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Hinyokika Kiyo. Acta Urologica Japonica Apr 2004An 80-year-old man visited our hospital because of dysuria and pollakisuria. He had undergone anti-androgen therapy for prostate cancer for 8 months at another hospital....
An 80-year-old man visited our hospital because of dysuria and pollakisuria. He had undergone anti-androgen therapy for prostate cancer for 8 months at another hospital. His serum prostate specific antigen (PSA) level was 14.4 ng/ml. We performed a prostate biopsy and identified poorly differentiated adenocarcinoma with Gleason score 4 + 5. After 4 months, his serum PSA level increased to 24.8 ng/ml, and we started maximum androgen blockade therapy using additional luteinizing hormone-releasing hormone (LH-RH) analogue. Subsequently, although his serum PSA level declined favorably, his condition worsened rapidly and he died at 16 months after the diagnosis. The autopsy pathology of his prostate revealed small cell carcinoma. We reviewed the initial biopsy specimens and found both small cell carcinoma and adenocarcinoma histologic types of prostate cancer.
Topics: Aged; Aged, 80 and over; Antineoplastic Agents, Hormonal; Carcinoma, Small Cell; Fatal Outcome; Gonadotropin-Releasing Hormone; Humans; Male; Prostate-Specific Antigen; Prostatic Neoplasms
PubMed: 15188622
DOI: No ID Found -
Hinyokika Kiyo. Acta Urologica Japonica Jan 2004Patients younger than 45 years with prostate cancer are rare. Between 1999 and 2002, we studied two cases of prostate cancer in men aged under 45 years. Case 1; a... (Review)
Review
Patients younger than 45 years with prostate cancer are rare. Between 1999 and 2002, we studied two cases of prostate cancer in men aged under 45 years. Case 1; a 45-year-old man admitted with the chief complaint of urination disorder. Serum level of prostate-specific antigen (PSA) was 5,000 ng/ml or higher. Transrectal needle biopsy of the prostate revealed moderately differentiated adenocarcinoma. Computed tomography (CT) and bone scan showed para-aorta lymph node metastasis and bone metastasis. Hormone therapy was performed. Case 2; a 37-year-old man admitted with the chief complaint of pollakisuria and sense of residual urine. Serum level of prostate-specific antigen (PSA) was 24 ng/ml. Magnetic resonance imaging (MRI) showed that the prostate tumor invaded the bladder wall. Transrectal needle biopsy revealed poorly differentiated adenocarcinoma. Hormone therapy and radiation therapy were performed. Twenty-one cases reported in Japan in addition to the present cases are reviewed.
Topics: Adenocarcinoma; Adult; Age Factors; Biomarkers, Tumor; Combined Modality Therapy; Diagnostic Imaging; Humans; Male; Middle Aged; Prognosis; Prostate-Specific Antigen; Prostatic Neoplasms
PubMed: 15032019
DOI: No ID Found -
International Urogynecology Journal and... 2004The aim of this study was to determine the short-term prevalence of de novo urinary symptoms after hysterectomy indicated by meno/metrorrhagia or...
