Purpose We retrospectively reviewed the cases of transurethral prostatectomy benign prostatic hyperplasia. We defined the morbidity, hospitalization and urethral catheter time, complication and operator's skilled experience and compared to transurethral prostatectomy in the historical series. Materials and Methods A retrospective chart review of 720 consecutive patients who underwent tranasurethral prostatectomy between 1990 and 1999 at our institution for symptomatic benign prostatic hyperplasia was performed. Perioperative and late postoperative morbidity and their risk factors, hospitalization and urethral catheter time, operator's skilled experience were analyzed. The objective cases were divided by operator's experience into 5 groups, and compared in each group. Results Patients were identified with an average of 66 years(range 45 to 88). Significant co-morbidity(2 or more co-morbid disease processes) was identified preoperatively in 22.1% of the patients. The most common indication for transurethral prostatectomy was prostatism only(63%). Average weight of resected tissue was 18.6gm. There was no perioperative patient mortality. Blood transfusion rate was 6.9%. The rates of early and late postoperative complications were 13.7% and 6.2%. Total average hospital stay was 5.5 days and 5.3 days from 1995 through 1999. Average preoperative symptom score was 23.8(range 10 to 35) and postoperative symptom score was 9.5(range 3 to 30) with an average follow up of 42 months(range 6 to 44 months). Conclusions In the 1990s complications of transurethral prostatectomy were relatively lower than rates in historical series. The average hospital stay and urethral catheter time have steadily decreased during the last 10 years. Transurethral resection of prostate could provide relief of lower urinary tract symptoms with high safety rate and low complication rate. Our study suggest that technique of trnasurthral resection is improving step by step by accumulating experience of operation and stabilized skillful technique will be achieved after experience of more than 150 cases.

Based on urological statistic results, finding a cyst in prostate are not common cases. The size of cysts are usually smaller than prostate and they are also generally found within prostate or seminal vesicles.Nevertheless, we have experienced a case of a large prostaic cystadenoma which is misdiagnosed as a mullerian duct cyst.A 55-year-old male visited Ewha Woman's University Hospital with the symptom of residual urine sensation and no other specific symptoms. We could find a large multiple septated cystic mass in his pelvis by CT scan. The large multiple septated cystic mass seemed a Mullerian duct cyst. But after surgical excision, the department of pathology noticed us it was a prostatic cystadenoma.Presently, we report this case with a review of the mullerian duct cyst and other cyst associated with prostate.

Objectives We retrospectively reviewed the cases of ureteroscopic stone removal at our hospital from January, 1994 to August, 1999 and defined the efficiency and complications of ureteroscopic stone removal. Methods Ureteroscopic stone removal was in 255 cases of ureteral stone from January, 1994 to August, 1999. Patients were 142 males and 113 females, and mean age was 42.5 years. 20 stones were located in the upper ureter, 29 stone in the mid ureter, 206 stones in the lower ureter. The stone size was less than 5mm in 95 cases, from 5 to 10mm in 117 cases and more than 10mm in 43 cases. Ureteroscpic stone ramoval was performed with 7.5Fr, 9.5Fr rigid ureteroscope under general, spinal, and epidural anesthesia. Results 255 cases of ureteroscopic stone removal were performed and over all success rate of ureteroscopic stone removal was 97 percent. The success rates of upper, mid and lower ureteral stones were 85, 93 and 99 percent. According to the size, the success rate was 99 percent in stones less than 5mm, 98 percent in stones of 5 to 10mm and 90 percent in stones more than 10mm. There were 8 cases of complication and over all complication rate was 3.1 percent. Complications consisted of severe mucosal injury(3 cases), ureteral perforation(3 cases), gross hematuria(1 case), urinary tract infecion(1 case). Complications were treated successfully with conservative treatment except 1 case of severe mucosal injury that required ureteral reimplantaton. Conclusion Ureteroscopic stone removal could provide rapid resolution of obstruction and colic due to ureteral calculi with high seccess rate and minimal complications.

