Japanese Journal of Urology最新文献

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[ENDOSCOPIC REMOVAL OF INTRAVESICAL RARE FOREIGN BODY USING FLEXIBLE CYSTOSCOPY: A CASE REPORT]. 【软性膀胱镜下切除膀胱内罕见异物1例】。
Japanese Journal of Urology Pub Date : 2020-01-01 DOI: 10.5980/jpnjurol.111.130
Akiyuki Asano, Ryo Ishida, Hiroko Morikami, Tomoyoshi Ohashi, Yushi Yamauchi, Hiroshi Yamada, Toshinori Nishikimi, Hiroaki Kobayashi
{"title":"[ENDOSCOPIC REMOVAL OF INTRAVESICAL RARE FOREIGN BODY USING FLEXIBLE CYSTOSCOPY: A CASE REPORT].","authors":"Akiyuki Asano,&nbsp;Ryo Ishida,&nbsp;Hiroko Morikami,&nbsp;Tomoyoshi Ohashi,&nbsp;Yushi Yamauchi,&nbsp;Hiroshi Yamada,&nbsp;Toshinori Nishikimi,&nbsp;Hiroaki Kobayashi","doi":"10.5980/jpnjurol.111.130","DOIUrl":"https://doi.org/10.5980/jpnjurol.111.130","url":null,"abstract":"<p><p>A 50-year-old man was admitted to our hospital for urinary retention. Computed tomography revealed a spherical intravesical foreign body, measuring 1.7cm in diameter, and cystoscopy revealed glass ball in the bladder. Considering the shape of the object and the possibility of self-insertion, we used a flexible cystoscope, foreign body forceps, and a transvaginal echo probe cover to remove the intravesical foreign body. The end of the echo probe cover was grasped with the foreign body forceps, and a glass ball was inserted into the probe cover and extracted manually with a scooping action similar to using a landing net. No intraoperative hemorrhage was observed, and the glass ball was safely removed with good visual field.The patient's postoperative courses was uneventful, and he has shown no recurrence one year postoperatively.</p>","PeriodicalId":38850,"journal":{"name":"Japanese Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39537536","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}
引用次数: 0
[OUTCOMES OF CHRONIC UNILATERAL HEMATURIA TREATED USING DIGITAL FLEXIBLE URETEROSCOPE]. [指式输尿管镜治疗慢性单侧血尿的疗效]。
Japanese Journal of Urology Pub Date : 2020-01-01 DOI: 10.5980/jpnjurol.111.16
Atsushi Asano, Shintaro Maru, Yutaka Toyoda, Takanori Sakuta, Kazuyuki Maeno, Kinya Matsumura, Tomohiko Koyanagi
{"title":"[OUTCOMES OF CHRONIC UNILATERAL HEMATURIA TREATED USING DIGITAL FLEXIBLE URETEROSCOPE].","authors":"Atsushi Asano,&nbsp;Shintaro Maru,&nbsp;Yutaka Toyoda,&nbsp;Takanori Sakuta,&nbsp;Kazuyuki Maeno,&nbsp;Kinya Matsumura,&nbsp;Tomohiko Koyanagi","doi":"10.5980/jpnjurol.111.16","DOIUrl":"https://doi.org/10.5980/jpnjurol.111.16","url":null,"abstract":"<p><p>(Objectives) We examined the treatment outcomes in cases of chronic unilateral hematuria treated using flexible ureteroscope for observation and hemostasis. (Methods) The study included 14 patients (7 men and 7 women) with a median age of 56.5 years who underwent ureteroscopy using a digital flexible ureteroscope for chronic unilateral hematuria between March 2014 and August 2019. All the patients presented with macroscopic hematuria as a clinical symptom, but in one patient, the hematuria was accompanied by anemia and required a blood transfusion. In addition, bleeding occurred on the left side in 8 patients and on the right side in 3 patients; however, for the remaining 3 patients, the affected side could not be identified. Fourteen patients were examined on the basis of the ureteroscopic findings, number of bleeding sites, hemostatic intervention, treatment effect, and presence or absence of recurrences. (Results) The ureteroscopic findings showed a hemangioma in 7 patients and minute venous