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Purpose Aquaporin (AQP), a protein located in the cellular membrane, allows rapid passage of water across the cell membrane. Various AQP subtypes have been associated with ureteral obstruction. In particular, AQP3 has two functions: water and glycerol transport. The aim of this study was to investigate the expression of AQP3 in the ipsilateral rat kidney in unilateral partial ureteral obstruction (UPUO). Materials and Methods Sprague-Dawley rats (n=30, 200-250 g) were divided into two groups. A sham operation was performed in the control group (n=10) and UPUO of the left upper ureter with a silicone tube was induced in the UPUO group (n=20). The left kidney was obtained from both groups 7 days after the operations. The kidney specimens underwent immunofluorescent staining with AQP3 monoclonal antibody, and the density of AQP3 in the tissue was measured with an image analyzer. Results In the UPUO group, thinning of the epithelial layer and infiltration of inflammatory cells was seen along with the localized expression of AQP3 in the basolateral aspect of the principal collecting duct cells. The mean optical density of AQP3 was significantly lower in the UPUO group than in the control group (100.9±17.5 compared with 131.7±16.9; p

Purpose: The effect of neoadjuvant hormonal therapy (NHT) on radical retropubic prostatectomy (RRP) for prostate cancer is various and remains a controversy for urologists. We conducted this study to comparatively evaluate whether NHT before RRP is indicated and beneficial in the aspects of postoperative complications, positive surgical margin, and biochemical recurrence. Materials and Methods: Between September 2006 and December 2009, 69 men were scheduled for RRP as a treatment for clinically localized and locally advanced prostate cancer and were divided into two groups. Group 1 (n=31, 44.9%) was treated with RRP only, and group 2 (n=38, 55.1%) underwent RRP with preoperative NHT. We evaluated clinical parameters, surgical parameters, and the positive margin rate in surgical specimens and the biochemical recurrence rate. Results: There were no statistical differences in age, body mass index (BMI), preoperative biopsy Gleason score, initial serum prostate-specific antigen (PSA) levels, International Prostate Symptom Score (IPSS), or quality of life (QoL) between the two groups (p＞0.05). We also observed no differences in the transfusion rate, mean catheterization time, or positive margin rate (p＞0.05). However, the mean operative time was significantly higher in the RRP with preoperative NHT group than in the other group (p=0.034). There was no significant difference in the biochemical recurrence rate during the last follow-up according to NHT (p=0.102) or positive surgical margin (p=0.473). Conclusions: These results suggest that there were no clinical benefits to the administration of NHT before RRP from the viewpoint of biochemical recurrence.

Purpose: Type III 5-α reductase (SRD5A3; steroid 5-α reductase 3) may be associated with the progression of prostate cancer (PCa). The aim of our study was to determine whether the length of AC repeats in the SRD5A3 gene is associated with the risk of PCa and the expression of androgen receptor (AR) protein in Korean men. Materials and Methods: We compared the length of AC repeats in the short tandem repeat (STR) region of the SRD5A3 gene in 68 PCa patients and 81 control subjects by genotyping. A total of 55 patients in the PCa group underwent radical prostatectomy. We evaluated the expression of AR protein by using Western blotting and tested the association between the type of AC repeats in the SRD5A3 gene and AR protein expression and clinical and pathologic parameters. Results: The short type of STR had less than 21 copies of AC repeats in the SRD5A3 gene. The SS type (short and short type) of STR of the SRD5A3 gene was 2.2 times as likely to occur in PCa patients as in controls (odds ratio, 2.21; 95% confidence interval, 1.14 to 4.31; p=0.019). However, AC repeats of the SRD5A3 gene were not associated with AR protein expression or clinical or pathologic parameters in PCa samples. Conclusions: These results suggest that the short AC repeats of SRD5A3 polymorphism are associated with an increased risk of PCa. SRD5A3 polymorphism may contribute to a genetic predisposition for PCa.

Purpose: We have performed both open partial nephrectomy (OPN) and laparoscopic radiofrequency ablation (RFA) on selected patients since January 2007 and have been following these patients through serial laboratory assessments and computed tomography (CT). The purpose of the present study was to evaluate long-term oncologic outcomes and renal function status for laparoscopic RFA versus OPN at a minimum follow-up of 3 years. Materials and Methods: A total of 55 patients with exophytic, single small renal masses were treated with either OPN (n=14) or laparoscopic RFA (n=41) by a single surgeon. The indications for laparoscopic RFA were as follows: 1) cases with the greatest dimension of the renal mass ＜3 cm, and 2) cases in which the collecting system, renal calyx, and great vessels were free from the tumor margins by 1 cm. Results: The estimated blood loss (EBL), the operation time, and the mean number of hospital days was significantly lower in the laparoscopic RFA group than in the OPN group. Oncologic data did not differ significantly between the two groups. Creatine clearance levels did not differ significantly compared with those before the operation in either group. Conclusions: Our data suggest excellent therapeutic outcomes with laparoscopic RFA with achievement of effective operative times, hospital stays, and EBL compared with OPN. According to our indications for laparoscopic RFA, laparoscopic RFA is an effective minimally invasive therapy for the treatment of small renal masses, yielding oncologic outcomes and renal function equivalent to those of OPN.

