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Purpose This study was designed to estimate the value of a second transurethral resection of bladder tumor (TURBT) procedure in patients with initially diagnosed T1 high-grade bladder cancer. Materials and Methods Between August 2009 and January 2013, a total of 29 patients with T1 high-grade bladder cancer prospectively underwent a second TURBT procedure. Evaluation included the presence of previously undetected residual tumor, changes to histopathological staging or grading, and tumor location. Recurrence-free and progression-free survival curves were generated to compare the prognosis between the groups with and without residual lesions by use of the Kaplan-Meier method. Results Of 29 patients, 22 patients (75.9%) had residual disease after the second TURBT. Staging was as follows: no tumor, 7 (24.1%); Ta, 5 (17.2%); T1, 6 (20.7%); Tis, 6 (20.7%); Ta+Tis, 1 (3.4%); T1+Tis, 1 (3.4%); and ≥T2, 3 (10.3%). The muscle layer was included in the surgical specimen after the initial TURBT in 24 patients (82.7%). In three patients whose cancer was upstaged to pT2 after the second TURBT, the initial surgical specimen contained the muscle layer. In the group with residual lesions, the 3-year recurrence-free survival and 3-year progression-free survival rates were 50% and 66.9%, respectively, whereas these rates were 68.6% and 68.6%, respectively, in the group without residual lesions. This difference was not statistically significant. Conclusions Initial TURBT does not seem to be enough to control T1 high-grade bladder cancer. Therefore, a routine second TURBT procedure should be recommended in patients with T1 high-grade bladder cancer to accomplish adequate tumor resection and to identify patients who may need to undergo prompt cystectomy.

PURPOSE Anogential distance (AGD) and the 2:4 digit length ratio appear to provide a reliable guide to fetal androgen exposure. We intended to investigate the current status of penile size and the relationship between penile length and AGD or digit length according to birth weight in Korean newborn infants. MATERIALS AND METHODS Between May 2013 and February 2014, among a total of 78 newborn male infants, 55 infants were prospectively included in this study. Newborn male infants with a gestational age of 38 to 42 weeks and birth weight>2.5 kg were assigned to the NW group (n=24) and those with a gestational age

PURPOSE We investigated the influence of the location of the partial renal vein obstruction on the left kidney, the bilateral testes, and cauda epididymal sperm quality and determined whether this animal model is suitable for varicocele study. MATERIALS AND METHODS A total of 25 adult male Sprague-Dawley rats were assigned to three groups: group 1 (experimental varicocele by partial ligation medial to the internal spermatic vein for 8 weeks, n=8), group 2 (partial ligation lateral to the internal spermatic vein for 8 weeks, n=10), and group 3 (sham operation for 8 weeks, n=7). Rats in groups 1, 2, and 3 underwent a left nephrectomy and bilateral orchiectomy at 8 weeks after the operation. Histological changes and Johnsen score in both testes were analyzed. Fibrotic changes in the left kidney were assessed by quantitative image analysis. Numbers of sperm and proportions of motile sperm in the cauda epididymides were determined. RESULTS Significant histological abnormalities and Johnsen score changes were observed in the testes in group 1. Renal fibrosis did not differ significantly among the groups. The proportions of motile sperm were significantly lower bilaterally in group 1 than in groups 2 and 3. However, the mean bilateral epididymal sperm count in group 1 was not significantly lower than in groups 2 and 3. CONCLUSIONS Our results showed that experimental varicocele in the rat, induced by partial ligation medial to the internal spermatic vein, influences epididymal sperm quality without harmful effects on the left kidney. The present study certifies that this traditional animal model is suitable for varicocele research.

