Japanese Journal of Urology最新文献

{"title":"[CLINICAL STUDY OF OPEN RADICAL CYSTECTOMY AND ILEAL CONDUIT CONSTRUCTION FOR BLADDER CANCER: RESULTS OF 15-YEAR SINGLE CENTER EXPERIENCE].","authors":"T. Uemura, Takehiro Ishibashi, Sang-Pill Pae, Norihide Shirakawa, T. Somoto, M. Shinohara, Masayuki Kobayashi, A. Komaru, S. Fukasawa","doi":"10.5980/jpnjurol.112.89","DOIUrl":"https://doi.org/10.5980/jpnjurol.112.89","url":null,"abstract":"(Objective) We retrospectively analyzed clinical outcome, prognostic factors and adjuvant chemotherapy for bladder cancer patients with open radical cystectomy (ORC) combined with ileal conduit construction (ICC). (Patients and methods) From February 2005 to February 2019, 179 patients underwent ORC and ICC for invasive bladder cancer or BCG unresponsive non-muscle invasive bladder cancer. We investigated intraoperative and early postoperative complications, overall survival (OS), cancer-specific survival (CSS), and poor prognostic factors affecting OS. Furthermore, we evaluated the prognosis of patients with pT3,4 or pN1-3 depending on adjuvant chemotherapy. (Results) Clavien-Dindo Grade 4 or 5 complications were not occurred. The 5-year and 10-year OS probability were 71.1% and 57.4%, respectively, while the 5-year and 10-year CSS probability were 76.5% and 71.5%, respectively. Multivariate analysis revealed that male (HR = 2.70, 95%CI [0.97-7.51]), pT3,4 (HR = 1.83, 95%CI [1.05-3.21]), and pN1-3 (HR = 2.85, 95%CI [1.62-5.03]) were independent poor prognostic factors. Adjuvant chemotherapy significantly improved OS (p = 0.03) and CSS (p = 0.017) in pN1-3 patients. (Conclusion) ORC combined with ICC was an effective operative method, and good results were obtained. Adjuvant chemotherapy may be effective for patients with positive regional lymph nodes.","PeriodicalId":38850,"journal":{"name":"Japanese Journal of Urology","volume":"233 1","pages":"89-95"},"PeriodicalIF":0.0,"publicationDate":"2021-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78300859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE SECRETION AS A SIDE EFFECT OF CHEMOTHERAPY FOR URACHAL CARCINOMA: A CASE REPORT].","authors":"Koki Maeda, Yuri Mori, M. Nakamura, Yoshimasa Harada, K. Kodama","doi":"10.5980/jpnjurol.112.100","DOIUrl":"https://doi.org/10.5980/jpnjurol.112.100","url":null,"abstract":"A 54-year-old woman was admitted to our hospital complaining of gross hematuria and difficulty urinating. Cystoscopy revealed a tumor 4 cm in size with calcification on top of the bladder. After diagnosis of urachal carcinoma by transurethral resection of the bladder, partial cystectomy with en bloc resection of the median umbilical ligament and pelvic lymphadenectomy was performed. Pathological diagnosis confirmed urachal carcinoma, pT3b, ly1, v0, pN1, RM0. TS-1 and cisplatin chemotherapy (TS-1 at 100 mg/day on days 1-21, CDDP at 60 mg/m2 on day 8) was administered. On day 13, the patient was admitted because of consciousness disorder (Glasgow Coma Scale E2V1M4). Hyponatremia (Na 109 mEq/l) and renal excretion of sodium were present and the patient was diagnosed with the syndrome of inappropriate antidiuretic hormone secretion (SIADH) induced by chemotherapy. Serum sodium level and her consciousness level gradually improved after administration of 3% saline. SIADH caused by chemotherapy containing cisplatin is a relatively rare, but potentially serious adverse effect that requires close attention.","PeriodicalId":38850,"journal":{"name":"Japanese Journal of Urology","volume":"100 1","pages":"100-104"},"PeriodicalIF":0.0,"publicationDate":"2021-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88410076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[ARTIFICIAL URINARY SPHINCTER IMPLANTATION AFTER ILEAL NEOBLADDER RECONSTRUCTION: A CASE REPORT].","authors":"Tadashi Tabei,&nbsp;Takako Iwai,&nbsp;Go Noguchi,&nbsp;Akio Horiguchi,&nbsp;Kazuki Kobayashi","doi":"10.5980/jpnjurol.112.34","DOIUrl":"https://doi.org/10.5980/jpnjurol.112.34","url":null,"abstract":"<p><p>A 62-year-old man was referred to our department for artificial urinary sphincter (AUS) implantation as treatment for total