-
Nihon Rinsho. Japanese Journal of... Apr 2017Japan is an aging society. In general, an elderly population has urological diseases. Therefore, to understand the epidemiology of urological diseases is clinically very...
Japan is an aging society. In general, an elderly population has urological diseases. Therefore, to understand the epidemiology of urological diseases is clinically very important. In a 15-year-longitudinal community-based study of Japanese men, prostate volume in- creased and lower urinary tract symptoms deteriorated. Many elderly Japanese females have pollakisuria. The 2015 cancer statistics suggest that the most common cancer in Japanese males is prostate cancer. Urothelial carcinoma develops in a relatively elderly population. The erectile function of aging Japanese men demonstrated an age-related decline in the community-based study, with erectile rigidity declining over a 15-year period.
Topics: Aged; Humans; Japan; Urologic Diseases
PubMed: 30549851
DOI: No ID Found -
Hinyokika Kiyo. Acta Urologica Japonica Dec 2016Case 1 : A 76-year-old man consulted a physician because of pollakisuria, decline of urinary stream. A high level of serum prostate specific antigen (PSA) was detected...
Case 1 : A 76-year-old man consulted a physician because of pollakisuria, decline of urinary stream. A high level of serum prostate specific antigen (PSA) was detected and he came to our hospital. He was diagnosed to have prostate cancer, cT3aN0M1b, and was treated with combined androgen blockage (CAB). Two years and nine months later, postrenal failure appeared and serum level of neuron-specific enolase (NSE) was 162 ng/ml. We performed re-biopsy of prostate, and pathological examination indicated small cell carcinoma of the prostate. We treated him with combination chemotherapy comprised of etoposide and carboplatin, which was effective. Serum level of NSE was decreased and computed tomography showed reduction of the prostate volume and metastasis. Case 2 : An 84-year-old man was treated at a hospital with radiation therapy and CAB, because of prostate cancer. He came to our hospital with bladder tamponade. We performed transurethral coagulation and transurethral biopsy. Pathologically it proved to be small cell carcinoma of the prostate. The stage was cT4N1M1a, NSE and pro-gastrin-releasing peptide (Pro-GRP) levels were high. The same treatment given to him as in case 1, effectively decreased the metastasis and the level of serum NSE.
Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Carboplatin; Carcinoma, Small Cell; Etoposide; Humans; Male; Prostatic Neoplasms; Tomography, X-Ray Computed
PubMed: 28103658
DOI: 10.14989/ActaUrolJap_62_12_639 -
Hinyokika Kiyo. Acta Urologica Japonica Dec 2015Systemic lupus erythematosus (SLE) is an autoimmune disease with various symptoms. We present a case of muscle invasive bladder cancer with lymph node swelling caused by...
Systemic lupus erythematosus (SLE) is an autoimmune disease with various symptoms. We present a case of muscle invasive bladder cancer with lymph node swelling caused by SLE. A 60-year-old man was referred to our hospital with high fever and pollakisuria, micro hematuria, proteinuria. We detecteda papillary tumor located behind the left ureteral orifice. Magnetic resonance imaging showed invasion of the tumor to the fat around the bladder. Computed tomography (CT) showed the swelling of left common iliac lymph node and bilateral inguinal lymph nodes. According to cystoscopy, imaging examination and transurethral resection of bladder tumor, we diagnosed it as a bladder cancer (cT3aN3M1). In addition, a close inspection of proteinuria was performed, and SLE was diagnosed. We started steroid therapy under the influence of neutropenia and thrombopenia caused by SLE. The swelling of lymph nodes disappeared on the CT three months later. After the therapy with gemcitabine andcisplatin, radical cystectomy and cutaneous ureterostomy were performed. Pathological examination showed invasive urothelial carcinoma and no lymph node metastasis. He now shows no evidence of disease 18 months after the operation.
Topics: Carcinoma; Humans; Lupus Erythematosus, Systemic; Male; Middle Aged; Urinary Bladder Neoplasms
PubMed: 26790764
DOI: No ID Found -
Nihon Hinyokika Gakkai Zasshi. the... 2016The Hem-o-lok clips (HOLC) is frequently used for hemostasis of the lateral pedicles in robot-assisted prostatectomy (RARP) and laparoscopic radical prostatectomy (LRP)....
