(Purpose) In recent years, laparoscopic sacrocolpopexy (LSC) and robot-assisted laparoscopic sacrocolpopexy (RASC) have been increasingly performed as surgical treatments for pelvic organ prolapse. These are excellent surgical procedures with low recurrence and complication rates. However, among the few complications, hemorrhage from the sacral promontory region and intervertebral discitis can be serious. Therefore, in our hospital, we perform laparoscopic lateral suspension (LLS) to lead two mesh arms to the external oblique fascia in high-risk LSC cases.

(Material and methods) Study subjects included 12 patients who underwent LLS for pelvic organ prolapse performed by a single surgeon between May 2019 and July 2023. The primary endpoint was pre- and post-operative POP-Q scores for objective recurrence. Pre- and post-operative residual urine volume were used as dysuria indicators. Evaluations were performed using a questionnaire (PFDI-20) as a subjective indicator.

(Results) Postoperative POP-Q scores showed significant improvement at points Ba, C, and Bp. Residual urine volume was significantly reduced from 83 ml to 2.5 ml after surgery. Pre- and post-operative subjective symptom scores were significantly improved for prolapse and urination symptoms, and no significant differences were observed for defecate symptoms. Peri-operative complications included adhesive ileus in one case, bladder injury in one case, and vaginal wall injury in one case.

(Conclusion) In pelvic organ prolapse cases where it is difficult to perform LSC, LLS can be a useful surgical treatment option.

(Purpose) National Clinical Database (NCD) is a large-scale, nationwide, web-based data entry system covering the most surgical cases performed in Japan. In 2018, data registration specific to urological surgery began, following the traditional NCD system. This article aims to summarize the outline of the Annual Report of NCD that was previously published in International Journal of Urology.

(Materials and methods) All urological surgeries performed at over 1,000 facilities have been registered since 2018. Here, we report the number of surgeries performed as stipulated in the "Japanese Urological Association Board-certified Urology Training Program" between April 2018 and December 2021.

(Results) Under the initiative of the Japanese Urological Association, a total of 1,377,677 cases were registered from 1,185 facilities nationwide. The number of surgeries performed annually has been reported with respect of 10 surgical categories.

(Conclusion) The NCD system continuously provides important information on the real-world clinical practice regarding preoperative status and surgical outcomes of urological surgeries performed in Japan.

(Purpose) National Clinical Database (NCD) in the field of urology in Japan was launched for registration in April 2018. This is a Japanese language summary of the first report, which was published in the International Journal of Urology, which focuses on five surgical procedures that have been registered with detailed information.

(Materials and methods) Annual trends of the five surgical procedures with detailed registration in the NCD, namely radical nephrectomy, partial nephrectomy, radical cystectomy, radical prostatectomy, and pyeloplasty, were compiled.

(Results) A total of 149,417 patients who underwent the aforementioned five surgical procedures were registered in the NCD during the period covered by this report. The number of patients was 55,630 for radical nephrectomy/partial nephrectomy from April 2018 to December 2021, 83,653 for radical prostatectomy from April 2018 to December 2021, and 9,342 for radical prostatectomy from January 2020 to December 2021. In 2021, 7,416 partial nephrectomies, 7,739 radical nephrectomies, 22,692 radical prostatectomies, 4,677 radical cystectomies, and 792 pyeloplasties were performed.

(Conclusion) The report revealed that robotic and laparoscopic procedures have replaced open surgery for all five procedures. Analysis of NCD data is useful for understanding temporal trends in major urological surgeries.

The disease severity of posterior urethral valve (PUV) ranges from life-threatening neonatal cases to milder forms diagnosed later in life because of urinary tract infection (UTI) or voiding dysfunction. Despite early intervention, predicting the prognosis of patients with PUV remains challenging, particularly regarding long-term bladder functional outcomes. Here, we present a case in which lower urinary tract function was restored without augmentation cystoplasty in a boy with PUV who presented with severe bladder deformity in infancy.

A 10-month-old boy with a history of febrile UTI (fUTI) was referred to our hospital for evaluation of bilateral hydronephroureters. The patient's family and prenatal histories were unremarkable. Ultrasonography revealed bilateral hydronephroureters with bladder deformity. Voiding cystourethrography (VCUG) demonstrated dilation of the posterior urethra, elevated bladder neck, and massive right-sided vesicoureteral reflux (VUR). Urethroscopy confirmed a type 3 PUV, which was successfully incised endoscopically. After valve ablation, impaired bladder compliance was noted with no resolution of VUR on video-urodynamic study; therefore, oxybutynin therapy was initiated. Owing to persistent upper urinary tract dilation, vesicostomy was performed at 1 year and 9 months of age. Postoperatively, neither hydronephrosis nor UTI was observed. A repeat video-urodynamic study showed improved bladder compliance and resolution of VUR, leading to vesicostomy closure at 5 years and 10 months of age. At nine years of follow-up, the patient remained dry throughout the day without medication, recurrent fUTIs, or hydronephrosis.