Overactive bladder(OAB) is a symptom syndrome including urinary urgency with or without urinary incontinence, usually combined with frequency and nocturia. There are lots of reports concerning the first-line treatment for OAB, the treatment is still challenging. Extracorporeal magnetic innervation(ExMI) therapy have been known to be safe and effective immediately in stress urinary incontinence and OAB. The aim of this study was to assess the effect of suprapubic magnetic innervation therapy by arm-typed plate in patients with OAB.

The selected subjects were 32 patients diagnosed with OAB between the periods of April to September, 2007. Mean age was 48.3±10.7 years old, and there were 10 males and 22 females patients. Voiding diary, International Prostatic Symptoms Score(IPSS), quality of life(QOL) questionnaire were evaluated as assessment of voiding symptoms. The treatment was performed for 15 minutes, 2 times a week, for 6 weeks with ExMI by arm-typed plate(BioCon-2000. M-Cube, Korea). All of the evaluations were repeated immediately and 3 months after treatment.

The mean urgency episodes decreased from 13.2±1.81 times to 8.7±1.95 times immediately after treatment and 9.6±2.18 times at 12 weeks after treatment(p<0.05). At 6 weeks after starting treatment, the mean frequency decreased from 5.4±1.58 times to 3.6±1.37 times(p<0.05), but the mean frequency after 6 months was 4.3±1.72 times(p>0.05). Significant improvements immediately after treatment were noted in the frequency, urgency, and QOL in IPSS, which were maintained for 3 months(p<0.05). There were improvements in mean voided volume, but these were minimal.

The symptoms of OAB are highly prevalent and significantly affect the quality of life. Effective and prompt management of OAB should be implemented. Our datas suggested that the EXMI therapy by arm-typed plate has the favorable effect on OAB and it may be persist for at least 12 months. Further studies are needed to establish the long-term efficacy of EXMI therapy in patients with symptoms of OAB.

Ureteral stent is commonly used after ureterscopic stone removal(URS). However, there is no definitive clinical criteria in inserting the ureteral stent after URS. Patients often complain of bladder irritative symptoms, hematuria. flank pain and additive endoscopic prodedure is necessary to remove the ureteral stent. Therefore, we studied the clinical epicacy of selective ureteral stenting only when it is required.

Of the patients who was taken URS, the following patients were exclu-ded from stent insertion ; 1) Patients who have mild hydronephrosis or symptoms less than 1week. 2) Patients who were able to insert the ureteroscope through the ureteral orifice without difficulty. 3) Patients who hardly have ureteral mucosal damage seen through the ureteroscopic field after the removal of ureteral stone. 4) Patients who did not need the additional lithoclast during the removal of ureteral stone. Other than the above patients and those with stones above the mid-ureter, a 6Fr. ureteral stent was inserted and kept for 3weeks. There were 29 unstented patients and 38 stented patients.

The average age of the non-stenting and stenting group were 37.5 years old and 39.7 years old and the average stone size were 0.68cm and 0.80cm. The average operation time was 3 minutes in the non-stenting and 8minutes(including ureteral stent insertion time) in the stenting group. Hospital stay was 3 days in both groups. Intermittent gross hematuria and irritative symptoms of the bladder was shown for 3 weeks after operation in most of the patients(32cases, 84.2%) of the stenting group while those in the unstenting group, the symptoms were relieved after2days after operation. Although mild flank pain was shown in few patients(4 cases, 13.8%) of the non-stenting group, severe pain requiring intravenous analgesics was not seen in both groups. There were no specific findings in the intravenous urography which was done at 6 weeks after operation, and no hematuria and pyuria was found in both groups.

The selective placement of ureteral stent following the ureteroscopic removal of stone did not bring specfic complications. We believe that ureteral stent insertion will minimize the inconvenience especially in patients who need to return to their everyday living immediately after operation. Thus ureteral stent insertion should be used in limited situations.

We assessed the quality of life in two different types of urinary diversion ; ileal conduit and orthotopic ileal neobladder through well-validated questionnaire in patients with invasive bladder cancer.

From February 1992 to February 2000, we used a questionnaire consisted of questions about occupational activity, travel, sexual activity, relationship with partner, global satisfactions, etc. in ileal conduit group and orthotopic ileal neobladder group. This questionnaire was scored according to distress from 1 point to 4 point(1 point-no problem, 2 point-a little, 3 point-much, 4 point-very much).

Numbers of patients in ileal conduit group and orthotopic neobladder group were 10 and 6, respectively. Mean age and follow-up period in each group was 72+21 years old, 32+31 month in ileal conduit group, and 55+10 years old. 18+12 months in orthotopic neobladder group. Quality of life in each group showed differences in keeping their jobs, having relationships with others, satisfaction rates about the type of diversion which they have, and overall satisfaction rates.

Even through our data is small in number and relatively short-term in follow-up duration, there are meaningful differences in quality of life and its overall satisfaction rate between ileal conduit group and orthetopic neobladder group. We suggest that it is recommendable to consider not only the surgical outcome but also patients' postoperative quality of life when deciding the type of urinary diversion in advanced bladder cancer patients.