Summary form only given. Most urologists still think that a fundamental treatment method for the BPH (benign prostatic hyperplasia) is the TUR (transurethral resection). However, a group of urologists and medical engineers have developed a variety of equipment that were designed to cover the demerits of the TUR based on the concept of thermotherapy. Though much of the equipment has already become obsolete, the procedure using a laser to ablate the prostate developed in the 1990s has been improved and has become well-known among urologists.

Objectives Urethral masses are not common in urogenital disease. The purpose of this study is to investigate and analyze urethral masses. Methods We reviewed 82 cases of urethral mass which were confirmed pathologically at Urology Department of Ewha Womans University Hospital from January 1985 to December 1994. Results 1) Age distribution was between 10 and 82 years(mean age 48.7 years), showing the highest incidence in 31 to 60 years(53/82, 64.6%) and female to male ratio was 5.8:1. 2) Major symptoms were foreign body sensation of urethra(42/82, 51.2%), vaginal spotting (20/82,24.4%), dysuria(12/82, 14.6%), residual urine sensation and urinary frequency. 3) Among them, 40 cases were urethral caruncle(40/82,48.8%), 13 were urethral diver-ticulum(13/82, 15.9%), 10 were urethral condyloma(10/82, 12.2%), and 8 were urethral leiomyoma(8/82, 9.8%). 4) Among urethral caruncles, 24 cases were telangiectatic type(24/40, 60%), 8 were papillomatous type(8/40, 20%) and 8 were granulomatous type(8/40, 20%). 5) Surgical excision with electrocauterization or laser fulguration was performed in all cases and radiation therapy was added in case of leiomyosarcoma. Conclusion These results suggest that urethral masses are more common in female than male, most of them are benign condition, urethral caruncle is a major disease, and surgical excision with electrocauterization or laser fulguration is a good treatment.

Cystic lymphangiomas are comparatively rare, benign tumors of lymphatic system and their histogenesis are uncertain. About 75% of theses lesions are in the neck, 20% are in the axillary region, and 5% are in the mediastinum, retroperitoneal region or groin. But retroperitoneal cystic lymphangiomas are very rare. Retroperitoneal cystic lymphangiomas are usually found incidentally during diagnostic procedures performed for unrelated clinical reasons or at surgery. Although retroperitoneal cystic lymphangioma is a benign lesion, it may cause significant morbidity due to its large size and its often invasive character with a strong tedency to secondary infection. They generally present as a palpable mass or abdominal pain and fever related to hemorrhage or inflammation of the cystic wall. The treatment of choice is surgical excision. We experienced a case of retroperitoneal cystic lymphangioma in a 4-year-old boy who had developed rapid abdominal distention and abdominal pain for 4 days. We have completely excised large cystic mass & histologically confirmed cystic lymphangioma. A brief review of literature was made. (J Korean Pediatr Soc 1999;43:111-116)

Objectives The purpose of this study is to investigate the clinical result of Marshall-Mar-chetti-Krantz operation, one of the treatment methods for stress urinary ncontinence. Methods Authors have analyzed the 66 cases out of 83 stress urinary incontinence patientsin whom Marshall-Marchetti-Krantz operation and 1 year follow-up was performed at UrologyDepartment of Ewha Womans University Hospital from January 1990 to December 1993. Results The results were as follows: 1) The patients' age distribution was from 33 to 53 years old (mean age 44.9 years). The average number of deliveries was 3.1 and 29 patients were multipara with more than 4 deliveries. 2) As compared with urinary incontinence grade, Grade I was seen in 22 cases (43.9%),Grade II in 40 rases (42.4%) and Grade III in 4 cases (6.1%). Overall Grade II was most frequent. 3) PUV angle between posterior urethra and bladder base seen by chain cystourethrographywas 154.0°(134-179°) in average and urethral inclination was 23.9°(14-50°)in average. 4) The operation took between 36 to 72 minutes with mean 45.2 minutes. Urethral catheter was placed after the operation for mean 5.0 days (4-8 days) ana hospitalization days weremean 8.3 days (7-15 days). 5) 6 cases (9%) of urinary retention was the only postoperative complication and all of themwere resolved 3-7 days after intermittent catheterization. 6) In the fi11ow-up after 6 months, recurrence was seen on the third month after the operationin 2 cases and on the 12th month in 3 cases which resulted in 92.4% of operation success rate. Conclusion Marshall-Marchetti-Krantz method can safely be performed in patients withstress urinary incontinence and further comparative study with otter operation method be needed.

