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옥봉기,지윤섭,고영휘,송필현 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.10
Purpose: To investigate the usefulness of urine cytology in the detection of tumor recurrencein terms of practicality and cost-effectiveness. Materials and Methods: We retrospectively analyzed 393 patients who underwent transurethralresection of bladder tumor (TURBT) for non–muscle-invasive bladder cancer(NMIBC) from January 2010 to June 2013. All patients underwent cystoscopy, urinecytology, urinalysis, and computed tomography (CT) at 3 and 6 months after TURBT. In 62 cases, abnormal bladder lesions were identified on cystoscopy within 6 months. Suspicious lesions were confirmed pathologically by TURBT or biopsy. Patients weregrouped by modalities: group I, urine cytology; group II, CT; group III, urinalysis; groupIV, urine cytology plus CT; group V, urine cytology plus urinalysis; group VI, CT plusurinalysis; group VII, combination of all three modalities. Each group was comparedby cost per cancer detected. Results: Forty-nine patients were confirmed to have tumor recurrence and 13 patientswere confirmed to have inflammation by pathology. The overall tumor recurrence ratewas 12.5% (49/393) and recurrent cases were revealed as NMIBC. Sensitivity in groupI (24.5%) was lower than in group II (55.1%, p=0.001) and group III (57.1%, p<0.001). However, in group VII (77.6%), the sensitivity was statistically similar to that of groupVI (75.5%, p=0.872). Under the Korean insurance system, total cost per cancer detectedfor group VII was almost double that of group VI (p=0.041). Conclusions: Routine urine cytology may not be useful for follow-up of bladder cancerin terms of practicality and cost-effectiveness. Application of urine cytology needs tobe adjusted according to each patient.
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Renal Venous Perforation during Reinsertion of a Percutaneous Nephrostomy Catheter
송필현,고영휘,옥봉기,김영욱,이권수,권대현,김현태,박신률,정희창 대한요로생식기감염학회 2014 Urogenital Tract Infection Vol.9 No.1
While the sustainment of percutaneous nephrostomy with regular change in chronic un-operable cases is widely performed for relief of urinary obstructions, performance of the blind procedure without fluoroscopic monitoring could result in clinical disaster. We report on a case of direct renal vein injury by mis-guidance of a nephrostomy catheter, which was successfully managed conservatively by serial venography monitoring combined with intensive conservative treatment. To the best of our knowledge, this is the first report on management of a renal vein injury during the percutaneous nephrostomy.
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