The Hem-o-lok clips (HOLC) is frequently used for hemostasis of the lateral pedicles in robot-assisted prostatectomy (RARP) and laparoscopic radical prostatectomy (LRP). We report a rare post-operative complication, the migration of a HOLC into the bladder leading to calculus formation after RARP. A 54 year-old man underwent RARP with nerve- sparing procedure with HOLCs in the left neurovascular bundle. Three months later, he was referred to our hospital for pollakisuria and spontaneous hematuria. Abdominal ultrasonographic examination and computed tomography (CT) demonstrated a bladder stone that was 7 mm in diameter. On cystourethroscopy, he was noted to have a yellow-colored stone at 9 o'clock position of vesicourethral anastomosis. A cystolithotripsy for a bladder stone was performed until the surface of it was broken. A HOLC with a calculus was revealed and retrieved by stone forceps through the urethra. Since then, Intravesical migration of a HOLC has not been observed.
Topics: Cystoscopy; Foreign Bodies; Foreign-Body Migration; Humans; Male; Middle Aged; Prostatectomy; Prostatic Neoplasms; Robotic Surgical Procedures; Surgical Instruments; Treatment Outcome; Urinary Bladder Calculi
PubMed: 28442669
DOI: 10.5980/jpnjurol.107.111 -
Clinical Drug Investigation Aug 2015Intravesical instillation of glycosaminoglycans is a promising option for the treatment of chronic cystitis, as it supports the regeneration of the damaged urothelial... (Observational Study)
Observational Study
BACKGROUND AND OBJECTIVE
Intravesical instillation of glycosaminoglycans is a promising option for the treatment of chronic cystitis, as it supports the regeneration of the damaged urothelial layer. We investigated the efficacy of short-term intravesical chondroitin sulphate treatment (six courses of instillation) in patients with chronic radiotherapy- or chemotherapy-associated cystitis.
METHODS
This prospective, observational study included patients with chronic radiotherapy- or chemotherapy-associated cystitis, who received six once-weekly intravesical instillations of 0.2% chondroitin sulphate 40 mL. Every week, patients recorded their symptoms and their benefits and tolerance of treatment, using a self-completed questionnaire.
RESULTS
The study included 16 patients (mean age 68.5 years; 50% male). During the study, a reduction in all evaluated parameters was observed. After one dose of chondroitin sulphate, symptom improvement was observed in 38% of patients, and after the second dose, an additional 31% of patients showed improvement. At week 6, 80% of patients had either improved or were symptom free, and significant improvements in urinary urgency (p = 0.0082), pollakisuria (p = 0.0022), urge frequency (p = 0.0033) and lower abdominal pain (p = 0.0449) were observed. Haematuria, present in 9 of the 16 patients at baseline, was completely resolved in all cases after 6 weeks. The majority of patients (93%) evaluated the tolerance of chondroitin sulphate as 'good' or 'very good'. No treatment-related adverse events were reported.
CONCLUSION
Intravesical administration of chondroitin sulphate was effective for the treatment of radiotherapy- or chemotherapy-associated cystitis. Even short-term treatment appears to be effective in reducing symptoms and improving the quality of life of patients.
Topics: Administration, Intravesical; Aged; Chondroitin Sulfates; Chronic Disease; Cystitis; Female; Humans; Male; Middle Aged; Prospective Studies
PubMed: 26175064
DOI: 10.1007/s40261-015-0306-6 -
Hinyokika Kiyo. Acta Urologica Japonica Jun 2015A 77-year-old man was seen at our hospital with the chief complaint of pollakisuria. Magnetic resonance imaging (MRI) showed a 25 mm cystic tumor with solid components...
A 77-year-old man was seen at our hospital with the chief complaint of pollakisuria. Magnetic resonance imaging (MRI) showed a 25 mm cystic tumor with solid components behind the prostate. A transrectal biopsy for the prostate showed no evidence of malignancy. Two years later, he complained of weak urinary stream, and the MRI diagnosis demonstrated an increase of the tumor size to 67 mm. Since prostatic sarcoma was diagnosed by the transrectal biopsy for the prostate, a tumor resection and prostatectomy were performed. At 19 months after the operation, there was no evidence of metastasis or recurrence, and he has had no dysuria. The final pathological diagnosis was of a prostatic STUMP.
