{"title":"[A CASE OF RENAL CELL CARCINOMA IN THE KIDNEY ALLOGRAFT 16 YEARS AFTER RENAL TRANSPLANTATION].","authors":"Tasuku Fujiwara, Noboru Shibasaki, Akihiro Yamamoto, Ami Masaoka, Akihiko Nagoshi, Takanari Kambe, Atsushi Igarashi, Naoki Akagi, Yuto Hattori, Daisuke Yamashita, Mutsushi Kawakita, Toshinari Yamasaki","doi":"10.82687/actaurojp.72.8_255","DOIUrl":"https://doi.org/10.82687/actaurojp.72.8_255","url":null,"abstract":"<p><p>A man in his 70s underwent ABO-incompatible renal transplantation 19 years ago at another hospital for end-stage renal failure due to IgA nephropathy. The immunosuppressive regimen included tacrolimus 4mg/day, mycophenolate mofetil 500 mg/day, and prednisolone 5 mg/day. Renal function remained stable post transplantation, withserum creatinine levels ranging from 1.0 to 1.2 mg/dl. Contrast-enhanced computed tomography performed for the sudden onset of the aortic dissection showed a tumor 14 mm in diameter on the ventral side of the kidney allograft, with early contrast enhancement. The tumor was less than 10 mm deep into the renal cortex. Based on these findings, the patient was diagnosed with cT1aN0M0 renal cell carcinoma in a kidney allograft, and an open partial nephrectomy was performed without renal ischemia. Histopathological examination demonstrated clear cell renal cell carcinoma, WHO/ISUP Grade 2, without vascular invasion, and negative surgical margins. Postoperatively, renal function was preserved, and no recurrence has been observed during a 2-year follow-up period.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"72 8","pages":"255-259"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888930","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}
Kazuyoshi Shigehara, Rei Sinzawa, Shingo Takada, Kotaro Fukukawa, Shohei Kawaguchi, Takahiro Nohara, Koji Izumi, Atsushi Mizokami
{"title":"[EFFICACY OF KEISHIBUKURYOGAN FOR HOT FLASH ASSOCIATED WITH HORMONE THERAPY IN PATIENTS WITH PROSTATE CANCER].","authors":"Kazuyoshi Shigehara, Rei Sinzawa, Shingo Takada, Kotaro Fukukawa, Shohei Kawaguchi, Takahiro Nohara, Koji Izumi, Atsushi Mizokami","doi":"10.82687/actaurojp.72.8_249","DOIUrl":"https://doi.org/10.82687/actaurojp.72.8_249","url":null,"abstract":"<p><p>The present retrospective study investigated the efficacy and safety of keishibukuryogan for hot flashes associated with androgen deprivation therapy (ADT) in patients with prostate cancer. Between January 2018 and September 2024, 102 prostate cancer patients who were administered keishibukuryogan for the first time for treatment of hot flash were included in this study. Three months after the treatment, the efficacy of this drugs was assessed based on any improvement in subjective symptoms by the medical interview as follows ;\"ineffective\", \"slightly effective\", \"moderately effective\", and\"excellently effective\". Desire to continue this drug, the duration of continuation, and adverse effects were investigated. The cases in which efficacy was\"slightly effective\"or better were defined as the responder group, and patients'characteristics were compared between the responder and non-responder groups. The mean age was 72.2 years, and the mean period from the start of ADT to keishibukuryogan administration was 14.5 months. The efficacy of this drug was excellent in 3 cases, moderately effective in 11, slightly effective in 36, and ineffective in 52. Fifty-six patients desired to continue the treatment after three months. The average duration of drug continuation in the responder group was 13.7 months. In the responder group, the cases with a history of radiation therapy were significantly frequent (p=0.0277). Six patients discontinued the drug administration due to adverse effects, with 3 experiencing itching, and 1 each experiencing loose stools, nightmares, and difficulty taking the drug. Keishibukuryogan was effective in approximately half of the cases with hot flash.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"72 8","pages":"249-253"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889058","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 PYOGENIC SPONDYLITIS CAUSED BY MESH INFECTION AFTER LAPAROSCOPIC SACROCOLPOPEXY].","authors":"Yukiya Fujisaki, Hiromasa Tsukino, Arashi Kyushima, Makoto Kondou, Keisuke Kawano, Kento Fukushima, Akira Ishihara","doi":"10.82687/actaurojp.72.8_261","DOIUrl":"https://doi.org/10.82687/actaurojp.72.8_261","url":null,"abstract":"<p><p>We report a case involving an 81-year-old woman who developed pyogenic spondylitis following laparoscopic sacrocolpopexy (LSC) for a cystocele in November year X. During concomitant uterine resection, purulent discharge