Acta Urologica Japonica最新文献

{"title":"[A Case of Thrombocytopenia as an Adverse Effect of Mycophenolate Mofetil before Blood Type-Incompatible Living-Donor Renal Transplantation].","authors":"Suguru Ito, Kazutoshi Okubo, Yoshiyuki Okada, Kosuke Ogawa, Yukari Tanaka, Noriyuki Ito, Hitomi Miyata, Toru Matsugasumi, Masakatsu Hishizawa","doi":"10.14989/ActaUrolJap_71_5_149","DOIUrl":"https://doi.org/10.14989/ActaUrolJap_71_5_149","url":null,"abstract":"<p><p>We present a patient who developed thrombocytopenia before blood type-incompatible living-donor renal transplantation, which inhibited proper evaluation and treatment of thrombocytopenia. A 45-year-old woman with kidney failure of unknown etiology who was on peritoneal dialysis for 2 years was admitted after receiving immunosuppressive drugs at an outpatient clinic. The platelet count gradually decreased and eventually reached a level that could interfere with surgery. Mycophenolate mofetil was considered the cause of thrombocytopenia. Thus, it was discontinued, which increased the platelet count. The patient also received platelet transfusion, and renal transplantation was successfully performed as planned. The patient did not develop hemorrhage after the transplantation. The pretransplantation administration of mycophenolate mofetil was suspected to have caused thrombocytopenia in this patient. Hence, sudden decline in platelet count before surgery should be promptly investigated to identify potential causes in order of their likelihood. It is important to confirm that there is no evidence of platelet consumption or destruction.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"71 5","pages":"149-153"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235491","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 Transverse Testicular Ectopia with Complete Descent to the Bottom of the Contralateral Scrotum].","authors":"Shinya Abe, Kazuma Hiramatsu, Toshihide Hosomi, Takashi Matsuoka, Yuki Kamiyama, Naofumi Tsutsumi, Takehiko Segawa","doi":"10.14989/ActaUrolJap_71_4_127","DOIUrl":"10.14989/ActaUrolJap_71_4_127","url":null,"abstract":"<p><p>We report a case of transverse testicular ectopia (TTE) with complete descent to the contralateral scrotum. A fifty-five-year-old man with malignant lymphoma in the left inguinal region was diagnosed with TTE and persistent Müllerian duct syndrome (PMDS) via CT scan. Ultrasound imaging and palpation revealed no malignant findings in the testes. Given the rarity of malignant transformation in müllerian duct remnant, we opted for follow-up through palpation and ultrasound. TTE is typically diagnosed in childhood, making adult cases comparatively rare. This case is particularly notable due to the complete descent of the testes. We also collected data on Japanese adult cases of TTE since 1980. Herein, we present this case of TTE along with a review of the literature.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"71 4","pages":"127-131"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001830","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":"[Conservative Treatment of Renal Trauma with Arterial Laceration : A Successful Case Report].","authors":"Kazuto Imai, Norihiko Masuda, Kanji Nagahama, Toshiya Akao","doi":"10.14989/ActaUrolJap_71_4_121","DOIUrl":"https://doi.org/10.14989/ActaUrolJap_71_4_121","url":null,"abstract":"<p><p>An octogenarian male presented to the emergency department following a fall. On admission, his systolic blood pressure was in the 70s mmHg range, and his pulse was around 60 bpm. Initial resuscitation efforts included fluid administration with normal saline and vasopressor support with noradrenaline. A contrast-enhanced abdominal computed tomographic (CT) scan revealed multiple simple intraparenchymal lacerations in the right kidney, accompanied by perinephric hematoma, and peripheral extravasation of contrast at the right renal artery. There was also partial luminal narrowing of the main right renal artery, raising concern for the development of a false lumen. The renal injury was classified as grade IIIa, PV, H1, according to the Japanese Association for the Surgery of Trauma (JAST) criteria. Although interventional radiology (IVR) was considered for management of perinephric hematoma, it was ultimately deemed inappropriate given the potential presence of a false lumen in the main right renal artery. The patient's hemodynamic status improved, and vasopressors were discontinued by the time of the follow-up CT scan. Despite subsequent imaging showing hematoma enlargement, the patient remained hemodynamically stable, and conservative management was chosen. During hospitalization, the patient required transfusion of 16 units of packed red blood cells, 10 units of platelet concentrate, and 20 units of fresh frozen plasma. Gradual mobilization began six days after admission, and the patient was discharged on day 15. The follow-up contrast-enhanced abdominal CT one-month post-injury showed no evidence of pseudoaneurysm, and the renal function remained preserved throughout the course of care.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"71 4","pages":"121-126"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053967","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":"[Investigation of the Usefulness of Intermittent Self-Dilation after Transurethral Surgery for Urethral Stricture].","authors":"Tomoya Yokoi, Rikuri Someya, Eriko Tanaka, Mami Yamasaki, Heisuke Iijima, Takehiro Takahashi, Masakatsu Ueda, Yusuke Shiraishi, Koji Yoshimura","doi":"10.14989/ActaUrolJap_71_4_105","DOIUrl":"https://doi.org/10.14989/ActaUrolJap_71_4_105","url":null,"abstract":"<p><p>We retrospectively examined the restenosis rate, factors associated withrestenosis withand without intermittent self-dilatation (ISD) after transurethral surgery for urethral stricture. Male patients diagnosed with urethral stricture between July 2012 and October 2019 who underwent primary treatment by internal urethrotomy or urethral stricture dilatation were divided into two groups : those who received ISD and those who did not. Factors associated with restenosis in the ISD group were also analyzed. The total number of patients analyzed was 45,34 (75.6%) in the ISD group and 11 (24.4%) in the no ISD group. The median age was 71 years. 19 (42.2%) had undergone transurethral surgery, 15 (33.3%) had undergone total prostatectomy, and the majority had undergone urological surgery. The hazard ratio in the ISD group was 0.1894 (95% confidence interval : 0.06749-0.5317, p＝0.001), suggesting that ISD significantly increased the time to recurrence. ISD significantly prolonged the time to recurrence. Also, restenosis was significantly more frequent when ISD was performed for less than 5 months (p＝0.00723). The results suggest that intermittent self-dilation after transurethral surgery as primary treatment for urethral stricture significantly increases the time to restenosis and that performing the procedure for more than 5 months reduces the rate of restenosis development.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"71 4","pages":"105-109"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050348","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 Open Poucholithotomy for Recurrence of Indiana Pouch Stones].","authors":"Naoya Nakatake, Norichika Ueda, Kentaro Takezawa, Taigo Kato, Koji Hatano, Yoichi Kakuta, Atsunari Kawashima, Shinichiro Fukuhara, Norio Nonomura","doi":"10.14989/ActaUrolJap_71_4_115","DOIUrl":"https://doi.org/10.14989/ActaUrolJap_71_4_115","url":null,"abstract":"<p><p>The patient was a 70-year-old male who underwent radical cystectomy and Indiana pouch construction for bladder cancer in March 1996. The first incidence of stone formation within the pouch occurred two years postoperatively, and was treated by endoscopic lithotripsy. Over the next decade, the patients required six additional endoscopic lithotripsies and two open poucholithotomy for stone removal. Recently, a recurrent stone grew to 50 mm in diameter, causing catheterization difficulties, and surgical intervention was performed. To extend the interval before future treatment, we performed open poucholithotomy, achieving stone-free status. The patient did not require additional treatments for 64 months postoperatively.