Topics: Aged; Biopsy; Humans; Magnetic Resonance Imaging; Male; Prostatectomy; Prostatic Neoplasms; Sarcoma; Stromal Cells
PubMed: 26153054
DOI: No ID Found -
World Journal of Gastroenterology Nov 2014IgG4-related autoimmune pancreatitis is frequently accompanied by relevant lesions in the genitourinary tract and retroperitoneal organs, which cause various clinical... (Review)
Review
IgG4-related autoimmune pancreatitis is frequently accompanied by relevant lesions in the genitourinary tract and retroperitoneal organs, which cause various clinical problems, ranging from non-specific back pain or bladder outlet obstruction to renal failure. The diagnosis of IgG4-related retroperitoneal fibrosis requires a multidisciplinary approach, including serological tests, histological examination, imaging analysis, and susceptibility to steroid therapy. Radiological examinations are helpful to diagnose this condition, but surgical resection is occasionally unavoidable to exclude malignancy, particularly for patients with isolated retroperitoneal involvement. Steroid therapy is the treatment of choice for this condition, the same as for other manifestations of IgG4-related disease. For patients with severe ureteral obstruction, additional ureteral stenting needs to be considered prior to steroid therapy to preserve the renal function. Some papers have suggested that IgG4-related disease can affect male reproductive organs including the prostate and testis. IgG4-related prostatitis usually causes lower urinary tract symptoms, such as dysuria and pollakisuria. Patients sometimes state that corticosteroids given for IgG4-related disease at other sites relieve their lower urinary tract symptoms, which leads us to suspect prostatic involvement in this condition. Because of the limited number of publications available, further studies are warranted to better characterize IgG4-related disease in male reproductive organs.
Topics: Adrenal Cortex Hormones; Animals; Autoimmune Diseases; Biomarkers; Diagnostic Imaging; Female Urogenital Diseases; Humans; Immunoglobulin G; Male; Male Urogenital Diseases; Pancreatitis; Predictive Value of Tests; Retroperitoneal Fibrosis; Risk Factors; Sex Factors; Stents; Treatment Outcome
PubMed: 25469023
DOI: 10.3748/wjg.v20.i44.16550 -
Der Urologe. Ausg. A Oct 2014The following data analysis studied the aspects of patient satisfaction following onabotulinum toxin A (BTX-A) treatment including modification of certain parameters,... (Clinical Trial)
Clinical Trial
BACKGROUND
The following data analysis studied the aspects of patient satisfaction following onabotulinum toxin A (BTX-A) treatment including modification of certain parameters, such as frequency of micturition and the use of pads and in particular, the applicability of the international consultation on incontinence questionnaire short form (ICIQ-SF) and the urgency perception scale (UPS) in patients with an overactive bladder (OAB).
PATIENTS AND METHOD
In this study 40 female patients were questioned in the form of validated questionnaires (extended ICIQ-SF and UPS) before and after being injected with 300 IU of BTX-A in each detrusor muscle. The average age of the patients was 66 years. All patients experienced anticholinergic refractory, non-neurogenic OAB.
RESULTS
The recommendation rate and related patient satisfaction was 82.5 %. A significant decrease in the frequency of micturition by 50.9 % (p < 0.01) was reported as well as a significant reduction in the use of pads by 66.7 % (p < 0.01). The average number of ICIQ-SF points could be significantly (p < 0.01) reduced via BTX-A from 15.9 to 7.3. Moreover, BTX-A demonstrated a significant improvement in the urgency to urinate, which was illustrated through the UPS.
CONCLUSION
Treatment with BTX-A achieves significant improvements in female patients with anticholinergic refractory OAB with regard to the individual symptoms of OAB (e.g. pollakisuria, nocturia, undesired urination and urgency). The use of the ICIQ-SF as the only questionnaire in OAB diagnostics proved to be unsuitable as it does not include female patients with dry OAB to an adequate degree. A combination of various validated questionnaires, such as ICIQ-SF and UPS, proved to be useful.
Topics: Administration, Intravesical; Aged; Botulinum Toxins, Type A; Female; Germany; Humans; Male; Neuromuscular Agents; Outcome Assessment, Health Care; Patient Satisfaction; Quality of Life; Reproducibility of Results; Sensitivity and Specificity; Surveys and Questionnaires; Treatment Outcome; Urinary Bladder, Overactive; Urology
PubMed: 24865242
DOI: 10.1007/s00120-014-3434-3