was observed, and oral levofloxacin was administered for 5 days postoperatively. Pathological examination revealed xanthogranulomatous endometritis, which was considered the source of the mesh infection. The patient was discharged on postoperative day 7 without complications. In early January year X+1, she developed buttock pain that persisted for approximately 2 weeks without improvement, prompting her to return to our hospital. Magnetic resonance imaging findings indicated pyogenic spondylitis. She was admitted and treated with intravenous sulbactam/ampicillin for 1 week, but her symptoms did not improve. Laparoscopic mesh removal was subsequently performed. After surgery, the antibiotic regimen was switched to intravenous imipenem/cilastatin, resulting in good infection control. However, progressive bone destruction was noted, and on postoperative day 37, posterior spinal fusion from L3 to the pelvis was performed by our orthopedic team. The postoperative course following spinal surgery was favorable, with marked symptom relief. Oral minocycline was initiated on postoperative day 69 and continued until day 133. The patient was discharged ambulatorily on postoperative day 139. Although pyogenic spondylitis is recognized as a serious complication of LSC, this represents postoperative case encountered at our institution. On the basis of a review of the literature, we discuss this case and its clinical implications.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"72 8","pages":"261-264"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888952","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":"[QUESTIONNAIRE SURVEY ON CLINICAL T CATEGORY OF PROSTATE CANCER FOR CLINICAL PHYSICIANS].","authors":"Kenta Onishi, Nobumichi Tanaka, Yasushi Nakai, Akira Tachibana, Yuki Oda, Mitsuru Tomizawa, Yosuke Morizawa, Shunta Hori, Daisuke Gotoh, Makito Miyake, Kiyohide Fujimoto","doi":"10.82687/actaurojp.72.7_225","DOIUrl":"https://doi.org/10.82687/actaurojp.72.7_225","url":null,"abstract":"<p><p>According to the 5th edition of the Japanese General Rule for Clinical and Pathological Studies on Prostate Cancer, clinical T2c is defined as\"a tumor involving both lobes\". It is not defined whether this refers only to continuous lesions spreading across both lobes or also includes small, non-continuous lesions present in both lobes. Furthermore, the General Rule stated that\"it is generally understood that pathological findings from biopsies are not taken into consideration when determining T categories\". We investigated how physicians interpret the General Rule and perform T classification in real-world clinical practice. We prepared five hypothetical cases with negative digital rectal examination findings but with lesions identified on magnetic resonance imaging (MRI) and conducted a questionnaire survey targeting board-certified urologists certified by the Japanese Urological Association. We received responses from 58 participants. Twenty-six participants (44.8%) diagnosed cases with discontinuous lesions in both lobes as cT2a, and 32 participants (55.2%) diagnosed them as cT2c. In addition, 41 participants (70.7%) diagnosed cases in which lesions were found in one lobe on MRI and cancer was detected in both lobes by biopsies as cT2a, while 17 participants (29.3%) diagnosed them as cT2c. Furthermore, three participants (5.2%) diagnosed cases in which cancer was detected by biopsies only from the contralateral side where lesions were found on MRI as cT1c, 49 participants (84.5%) diagnosed them as cT2a, and six participants (10.3%) diagnosed them as cT2c. In staging prostate cancer, the General Rule can have multiple meanings and there are cases in which even specialists disagree. Since T classification affects treatment strategies, it is desirable to have a uniform understanding based on a clear definition.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"72 7","pages":"225-230"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674346","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":"[PRIMARY MALIGNANT LYMPHOMA OF THE RENAL PELVIS : A CASE REPORT].","authors":"Tomoya Kimura, Yasuhiro Yamashita, Yoshiya Shimao, Toshiyuki Kamoto","doi":"10.82687/actaurojp.72.7_237","DOIUrl":"10.82687/actaurojp.72.7_237","url":null,"abstract":"<p><p>Primary malignant lymphoma of the renal pelvis is extremely rare ; only 13 cases have been reported to date, and it is often difficult to distinguish from urothelial carcinoma. A 63-year-old woman presented with fever and right flank pain. Computed tomography revealed right hydronephrosis, a renal pelvic mass, and para-aortic lymphadenopathy. Selective urinary