Comparison of intraoperative and short-term postoperative outcomes between robot-assisted laparoscopic multi-port pyeloplasty using the da Vinci Si system and single-port pyeloplasty using the da Vinci SP system in children

강숭구,장원식,김성훈,김상운,한상원,이용승 대한비뇨의학회 2021 Investigative and Clinical Urology Vol.62 No.5

Purpose: We compared the intraoperative and postoperative outcomes of single-port robot-assisted laparoscopic pyeloplasty (S-RALP) using the da Vinci SP® system and conventional multi-port robot-assisted laparoscopic pyeloplasty (M-RALP) in pediatric patients. Materials and Methods: Multi-port and single-port pyeloplasty have been performed in pediatric patients in our institution since October 2015 and February 2019, respectively. We conducted an entire cohort comparison. Considering the learning curve of M-RALP, we defined the last 15 cases of M-RALP as a subgroup of M-RALP and compared this subgroup with the entire cohort of S-RALP patients. Results: Thirty-one patients who underwent multi-port pyeloplasty and 15 patients who underwent single-port pyeloplasty were enrolled in this study. Age, height, body weight, laterality, surgical indication, and ipsilateral differential renal function were statistically similar in the M-RALP and S-RALP groups. The median operative time (3.0 h vs. 2.4 h; p=0.01) and the median console time (2.2 h vs. 1.5 h; p<0.001) were longer in the M-RALP group than in the S-RALP group. There was no significant difference in operative time or console time between the M-RALP subgroup and the S-RALP group. There were no significant differences in the length of hospitalization, pain score, morphine-equivalent use of analgesics, or postoperative differential renal function in all comparisons. Conclusions: This study confirmed that pyeloplasty using the da Vinci® SP system can be started by robotic surgeons who can overcome the learning curve. Robot-assisted laparoscopic single-port pyeloplasty is feasible in noninfant pediatric patients.

남성하부요로증상의 병인

이정구 대한비뇨의학회 2005 Investigative and Clinical Urology Vol.46 No.9

In the past, older male with frequency, weak stream, hesitancy nocturia has prostatism implying his symptoms are related to benign prostatic hyperplasia(BPH). Recently, it was recognized that such symptoms are not a surrogate for BPH. Lower urinary tract symptoms(LUTS) have many causes, of which BPH is but one. The pathophysiology of LUTS is multifactorial. Bladder outlet obstruction(BOO) is one of the principal causes of LUTS: in addition to BOO, detrusor factors such as detrusor overactivity and detrusor underactivity can contribute to the development of LUTS. Of the men with LUTS, lots of them exhibited non-obstructed causes of LUTS in the urodynamic analysis. Increased awareness that there are multifactorial causes of LUTS became a force in changing the pattern of management. Therefore, relieving BOO such as debulking of the prostate mass may not be crucial for solution of LUTS. Aims of the treatment of LUTS also changed from the reducing obstruction and increasing the flow to the patient quality of life and satisfaction by using medical therapy such as alpha-adrenoceptor blockers. This review summarized the multifactorial causes of LUTS in men based on recent literatures 폐색과 노화 및 노화와 연관된 질환들, 신경계질환, 야간다뇨증, 호르몬변화 및 방광질환 등은 다양한 형태로 방광기능에 영향을 미쳐서 하부요로증상을 유발한다 (Table 1). 폐색과 노화의 연관성은 아직 명확하지 않으며 하부요로증상도 비특이성 증상이므로 폐색만으로 그 원인을 설명하기가 어렵다. 더욱이 배뇨근과활동성이나 수축력 저하 시에 나타나는 증상들은 폐색증상과 유사하다. 따라서 전립선비대증의 올바른 치료를 위해서는 하부요로증상을 유발하는 각각의 요인들을 정확하게 감별하는 일이 중요하다.폐색과 노화에 따른 배뇨근의 변화는 일반 조직검사에서는 큰 차이가 없으나, 전자현미경소견에서는 노화와 폐색, 배뇨근수축력저하, 배뇨근불안정 간에 뚜렷한 차이를 보인다. 최근 전립선비대증에 대한 진단이나 치료는 증상점수분석이나 요속검사 결과 등을 기준으로 하지만 두 가지 모두 하부요로증상의 원인적 진단을 내리는 데에는 부족하다. 현재로서는 폐색을 비롯한 하부요로증상의 정확한 진단은 압력요류검사를 포함한 요역동학검사로서만 가능하지만, 앞으로는 배뇨근조직에 대한 조직검사 소견에 의해 하부요로증상의 원인들을 감별할 수 있으리라 기대한다. 하부요로증상을 유발하는 여러 가지 복합적인 요인들에 대한 새로운 인식은 하부요로증상의 치료형태에 변화를 가져오고 있다. 따라서 하부요로증상을 치료하는 데 더 이상 폐색된 전립선비대를 제거하는 것만으로는 충분하지 않을 수 있다. 하부요로증상의 치료는 페색을 제거하고 요류를 향상시키는 목표로부터 환자의 만족도나 삶의 질을 증진시키는 방향으로 전환이 되고 있으며 이에 부응하는 알파아드레날린수용체차단제를 비롯한 다양한 약물치료들이 시도되고 있다.