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"71 4","pages":"115-119"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062659","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":"[Nephrogenic Adenoma : A Case Report].","authors":"Ryota Ikadai, Shigeki Arase, Yoshihiro Hasegawa","doi":"10.14989/ActaUrolJap_71_4_111","DOIUrl":"https://doi.org/10.14989/ActaUrolJap_71_4_111","url":null,"abstract":"<p><p>A 62-year-old woman was diagnosed with bladder urothelial carcinoma in situ. Transurethral resection of bladder tumor (TURBT) was performed, followed by intravesical therapy with bacillus Calmette Guérin. Two months later, a papillary lesion was observed around the scar. The lesion was biopsied, and histological examination revealed papillary and tubular formation with inflammatory cell infiltration. Therefore, the lesion was diagnosed as nephrogenic adenoma. We opted for watchful waiting because the lesion had disappeared and nephrogenic adenoma is a benign tumor. At 6 months after the biopsy of the nephrogenic adenoma, the patient showed no signs of recurrence.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"71 4","pages":"111-113"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050349","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":"[Effect of Body Mass Index on Outcomes of Mini-ECIRS for Renal Stone].","authors":"Tetsuo Fukuda, Hiroki Ito, Takahiko Watanabe, Tadashi Tabei, Fukashi Yamamichi, Takaaki Inoue, Kazuki Kobayashi, Junichi Matsuzaki","doi":"10.14989/ActaUrolJap_71_3_71","DOIUrl":"https://doi.org/10.14989/ActaUrolJap_71_3_71","url":null,"abstract":"<p><p>We retrospectively compared treatment outcomes and complications based on body mass index (BMI) in patients with renal stones treated with mini-endoscopic combined intrarenal surgery (ECIRS) using percutaneous tracts 20 Fr or smaller. Among 1,432 patients who had ECIRS performed at multiple registered facilities between January 2015 and December 2022, 870 patients with renal stones who underwent mini-ECIRS were included after excluding those with anatomical anomalies or incomplete clinical data. The patients were divided into two groups : BMI ≥30 (Group A) and BMI ＜30 (Group B). The treatment outcomes and complications were compared between the two groups. One month postoperatively, plain computed tomography (CT) and kidney ureter bladder radiography (KUB) were performed to assess stone fragmentation and hydronephrosis. According to postoperative imaging, stone-free was defined as residual fragments 4 mm or less on KUB and 2 mm or less on CT. Of the 870 patients, 86 were in Group A and 784 in Group B. The median (interquartile range) cumulative stone diameter was 33.8 (26.35-50.75) mm in Group A, and 32 (24-47) mm in Group B, respectively. The median operative time was 122.5 (92.25- 166.75) min in Group A and 114.5 (89.75-156) min in Group B. The mean and median (interquartile range) postoperative hospital stay were 5.9±2.5 days and 5 (4-7) days in Group A, and 5.4±3.3 days and 5 (4-6) days in Group B. Stone-free rates were 77.9% (67 cases) by KUB and 61.6% (53 cases) by CT in Group A, and 76.1% (597 cases) by KUB and 58.0% (455 cases) by CT in Group B. The incidence of postoperative fever (≥38.0°C) was 38.4% (33 cases) in Group A and 31.8% (249 cases) in Group B, while septic shock occurred in 2.3% (2 cases) of Group A and 2.6% (20 cases) of Group B. A statistically significant difference (p＜0.05) was found in the postoperative hospital stay between the two groups, but no significant differences were observed in the stone-free rates or complication rates. Mini-ECIRS using percutaneous tracts of 20Fr or smaller for renal stones showed no significant difference in SFR and complications between patients with a BMI ≥30 and those with a BMI ＜30.