Symptom Score (IPSS). The mean prostate volume subjected to TUMT was 59 cc (range 40-149.7 cc). The patients were followed every 3 months with measurements of peak flow rate, postvoiding residual urine volume estimation, and IPSS. RESULTS: Of the 200 patients, 33 were lost to follow-up, 155 were responsive (catheter free with physiologically acceptable peak flow rate), and 12 (7%) were nonresponsive. Only 4 patients (2%) experienced deterioration in their flow rates during the follow-up period of 2 years. They underwent transurethral resection. High-energy thermotherapy resulted in irritative voiding complaints in 80% of patients for 2 to 4 weeks. CONCLUSION: The initial results were encouraging, and the 2-year follow-up has shown appreciable sustainability in the treatment outcome, particularly in patients at high anesthesia risk.