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Hinyokika Kiyo. Acta Urologica Japonica Oct 2009A 79-year-old man was admitted to our hospital with a chief complaint of pollakisuria. He was diagnosed as having bladder tumors and bladder stone by cystoscopy.... (Review)
Review
A 79-year-old man was admitted to our hospital with a chief complaint of pollakisuria. He was diagnosed as having bladder tumors and bladder stone by cystoscopy. Transurethral resection of bladder tumors (TURBT) and transurethral cystolithotripsy were performed and histology revealed non-muscle-invasive hepatoid adenocarcinoma that produced alpha-fetoprotein (AFP) and urothelial carcinoma. The serum AFP level was present at a high level of 39.08 ng/ml. After five months' follow up, recurrent tumor were detected in the bladder. TURBT was performed and the pathologic finding showed non-muscle-invasive (not hepatoid) adenocarcinoma that produced AFP. After eight months' follow up, a recurrent tumor was detected in the bladder again. TURBT was performed and the pathologic finding showed non-muscle-invasive urothelial carcinoma. However, the serum AFP level remained above 35 ng/ml. After the 3rd TURBT, intravesical intillations were performed, which led to a normalization of the serum AFP level. Nineteen months after his final hospitalization, the patient has had no evidence of recurrence.
Topics: Adenocarcinoma; Aged; Humans; Male; Urinary Bladder Neoplasms; alpha-Fetoproteins
PubMed: 19926947
DOI: No ID Found -
Urologia Internationalis 2003Augmentation cystoplasty is an effective approach to the detrusor hyperreflexia which is refractory to conservative treatment. Sporadic data have been published in...
INTRODUCTION
Augmentation cystoplasty is an effective approach to the detrusor hyperreflexia which is refractory to conservative treatment. Sporadic data have been published in patients with progressive diseases such as multiple sclerosis (MS).
MATERIALS AND METHODS
Augmentation ileocystoplasty (Goodwin 'cup-patch') was performed in 9 patients (7 females, 2 males). The average Expanded Disability Status Scale score was 4.1 (range 3.0-6.5); 7 patients had relapse-remitting MS and 2 patients secondary-progressive MS. The indication was a detrusor hyperreflexia refractory to conservative treatment in 8 patients and a detrusor hyperrefluxia with third degree bilateral vesico-ureteral reflux and renal insufficiency in 1 patient. Pre- and postoperative objective parameters were evaluated by urodynamic examination, imaging methods and laboratory examination. Subjective evaluation was performed using a questionnaire on micturition symptoms (score 0-5) and on quality of life (score 0-6).
RESULTS
With a follow-up of 6-19 months, we recorded an average increase of the maximum detrusor capacity from 105 to 797 ml and decrease of maximum detrusor pressure from 53 to 30 cm H(2)O. Postmicturition residual urine >25% of the maximum capacity was present in 6 patients who performed clear intermittent autocatheterization postoperatively (2 patients preoperatively). In all patients there was a significant improvement in the irritation micturition symptomatology (pollakisuria, nycturia, urgency and urge incontinence) and the quality of life score improved on average from 5 to 0.7. In the case of the patient with renal insufficiency, the creatinine level decreased from 286 to 150 micromol/l; in the other patients renal function remained normal.
CONCLUSIONS
Augmentation cystoplasty is a safe and effective method for indicated patients, which significantly enhances their quality of life.
Topics: Adult; Female; Follow-Up Studies; Humans; Ileum; Male; Middle Aged; Multiple Sclerosis; Prospective Studies; Sampling Studies; Severity of Illness Index; Treatment Outcome; Urinary Bladder, Neurogenic; Urinary Reservoirs, Continent; Urodynamics; Vesico-Ureteral Reflux
PubMed: 12566810
DOI: 10.1159/000067708 -
Hinyokika Kiyo. Acta Urologica Japonica Apr 2008A 74-year-old man visited our hospital presenting with pollakisuria. Cystoscopy revealed a bladder cancer with necrotic tissue. The patient was initially treated by... (Review)
Review
A 74-year-old man visited our hospital presenting with pollakisuria. Cystoscopy revealed a bladder cancer with necrotic tissue. The patient was initially treated by transurethral resection of bladder tumor (TUR-Bt). Pathologically, the tumor was shown to be a carcinoma of bladder with human chorionic gonadotropin (hCG) positivity. After TUR-Bt, chemotherapy with M-VAC (methotrexate, vinblastine, adriamycine and cisplatin) was performed. This patient is still alive eight months after resection. To our knowledge, there are 37 cases of beta-hCG-producing urothelial carcinoma of the urinary bladder reported in the Japanese literature.
Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Carcinoma; Chorionic Gonadotropin, beta Subunit, Human; Humans; Male; Paraneoplastic Endocrine Syndromes; Urinary Bladder Neoplasms
PubMed: 18516923
DOI: No ID Found -
Hinyokika Kiyo. Acta Urologica Japonica May 1992A 71-year-old man had pollakisuria, macrohematuria and sense of urinary retention. His urethrogram showed a giant bladder stone with a small urethral stone. He received... (Review)
Review
A 71-year-old man had pollakisuria, macrohematuria and sense of urinary retention. His urethrogram showed a giant bladder stone with a small urethral stone. He received cystolithotomy. The giant bladder stone was removed. It weighed 310 g and is the 32nd reported in Japan.
Topics: Aged; Humans; Male; Urethral Diseases; Urinary Bladder Calculi; Urinary Calculi
PubMed: 1609672
DOI: No ID Found -
Hinyokika Kiyo. Acta Urologica Japonica Nov 2003We report 3 cases of leiomyoma of the urinary bladder. One patient was a 57-year-old female. Magnetic resonance imaging (MRI) revealed a small tumor, and cystoscopy... (Review)
Review
We report 3 cases of leiomyoma of the urinary bladder. One patient was a 57-year-old female. Magnetic resonance imaging (MRI) revealed a small tumor, and cystoscopy revealed a submucosal tumor on the left wall. Partial cystectomy was performed, and she has had no recurrence for 10 months. Two females who were aged 68 years and 52 years, were referred to our hospital with the complaint of pain of meatus of urethra, and pollakisuria, respectively. Transurethral resection of bladder tumor (TURBT) was performed, and they have had no recurrence for more than 3 and 4 years, respectively. Histological examination in the three cases showed a leiomyoma of the urinary bladder. To our knowledge, there are 151 cases of leiomyoma of the urinary bladder reported in the literature in Japan.
Topics: Aged; Cystectomy; Cystoscopy; Female; Humans; Leiomyoma; Magnetic Resonance Imaging; Middle Aged; Tomography, X-Ray Computed; Urinary Bladder Neoplasms
PubMed: 14719456
DOI: No ID Found -
Hinyokika Kiyo. Acta Urologica Japonica Jan 1997A 63-year-old female with a complaint of pollakisuria was referred to our clinic for the treatment of bilateral hydronephrosis. Ultrasonography, computerized tomography... (Review)
Review
A 63-year-old female with a complaint of pollakisuria was referred to our clinic for the treatment of bilateral hydronephrosis. Ultrasonography, computerized tomography (CT) scan and magnetic resonance imaging (MRI) revealed bilateral hydronephrosis due to stenosis of the vesicoureteral junction, which was caused by a nodular mass on the posterior wall of the bladder. Cystoscopy revealed a yellowish-white mass on the trigone. Bilateral percutaneous nephrostomy for the treatment of chronic renal failure due to bilateral hydronephrosis and transurethral resection of bladder tumor were performed. Histological findings indicated a chronic granuloma with Michaelis-Gutmann body and the tumor was diagnosed as vesical malacoplakia. Oral administration of trimethoprim sulfamethoxazole, bethanecol chloride and vitamin C was done for the conservative therapy of malacoplakia. However, stenosis of the vesicoureteral junction remained. Then, bilateral vesicoureteroneostomy was performed and there was no obvious recurrence of malacoplakia 20 months postoperatively.
Topics: Female; Humans; Hydronephrosis; Malacoplakia; Middle Aged; Urinary Bladder Diseases
PubMed: 9046423
DOI: No ID Found -
Hinyokika Kiyo. Acta Urologica Japonica Sep 1990Signet-ring cell carcinoma of the urinary bladder is a rare disease. A 78-year-old man was admitted to our hospital on March 18, 1988 with the complaints of... (Review)
Review
Signet-ring cell carcinoma of the urinary bladder is a rare disease. A 78-year-old man was admitted to our hospital on March 18, 1988 with the complaints of microhematuria and pollakisuria. Cystoscopic examination revealed non-papillary tumor at the dome of the bladder. partial cystectomy was done under epidural anesthesia. Pathological findings revealed signet-ring cell carcinoma. The gastrointestinal, respiratory and genitourinary tracts were examined but no other tumor lesions could be found. The postoperative course was uneventful, and chemotherapy such as biological response modifier was administered. However, the patient died of heart failure on July 14, 1988. This is the sixtieth case reported in the literature.