rupture in 3, but the remaining 4 patients showed no clear findings. The site of the findings was in the superior calyces in 8 cases, middle calyces in 4 cases, inferior calyces in 4 cases, and renal pelvic wall in 1 case. In addition, the findings were located at multiple sites in 6 cases, including all renal calyces in 2 cases. Ten patients with findings underwent hemostatic interventions (electrocoagulation and laser treatment). The median postoperative follow-up period was 32.4 months (range, 6.4-65.4 months). In all the cases, the hematuria disappeared after treatment. One of the 2 patients with findings in all renal calyces showed recurrence of macroscopic hematuria at 1 year and 6 months, which disappeared after conservative treatment. (Conclusions) In this study, observation using digital flexible ureteroscope was useful in the treatment of chronic unilateral hematuria, and the hemostatic interventions performed on the bleeding sites in the renal pelvis were effective.</p>","PeriodicalId":38850,"journal":{"name":"Japanese Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38841216","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}
引用次数: 0
[A CASE OF DISSEMINATED INTRAVASCULAR COAGULATION CAUSED BY ADVANCED PROSTATE CANCER]. [晚期前列腺癌致弥散性血管内凝血1例]。
Japanese Journal of Urology Pub Date : 2020-01-01 DOI: 10.5980/jpnjurol.111.94
Takeshi Fukazawa, Tadashi Tabei, Takuma Nirei, Risa Shinoki, Sogo Tsutsumi, Masashi Imano, Hiroki Ito, Kazuki Kobayashi
{"title":"[A CASE OF DISSEMINATED INTRAVASCULAR COAGULATION CAUSED BY ADVANCED PROSTATE CANCER].","authors":"Takeshi Fukazawa,&nbsp;Tadashi Tabei,&nbsp;Takuma Nirei,&nbsp;Risa Shinoki,&nbsp;Sogo Tsutsumi,&nbsp;Masashi Imano,&nbsp;Hiroki Ito,&nbsp;Kazuki Kobayashi","doi":"10.5980/jpnjurol.111.94","DOIUrl":"https://doi.org/10.5980/jpnjurol.111.94","url":null,"abstract":"<p><p>The 79 years old man was referred to our department due to high value of serum prostate specific antigen (39.54 ng/ml). The magnetic resonance imaging demonstrated diffuse low signal at his prostate. Bone scintigraphy revealed multiple metastatic lesion. Needle biopsy was performed for definite diagnosis. Systemic purpura showed after prostate needle biopsy although he had noticed local purpura at his back before the examination. He was diagnosed as disseminated intravascular coagulation (DIC) syndrome due to advanced prostate cancer. Treatment with anti-DIC therapy, blood transfusion, subcutaneous injection of degarelix acetate settled the DIC. Abiraterone hydrochloride and prednisolone was added as we confirmed Gleason score5+4 in the pathological examination. He has been alive for 15 months after diagnosis without desease progression.</p>","PeriodicalId":38850,"journal":{"name":"Japanese Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39218628","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}
引用次数: 0
[A CASE OF SPINDLE CELL LIPOMA ARISING IN THE INGUINAL SUBCUTIS: A CASE REPORT]. 腹股沟皮下梭形细胞脂肪瘤1例。
Japanese Journal of Urology Pub Date : 2020-01-01 DOI: 10.5980/jpnjurol.111.102
Kenichi Sasaki, Masaki Kimura, Akihiko Sakamoto, Kaori Endo, Atsushi Kanatani, Sayuri Takahashi, Yukio Yamada, Tsuyoshi Ishida, Satoshi Abe, Hirotaka Kawano, Hideyo Miyazaki, Tohru Nakagawa