cytology was negative, and ureteroscopic examination showed no visible tumor. Because of recurrent febrile urinary tract infections, retroperitoneal laparoscopic right nephrectomy was performed. The resected specimen showed mucosal thickening and a mass lesion in the renal pelvis. Histopathological examination demonstrated diffuse proliferation of atypical lymphoid cells positive for CD20 and CD79a, consistent with diffuse large B-cell lymphoma (DLBCL). The patient received eight cycles of R-THP-COP (rituximab, pirarubicin, cyclophosphamide, vincristine and prednisolone) chemotherapy, and para-aortic lymphadenopathy regressed. She remains in complete remission 60 months after surgery. As imaging findings are nonspecific and urinary cytology is usually negative, preoperative diagnosis of renal pelvic lymphoma is challenging. Nephroureterectomy can serve as both a diagnostic and therapeutic procedure, and malignant lymphoma should be considered in the differential diagnosis of renal pelvic tumors.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"72 7","pages":"237-240"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674277","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":"[INTRAVESICAL MIGRATED SUTURE AFTER LAPAROSCOPIC SACROCOLPOPEXY SUCCESSFULLY TREATED BY TRANSURETHRAL AND TRANSVESICAL SURGERY : A CASE REPORT].","authors":"Tomonori Kurita, Takuya Takasawa, Chihiro Suzuki, Yoshiaki Kinebuchi","doi":"10.82687/actaurojp.72.7_241","DOIUrl":"https://doi.org/10.82687/actaurojp.72.7_241","url":null,"abstract":"<p><p>A 68-year-old woman presented to a local physician with lower abdominal pain. Urinary bladder stones were identified, and the patient was referred to our department. She had undergone laparoscopic sacrocolpopexy (LSC) for uterine prolapse 2 years ago. Transurethral cystolithotripsy (TUCL) was performed, and a suture was found in the stone arising from the posterior bladder wall. We speculated that the suture migrated into the urinary bladder after LSC and formed a bladder stone. The sutures could not be removed transurethrally using a laser. A nephroscope was employed to attempt suture division using laparoscopic scissors ; however, the suture remained difficult to grasp or cut. The second surgery was performed using a transurethral nephroscope and a transvaginal laparoscopic trocar. The suture was grasped using forceps inserted through the trocar and excised through a nephroscope using scissors. No postoperative complications or recurrences were observed. Combined transurethral and transvesical approaches are useful for treating foreign bladder bodies that require grasping for removal.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"72 7","pages":"241-244"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674298","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}
Iori Matsuda, Santa Sugihara, Shingo Kitora, Tomoki Ohnishi, Tomoya Okuno, Takuro Sunada, Kaoru Murakami, Noriaki Utsunomiya, Akito Terai, Koji Inoue
{"title":"[EXTRAMEDULLARY HEMATOPOIESIS PRESENTING AS A RENAL MASS DURING TREATMENT OF CASTLEMAN DISEASE : A CASE REPORT].","authors":"Iori Matsuda, Santa Sugihara, Shingo Kitora, Tomoki Ohnishi, Tomoya Okuno, Takuro Sunada, Kaoru Murakami, Noriaki Utsunomiya, Akito Terai, Koji Inoue","doi":"10.82687/actaurojp.72.7_231","DOIUrl":"https://doi.org/10.82687/actaurojp.72.7_231","url":null,"abstract":"<p><p>A 66-year-old man receiving medication for Castleman disease was found to have a gradually enlarging renal mass on a computed tomography (CT) scan. Contrast-enhanced CT and magnetic resonance imaging scan were performed for diagnostic evaluation, and renal cell carcinoma was suspected, prompting consideration of surgical resection. However, we determined that histopathological confirmation was necessary to rule out recurrent Castleman disease and other conditions. Therefore, we performed a tumor biopsy before any surgical intervention. An ultrasound-guided percutaneous needle biopsy revealed extramedullary hematopoiesis. Currently, the lesion is under observation without intervention.