표재성 방광암에서 종양 형태의 예후적 의의

권순우,박창면,김한권,강길현,송재석,박종연 대한비뇨의학회 2006 Investigative and Clinical Urology Vol.47 No.3

PC3 세포주에서 Docetaxel에 의해 유발된 세포고사에 대한 Sulfated Glycoprotein-2(Clusterin)의 작용에 대한 연구

최종보,김영수,원남희,조재흥 대한비뇨의학회 2002 Investigative and Clinical Urology Vol.43 No.7

Effect of Korean Red Ginseng on Testicular Tissue Injury after Torsion and Detorsion

김영호,김건화,신주현,김강섭,임재성 대한비뇨의학회 2010 Investigative and Clinical Urology Vol.51 No.11

Purpose: Korean red ginseng (KRG) is a potent antioxidant and a free radical scavenger. This study was designed to determine whether KRG could protect against dysfunction and oxidative stress induced by torsion-detorsion injury in rat testis. Materials and Methods: Six-week-old male Sprague-Dawley rats were randomly divided into four groups: a sham-operated control group (C), a sham-operated and KRG-treated group (K), a 2 hours torsion and detorsion group (T), and a 2 hours torsion and detorsion and KRG-treated group (T+K). We measured testis weight and hormone levels and reactive oxygen species (ROS) from the left renal vein. Superoxide generation was measured on the basis of lucigenin-enhanced chemiluminescence in testis tissue. Results: Testicular weight was significantly higher in the T+K group than in the T group; however, there were no significant differences in hormone levels between the 4 groups. The mean level of ROS and superoxide production was significantly higher in the T group than in the C group, whereas administration of KRG attenuated this increase. Upon histologic evaluation, the T group was found to have cellular disarray, a lack of cellular cohesiveness, degenerative changes in the germinal cells, and less distinct changes in the seminiferous tubules, whereas the T+K group had a germinal epithelial layer that appeared nearly normal. Conclusions: The present study demonstrated that KRG recovered the testis dysfunction in the rat testis by suppressing superoxide production. Purpose: Korean red ginseng (KRG) is a potent antioxidant and a free radical scavenger. This study was designed to determine whether KRG could protect against dysfunction and oxidative stress induced by torsion-detorsion injury in rat testis. Materials and Methods: Six-week-old male Sprague-Dawley rats were randomly divided into four groups: a sham-operated control group (C), a sham-operated and KRG-treated group (K), a 2 hours torsion and detorsion group (T), and a 2 hours torsion and detorsion and KRG-treated group (T+K). We measured testis weight and hormone levels and reactive oxygen species (ROS) from the left renal vein. Superoxide generation was measured on the basis of lucigenin-enhanced chemiluminescence in testis tissue. Results: Testicular weight was significantly higher in the T+K group than in the T group; however, there were no significant differences in hormone levels between the 4 groups. The mean level of ROS and superoxide production was significantly higher in the T group than in the C group, whereas administration of KRG attenuated this increase. Upon histologic evaluation, the T group was found to have cellular disarray, a lack of cellular cohesiveness, degenerative changes in the germinal cells, and less distinct changes in the seminiferous tubules, whereas the T+K group had a germinal epithelial layer that appeared nearly normal. Conclusions: The present study demonstrated that KRG recovered the testis dysfunction in the rat testis by suppressing superoxide production.

혈관인성 발기부전에서 Dimethylarginine Dimethylamino-hydrolase의 기능부전이 발기능의 병태 생리에 미치는 영향

오진규,박관진,백재승 대한비뇨의학회 2006 Investigative and Clinical Urology Vol.47 No.10

신우에 발생한 해면상 혈관종

정문수,정무열,신옥란,한창희,강성학,이용석 대한비뇨의학회 2008 Investigative and Clinical Urology Vol.49 No.5

Hemangioma in the urinary tract is a very rare benign tumor that usually causes painless or painful gross hematuria. Its preoperative diagnosis is extremely difficult or even impossible. A female 47-year old patient presented with painless gross hematuria that she'd experience for 4 days. The patient underwent abdominal ultrasound, intravenous pyelography (IVP), cystoscopy, urine cytology, retrograde pyelography (RGP), kidney dynamic computed tomography (CT) and surgical excision. She was finally diagnosed with cavernous hemangioma in the renal pelvis. (Korean J Urol 2008;49:457-460)

상부요로상피종양 환자의 근치적 수술 후 방광종양 재발에 관여하는 인자

조덕현,김재수,김현태,유은상,권태균,김법완 대한비뇨의학회 2006 Investigative and Clinical Urology Vol.47 No.10

신낭종 내 발생한 외상성 출혈

강필문,서원익,최익준,정성환,곽호섭,박오환,정수진,강동일 대한비뇨의학회 2008 Investigative and Clinical Urology Vol.49 No.10

Spontaneous and post-traumatic renal intracystic hemorrhages are extremely rare, but are a potential danger to patients with cystic kidney disease. We report two cases of post-traumatic intracystic massive hemorrhage in renal cysts. One patient was a 27-year-old male who presented with left flank pain and gross hematuria after slipping on the stairs 2 days previously. The other patient was a 58-year-old male who presented with back pain due to an accident. The circulatory states of the two patients were deteriorated and renal intracystic hemorrhages were detected on computed tomography. One patient underwent a simple nephrectomy and the other patient was treated with arterial embolization. We present two cases of renal intracystic hemorrhage, emphasizing early diagnosis and the treatment of choice.

Retrovesical Multilocular Prostatic Cystadenoma Mimicking a Pelvic Cavity Tumor

황의창,박준백,정승일,임창민,김선옥,강택원,권동득,박광성,류수방,최찬 대한비뇨의학회 2009 Investigative and Clinical Urology Vol.50 No.12

We report the case of a 58-year-old man with a multilocular prostatic cystadenoma in the retrovesical space that mimicked a pelvic cavity tumor. Multilocular prostatic cystadenoma is a rare form of benign prostatic hyperplasia that originates from the prostate with extensive spread into the pelvis. Histologically, the tumor consisted of glands and cysts lined by prostatic-type epithelium lying in a hypocellular fibrous stroma. For a cystic tumor adjacent to the urinary tract, ectopic prostatic cystadenoma is needed to be considered in the differential diagnosis of pelvic cavity tumors.