Various ablation therapies, such as cryoablation (CA), radiofrequency ablation (RFA), mi-crowave ablation, irreversible electroporation, and high intensity focused ultrasound, are performed for renal cell carcinoma worldwide. In Japan, of these, only CA is covered by national insurance now and CA and RFA are often performed mainly for non-candidates for surgical resection. These ablation therapies are less invasive than surgery and can be performed per-cutaneously under image guidance and local anesthesia. Both CA and RFA have high technical effectiveness (>90% local tumor control). They are safe and their complications are usually minor and asymptomatic. Complications include bleeding, thermal injury of the surrounding organs, infection, pneumothorax, and dissemination. As another advantage, renal function is less affected by ablation therapies. The opportunities of ablation therapies will increase more in the future.

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Bladder cancer tumors are divided into superficial bladder cancer (Tis, Ta, T1) and invasive bladder cancer (T2, T3, T4) depending on the infiltration depth, and the treatment methods for the two types differ greatly.
For superficial bladder cancer, endoscopic transurethral resection of the bladder tumor (TUR-BT) is performed, while for invasive bladder cancer, total cystectomy is the standard treatment.
However, the decrease in quality of life (QOL) after total cystectomy is a major problem, and the 5-year survival rate is less than 60% even after total cystectomy.
In recent years, it is becoming necessary to improve the QOL even in patients who have had total cystectomy.
Therefore, it is extremely important to develop a bladder-preserving therapy with high thera-peutic effect from the standpoint of emphasizing QOL in the treatment of local muscle-invasive bladder cancer.
However, bladder cancer is highly sensitive to chemotherapy, and bladder-preserving chemo-radiotherapy has been performed for about 30 years.
Chemoradiotherapy is also favored by the NCCN guidelines, and our hospital administers chemoradiotherapy + intra-arterial infusion chemotherapy in what we refer to as the OMC-regimen (Osaka Medical College bladder-preserving therapy) as a tetra-modality therapy.
In this paper, we first review the history of treatments with systemic chemotherapy (neo-adjuvant, adjuvant) and chemoradiotherapy (systemic chemotherapy+radiotherapy, in-tra-arterial infusion chemotherapy+radiotherapy) that have been performed at many facilities to date.
Next, we explain in detail the treatment methods, results, and their place in the blad-der-conserving therapy referred to as the OMC-regimen, which is a combination of TURBT, chemotherapy, radiation therapy, and intra-arterial infusion chemotherapy.

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Hematuria, a condition in which red blood cells are mixed in urine, is an important sign which requires the diagnosis and treatment of renal and urinary diseases. Among these diseases, the pathological conditions that cause gross hematuria, also referred to intractable hematuria, often include difficult diseases to treat which require urgent treatment. In such a situation, endovascular procedures such as embolization and stent placement play an important role. Herein, we introduce the management and endovascular procedure for massive intractable hematuria.

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The aim of this article is to provide the basic idea of priapism and practical knowledge for transarterial embolization for non-ischemic priapism.
Learning objectives: 1. Definition, epidemiology, etiology of priapism. 2. Symptoms and findings of priapism. 3. Differentiation between ischemic and non-ischemic priapism. 4. Vascular anatomy of male reproductive system. 5. Indication and methods of transarterial embolization for non-ischemic priapism. Priapism is a full or partial erection that continues for more than 4 hours beyond or unrelated to sexual stimulation1. Calculated cases per 100,000 person-year have been reported to be 0.34-1.5 in Western countries and assumed to be much less in Japan. Priapism falls into three major types, which are ischemic, non-ischemic and stuttering. Among these, ischemic priapism comprises about 95%. Non-ischemic priapism is largely caused by trauma.
Selective transarterial embolization could be an effective way to treat non-ischemic priapism. Even though both domestic and oversea guidelines recommend conservative measures such as applying pressure and cold packing as initial treatment, recent reports revealed that selective embolization has been more frequently performed and yielded feasible results for non-ischemic priapism.

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Erectile dysfunction (ED) is defined as the inability to achieve and maintain a penile erection adequate for satisfactory sexual intercourse. There are many causes of ED. Although, it is often multifactorial, one of the most common causes of organic ED is arterial steno-occlusive disease. Arteriogenic ED is mainly attributed to steno-occlusive disease of the internal iliac, internal pudendal, common penile, dorsal penile artery, which compromises the arterial inflow to the penile corpora cavernosa. Oral phosphodiesterase - 5 inhibitor is the first-line treatment for organic ED. When oral ED therapy fails, subsequent therapies are progressively invasive and include intracavernosal injections, vacuum devices, surgical revascularization, and penile prostheses. Recently, angioplasty aims to offer a less invasive alternative to surgical revascularization. Angioplasty is performed by standard balloon dilatation procedures. In the previous reports, the procedural success rate was 90-100%. However, the restenosis rate was reported to be 30-40%. Angioplasty for refractory arteriogenic ED can be one of the treatment options.

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