Purpose Ureteroscopic removal of stones (URS) has been widely used to treat ureteral stones because it is comparatively safe, has a high success rate, and enables patients to rapidly return to their daily routines. However, some patients experience pain after URS, but the incidence of acute post-URS pain remains largely unknown. This study aimed to investigate the incidence of acute postoperative pain after URS and the associated risk factors. Materials and Methods Data for 143 consecutive patients who underwent URS from June 2008 to December 2010 were collected. After excluding 8 patients who developed intraoperative complications, the patients were divided into two groups according to postoperative pain on the first postoperative day. Acute postoperative pain was defined as a pain score greater than 4 on a visual analogue pain scale (normal range, 0 to 10). Various factors were analyzed to identify the risk factors that could predict acute postoperative pain after URS. Results The stone-free rate without URS intraoperative complications was 95.5%. A total of 21 (14.6%) patients experienced postoperative pain on the first postoperative day. Young age, psychiatric illness, history of urinary tract infection, use of a stone basket, large stone size, and prolonged operation time were identified as risk factors for acute postoperative pain. Conclusions The incidence of acute postoperative pain is not that low and should not be overlooked, because it is associated with postoperative complications that could result in an unscheduled hospital admission or visit. Active pain control should be contemplated after URS in young patients and in those with a history of urinary tract infection, psychiatric illness, large stone size, and prolonged operation time.

Purpose: The objective of this study was to evaluate the efficacy of tamsulosin on stone clearance after extracorporeal shock wave lithotripsy (ESWL) in patients with a single proximal ureteral stone. Materials and Methods: This prospective randomized controlled trial was performed on 88 patients with a single proximal ureteral stone. After consenting with a doctor, the patients were allocated to the treatment (tamsulosin 0.2 mg once a day) or control (no medication) group, and the efficacy of tamsulosin was evaluated. The primary outcome of this study was the stone-free rate, and the secondary outcomes were the period until clearance, pain intensity, analgesic requirement, and incidence of complications. Results: A stone-free state was reported in 37 patients (84.1%) in the treatment group and 29 (65.9%) in the control group (p=0.049). The mean expulsion period of the stone fragments was 10.0 days in the treatment group and 13.2 days in the control group (p=0.012). There were no statistically significant differences in aceclofenac requirement or pain score between the two groups. Only one patient in the treatment group experienced transient dizziness associated with medical expulsive therapy, and this adverse event disappeared spontaneously. Conclusions: The results of this prospective randomized controlled trial of the efficacy of tamsulosin after ESWL for a single proximal ureteral stone suggest that tamsulosin helps in the earlier clearance of stone fragments and reduces the expulsion period of stone fragments after ESWL.

Purpose To investigate the relationship of transrectal ultrasound (TRUS) findings with the pathological characteristics of prostate cancer (PCa). Materials and Methods The study was conducted retrospectively by analyzing the data for 970 patients who underwent prostate biopsies. Gleason scores and other clinical variables were compared between PCa patients with and without hypoechoic lesions on TRUS. Results Of the 970 patients, PCa was diagnosed in 291 (30%). Of these, high-grade PCa (Gleason score of 7 or more) was diagnosed in 190 (65%). The cancer detection rate was higher in patients with hypoechoic lesions (43.9%) than in those without hypoechoic lesions (21.4%, p

Purpose Although the measles-mumps-rubella vaccination covers most children against mumps in Korea, the development of mumps has been reported. However, the clinical manifestations of mumps orchitis in postpubertal vaccinated patients have never been investigated. Herein we report the clinical features of mumps orchitis in postpubertal vaccinated patients. Materials and Methods This study included a total of 62 postpubertal males who developed acute mumps orchitis from 2005 to 2010. The clinical manifestations such as the incubation period, febrile duration, and the mean duration of orchitis were retrospectively investigated. The laboratory and sonographic findings were also reviewed and compared with the features of previously reported cases of unvaccinated postpubertal mumps orchitis. Results The mean age of the 62 patients was 17.56 years (range, 15 to 29 years). All patients were serologically confirmed with acute mumps infection (positive immunoglobulin [Ig] M and negative or positive IgG). The mean incubation period was 5.39 days (range, 0 to 23 days), with a febrile duration of 1.8 days (range, 0.5 to 3 days), and a mean duration of orchitis of 4.96 days (range, 0 to 17 days). Sonography revealed unilateral orchitis in 58 patients (93.6%) and bilateral orchitis in only 6 (6.4%). Conclusions In our study, mumps orchitis in postpubertal vaccinated patients showed a relatively shorter febrile duration. In addition, less scrotal swelling and a lower incidence of bilaterality were found upon physical examination and ultrasonography. In the future, additional long-term follow-up is needed to determine the features of mumps orchitis in postpubertal vaccinated males, and an additional booster vaccination should be considered.