Rhabdomyosarcoma is the most common soft tissue sarcoma in childhood and 20 percent of Rhabdomyosarcoma in children arise in the urogenital. The paratesticular rhabdomyo-sarcoma is a highly malignant neoplasm with early invasion and metastases, which has retroperitoneal metastases in about half of the patient at time of dignosis. However, the survival rates have been improved greatly by using multimoaltherapy.We report a case of paratesticular rhabdomyosarcoma with brief review of the literatures.

The largest character of the modern society, so called the era of the information. is 'C&C'(Computer and communication). As the up-to-date science and new knowledges develope,so far there is increasement of the real necessity of the computer to use huge medical informationmore rapidly and effectively.As the electronic industry is developed, it is possible to do a business with the personalcomputer(PC), which was possible only by a large-computer at past.After the recognition of the rational inevitability of the business computerization, and ifsomeone looks for the sujects to computerize. they must choose the supervision of the clinicaldata about the in-patient first of all.The patient supervising system should retain the databases which serve the reference functionto user's requirements. Under these purposes, it is very important to classify the cases dependingon the names of the diagnoses and operations, and easy and rapid recollect of the appropriatedata. And of course this system also be able to contribute to the research and education aswell as the preservation of the patient data.So, we report the results of 2-year practice in urologic patient supervising program, whichwe enlighted for presenting the guidelines for Program making of the in-patinent data- supervi-sion and the standard for the mandatory clause and database files so that in order to gaugethe ability of the computerization of the patient supervision with PC from now on.

Primary signet ring cell adenocarcinoma of the bladder accounts for less than 1 per centof all primary bladder neoplasm. 19 cases have been reported in the literature.This tumor is insidious because of its subepithelial infiltrative nature, which makes diagnosis possible only late in the course of the disease.Survival is poor ; greater 50 per cent of the patients are dead within a year after diagnosis.Radical surgery offers the only hope of palliation ; irradiation and chemotherapy have notbeen effective.We are reporting two cases of primary signet ring cell adenocarcinoma of the bladder treatedwith radical cystectomy with pathological findings and review of the literature.

Benign urethral neoplasm, especially leiornyoma of the female urethra, is a very rare entity, with relatively few cases reported.Recently we experienced 3 cases of leiomyoma in the female urethra and so reported with review of the literatures.

Treatment of benign urethral strictures frequently is difficult because of a high rate of recurrence.In general electrocautery resection of fibrous scar tissue has been unsatisfactory. since the irregular thermal injury may only promote further scarring. Because of their unique physical properties and tissue effects lasers theoretically offer advantages over conventional techniques for treatment of urethral strictures. The thermal injury resulting from neodymium : YAG laser irradiation may heal with more elastic properties and less fibrous contraction than an electrocautery burn. Accordingly endoscopic application of laser energy could produce thermal coagulation of the fibrous area with a secondary slough of the scar tissue and re-epithelialization without scar.A total of 19 cases with benign urethral strictures underwent treatment with circumferential application of neodymium : YAG laser irradration to the scarred area after endoscopic cold urethrotomy.There were no adverse effects and although one patient suffered recurrent stricture within 2 months, the postoperative results were good in all patients including recurrent case.We reviewd our experience with neodymium : YAG laser treatment of benign urethral strictures.