incontinence after laparoscopic radical prostatectomy. Preoperative cystoscopy revealed bladder tumor that was proven to be high-grade micropapillary urothelial carcinoma by transurethral resection. We performed radical cystectomy with ileal neobladder reconstruction, followed by AUS implantation to treat incontinence. The AUS implantation procedure was performed 5 months after total cystectomy and resulted in significant continence recovery. To date, AUS implantation after neobladder reconstruction has not been reported in Japan, although some case series have described this procedure overseas. In our view, AUS implantation is a useful therapeutic option for incontinence in patients undergoing neobladder reconstruction.</p>","PeriodicalId":38850,"journal":{"name":"Japanese Journal of Urology","volume":"112 1","pages":"34-37"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39834797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A CASE OF CONGENITAL UNILATERAL ABSENCE OF THE VAS DEFERENS WITH SUSPECTED IPSILATERAL RENAL AGENESIS].","authors":"Junki Harada,&nbsp;Toshiharu Kihara,&nbsp;Ken Kawada,&nbsp;Suzuna Gono,&nbsp;Ryo Sagawa,&nbsp;Tsubasa Kondo,&nbsp;Tsutomu Yuno,&nbsp;Yohei Shida,&nbsp;Tomoaki Hakariya,&nbsp;Taiichiro Kosaka,&nbsp;Sumito Dateki,&nbsp;Yasuyoshi Miyata,&nbsp;Hideki Sakai","doi":"10.5980/jpnjurol.112.154","DOIUrl":"https://doi.org/10.5980/jpnjurol.112.154","url":null,"abstract":"<p><p>A 5-month-old boy was referred to our department to examine poor development of external genitalia. The patient was diagnosed with micropenis and bilateral impalpable testes, and testosterone replacement therapy was recommended. The testes remained impalpable at 14 months of age; therefore, laparoscopy was performed to explore intra-abdominal testes. The patient was incidentally diagnosed with congenital unilateral absence of the right vas deferens. A renal sonography performed after the operation revealed a high possibility of right renal agenesis. Congenital absence of the vas deferens is associated with a high probability of renal anomalies. It is, therefore, essential to pay careful attention to renal dysfunction.</p>","PeriodicalId":38850,"journal":{"name":"Japanese Journal of Urology","volume":"112 3","pages":"154-158"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40539561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[INITIAL TREATMENT OF NOCTURIA CAUSED BY NOCTURNAL POLYURIA WITH LOW-DOSE DESMOPRESSIN].","authors":"Keiichiro Hayashi,&nbsp;Kohzo Fuji,&nbsp;Madoka Omizu,&nbsp;Aya Hiramatsu,&nbsp;Shintaro Koizumi,&nbsp;Eiji Matsubara,&nbsp;Katsuyuki Saito,&nbsp;Motoki Yamagishi,&nbsp;Haruaki Sasaki,&nbsp;Takashi Fukagai,&nbsp;Kimiyasu Ishikawa,&nbsp;Yoshio Ogawa","doi":"10.5980/jpnjurol.112.18","DOIUrl":"https://doi.org/10.5980/jpnjurol.112.18","url":null,"abstract":"<p><p>(Objective) Nocturia, an important male lower urinary tract symptom (LUTS), is often difficult to treat. Herein, we report our experience of the initial treatment of nocturia with the novel drug desmopressin. (Subjects and methods) Subjects included 25 patients with LUTS treated with desmopressin who had the chief complaint of nocturia. Before treatment, the frequency of nocturnal urination (≥2) and nocturnal polyuria index (≥0.33) were confirmed based on the urination diary for ≥ 72 h. Before sleep, 25 or 50 mg desmopressin (Minirin^® Melt OD tablets) was administered once daily. The frequency of nocturnal urination, volume of nocturnal urine, time from falling asleep to first urination, first urinary volume after falling asleep, nocturnal polyuria index, International Prostate Symptom Score (IPSS), quality of life index, Overactive Bladder Symptom Score, and residual urine volume were comparatively evaluated before and 4 weeks after treatment. Treatment effect was self-evaluated by patients 4 weeks after the treatment. Safety was evaluated by interview and blood testing 1 and 4 weeks after the treatment. (Results) Decrease in the frequency of nocturnal urination and improvement in IPSS were observed. According to self-evaluation of the treatment, 72.6% of the patients considered the treatment efficacious. Regarding safety, adverse events were observed in 28% of the patients, particularly hyponatremia (12% of the patients). (Conclusion) Desmopressin is a potential key drug for the treatment of nocturia caused by nocturnal polyuria.