{"title":"[A CASE OF SPINDLE CELL LIPOMA ARISING IN THE INGUINAL SUBCUTIS: A CASE REPORT].","authors":"Kenichi Sasaki,&nbsp;Masaki Kimura,&nbsp;Akihiko Sakamoto,&nbsp;Kaori Endo,&nbsp;Atsushi Kanatani,&nbsp;Sayuri Takahashi,&nbsp;Yukio Yamada,&nbsp;Tsuyoshi Ishida,&nbsp;Satoshi Abe,&nbsp;Hirotaka Kawano,&nbsp;Hideyo Miyazaki,&nbsp;Tohru Nakagawa","doi":"10.5980/jpnjurol.111.102","DOIUrl":"https://doi.org/10.5980/jpnjurol.111.102","url":null,"abstract":"<p><p>A 39-year-old man was referred to us for further examination of a right inguinal mass. He had noticed the mass several months prior and had undergone positron emission tomography/computed tomography, which revealed a mass with an SUVmax of 1.48 at the right inguinal subcutis. Magnetic resonance imaging (MRI) showed a well-circumscribed, heterogeneously enhanced adipose tumor 7cm in length, adjacent to the right spermatic cord and corpora cavernosa with clear boundaries. The tumor was a suspected atypical lipomatous tumor (well-differentiated liposarcoma), and he underwent tumor extirpation surgery. At surgery, the right inguinal canal was not opened, and the right spermatic cord and corpora cavernosa were safely spared. The excised specimen was composed of lipomatous tissue macroscopically. Histopathological diagnosis was of a spindle cell lipoma. Spindle cell lipomas are relatively rare, benign tumors, comprising only 1.5% of all lipomatous tumors. They arise most commonly in the shoulder and posterior region of the neck, and rarely develop in the groin. Differential diagnosis includes atypical lipomatous tumors, but radiological diagnosis is often difficult because of similar findings on MRI. Spindle cell lipomas typically present as a subcutaneous tumor, while atypical lipomatous tumors arise in the deep layers of connective tissue. This difference in the site of the tumor may contribute to their differential diagnosis before surgery.</p>","PeriodicalId":38850,"journal":{"name":"Japanese Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39220281","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}
引用次数: 0
[SIMULATION ANALYSIS ON COST-EFFECTIVENESS OF SANITARY AND MEDICAL MATERIAL USAGE AT URINARY TRACT INFECTION OUTBREAK CAUSED BY ANTIBIOTIC-RESISTANT BACTERIA IN UROLOGICAL WARD]. [泌尿科病房耐药菌尿路感染暴发卫生医疗物资使用成本效益模拟分析]。
Japanese Journal of Urology Pub Date : 2020-01-01 DOI: 10.5980/jpnjurol.111.63
Katsumi Shigemura, Koichi Kitagawa, Naoki Yamada, Masashi Nomi, Nozomi Takami, Masato Fujisawa
{"title":"[SIMULATION ANALYSIS ON COST-EFFECTIVENESS OF SANITARY AND MEDICAL MATERIAL USAGE AT URINARY TRACT INFECTION OUTBREAK CAUSED BY ANTIBIOTIC-RESISTANT BACTERIA IN UROLOGICAL WARD].","authors":"Katsumi Shigemura,&nbsp;Koichi Kitagawa,&nbsp;Naoki Yamada,&nbsp;Masashi Nomi,&nbsp;Nozomi Takami,&nbsp;Masato Fujisawa","doi":"10.5980/jpnjurol.111.63","DOIUrl":"https://doi.org/10.5980/jpnjurol.111.63","url":null,"abstract":"<p><p>(Purpose) The purpose of this study is to compare the costs of active surveillance culture (ASC) and of an environmental cleaner and disinfectant, with the medical costs for inhibiting hospitalized urinary tract infection (UTI) outbreaks in a urology ward over a 3 year 8 months period by simulation calculation. (Methods) We previously reported a UTI outbreak via antibiotic resistant bacteria transmission in 9 hospitalized patients, for which we initiated ASC and introduced a potassium peroxymonosulfate-based product (RUBYSTA<sup>®</sup> (RST)) as a disinfectant environmental cleaner, then prevented recurrence for 3 years and 8 months. This study compared the actual costs of ASC and RST use to the calculated medical expense for an outbreak leading to urosepsis on the same scale caused by transmission of antibiotic resistant bacteria. (Results) Based