Sang Jin Oh

Laparoscopic Excision of a Urachal Cyst Containing Large Stones in an Adult

Stone-containing urachal cysts are extremely rare in adults. Here, we report the case of a 58-year-old man with a urachal cyst who had lower abdominal pain and urinary frequency. Abdominal ultrasonography and computed tomography showed hyperdense stones in the urachus. He was treated with a laparoscopic excision using a transperitoneal approach. The pathological diagnosis was an inflammed urachal cyst. This rare case illustrates an inflammed urachal cyst containing stones treated with laparoscopy.

Early Experience with Transobturator Vaginal Tape Inside-out(TVT-O) Procedure for the Treatment of Female Stress Urinary Incontinence

Purpose: Tension free vaginal tape, which has become the common therapy for female stress urinary incontinence, has a complication associated with a blind passage. Transobturator vaginal tape inside-out (TVT-O) is a technique for the passage of the tape through the obturator foramens from inside to outside. We intend to evaluate the efficacy and safety of the TVT-O. Materials and Methods: From September 2004 to December 2004, 35 patients underwent TVT-O under spinal anesthesia. Among them, 30 patients have been followed-up more than 12 months. The preoperative assessment included past history, physical examination, voiding diary, 1-hour pad test, urinalysis, voiding cystourethrography (VCUG), urodynamic study. Post-operatively a 16 Fr urethral Foley catheter was left for 24 hours. The procedural outcome, subjective satisfaction and complications were assessed retrospectively. Results: The mean operative time was 15 minutes (range 12∼20). Average hospital stay was 3.5 days (range 2∼14). No intraoperative or postoperative complications were noted. One patient had immediate voiding difficulty, which was resolved after 2 weeks of clean intermittent catheterization. Three out of 10 patients (30%) with urge incontinence improved after the operation. The mean followed-up period was 13 months. Of 30 patients, 29 patients (96.6%) were cured and 1 patient (3.3%) improved. Subjective cure was present in 29 patients (96.6%). Conclusion: TVT-O is a simple, safe and effective surgical treatment for female stress urinary incontinence. However, a longer follow-up will be necessary to determine its long-term effect. (J. Korean Continence Society 2006;10:33-37)