• Archives of Plastic Surgery
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• v.33 no.4
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• pp.514-517
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• 2006

Purpose: To report a rare case of concealed penis that was aggravated by circumcision and simple way of treatment using skin flap. The concealed penis is a primarily pediatric disease and is usually treated by urologists. The plastic surgeons tend to see these patients when it become secondary deformation or in conjoinment with other specialties. In such situation, the plastic surgeons do not have many experiences. Methods: A 3-year-old boy was admitted with aggravated concealed penis after circumcision in congenital webbed penis. Patient had been operated with scar revision and skin flap and peri operative antibiotics. Results: The patient recovered well without any complication such as infection, hematoma and necrosis of flap. Patient was discharged POD#7 with remaining sutures. Patient was followed up for 7 months and he has no sign of erectile dysfunction, voiding dysfunction and evidence of inflammation of the urinary system. Conclusion: We experienced a case of concealed penis that was aggravated from aggressive circumcision in congenital webbed penis.

• Journal of Korean Neurosurgical Society
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• v.47 no.6
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• pp.473-476
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• 2010

Sacral nerve stimulation (SNS) is an effective treatment for bladder and bowel dysfunction, and also has a role in the treatment of chronic pelvic pain. We report two cases of intractable pain associated with cauda equina syndrome (CES) that were treated successfully by SNS. The first patient suffered from intractable pelvic pain with urinary incontinence and fecal incontinence after surgery for a herniated lumbar disc. The second patient underwent surgery for treatment of a burst fracture and developed intractable pelvic area pain, right leg pain, excessive urinary frequency, urinary incontinence, voiding difficulty and constipation one year after surgery. A SNS trial was performed on both patients. Both patients' pain was significantly improved and urinary symptoms were much relieved. Neuromodulation of the sacral nerves is an effective treatment for idiopathic urinary frequency, urgency, and urge incontinence. Sacral neuromodulation has also been used to control various forms of pelvic pain. Although the mechanism of action of neuromodulation remains unexplained, numerous clinical success reports suggest that it is a therapy with efficacy and durability. From the results of our research, we believe that SNS can be a safe and effective option for the treatment of intractable pelvic pain with incomplete CES.

• Archives of Reconstructive Microsurgery
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• v.25 no.1
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• pp.19-24
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• 2016

Urethral reconstruction is a problematic issue, thus its management can be challenging. Different methods using various materials were introduced for urethral reconstruction. The authors have made some changes in the groin flap surgery, affording more successful urethral reconstruction for defects of long urethra and penile soft tissue. A 45-year-old male requested both functional and cosmetic reconstruction of his defected penis, caused by an iatrogenic urethral injury and chronic infection following removal of paraffin self-injected on the penile shaft. The defect affected the full length of the penile urethra, corpus spongiosum, and prepuce. A groin flap was designed, measuring $28{\times}10cm$. The most distal flap was utilized for the construction of the luminal surface of the neourethra; relaxed length measuring 8 cm, and the lumen wide enough. Competent external meatus and neourethra was confirmed by retrograde cystogram and the patient voided with sufficient urine caliber up to 2 years follow-up. This operative technique has advantages. Donor sites have non-hair bearing skin for the neourethra and minimal or almost notrecognizable donor site morbidity. After surgery, the patient was relieved from voiding difficulties combined with psychological stress. The author would like to introduce a unique approach for the urethral and ventral phalloplasty using the groin flap.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.16 no.3
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• pp.200-205
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• 2013

We present a case of a 47-month-old female suffering from acute urinary bladder neck obstruction and bilateral hydronephrosis secondary to a fecaloma. Fecaloma is defined as an accumulation of inspissated feces in the colon or rectum giving the appearance of an abdominal mass. A fecaloma can be developed by diverse causes and the causes of the fecaloma in this case were septum reformation after the Duhamel procedure and long-term constipation. Chronic constipation is very common at outpatient clinic. However, acute urinary retention and voiding difficulty caused by fecaloma in the giant Duhamel pouch has never been reported in Korea. We would like to present our case with acute urinary retention due to a fecaloma and suggest that fecaloma might be considered as one of the causes for acute urinary retention, especially in cases with previous Duhamel operation for repair of Hischsprung disease.

• Childhood Kidney Diseases
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• v.7 no.1
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• pp.106-111
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• 2003

We experienced a 4-month-old boy presenting with fever and painful scrotal swelling. Diagnostic work-up showed the presence of urinary tract infection and concurrent acute epididymitis. On the voiding cystourethrography, vesicoureteral reflux and urinary reflux through the ejaculatory duct and the seminal vesicle were detected without obvious urethral obstruction. In general, urinary reflux into the seminal vesicle can take place with obstructive lesions of the urethra and may cause epididymitis in infants. We report a case of urinary reflux without urethral obstruction with a brief review of related literatures.