on our simulation calculation, ASC and disinfectant costs were about 770,000 Japanese yen lower than the medical expense of resolving an outbreak without recurrence for a period of 3 years and 8 months, based on our direct clinical experience. (Conclusion) Even though it is needless to say that education for medical stuffs, patients and their families is the most important as to the measures for prevention of infections, our simulation study suggests that ASC and RST use may reduce medical costs for resolving such outbreaks and preventing their recurrence for an extended period of time.</p>","PeriodicalId":38850,"journal":{"name":"Japanese Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39220282","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}
引用次数: 0
[A STUDY OF MULTIPARAMETER ANALYSIS OF SERUM URIC ACID LEVELS -A STUDY IN APPARENTLY HEALTHY JAPANESE MEN AND WOMEN]. [一项血清尿酸水平多参数分析研究-一项对健康的日本男性和女性的研究]。
Japanese Journal of Urology Pub Date : 2020-01-01 DOI: 10.5980/jpnjurol.111.22
Tomoyuki Shimabukuro, Chietaka Ohmi, Koji Shiraishi, Hideyasu Matsuyama
{"title":"[A STUDY OF MULTIPARAMETER ANALYSIS OF SERUM URIC ACID LEVELS -A STUDY IN APPARENTLY HEALTHY JAPANESE MEN AND WOMEN].","authors":"Tomoyuki Shimabukuro,&nbsp;Chietaka Ohmi,&nbsp;Koji Shiraishi,&nbsp;Hideyasu Matsuyama","doi":"10.5980/jpnjurol.111.22","DOIUrl":"https://doi.org/10.5980/jpnjurol.111.22","url":null,"abstract":"<p><p>(Background) Hyperuricemia is associated with hypertension, vascular disease, cardiovascular events, and renal dysfunction. Several studies have reported the relationship between serum uric acid (UA) level and clinical outcome in the general population. However, most such studies have not quantitatively evaluated the association between UA and age, body mass index (BMI), and estimated glomerular filtration rate (eGFR). (Method) From April 2015 to March 2016, a total 10,133 healthy individuals underwent multiphasic screening at our medical checkup center. Among all participants, eGFR was evaluated in 1,684 men and 1,195 women. The data of this cohort were reviewed and analyzed. (Results) The median age of men and women was 51.0 and 50.0 years, respectively. Median serum UA was 6.1 mg/dL in men and 4.5 mg/dL in women. The prevalence of hyperuricemia was 23.9% in men and 8.5% in women. In all 10-year age groups, men had significantly higher serum UAs than women. In men, no significant differences of serum UA were observed among 10-year age groups. Menopause-associated increases in serum UA among women were observed. Men in their 20s to 50s and women in their 30s to 60s showed significant differences in serum UA between each BMI category in the same age decade. Both men and women in their 40s to 60s showed significant differences in serum UA between each eGFR category in the same age decade. We used the results of multiple regression analysis to derive equations to predict the associations among these variables, as follows: men, UA (mg/dL) = 5.637+0.065 × (BMI) - 0.014 × (eGFR) (R<sup>2</sup> = 0.059, P < 0.0001); women < 50 years old, UA (mg/dL) = 4.068+0.065 × (BMI) - 0.014 × (eGFR) (R<sup>2</sup> = 0.091, P < 0.0001) and women > 50 years old, UA (mg/dL) = 4.311+0.075 × (BMI) - 0.017 × (eGFR) (R<sup>2</sup> = 0.116, P < 0.0001). (Conclusions) We present epidemiological evidence indicating that the levels of serum UA vary with BMI and eGFR in both sexes. In women, it should be recognized that menopause is independently associated with higher levels of UA.</p>","PeriodicalId":38850,"journal":{"name":"Japanese Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38841217","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}
