- Email: [email protected]
MP-11.03
MODERATED POSTER SESSIONS
tients started to use vacuum device twice a day during the first three months. Results: Follow-up was from 8 to 37 months (mean 17 months). Skin defect was ranged from 6-11cm in erect penis. Good functional and esthetical results are achieved in 14 patients, while in remaining two patients, additional correction of skin deformities was needed. Conclusions: Trapped penis is caused mainly by very radical circumcision especially in cases with associated anomalies of penile skin (concealed penis, webbed penis, scrotalized penis, etc.) Various vascularized scrotal skin flaps should be used for one stage reconstruction of missing penile skin.
dribbling of urine and ejaculatory dysfunction in 10 cases. Major problem was the use of hair bearing skin and growing of hair within the urethra causing incrustation and urethritis. The success rate in respect to complications, average urine flow rate and urethral caliber viewed in RGU and MCU in dorsal free graft urethroplasty were 96% and in pedicled skin flap urethroplasty were 84%. Conclusion: Dorsal free graft urethroplasty is better than pedicled skin flap urethroplasty for the treatment of long segment anterior urethral stricture and failed repair of hypospadias.
MP-11.02 Choice of treatment of long segment anterior urethral stricture: pedicled skin flap urethroplasty or dorsal free graft urethroplasty Hossain S1, Hossain A1, Khan S1, Islam M2 1 Dhaka Medical College; 2Bangladesh Medical College, Dhaka, Bangladesh
MP-11.03 Histologic type and staging distribution of germ cell tumors in Korean adults Park D1, Chung M2, Chung J2, Ahn H2, Lee E2, Choi H2, Hong S2, Cheon J2, Yoon D2, Lee Y2, Yoon S 2, Kim W2, Kim H 2, Ryu S2, Lee S2 1 Bundang CHA Hospital, Pochon Cha University, Sungnam, Korea, 2The Korean Urological Oncology Society
Introduction: To explore the feasibility of applying dorsal free graft for the treatment of long segment anterior urethral strictures or failed repair of hypospadias by ventral urethrotomy and to compare the outcome with the pedicled skin flap urethroplasty. Methods: From September 2001 to December 2003, 100 patients of 15 to 65 years with recurrent, multiple, long segment anterior urethral stricture and failed repair of hypospadias, length ranging from 2 to 12 cm were treated by dorsal free graft urethroplasty and pedicled skin flap urethroplasty. 50 patients were treated by dorsal free graft urethroplasty through ventral urethrotomy using free full thickness skin of the distal shaft of penis in 46 cases and buccal mucosa in 4 cases. 50 cases were treated by pedicled skin flap urethroplasty. Results: Follow up of 6 to 12 months revealed normal caliber urethra in retrograde urethrogram and good flow of urine (Qave⬎16 ml/sec) in 48 cases out of 50 cases of dorsal free graft urethroplasty. Urethroscopy showed good take up of the graft in all cases. 2 patients developed wound infection in postoperative period and developed recurrent stricture distal to the graft and managed by optical urethrotomy. In case of pedicled skin flap urethroplasty 6 patients developed recurrent urethritis, 5 patients developed recurrent stricture and 16 patients developed pseudo diverticulum causing post void
Introduction: To investigate the presentation of germ cell tumors (GCT) in terms of histology and stage, as the epidemiology of this disease in uncertain in eastern Asia. Methods: 698 patients, older than 14 years-old and diagnosed with GCT in 20 institutions between 1995 and 2004, were analyzed. Clinical parameters at the time of initial diagnosis such as histology of primary tumor, extent of the disease in terms of the American Joint Committee on Cancer (AJCC) tumor, nodes, metastasis staging (TNMS) system and International Germ Cell Cancer Collaborative Classification (IGCCC), and high-risk stage I nonseminomatous GCT (NSGCT) of testis were classified. Results: Distributions of primary site were 471 cases (67%) of testis including undescended testis, bilateral disease; central nervous system (CNS) 137 cases (20%); mediastinum 78 cases (11%); and retroperitoneum 12 cases (2%). 239 (51%) of 471 testis primary patients were seminoma. Mean age of seminoma and NSGCT of testis were different as 37.0 vs. 28.1. 160 (72% of 223 Nonseminomatous GCT of testis) mixed GCT, 20 (9%) embryonal carcinoma, 8 (4%) endodermal sinus tumor on histology were presented. NSGCTs were dominant in mediastinum primary cases, whereas germinoma was the most common histologic type in CNS primary patients. Pineal gland was the most common site of CNS GCT. High risk vs.
