The Japanese Journal of Urology
Online ISSN : 1884-7110
Print ISSN : 0021-5287
ISSN-L : 0021-5287
Volume 104, Issue 6
Displaying 1-7 of 7 articles from this issue
Original Article
  • Tatsuya Takayama, Takayuki Sugiyama, Hiroshi Furuse, Takashi Yajima, T ...
    2013 Volume 104 Issue 6 Pages 681-687
    Published: November 20, 2013
    Released on J-STAGE: December 11, 2014
    JOURNAL FREE ACCESS
    (Objectives) To evaluate the treatment for castration-refractory prostate cancer (CRPC) resistant to docetaxel (Materials and methods) Among 45 patients with CRPC treated with docetaxel (70-75 mg/m2) every 3 to 4 weeks at Hamamatsu University Hospital from January 2004 to July 2012, 19 patients underwent salvage treatments. We retrospectively analyzed the medical records of 14 patients except for 5 patients who were enrolled in clinical trials. (Results) The median age and serum prostate-specific antigen (PSA) level at starting salvage treatments was 71 years (range 45 to 79) and 241.1 ng/mL (range 3.06 to 1,643.0), respectively. All patients maintained castration status. Salvage treatments include DTX (30 mg/m2) +cisplatin (CDDP) (70 mg/m2) /carboplatin (Area under the curve=4), etoposide+CDDP, paclitaxel+CDDP, cyclophosphamide, S-1, tegaful-uracil. The reasons why 14 patients moved to salvage treatments after DTX were progressive disease in 12 patients and adverse events in 2. Eight patients had a PSA response, 3 patients>50% and 5 patients<50%. Six patients had a PSA progression. The median overall survival was 10.4 months (range 4.1 to 27.3). All patients died of cancer, 13 patients with prostate cancer and one patient with lung adenocarcinoma. Most adverse events were mild. Transitory grade 3 leukopenia was observed in 2 patients, and grade 3 anemia in 2. No grade 4 toxicities were noted. (Conclusions) All salvage treatments without grade 4 toxicities described in this study may be acceptable in the patients with CRPC progressing after docetaxel although the effect would be limited.
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  • Masato Yanagi, Yukihiro Kondo, Yuki Endo, Taiji Nishimura, Kimiyoshi M ...
    2013 Volume 104 Issue 6 Pages 688-696
    Published: November 20, 2013
    Released on J-STAGE: December 11, 2014
    JOURNAL FREE ACCESS
    (Purpose) We evaluated usefulness of transcatheter arterial embolization (TAE) for deep renal injury, and investigated whether there is any difference in outcomes for transcatheter arterial embolization (TAE) performed for deep renal injury in a large-sized hospital (university hospital) in comparison with a middle-sized hospital (local hospital). (Methods) We retrospectively reviewed the outcomes of 42 patients with renal injury who were transported to the critical care center of Nippon Medical School (NMS) Hospital in Tokyo from April 2001 to April 2011 and 33 patients of renal injury transported to the critical care center of Ohtawara Red Cross (ORC) Hospital in Tochigi prefecture from April 2001 to April 2009. Therefore, a total of 75 patients, which is the sum of the patients presenting to both the hospitals for renal injury were reevaluated according to the guidelines developed by the Japanese Association for the Surgery of Trauma (JAST) and published in 2008. (Results) Forty-two patients in NMS hospital included 6 women and 36 men who were 16 to 88 years old (mean 41.6), and they were divided into Type I (16), Type II (11), and Type III (15) and were treated with bedrest (30), TAE (7), or laparotomy (5). Five patients died, but no one succumbed solely due to the renal injury. On the other hand, 33 Patients in ORC Hospital included 8 women and 25 men who were 16 to 87 years old (mean 46.6). They were divided into Type I (9), Type II (12), and Type III (12) and were treated with bedrest (24) or TAE (9). Eight patients died, but no one succumbed solely due to the renal injury. Sixteen patients were treated successfully with TAE in the 2 hospitals, and 15 of these 16 patients were divided into type III renal injury. Therefore, we believe that nephrectomy should be avoided in such patients because of the benefits offered by TAE. (Conclusion) TAE was found to be useful for the treatment of type III renal injury in both institutions, irrespective of the size of a hospital.
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  • Shinro Hata, Toru Inoue, Mutsushi Yamasaki, Tadasuke Ando, Toshitaka S ...
    2013 Volume 104 Issue 6 Pages 697-701
    Published: November 20, 2013
    Released on J-STAGE: December 11, 2014
    JOURNAL FREE ACCESS
    (Objective) We examined laparoendoscopic single-site surgery (LESS) for urachal remnants and evaluated its usefulness and efficacy. (Patients and methods) From August 2011 to July 2012, we underwent this surgery for 5 patients (3 males, 2 females). The mean age was 30.8 (25-36) years old. A 2 cm incision was made around the umbilicus and Access Platform was placed. The entire urachal tissues were excised, and this 2 cm incison was reshaped as the umbilicus. (Results) The median operative time was 220 (156-460) minutes, and the median operative blood loss was 10 (10-70) ml. They had no operative complications, and were discharged 6 (5-14) days after surgery. (Conclusions) Our surgical procedures have very excellent cosmesis and advantages in particular for young because we reshape as the umbilicus the surgical wound. We think that this surgery can be performed safe and effectively for surgeons trained in the conventional laparoscopic procedures.