引用次数: 1
[ADOPTION OF ENHANCED RECOVERY AFTER SURGERY (ERAS) PROTOCOL FOR THE MANAGEMENT OF PATIENTS UNDERGOING RADICAL CYSTECTOMY IN JAPAN]. [日本根治性膀胱切除术患者采用术后增强恢复(eras)治疗方案]。
Japanese Journal of Urology Pub Date : 2020-01-01 DOI: 10.5980/jpnjurol.111.9
Yushi Naito, Hideyuki Kanazawa, Yurika Okada, Jun Nagayama, Norie Syo, Akiyuki Yamamoto, Ippei Kojima, Yasuhiro Terashima, Tatsuya Nagai
{"title":"[ADOPTION OF ENHANCED RECOVERY AFTER SURGERY (ERAS) PROTOCOL FOR THE MANAGEMENT OF PATIENTS UNDERGOING RADICAL CYSTECTOMY IN JAPAN].","authors":"Yushi Naito,&nbsp;Hideyuki Kanazawa,&nbsp;Yurika Okada,&nbsp;Jun Nagayama,&nbsp;Norie Syo,&nbsp;Akiyuki Yamamoto,&nbsp;Ippei Kojima,&nbsp;Yasuhiro Terashima,&nbsp;Tatsuya Nagai","doi":"10.5980/jpnjurol.111.9","DOIUrl":"https://doi.org/10.5980/jpnjurol.111.9","url":null,"abstract":"<p><p>(Objectives) The Enhanced Recovery After Surgery (ERAS) protocols are standardized and multimodal perioperative care pathways designed to improve surgical outcomes by minimizing stress response and inflammation following surgery. First adopted in colorectal surgery, ERAS is now being employed in various other types of surgeries, most recently in patients undergoing radical cystectomy (RC). Implementation of ERAS protocols resulted in reductions in perioperative complication rates and length of hospital stay (LOS). However, information on the adoption of ERAS in patients undergoing RC in Japan is limited. The objective of this study was to evaluate the safety and efficacy of ERAS implemented in the Toyohashi Municipal Hospital in 2017 for the management of patients with RC. (Patients and methods) This was a retrospective study of 103 patients who underwent RC and urinary diversion from January 2012 to March 2019. Of the 103 patients, 71 underwent surgery prior to the introduction of the ERAS were allocated to the 'traditional' group, while 32 were exposed to the ERAS protocol were allocated to the 'ERAS' group. In this study, ERAS included no bowel preparation, preoperative carbohydrate loading, preoperative fluid reduction, preoperative fasting, reduced drainage use, no nasogastric intubation, and early postoperative drinking and eating. A comparative analysis was performed to evaluate LOS and postoperative complication rate (Clavien classification ≥2) after RC between the 'traditional' and 'ERAS' groups. (Results) Patient characteristics and intraoperative variables such as median age, sex, body mass index, clinical and pathological cancer stage, amount of bleeding, need for transfusion, and technique of urinary diversion did not differ between groups. However, duration of surgery was significantly shorter in the ERAS group than in the traditional group (402 min vs. 470 min; P = 0.03). Further, rate of complication was significantly lower (43.8% vs. 67.6%; P=0.03) and LOS after RC was significantly shorter (21 days vs. 28 days; P<0.001) in the ERAS group compared to the traditional group. Moreover, ERAS was an independent factor affecting shorter LOS after RC (OR, 5.22; 95% CI, 1.52-17.90; P = 0.009) in multivariate analyses. (Conclusions) It is possible that the ERAS protocol adopted in this study reduced the LOS and postoperative complication rate after RC at this site in Japan.</p>","PeriodicalId":38850,"journal":{"name":"Japanese Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38841220","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}