122
non-high risk stage I NSGCT cases were 62 vs. 58. 129 (58%) good, 73 (33%) intermediate, 21 (9%) poor prognosis were presented in NSGCT of testis based on IGCCC, whereas 231 (99%) patients were classified as good and 3 (1%) as intermediate prognosis in seminoma of testis. 193 (82%) cases were presented as Stage I Seminoma testis, 160 (68%) pT1, where 126 patients were stage Ia and Ib, and 67 stage Is. 120 (54%) cases were presented as Stage I NSGCT, 131 (59%) pT1, where 65 patients were stage Ia and Ib, and 55 stage Is. Conclusions: Extragonadal primary GCTs are common in Korean patients. NSGCT presents as a more aggressive form whereas seminoma is a very indolent one when compared with western countries. Our data would be helpful in understanding the eastern Asian GCT presentation. MP-11.04 Unusual genitourinary cancers: results of irradiation treatment for penile cancer Mayer R1, Poschauko J1, Quehenberger F2, Eder T1, Pummer K3 1 Dept. of Therapeutic Radiology and Oncology, 2Statistics and Documentation, 3 Dept. of Urology, Medical University of Graz, Austria Introduction: Penile cancer is a rare disease. We report the treatment results of 16 patients referred for radiotherapy during a time period of 23 years. Methods: Sixteen patients (median age, 59 years) with squamous cell carcinoma of the penis (T1: n⫽9; T2: n⫽4; T3: n⫽3) received external radiotherapy (n⫽14) or Ir 192-HDR-brachytherapy (n⫽2) following total penectomy (n⫽5), partial penectomy (n⫽4) or local excision (n⫽7). Surgery turned out to be macroscopically incomplete in 6 patients. Histological grade was as follows: Grade 1 (n⫽3), grade 2 (n⫽5), and Grade 3 (n⫽8). Involvement of the inguinal lymph nodes was evident in 6 patients clinically and lymphadenectomy was performed in four of them. External radiotherapy ranged from 50 to 60 Gy/1.8-2 Gy with a median of 56 Gy. Brachytherapy was given with a total dose of 45 Gy/3 Gy. Results: During a mean follow up of 61 months (median 56 months, range, 13 to 142 months) penile or perineal recurrence was seen in 3 out of 16 patients (18.8%) which all had stage T2 disease at initial presentation. In two of them, a lymph node as well as distant failure was seen giving a 5-year disease free survival rate of 75.1%. Nine patients have died,
UROLOGY 68 (Supplement 5A), November 2006
tients started to use vacuum device twice a day during the first three months. Results: Follow-up was from 8 to 37 months (mean 17 months). Skin defect was ranged from 6-11cm in erect penis. Good functional and esthetical results are achieved in 14 patients, while in remaining two patients, additional correction of skin deformities was needed. Conclusions: Trapped penis is caused mainly by very radical circumcision especially in cases with associated anomalies of penile skin (concealed penis, webbed penis, scrotalized penis, etc.) Various vascularized scrotal skin flaps should be used for one stage reconstruction of missing penile skin.
dribbling of urine and ejaculatory dysfunction in 10 cases. Major problem was the use of hair bearing skin and growing of hair within the urethra causing incrustation and urethritis. The success rate in respect to complications, average urine flow rate and urethral caliber viewed in RGU and MCU in dorsal free graft urethroplasty were 96% and in pedicled skin flap urethroplasty were 84%. Conclusion: Dorsal free graft urethroplasty is better than pedicled skin flap urethroplasty for the treatment of long segment anterior urethral stricture and failed repair of hypospadias.