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"71 3","pages":"71-75"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048954","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 Radical Nephrectomy that Achieved Complete Remission after Combination Therapy with Pembrolizumab and Lenvatinib for Metastatic Renal Cell Carcinoma].","authors":"Hitoshi Yokozeki, Takaaki Takuma, Kazuki Kokura, Shoko Uketa, Tomohiro Fukui, Yuichi Uemura, Jun Watanabe","doi":"10.14989/ActaUrolJap_71_3_81","DOIUrl":"https://doi.org/10.14989/ActaUrolJap_71_3_81","url":null,"abstract":"<p><p>An 81-year-old woman to our hospital complaining of backpain and was diagnosed with a left renal tumor with lung and iliac metastasis. A renal tumor biopsy confirmed clear cell renal cell carcinoma. The patient began combination therapy with pembrolizumab and lenvatinib but experienced fatigue and edema after 1 month. Suspecting cardiac dysfunction induced by Lenvatinib, Lenvatinib was discontinued and treatment with pembrolizumab alone was continued. Three months after treatment initiation, the lung and iliac metastases had resolved, allowing for laparoscopic nephrectomy. Five months post-surgery, no new metastases were detected.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"71 3","pages":"81-86"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040591","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 Paraganglioma of the Spermatic Cord].","authors":"Sayuri Ishibashi, Kotoe Matsuda, Ken Tanaka, Manabu Komine, Koji Kikuchi","doi":"10.14989/ActaUrolJap_71_3_87","DOIUrl":"https://doi.org/10.14989/ActaUrolJap_71_3_87","url":null,"abstract":"<p><p>A49-year-old man noticed discomfort in the right scrotum and consulted a nearby medical institution. Magnetic resonance imaging revealed a 10 mm tumor in the right spermatic cord, showing low signal intensity on T1-weighted images and high signal intensity on T2-weighted and diffusion-weighted images. Since malignancy could not be ruled out, he was referred to our hospital. Physical examination revealed an elastic, mobile tumor in the right spermatic cord. Ultrasonography showed a solid tumor measuring 10 mm near the right testicle. Although differential diagnoses included lipoma and neurilemmoma, the possibility of malignancy prompted tumor resection. The tumor was a nodular lesion with a clear brown border. Histopathological examination confirmed the diagnosis of paraganglioma. Postoperative metaiodobenzylguanidine scintigraphy, computed tomographic imaging, and hormone testing did not reveal any significant findings, confirming the diagnosis of paraganglioma originating from the spermatic cord.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"71 3","pages":"87-91"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040721","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 Venous Leiomyosarcoma of the Inferior Vena Cava Diagnosed Preoperatively as an Adrenal Tumor].","authors":"Yushi Miyata, Tomohiro Kanaki, Jumpei Oshima, Takanori Kinjo, Wataru Nakata, Hitoshi Inoue","doi":"10.14989/ActaUrolJap_71_3_77","DOIUrl":"https://doi.org/10.14989/ActaUrolJap_71_3_77","url":null,"abstract":"<p><p>A 72-year-old woman was referred to our hospital complaining of abdominal pain. Contrast enhanced computed tomography revealed a 53 mm solid tumor with low contrast enhancement on the medial aspect of the right adrenal gland. On magnetic resonance imaging, the tumor showed low signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and high signal intensity on diffusion-weighted images. The patient was diagnosed as having a right adrenal tumor and was referred to our hospital for surgery. Laparoscopic right adrenalectomy was performed. During surgery, we could easily peel the tumor from the adrenal gland, but it was strongly adhered at the inferior vena cava. Considering the possibility of a primary tumor of the inferior vena cava, we converted to open surgery and achieved complete tumor resection by combined partial resection of the inferior vena cava. The cut surface of the tumor was white and firm. Histopathological examination with hematoxylin-eosin staining revealed spindle cell proliferation forming bundle-like structures. Immunohistochemical staining was positive for DESMIN and α-SMA, suggesting leiomyosarcoma. Furthermore, the vascular smooth muscle structure of the resected inferior vena cava was completely replaced by leiomyosarcoma. Therefore, our diagnosis was venous leiomyosarcoma originating from the inferior vena cava. The patient has remained recurrence-free at 21 months after surgery.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"71 3","pages":"77-80"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037928","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}