引用次数: 2
[CLINICAL RESULTS OF TWO PATIENTS WITH LATE RECURRENCE OF RENAL CELL CARCINOMA AFTER LONG TERM OBSERVATION WITHOUT TREATMENT]. 【2例肾细胞癌晚期复发患者长期观察未经治疗的临床结果】。
Japanese Journal of Urology Pub Date : 2020-01-01 DOI: 10.5980/jpnjurol.111.39
Toshikazu Okaneya, Taisho Noda, Takayoshi Fu, Michikata Hayashida, Kiichi Hagiwara, Shoichi Nagamoto, Kazushige Sakaguchi, Hirokatsu Murata, Akihiro Yano, Shinji Urakami
{"title":"[CLINICAL RESULTS OF TWO PATIENTS WITH LATE RECURRENCE OF RENAL CELL CARCINOMA AFTER LONG TERM OBSERVATION WITHOUT TREATMENT].","authors":"Toshikazu Okaneya,&nbsp;Taisho Noda,&nbsp;Takayoshi Fu,&nbsp;Michikata Hayashida,&nbsp;Kiichi Hagiwara,&nbsp;Shoichi Nagamoto,&nbsp;Kazushige Sakaguchi,&nbsp;Hirokatsu Murata,&nbsp;Akihiro Yano,&nbsp;Shinji Urakami","doi":"10.5980/jpnjurol.111.39","DOIUrl":"https://doi.org/10.5980/jpnjurol.111.39","url":null,"abstract":"<p><p>Two patients with late recurrence of renal cell carcinoma were observed long term without treatment. Case 1 is an 83-year-old woman who underwent right nephrectomy at 57 years of age following a renal tumor diagnosis. Histopathological results revealed clear cell renal cell carcinoma, G2, pT1aN0M0. Pancreatic metastasis developed at age 71, and pancreatic tail excision was performed. A metastatic lesion appeared again at the head of the pancreas at age 74. The patient has been followed by observation only for 9 years without any new lesions. Tumor doubling time calculated from abdominal ultrasonography was 13.3 months.Case 2 is a 91-year-old male. At 78 years of age, right nephrectomy and inferior vena cava tumor embolectomy were performed for renal tumor. Histopathological results revealed clear cell renal cell carcinoma, G2, pT3bN0M0. Left adrenal metastasis appeared at age 84, and the patient has been followed for 7 years without new lesions. Tumor doubling time calculated from abdominal computed tomography (CT) images was 14.1 months.In both patients, no symptoms due to tumor recurrence ever appeared, and their activities of daily living (ADL) were maintained fairly well. In the case of solitary late recurrence in elderly renal cancer patients, observation may be a treatment option that avoids adverse effects and complications caused by treatment. In addition, it appears possible to predict the need for subsequent treatment by calculating the doubling time using several sequential CT images obtained after recurrence. If a new recurrent metastatic lesion appears or if the doubling time during a 2-to 3-year follow-up period is relatively short, however, new treatment should be considered without delay.</p>","PeriodicalId":38850,"journal":{"name":"Japanese Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38902967","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}
引用次数: 0
[PUBERTAL TESTICULAR TORSION OF POLYORCHIDISM DIAGNOSED IN INFANCY: A CASE REPORT]. [婴儿期诊断多儿症青春期睾丸扭转1例]。
Japanese Journal of Urology Pub Date : 2020-01-01 DOI: 10.5980/jpnjurol.111.53
Yurie Hirata, Kimihiko Moriya, Michiko Nakamura, Masafumi Kon, Yoko Nishimura, Kazuhiro Ujihashi, Madoka Higuchi, Ryuji Matsumoto, Takeya Kitta, Nobuo Shinohara