• Archives of Plastic Surgery
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• v.39 no.3
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• pp.257-260
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• 2012

This report describes the use of a tubularized random flap for the curative treatment of recurrent anterior urethral stricture. Under the condition of pendulous lithotomy and suprapubic cystostomy, the urethral stricture was removed via a midline ventral penile incision followed by elevation of the flap and insertion of an 18-Fr catheter. Subcutaneous buried interrupted sutures were used to reapproximate the waterproof tubularized neourethra and to coapt with the neourethra and each stump of the urethra, first proximally and then distally. The defect of the penile shaft was covered by advancement of the surrounding scrotal flap. The indwelling catheter was maintained for 21 days. A 9 month postoperative cystoscopy showed no flap necrosis, no mechanical stricture, and no hair growth on the lumen of the neourethra. The patient showed no voiding discomfort 6 months after the operation. The advantages of this procedure are the lack of need for microsurgery, shortening of admission, the use of only spinal anesthesia (no general anesthesia), and a relatively short operative time. The tubularized unilateral penile fasciocutaneous flap should be considered an option for initial flap urethroplasty as a curative technique.

• Archives of Plastic Surgery
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• v.36 no.2
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• pp.225-228
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• 2009

Purpose: Urethral reconstruction following failed hypospadias repair is difficult because of a severe shortage of the skin on ventral surface of the penis. We experienced a successful reconstruction of a failed hypospadias repair using the radial forearm free flap. So we present our case. Methods: A 16 - year - old boy had a proximal shaft hypospadias and had been taken a transverse preputial island flap but it completely broke down. There was no spare skin on the shaft of the penis. So we reconstructed a neo - urethra and the ventral skin of the penis with the radial forearm free flap. Results: Postoperatively he made relatively good process. The urethral catheter was maintained for 10 days and self - voiding was started. The suprapubic catheter was removed at the postoperative 30th day after control of cystitis. The postoperative appearance of the penis is acceptable and a straight erection is achieved. Conclusion: In the scarred penis with hypospadias, the radial forearm free flap transfer is a reliable reconstructive method for the neo - urethra and the ventral skin of the penis.

• Journal of Sensor Science and Technology
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• v.13 no.6
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• pp.436-445
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• 2004

In this study, a uroflowmetry system was developed to detect a voiding symptom conveniently at home or hospital. A implemented hardware was composed of mechanism and system circuit part, the software was developed to process uroflow data, graph display, extraction of parameter, and evaluation of congregate rate so as to analysis obtaining uroflow data. The following experiment was performed to evaluate an ability of classification and fitness. The curve pattern of uroflow was classified into each symptom. Various parameters were calculated in the curve pattern of each uroflow as follows. The parameters are MFR, AFR, VOL, VT, and FT. A significant difference among parameters was examined by a statistical analysis for extracted parameters between normal and abnormal experimental group. The uroflow data with the various symptom was divided into normal and abnormal group using fuzzy classifier. The result of the fuzzy classification using MFR and AFR was superior by 91.23 % than grouping evaluation including VOL.

• Journal of Veterinary Clinics
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• v.29 no.2
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• pp.181-185
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• 2012

An 11-year-old, intact female Shihtzu showing anuria was diagnosed as a urethral leiomyoma. The tumor occupied and obstructed the urethral lumen. In this report, the urethral tumor and secondary obstruction could be diagnosed via ultrasonography and contrast study such as excretory urography and voiding urethrography. Ultrasonography revealed a hypoechoic, demarcated urethral mass in proximal urethra. Contrast study confirmed the urethral obstruction and ruled out the expansion of the tumor into the urinary bladder. The clinical signs of the dog were completely resolved after removing the urethral mass and urethral anastomosis. Leiomyoma is a benign smooth muscle tumor, and rarely reported in lower urinary tract.

• Journal of Korean Biological Nursing Science
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• v.19 no.2
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• pp.60-68
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• 2017

Purpose: The purpose of this study was to analyze the relationship between lower urinary tract symptoms and urodynamic parameters to investigate the characteristics of mixed urinary incontinence (MUI) and stress urinary incontinence (SUI). Methods: The subjects were 318 women with MUI and 128 women with SUI. Data were collected retrospectively from electronic medical records including Bristol Female Lower Urinary Tract Symptoms-Scored Form (BFLUTS-SF), Incontinence Quality of Life Instrument (I-QOL), voiding diaries, and urodynamic parameters. Results: Compared with the SUI group, the MUI group was older and showed lower I-QOL and more severe urinary tract symptoms. The MUI group had more urinary frequency, more nocturia, and a higher urgency score than the SUI group. In the correlation analysis, the greatest difference between the two groups was that urgency was associated with Qmax, maximal cystometric capacity, and detrusor overactivity only in the MUI group (r = -.175, p= .004; r = -.281, p< .001; r= .232, p< .001, respectively). Conclusion: As a result of this study, we propose that a customized management program that emphasizes the control of urgency for the MUI group, and one that effectively strengthens the weak pelvic floor for the SUI group.