</p>","PeriodicalId":38850,"journal":{"name":"Japanese Journal of Urology","volume":"112 1","pages":"18-24"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39834794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[ONE COURSE OF PEMBROLIZUMAB AFTER RADIATION THERAPY WAS VERY EFFECTIVE AGAINST METASTATIC BLADDER CANCER AND CR WAS CONFIRMED: A CASE REPORT].","authors":"Takuro Sakamoto,&nbsp;Naohiro Fujimoto,&nbsp;Michitaka Nakashima","doi":"10.5980/jpnjurol.112.220","DOIUrl":"https://doi.org/10.5980/jpnjurol.112.220","url":null,"abstract":"<p><p>A 78-year-old man was referred to our institution for the evaluation of macroscopic hematuria and a bladder tumor for which we initially performed a transurethral resection of the bladder tumor. Pathological examination revealed that the tumor was a high-grade invasive urothelial carcinoma that was at least stage T2. Computed tomography scan showed a bladder carcinoma with no nodal or distant metastases. Assuming radical cystectomy, we administered two courses of neoadjuvant chemotherapy (i.e., gemcitabine and cisplatin chemotherapy). Unfortunately, the bladder tumor metastasized to the right internal iliac lymph node. We performed consolidative radiotherapy (54 Gy/ 27 fractions to the bladder area containing the right internal iliac lymph node). One month later, bilateral lung metastases and local penile infiltration appeared; thus, second-line chemotherapy (pembrolizumab) was added to the regimen. The patient rejected further chemotherapy after the first course of pembrolizumab. A computed tomography scan performed four months after one course of pembrolizumab therapy showed complete resolution of the metastatic lesions. As of this writing, 20 months after the first course of pembrolizumab, the patient continues to be in complete remission.</p>","PeriodicalId":38850,"journal":{"name":"Japanese Journal of Urology","volume":"112 4","pages":"220-223"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40645393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[TETHERED CORD SYNDROME IN CHILDREN WITH DAYTIME INCONTINENCE].","authors":"Yosuke Morizawa,&nbsp;Hiroyuki Satoh,&nbsp;Atsuko Sato,&nbsp;Shun Iwasa,&nbsp;Yujiro Aoki","doi":"10.5980/jpnjurol.112.168","DOIUrl":"https://doi.org/10.5980/jpnjurol.112.168","url":null,"abstract":"<p><p>(Introduction) In tethered cord syndrome, the lower end of the spinal cord is moored to the caudal tissue, causing various neuropathies. Bladder dysfunction often appears early. We herein evaluated children with daytime urinary incontinence in whom tethered cord syndrome was eventually diagnosed. (Method) Eighteen children (9 males and 9 females) with daytime urinary incontinence were enrolled between March 2011 and October 2017. The causes of their urinary incontinence were investigated using spinal MRI and changes in clinical symptoms before and after untethering surgery. (Results) The average age at the first visit was 6.3 years (range: 4-9 years). Urodynamic testing and a voiding cystourethrogram (VCUG) were performed in all cases of refractory daytime incontinence, and all patients with abnormal findings on either test underwent spinal MRI. The diagnosis based on spinal MRI findings was filum lipoma in eight, occult tethered cord syndrome in four, low set conus in four, conus lipoma in one, and sacral meningeal cyst in one, patient. The average observation period after untethering surgery was 66.3 months (range: 22-116 months). All the patients achieved a cure postoperatively. Four patients were treated for nocturnal enuresis by oral medication, and three patients required urological management via clean, intermittent catheterization. (Conclusions) When treating children with daytime continence, one should consider the possibility of tethered cord syndrome, the diagnosis of which can be aided by urodynamic assessment of bladder function.