{"title":"[PUBERTAL TESTICULAR TORSION OF POLYORCHIDISM DIAGNOSED IN INFANCY: A CASE REPORT].","authors":"Yurie Hirata,&nbsp;Kimihiko Moriya,&nbsp;Michiko Nakamura,&nbsp;Masafumi Kon,&nbsp;Yoko Nishimura,&nbsp;Kazuhiro Ujihashi,&nbsp;Madoka Higuchi,&nbsp;Ryuji Matsumoto,&nbsp;Takeya Kitta,&nbsp;Nobuo Shinohara","doi":"10.5980/jpnjurol.111.53","DOIUrl":"https://doi.org/10.5980/jpnjurol.111.53","url":null,"abstract":"<p><p>Left polyorchidism was found in a 2-month-old boy with a left scrotal mass. As he was asymptomatic and all testes were in the scrotum, he was conservatively followed up. At 17 years of age, he presented with left acute scrotum due to testicular torsion of the left supernumerary testis. Counterclockwise 720-degree rotation of the left supernumerary testis was noted during emergency surgery, and orchidopexy of the 3 testes (2 left testes and 1 right testis) was performed. Biopsy of the left supernumerary testis demonstrated spermatogenesis and no malignancy. One and a half years after surgery, all testes were viable without atrophy.Polyorchidism is a rare condition and there is no consensus on the management of asymptomatic cases detected early in life. The position of the supernumerary testis (intrascrotal or extrascrotal) is important when deciding the management strategy because of the risk of malignancy. If conservative management is selected initially, elective surgery, such as prophylactic orchiectomy or orchidopexy, may be needed because of the risk of malignancy and torsion.</p>","PeriodicalId":38850,"journal":{"name":"Japanese Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38896632","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}
引用次数: 0
[CASE REPORT: COMPLETE RESECTION OF RETROPERITONEAL CYSTIC LYMPHANGIOMA AND SURROUNDING ORGANS]. 【病例报告:腹膜后囊性淋巴管瘤及周围脏器全切除术】。
Japanese Journal of Urology Pub Date : 2019-01-01 DOI: 10.5980/jpnjurol.110.52
Kojiro Morita, Kaoru Nemoto, Hiroya Hasegawa, Ryo Matsuoka, Hiroki Nakamori, Hiroyoshi Kono, Kuniaki Tanabe, Masato Yanagi, Yasutomo Suzuki, Yukihiro Kondo
{"title":"[CASE REPORT: COMPLETE RESECTION OF RETROPERITONEAL CYSTIC LYMPHANGIOMA AND SURROUNDING ORGANS].","authors":"Kojiro Morita,&nbsp;Kaoru Nemoto,&nbsp;Hiroya Hasegawa,&nbsp;Ryo Matsuoka,&nbsp;Hiroki Nakamori,&nbsp;Hiroyoshi Kono,&nbsp;Kuniaki Tanabe,&nbsp;Masato Yanagi,&nbsp;Yasutomo Suzuki,&nbsp;Yukihiro Kondo","doi":"10.5980/jpnjurol.110.52","DOIUrl":"https://doi.org/10.5980/jpnjurol.110.52","url":null,"abstract":"<p><p>A 65-year-old man was admitted to our institution with vomiting and right flank pain. Computed tomography (CT) imaging showed a 21-cm retroperitoneal multilocular cystic tumor which had been identified four years previously. It had increased from 17 to 21 cm. The initial diagnosis was cystic lymphangioma because it was a clear cystic tumor without a boundary or a solid component in the first CT, but later CT revealed an unclear boundary with surrounding organs suggesting malignancy. We decided to resect the tumor because it was symptomatic and might be malignant. The tumor was then resected along with surrounding organs because invasion was suspected. Pathological findings indicated a diagnosis of cystic lymphangioma with chronic inflammation and confirmed complete resection of the tumor. The patient has remained free of recurrence at one year after surgery. This experience indicates that cystic lymphangioma should be completely resected to prevent recurrence.</p>","PeriodicalId":38850,"journal":{"name":"Japanese Journal of Urology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5980/jpnjurol.110.52","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37558205","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}
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