MP-11.02 Choice of treatment of long segment anterior urethral stricture: pedicled skin flap urethroplasty or dorsal free graft urethroplasty Hossain S1, Hossain A1, Khan S1, Islam M2 1 Dhaka Medical College; 2Bangladesh Medical College, Dhaka, Bangladesh
MP-11.03 Histologic type and staging distribution of germ cell tumors in Korean adults Park D1, Chung M2, Chung J2, Ahn H2, Lee E2, Choi H2, Hong S2, Cheon J2, Yoon D2, Lee Y2, Yoon S 2, Kim W2, Kim H 2, Ryu S2, Lee S2 1 Bundang CHA Hospital, Pochon Cha University, Sungnam, Korea, 2The Korean Urological Oncology Society
Introduction: To explore the feasibility of applying dorsal free graft for the treatment of long segment anterior urethral strictures or failed repair of hypospadias by ventral urethrotomy and to compare the outcome with the pedicled skin flap urethroplasty. Methods: From September 2001 to December 2003, 100 patients of 15 to 65 years with recurrent, multiple, long segment anterior urethral stricture and failed repair of hypospadias, length ranging from 2 to 12 cm were treated by dorsal free graft urethroplasty and pedicled skin flap urethroplasty. 50 patients were treated by dorsal free graft urethroplasty through ventral urethrotomy using free full thickness skin of the distal shaft of penis in 46 cases and buccal mucosa in 4 cases. 50 cases were treated by pedicled skin flap urethroplasty. Results: Follow up of 6 to 12 months revealed normal caliber urethra in retrograde urethrogram and good flow of urine (Qave⬎16 ml/sec) in 48 cases out of 50 cases of dorsal free graft urethroplasty. Urethroscopy showed good take up of the graft in all cases. 2 patients developed wound infection in postoperative period and developed recurrent stricture distal to the graft and managed by optical urethrotomy. In case of pedicled skin flap urethroplasty 6 patients developed recurrent urethritis, 5 patients developed recurrent stricture and 16 patients developed pseudo diverticulum causing post void
Introduction: To investigate the presentation of germ cell tumors (GCT) in terms of histology and stage, as the epidemiology of this disease in uncertain in eastern Asia. Methods: 698 patients, older than 14 years-old and diagnosed with GCT in 20 institutions between 1995 and 2004, were analyzed. Clinical parameters at the time of initial diagnosis such as histology of primary tumor, extent of the disease in terms of the American Joint Committee on Cancer (AJCC) tumor, nodes, metastasis staging (TNMS) system and International Germ Cell Cancer Collaborative Classification (IGCCC), and high-risk stage I nonseminomatous GCT (NSGCT) of testis were classified. Results: Distributions of primary site were 471 cases (67%) of testis including undescended testis, bilateral disease; central nervous system (CNS) 137 cases (20%); mediastinum 78 cases (11%); and retroperitoneum 12 cases (2%). 239 (51%) of 471 testis primary patients were seminoma. Mean age of seminoma and NSGCT of testis were different as 37.0 vs. 28.1. 160 (72% of 223 Nonseminomatous GCT of testis) mixed GCT, 20 (9%) embryonal carcinoma, 8 (4%) endodermal sinus tumor on histology were presented. NSGCTs were dominant in mediastinum primary cases, whereas germinoma was the most common histologic type in CNS primary patients. Pineal gland was the most common site of CNS GCT. High risk vs.
122
non-high risk stage I NSGCT cases were 62 vs. 58. 129 (58%) good, 73 (33%) intermediate, 21 (9%) poor prognosis were presented in NSGCT of testis based on IGCCC, whereas 231 (99%) patients were classified as good and 3 (1%) as intermediate prognosis in seminoma of testis. 193 (82%) cases were presented as Stage I Seminoma testis, 160 (68%) pT1, where 126 patients were stage Ia and Ib, and 67 stage Is. 120 (54%) cases were presented as Stage I NSGCT, 131 (59%) pT1, where 65 patients were stage Ia and Ib, and 55 stage Is. Conclusions: Extragonadal primary GCTs are common in Korean patients. NSGCT presents as a more aggressive form whereas seminoma is a very indolent one when compared with western countries. Our data would be helpful in understanding the eastern Asian GCT presentation. MP-11.04 Unusual genitourinary cancers: results of irradiation treatment for penile cancer Mayer R1, Poschauko J1, Quehenberger F2, Eder T1, Pummer K3 1 Dept. of Therapeutic Radiology and Oncology, 2Statistics and Documentation, 3 Dept. of Urology, Medical University of Graz, Austria Introduction: Penile cancer is a rare disease. We report the treatment results of 16 patients referred for radiotherapy during a time period of 23 years. Methods: Sixteen patients (median age, 59 years) with squamous cell carcinoma of the penis (T1: n⫽9; T2: n⫽4; T3: n⫽3) received external radiotherapy (n⫽14) or Ir 192-HDR-brachytherapy (n⫽2) following total penectomy (n⫽5), partial penectomy (n⫽4) or local excision (n⫽7). Surgery turned out to be macroscopically incomplete in 6 patients. Histological grade was as follows: Grade 1 (n⫽3), grade 2 (n⫽5), and Grade 3 (n⫽8). Involvement of the inguinal lymph nodes was evident in 6 patients clinically and lymphadenectomy was performed in four of them. External radiotherapy ranged from 50 to 60 Gy/1.8-2 Gy with a median of 56 Gy. Brachytherapy was given with a total dose of 45 Gy/3 Gy. Results: During a mean follow up of 61 months (median 56 months, range, 13 to 142 months) penile or perineal recurrence was seen in 3 out of 16 patients (18.8%) which all had stage T2 disease at initial presentation. In two of them, a lymph node as well as distant failure was seen giving a 5-year disease free survival rate of 75.1%. Nine patients have died,
UROLOGY 68 (Supplement 5A), November 2006