Castleman's disease(Giant lymph node hyperplasia) is a disorder characterized by massive enlargement of lymph node in the mediastinum and occurs rarely in the neck, axillary area and abdomen. Giant lymph node hyperplasia was first described by Castleman in 1954. The Castleman's disease in the retropertoneum is the extremely rare disease according to the literatures.The authors experienced a Castleman's disease in the retroperitoneum of 40 year old male patient who had been suffered from intermittent abdominal discomfort and indigestion. and so reported the case with thereview of the literatures.

Primary non-refluxing, non-obstructed megaureter is a rare condition among the megaureter.A 11 month old monozygote twin baby had been admitted due to blood and pus tinged spotson a diaper. Although the excretory urogram showed moderately dilated left ureter, but the voiding cystogram and diruetic renogram showed no reflux and no obstruction. So we diagnosed as a primary non-refluxing, non-obstructed megaureter.We report this case with the review of literatures.

Urolithiasis is common but one the most important disease in the field of urology. Recently the incidence of urolithiasis is increasing according to the improvement of living standards in Korea. Althought the etiology and pathogenesis of urolithiasis are interactions of a very complex process ans has not yet been clearly established, it is believed that diet containing calcium, a one of the stone forming-components, such as milk may play a principle role in the stone formation.We carried out epidemiologic study to determine the relationship between urilithiasis and dietary pattern changes to westernized food in Korean people. Comparision study was carried out between 1970s and 1980s.The following results were obtained :1) The yearly personal consumption of rice was not much changed in 1970s but in 1980s it continued to decrease. The yearly barley consumption continued to decrease after late 1970s, declining to level below 2kg in 1987.2) The yearly personal comsumption of meat was not much changed upto mid 1970s but after 1977 it continueed to increase, showing 2.7 times increase in 1989 compared to that of 1977.3) The yearly personal consumption of milk and dairy products was markedly increased ; 8.4 times in 1970s and 3.6 times in 1980s. In 1989 it increased 35.2 times compared to that of 1970.4) Changes in the ratio of patients with urolithiasis to the total patients admitted to urologic department was not remarkable, but yearly, number of patients with urolithiasis continued to increase, especially from the late 1970s to the early 1980s. In 1970s the urolithiasis prevalence was highest in the regious such as Pusan, Kyungbook, Honam but in 1980s it changed its stage to Seoul.5) Age distribution revealed under the age of 20, no specific changes were noted in both 1970s and 1980s. In 1970s urolithiasis patients over the age of 40 revealed high increase rate 3.4 times, but in 1980s age group over 40 only showed 1.6 times increase. to the surprise, age group between 20-40 showed 1.4 times increase, indicating not much differences between both age groups in patient numbers of increase rate.6) Sex prevalence was greater in famale than male in both 1970s and 1980s.7) Locational prevalence of urolithiasis showed increased rate of renal stone in both 1970s and 1980s. But that of bladder stone was not remarkable.8) Seasonal prevalence revealed highest prevalence rate in summber and lowest in winter.9) Through analysis of following factors ; higher living standards due to ecnomic growith, increased milk and meat concumption due to change in dietary pattern to westernized food, decrease carbohydrates such as rice and barley, we can conclude that dietary change is closely related to urolithiasis and its correlation is more significant in 1980s than 1970s.

Cholesteatoma is a form of squamous metaplasia resulting in a collection of keratin composed of desquamated epithelial cells and occurs extremely rarely in the urinary tract.Cholesteatoma of the renal plvis was first described by Ebstein in 1982. Since the fewer than 30 cases have been reported until now in the literatures.The authors experienced a cholesteatoma of the renal pelvis in 42 years old female patient who had been suffered from intermittent right flank pain, and reported the case with review of the literatures.

Retrocaval ureter is a rare congenital anomaly that occurs is patients almost exclusively on the right side. The usual cause is the persistence of fetal posterior cardinal vein, then the ureter passes posterior to the vena cava and is deviated medially as the vena cava migrates medially to its normal position. This produces the typical S-shaped configuration of retrocaval ureter. Since 1983, when Hochstetter first described this condition. about 200 cases have been reported(8 cases in Korea).Herein we will report on 2 cases with the brief review of literatures.