</p>","PeriodicalId":38850,"journal":{"name":"Japanese Journal of Urology","volume":"112 4","pages":"168-172"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40374539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[EXPLORATORY EXAMINATION FOR THE FACTORS RELATED TO VOIDING DYSFUNCTION IN PATIENTS AFTER SURGERY FOR PROXIMAL FEMORAL FRACTURES].","authors":"Katsumi Kadekawa,&nbsp;Mami Shiroma,&nbsp;Itsuki Uema,&nbsp;Seishi Yogi,&nbsp;Jun Kubagawa,&nbsp;Hajime Wakabayashi,&nbsp;Hitoshi Kinjo,&nbsp;Ken Uehara,&nbsp;Tomohiro Tsuda,&nbsp;Masayoshi Uehara,&nbsp;Kimio Sugaya","doi":"10.5980/jpnjurol.112.1","DOIUrl":"https://doi.org/10.5980/jpnjurol.112.1","url":null,"abstract":"<p><p>(Purpose) While urinary retention and urinary tract infections accompanying residual urine are often experienced following proximal femoral fractures (femoral neck fractures and trochanteric fractures) in clinical practice, the pathology of the onset of voiding dysfunction for this disease is unclear since the nervous system associated with urination is not damaged due to the fracture not reaching the pelvis. Therefore, we exploratorily examined the factors related to voiding dysfunction in proximal femoral fractures. (Subjects and method) Among the patients who underwent surgery for proximal femoral fractures, we examined the relation between the proportion of cases in which withdrawing urine was required for residual urine after removing the urethral catheter and the differences in the fracture sites, pain, the ability to maintain a sitting position, the strength to bend the hip joints, and the volume of the iliopsoas muscle. (Results) The proportion of cases in which withdrawing urine was required was higher in the group suffering trochanteric fractures than the group suffering femoral neck fractures (41% vs. 11%), while the strength to bend the hip joints was lower. Regarding trochanteric fractures, compared to the group in which no urine was withdrawn, the group in which urine was withdrawn included more of the unstable type in which the fracture reached the lesser trochanter, which is the femoral insertion of the iliopsoas muscle (56% vs. 82%), in addition to having a significant decrease in the strength to bend the hip joints. Regarding trochanteric fractures, compared to the group without injury in lesser trochanter, the group with injury in lesser trochanter had a higher proportion of cases in which withdrawing urine was required (23% vs. 51%), in addition to the iliopsoas muscle thereof having been atrophied (-15.7% vs. -35.2%). (Conclusion) As factors related to voiding dysfunction following surgery for proximal femoral fractures, the relation between fracture sites, the strength to bend the hip joints associated with maintaining posture, the presence of injuries in the lesser trochanter, and the volume of the iliopsoas muscle were suggested. Therefore, it is possible that the proportion of cases in which the withdrawal of urine was required increased with the increase in residual urine due to the decrease in the ability to maintain a urinating posture until the bladder is completely empty.</p>","PeriodicalId":38850,"journal":{"name":"Japanese Journal of Urology","volume":"112 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39834792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[EFFICACY AND SAFETY OF 25 AND 50 μg DESMOPRESSIN ORALLY DISINTEGRATING TABLETS IN NOCTURIA DUE TO NOCTURNAL POLYURIA IN JAPANESE MALE PATIENTS].","authors":"Keiichiro Hayashi,&nbsp;Kohzo Fuji,&nbsp;Madoka Omizu,&nbsp;Aya Hiramatsu,&nbsp;Shintaro Koizumi,&nbsp;Eiji Matsubara,&nbsp;Katsuyuki Saito,&nbsp;Kimiyasu Ishikawa,&nbsp;Haruaki Sasaki,&nbsp;Takashi Fukagai,&nbsp;Yoshio Ogawa","doi":"10.5980/jpnjurol.112.159","DOIUrl":"https://doi.org/10.5980/jpnjurol.112.159","url":null,"abstract":"<p><p>(Purpose) To conduct a prospective study on the efficacy and safety of desmopressin for nocturnal polyuria. (Materials and methods) We selected 51 Japanese men, aged ≥50 years, with complaints of nocturia and a nocturnal polyuria index of ≥0.33. We administered 25 or 50 μg desmopressin (Minirinmelt Orally Disintegrating Tablet^®), once daily at bedtime. We