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"72 7","pages":"231-235"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674296","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 PROSTATE CANCER COMPLICATED BY PELVIC INSUFFICIENCY FRACTURES].","authors":"Masato Nozawa, Hiroshi Fujiwara, Yasushi Takashima, Michihito Miyagi, Yusuke Yagihashi, Tetsuya Noguchi","doi":"10.82687/actaurojp.72.6_205","DOIUrl":"https://doi.org/10.82687/actaurojp.72.6_205","url":null,"abstract":"<p><p>We report a case of high-risk prostate cancer (pT3bN1Gleason score 4+5), in a 63-year-old male who underwent robot-assisted radical prostatectomy with extended pelvic lymph node dissection in May 2019, followed by adjuvant combined androgen blockade (CAB) therapy. In June 2022, the case progressed to castration-resistant prostate cancer (CRPC), and enzalutamide was initiated. Bone metastases to the sacrum and seventh thoracic vertebra were identified concurrently and treated with radiotherapy. In January 2024, the patient presented with lower back pain and left thigh pain. Computed tomography revealed a right iliac fracture and multiple fractures of the left sacroiliac joint, consistent with radiotherapy-related pelvic insufficiency fractures (PIFs). While PIFs are well-documented in patients with gynecologic malignancies, reports on prostate cancer patients remain limited. We analyzed cases of pelvic fractures following pelvic radiotherapy for prostate cancer at our institution, including the present case, and discussed them in the context of the existing literature.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"72 6","pages":"205-209"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353982","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 QUESTIONNAIRE SURVEYON TREATMENT SELECTION FOR PATIENTS WITH ADVANCED PROSTATE CANCER IN JAPAN].","authors":"Kohei Hashimoto, Masaki Shiota, Masaki Yoshida, Takahiro Kimura, Hiroyoshi Suzuki, Toshiyuki Kamoto, Mikio Sugimoto","doi":"10.82687/actaurojp.72.6_187","DOIUrl":"https://doi.org/10.82687/actaurojp.72.6_187","url":null,"abstract":"<p><p>We conducted a web-based questionnaire survey targeting urologists in Japan on the real-world treatment selection for patients with advanced prostate cancer. The results were stratified by medical institution category and compared with those reported in the Advanced Prostate Cancer Consensus Conference 2024 (APCCC24). The survey included 124 urologists working at cancer centers/university hospitals (n=48), public hospitals (n=32), and general hospitals (n=44). The proportion of respondents who selected triplet therapy for the majority of patients with metastatic hormone-sensitive prostate cancer (mHSPC) was higher among doctors at cancer centers/university hospitals or public hospitals, as was reported in the APCCC24, when compared with that among doctors at general hospitals. There are differences in opinions regarding the discontinuation of systemic therapy after achieving a deep prostate-specific antigen response. For cases which had progressed to metastatic castration-resistant prostate cancer after androgen receptor signaling inhibitor (ARSI) therapy and had mutations in the BRCA2 gene, the most commonly selected first line treatment was combination therapy of a poly ADP-ribose polymerase (PARP) inhibitor and an ARSI among doctors at cancer centers/university hospitals, and PARP inhibitor monotherapy among doctors at public and general hospitals. Opinions vary within the APCCC24 on whether to choose combination therapy or monotherapy. The survey results suggest that treatment selection of Japanese doctors may differ from those of the APCCC24. More extensive surveys are needed for further discussion on the treatment selection for patients with advanced prostate cancer in Japan.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"72 6","pages":"187-203"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353977","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 PREGNANCY POST VASECTOMY].","authors":"Akiou Okumura, Hiroshi Kitamura","doi":"10.82687/actaurojp.72.6_217","DOIUrl":"10.82687/actaurojp.72.6_217","url":null,"abstract":"<p><p>A 43-year-old man visited our clinic to have surgeryfor contraception. Vasectomywas performed under local anesthesia. The scrotal skin was incised with a scalpel. The vas deferens was cut and the bilateral ends were ligated twofold using 2-0 silk and 4-0 polyglycolic acid suture without mucosal cautery of the vas deferens. Semen analysis revealed two nonmotile sperms in the entire high-power field one month after the surgery. However, eight months later, his partner was pregnant, and subsequent semen analysis revealed 10 to 20 motile sperms per high-power field. Post vasectomyrecanalization of the vas deferens was suspected. It is important to inform couples of the possibilityof pregnancypost vasectomydue to recanalization of the vas deferens. Therefore, obtaining prior informed consent not onlyfrom the patient but also from the partner is needed to avoid litigation.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"72 6","pages":"217-220"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354059","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}