Purpose: We assessed the efficacy and safety of the tyrosine kinase inhibitor sunitinib in Korean patients with metastatic renal cell carcinoma (mRCC). Materials and Methods: Between September 2007 and December 2009, all twenty-one patients who had mRCC with a clear-cell component were retrospectively reviewed. Sunitinib was administered orally at a dose of 50 mg daily until disease progression or intolerance to treatment occurred. The primary end point of this study was the objective tumor response assessed by Response Evaluation Criteria in Solid Tumors (RECIST), and the secondary end points were progression-free survival (PFS) and overall survival (OS) rates as well as assessment of adverse effects. Results: After a median of 17.4 months (range, 5.7-33.1 months) of treatment, 11 patients (52.4%) had an objective response with a complete response in 1 patient (4.8%), and a partial response in 10 patients (47.6%) as the best tumor response. The median PFS was 13.4 months (95% confidence interval [CI], range, 12.3-14.5 months), and the median OS was 28.1 months (95% CI, 21.8-34.4 months). All patients experienced adverse events of some sort, but the studied treatment protocol was well tolerated and most patients experienced reversible grade 1 or 2 toxicities. Conclusions: Sunitinib was efficacious in the treatment of metastatic clear-cell RCC, and was well tolerated in Korean patients. Although sunitinib treatment-related adverse events such as hand-foot syndrome and facial/generalized edema were observed with a higher incidence than in Western trials, they were mainly mild to moderate, and readily managed.

Purpose: To evaluate the safety and clinical effects of extracorporeal magnetic innervation (ExMI) for urinary incontinence after radical prostatectomy. Materials and Methods: Thirty-two patients with urinary incontinence after radical prostatectomy were randomly assigned to receive either ExMI treatment or pelvic floor training alone. For the ExMI group, treatment was initiated 1 week after catheter removal and the treatment sessions were for 20 minutes, twice a week, for 8 weeks. For the control group, only pelvic floor muscle exercises were performed. Patients were followed up at 1 week and 1, 2, 3, and 6 months. Outcomes were assessed by 24-hour pad weight testing, the number of pads used daily, and a quality-of-life survey (I-QoL). Results: Leakage weight during the 24 hours after removing the catheter was 655g and 646g for the ExMI and control groups, respectively. At 1 month, it was 147g and 187g; at 2 months, 33g and 81g (p=0.001); and at 3 months, 9g and 45g (p=0.001), respectively. Finally, 6 months later, leakage weight was less than 10g in both groups. The number of pads used daily after removing the catheter was 4.2 and 4.1 for the ExMI and control groups, respectively. At 1 month, it was 1.5 and 1.8; at 2 months, 0.6 and 0.9 (p=0.033); and at 3 months, 0.1 and 0.6 (p=0.002), respectively. Finally, 6 month later, pads counts were 0 and 0.1. I-QoL scores decreased after surgery, but gradually improved in both groups. No other side effects or adverse events were observed. Conclusions: ExMI provided earlier recovery of continence than in the control group after radical prostatectomy.

Laparoscopic radical nephrectomy is a standard treatment for localized renal cell carcinoma. Although it is less invasiveness than open surgery, it has a steeper learning curve compared with open surgery. We analyzed the results of laparosopic radical nephrectomy that was per-formed by 3 surgeons who had finished a 1-year laparoscopy educational program.

Purpose: Although hydrocelectomy is commonly performed in general urological practice, the incidence of complications and the outcomes of this procedure seem to be underreported in the literature. We evaluated the incidence of complications and the outcomes of patients who underwent hydrocelectomy. Materials and Methods: Between January 1996 and December 2005, 289 patients with hydrocele were retrospectively assigned into three groups according to the degree of dissection or the amount of the excision of the hydrocele sac. Group 1 included 78 patients who were treated by dissection and excision of the entire hydrocele sac. Group 2 consisted of 149 patients who were treated by dissection and eversion of the hydrocele sac. The 62 patients in group 3 underwent operations in which there was little or no dissection of the hydrocele. We analyzed the complications, the effects of surgical treatment and the results according to the surgical techniques. Results: The duration of recovery showed no differences among the three groups. The overall complication rate was 36.3%. Transient scrotal swelling occurred in 28.0% of the patients, hematoma in 2.7%, wound infection in 1.7%, and injury to the epididymis or testis, chronic pain and persistent swelling occurred in 1.3%. The overall incidence of postoperative complications was significantly lower among the patients in group 3. The rate of scrotal swelling was significantly correlated to the volume of the hydroceles and the amount of the excision of the hydrocele sac. Conclusions: The long term results of hydrocelectomy were good. The most common complications following scrotal surgery for hydroceles were scrotal swelling, hematoma, wound infection and injury to the epididymis and testis. Most of the complications were treated by conservative manage

Purpose: Ureter stones are the most common urological disease. The principal objective of this study was to evaluate the results, efficacy, and safety rates of laparoscopic ureterolithotomy for the treatment of large, upper ureteral stones. Materials and Methods: Between April 2006 and February 2008, we conducted laparoscopic ureterolithotomy in 7 patients with upper ureter stones (L2-3). Laparoscopic ureterolithotomy was conducted in 5 patients as a salvage procedure after failed shock wave lithotripsy, in 1 patient as the primary procedure for a large stone (28mm), and in 1 patient for treatment of a radiolucent matrix stone. Laparoscopic ureterolithotomy was conducted via a transperitoneal approach. The mean stone size was 20.7±5.9mm. Results: Laparoscopic ureterolithotomy was successful in 7 patients, and none of the patients required an open procedure. All patients were rendered stone-free after a single procedure. The mean operative duration, mean postoperative hospital stay, and mean estimated blood loss were 142±49 min, 6±2.2 days and 85±29.5ml, respectively. Conclusions: Although the majority of patients with ureter stones can be rendered stone-free via shock wave lithotripsy and endourological procedures, open surgery is required for large and upper ureter stones. In cases of large and upper ureter stones, laparoscopic ureterolithotomy may be considered for a limited group, although many will require open surgery. (Korean J Urol 2008;49:727-732) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