Topics: Adenocarcinoma, Mucinous; Aged; Humans; Male; Urinary Bladder Neoplasms
PubMed: 2173382
DOI: No ID Found -
Hinyokika Kiyo. Acta Urologica Japonica Oct 2003Clear cell adenocarcinoma of the female urethra is extremely rare. We herein describe the 33rd case of clear cell adenocarcinoma of the female urethra in Japan. A... (Review)
Review
Clear cell adenocarcinoma of the female urethra is extremely rare. We herein describe the 33rd case of clear cell adenocarcinoma of the female urethra in Japan. A 54-year-old female who presented with pollakisuria was referred to our department. Transvaginal examination showed a walnut-sized firm mass on the anterior vaginal wall. Computed tomography, magnetic resonance imaging (MRI), cystourethroscopy and the histopathological findings of the biopsied specimen revealed adenocarcinoma of the urethra. Anterior pelvic exenteration and ileal conduit urinary diversion were performed and the final pathological diagnosis was clear cell adenocarcinoma of the urethra, pT3, pN2. No further adjuvant therapy was conducted. She remains alive 6 months after surgery in spite of paraaortic and inguinal lymph node metastases.
Topics: Adenocarcinoma, Clear Cell; Endoscopy; Female; Humans; Magnetic Resonance Imaging; Middle Aged; Tomography, X-Ray Computed; Urethral Neoplasms
PubMed: 14655611
DOI: No ID Found -
Hinyokika Kiyo. Acta Urologica Japonica Dec 1996A case of ectopic ureter without urinary incontinence despite its ureteral orifice in the vestibulum is reported. A 2-year-and-9-month-old female was referred to our... (Review)
Review
A case of ectopic ureter without urinary incontinence despite its ureteral orifice in the vestibulum is reported. A 2-year-and-9-month-old female was referred to our hospital with the pain of external genitalia, pollakisuria and macroscopic hematuria. Examination revealed a complete double system of the left upper tract with vestibular opening from the upper moiety. She did not show any signs of ureteric incontinence after the establishment of voiding habits. Because radioisotope (RI) scintigram showed apparent uptake in the upper half of the left kidney we performed left ureterocystoneostomy with psoas hitch procedure. We postulate that the incontinence mechanism is maintained when the running course of the ectopic ureter is through some portion of the urethral sphincter musculature. This is the 10th case reported in Japan.
Topics: Child, Preschool; Female; Humans; Ureter; Urinary Diversion; Urinary Incontinence; Vagina
PubMed: 9013233
DOI: No ID Found -
[Vesicoenteric fistula complicating Crohn's disease, responded to medical treatment: a case report].Hinyokika Kiyo. Acta Urologica Japonica Mar 1992A 20-year-old man was admitted on February 2, 1990 with the chief complaint of pollakisuria, miction pain and macrohematuria. Urinalysis revealed numerous leukocytes and... (Review)
Review
A 20-year-old man was admitted on February 2, 1990 with the chief complaint of pollakisuria, miction pain and macrohematuria. Urinalysis revealed numerous leukocytes and Enterobacter was identified by urine culture. Cystoscopy revealed an edematous region. Contrast film of small intestines demonstrated vesicoileal fistula. Judging from these and the radiographic findings, we made the diagnosis of vesicoileal fistula with Crohn's disease. After medical therapy between February 22 and May 25, urinalysis became normal and we assumed that the fistula had closed. Now, it is about a year since the therapy began, the patient remains well, without urinary and enteric symptoms. Cystoscopy and urinalysis did not reveal recurrence of the fistula. Despite previous reports that vesicoenteric fistulas complicating Crohn's disease require surgical treatment, this case responded to medication, and required no surgical treatment. This case is a reminder of the importance of the principle of therapy.
Topics: Adult; Crohn Disease; Humans; Ileal Diseases; Intestinal Fistula; Male; Parenteral Nutrition, Total; Urinary Bladder Fistula
PubMed: 1523992
DOI: No ID Found