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Case Report
  • Akiou Okumura, Shinji Tsuritani, Kiyoshi Takagawa, Hideki Fuse
    2013 Volume 104 Issue 6 Pages 702-705
    Published: November 20, 2013
    Released on J-STAGE: December 11, 2014
    JOURNAL FREE ACCESS
    We report a case of a 73-year-old male with heterochronous triple urogenital cancer. The patient was referred to our hospital because serum PSA was elevated (7.0 ng/ml) in 1998. Prostatic needle biopsy revealed prostatic cancer in the right lobe, and total prostatectomy was performed. The histopathological diagnosis was moderately differentiated adenocarcinoma (T1cN0M0). Non-muscle invasive bladder cancer (NMIBC) was detected during an examination for microhematuria in 2002. Transurethral resection of the bladder tumor (TURBT) procedure was performed, and the histopathological diagnosis was grade 2 urothelial carcinoma (pTa). A right renal mass was detected incidentally on follow-up CT for bladder cancer in 2008. Renal enucleation was performed in 2009. The histopathological diagnosis was grade 2 clear cell renal cell carcinoma (pT1aNXM0). NMIBC was detected on follow-up urethrocystoscopy in 2011. The TURBT procedure was performed, and the histopathological diagnosis was grade 2 urothelial carcinoma (pTa). On follow-up for urogenital cancer patients, it is important to investigate recurrence of the primary cancer and also heterochronous canceration of other urogenital organs.
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  • Shimpei Sugiura, Tomoyuki Tatenuma, Ryoko Sakata, Tomohiro Tajiri, Kaz ...
    2013 Volume 104 Issue 6 Pages 706-711
    Published: November 20, 2013
    Released on J-STAGE: December 11, 2014
    JOURNAL FREE ACCESS
    We report the case of a malignant fibrous histiocytoma/undifferentiated pleomorphic sarcoma (MFH/UPS) of the penis in a 78-years-old-man who had undergone previous radical prostatectomy, external beam radiation therapy for prostatic adenocarcinoma. The mass was a 9-cm firm lesion at the base of the penis predominantly composed of malignant spindle cells arranged in sweeping fascicles and storiform pattern. The tumor cells stained for vimentin, α-smooth muscle actin, S-100, and were negative for keratin, desmin, Melan A, PSA. Despite total penectomy, he developed a local reccurence 4 months after surgery, and died from dissemination 6 months after surgery. This is the 8th case of penile MFH/UPS.
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  • Manami Kaneda, Hideaki Ito, Naoyo Horie, Minekatsu Taga, Nozomu Watana ...
    2013 Volume 104 Issue 6 Pages 712-715
    Published: November 20, 2013
    Released on J-STAGE: December 11, 2014
    JOURNAL FREE ACCESS
    Two cases of epithelioid angiomyolipoma of the kidney are reported. A 62-year-old female with incidental left renal tumor underwent laparoscopic leftpartial nephrectomy under a diagnosis of renal cell carcinoma. A pathological examination revealed epithelioid angiomyolipoma. The second case was that of a 35-year-old female with back pain. A laparoscopic right nephrectomy revealed epithelioid angiomyolipoma. This recently identified variant of angiomyolipoma is sometimes associated with aggressive clinical behavior including local recurrence and metastasis.
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  • Ryo Oka, Naoto Kamiya, Keiko Sugiura, Takumi Endo, Masashi Yano, Makit ...
    2013 Volume 104 Issue 6 Pages 716-719
    Published: November 20, 2013
    Released on J-STAGE: December 11, 2014
    JOURNAL FREE ACCESS
    We describe endovascular stenting of the left renal vein to treat Nutcracker syndrome accompanied by gross hematuria. A 26-year-old woman with a history of hematuria and left flank pain was admitted to another hospital in January 2009. She was referred to our hospital in August 2010 for further investigation and treatment for suspected Nutcracker syndrome based on her medical history and the recurrent gross hematuria. Computed tomography (CT) imaging revealed compression of the left renal vein between the aorta and the superior mesenteric artery and cystoscopy revealed bloody urine from the left ureteric orifice. Ureteroscopy revealed diffuse bleeding from the renal pelvic mucosa. The cytodiagnosis of urine was Class II. She developed left flank pain and further recurrent hematuria in July 2011 and sought active treatment by stenting at our hospital. After we obtained the approval of the Ethical Review Board in our institution, we treated by endovascular stenting of the left renal vein. The venous phase of selective renal angiography during the procedure revealed dilation of the mid-renal vein with delayed flow into the inferior vena cava and tortuous dilated collateral vessels. Two E-LUMINEXX Vascular Stents (12×40 mm) were deployed at the stenotic site of the left renal vein via the right femoral vein. This strategy improved the stenosis and collateral vessels. No significant postoperative adverse events developed other than dull back pain that disappeared after a few days, and the patient was discharged on postoperative day 4. CT findings three months after the procedure confirmed resolution of the left renal vein compression. Six months post-procedure, the patient had no left flank pain or further hematuria.
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