evaluated the nighttime urinary frequency and urine volume, nocturnal polyuria index, time to the first urination after falling asleep, and International Prostate Symptom Score (IPSS) at baseline and at 4, 8, and 12 weeks after administration. In addition, they underwent clinical examinations and blood tests at 1, 4, and 12 weeks to evaluate the safety of the drug. (Results) We observed a decrease in the nighttime urinary frequency and urine volume, and nocturnal polyuria index, increased prolonged time to the first urination after falling asleep, and improved IPSS at and after 4 weeks, compared to baseline data. Furthermore, the drug remained effective even at 12 weeks for all parameters. We observed adverse events in 31.3% of the patients. The incidence of hyponatraemia was particularly high in 15.7% of the patients. Those with a lower serum sodium level and lesser body weight at baseline were more likely to develop hyponatraemia. (Conclusion) Desmopressin was identified as a potential drug for the treatment of nocturnal polyuria. However, hyponatraemia, an important adverse event, resulted in treatment discontinuation in several patients. A sodium level lower than the normal level and low body weight at baseline were the risk factors for hyponatraemia.</p>","PeriodicalId":38850,"journal":{"name":"Japanese Journal of Urology","volume":"112 4","pages":"159-167"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40374538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[SIGNIFICANCE OF IgG4 IN IDIOPATHIC RETROPERITONEAL FIBROSIS].","authors":"Masaaki Sanda,&nbsp;Naoto Kamiya,&nbsp;Yuka Sugizaki,&nbsp;Takamichi Mori,&nbsp;Masayasu Sugiyama,&nbsp;Seiji Kato,&nbsp;Ryo Oka,&nbsp;Takanobu Utsumi,&nbsp;Takumi Endo,&nbsp;Masashi Yano,&nbsp;Nobuyuki Hiruta,&nbsp;Hiroyoshi Suzuki","doi":"10.5980/jpnjurol.112.192","DOIUrl":"https://doi.org/10.5980/jpnjurol.112.192","url":null,"abstract":"<p><p>(Objective)Retroperitoneal fibrosis is largely divided into the idiopathic and secondary types. Some idiopathic cases include IgG4-related diseases, which are often similar to malignant diseases, such as lymphoma and sarcoma. The diagnostic criteria for IgG4-related disease are used and pathologic examination is necessary for a definitive diagnosis of IgG4-related retroperitoneal fibrosis. The first choice of treatment for IgG4-related retroperitoneal fibrosis is steroid administration, but no consensus has been established regarding its dose and tapering schedule. We investigated the significance of IgG4 in diagnosis and treatment of idiopathic retroperitoneal fibrosis. (Patients and methods)We examined 14 cases diagnosed as idiopathic retroperitoneal fibrosis between April 2013 and March 2019. Serum IgG4 was measured at the time of diagnosis in 13 cases, and changes over time in serum IgG4 before and after the induction of steroid therapy were measured in 6 cases. Computed tomography-guided biopsy was performed on 4 cases. (Results)Of all cases, 1 patient was diagnosed as IgG4-related retroperitoneal fibrosis and 5 patients were classified as possible group. Ten patients were administered steroid therapy. Percutaneous nephrostomy tube was placed in 3 patients and was removed in 2 of these patients after steroid therapy. The serum high levels of IgG4 were confirmed in all 4 patients who were classified into the possible group and who were treated with steroids. (Conclusion)Although histologic examination is necessary for the diagnosis of retroperitoneal fibrosis, tissue collection by open or laparoscopic surgery is highly invasive. CT-guided biopsy may be useful in high-risk cases, such as elderly patients on anticoagulation. After excluding other diseases in high-risk cases, response to empiric steroid therapy may be diagnostic. In the possible group, changes in serum IgG4 levels may reflect the disease condition and might be useful in determining the maintenance dose of steroids.</p>","PeriodicalId":38850,"journal":{"name":"Japanese Journal of Urology","volume":"112 4","pages":"192-198"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40374543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}