The aim of this study was to determine the short-term prevalence of de novo urinary symptoms after hysterectomy indicated by meno/metrorrhagia or dysmenorrhea/dyspareunia. The study group consisted of 451 women who had had a hysterectomy for reasons of meno/metrorrhagia or dysmenorrhea/dyspareunia. Fifty-three (12%) had a supracervical, 151 (33%) a total abdominal and 247 (55%) a vaginal hysterectomy. As a non-gynecologic background population we enrolled 110 women who had had their gallbladder removed laparoscopically. All women received a postal questionnaire 9-45 months after their operation. Specific questions were asked about their voiding habits, comprising significant stress incontinence, bothersome stress incontinence, significant urge incontinence, bothersome urge incontinence, pollakisuria, nocturia, use of pads, and the feeling of having a hygiene problem. To evaluate de novo symptoms or de novo cure, the women assessed the symptoms before as well as after the operation. Results showed that abdominal hysterectomy lasted longer, had heavier blood loss and required longer hospitalization than did vaginal or supracervical hysterectomy. Women scheduled for a supracervical hysterectomy had preoperatively more significant and bothersome urge incontinence, and postoperatively more significant urge, urgency, and feeling of having a hygienic problem than did women having a vaginal hysterectomy, a total abdominal hysterectomy or a laparoscopic cholecystectomy. When assessing de novo symptoms, supracervical hysterectomy was associated with more urgency and the feeling of having a hygienic problem. Some women experienced de novo cure, but these were almost exclusively in the study group and rarely in the control group. It was concluded that supracervical hysterectomy is related to more urinary symptoms than vaginal or total abdominal hysterectomy. De novo symptoms as well as de novo cure are common, which is why urinary symptoms after hysterectomy must be evaluated over time.
Topics: Adult; Dysmenorrhea; Female; Follow-Up Studies; Humans; Hysterectomy; Menorrhagia; Middle Aged; Postoperative Complications; Prevalence; Urinary Incontinence; Urination Disorders
PubMed: 14752593
DOI: 10.1007/s00192-003-1105-9 -
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 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 Jul 2003A 58-year-old man visited our clinic with complaints of gross hematuria and pollakisuria. Cystoscopic examination revealed multiple non-papillary broad based tumors and... (Review)
Review
A 58-year-old man visited our clinic with complaints of gross hematuria and pollakisuria. Cystoscopic examination revealed multiple non-papillary broad based tumors and reddish unstable mucosa in the bladder. The pathological specimen of the transurethral biopsy of the tumors showed signet-ring cell carcinoma predominantly and adenocarcinoma transforming into signet-ring cell carcinoma partially. A total cystectomy with ileal conduit urinary diversion was performed. The histopathological finding of the radical cystectomy specimen was grade 3 transitional cell carcinoma accompanied by adenocarcinoma. These findings suggest that the adenomatous metaplasia of transitional cell carcinoma in the bladder could differentiate into signet-ring cell carcinoma.
Topics: Carcinoma, Signet Ring Cell; Carcinoma, Transitional Cell; Cystectomy; Humans; Male; Middle Aged; Neoplasms, Multiple Primary; Urinary Bladder Neoplasms
PubMed: 12968484
DOI: No ID Found -
Nihon Hinyokika Gakkai Zasshi. the... Jul 2003We report a patient whose irritable bladder symptoms following Bacillus Calmette Guerin (BCG) instillation were satisfactorily treated by steroid administration. A...
We report a patient whose irritable bladder symptoms following Bacillus Calmette Guerin (BCG) instillation were satisfactorily treated by steroid administration. A 59-year-old male had undergone transurethral resection for the bladder carcinoma recurred three times. The histopathological examination revealed the tumor as transitional cell carcinoma, G1 to G2, and pTa. Subsequently an instillation of 80 mg BCG into the bladder was planned 8 times every 7 days. After the 5th instillation he presented with gross hematuria, painful micturition, pollakisuria, urgency and reduced bladder capacity of 15 ml. The dose was reduced to 40 mg and another 3 instillations were accomplished. Since conventional treatments of anti-cholinergics, analgesics and epidural anesthesia were of little help for the subjective symptoms, he was put on the steroid pulse therapy 2 weeks after completion of the BCG regimen. The treatment gradually improved the subjective symptoms and increased the bladder capacity up to 160 ml. In conclusion, we believe that the steroid pulse therapy deserves considering in the early stage of irritable bladder symptoms following BCG instillation.
Topics: Administration, Intravesical; BCG Vaccine; Carcinoma, Transitional Cell; Drug Administration Schedule; Humans; Methylprednisolone; Middle Aged; Prednisolone; Pulse Therapy, Drug; Urinary Bladder Neoplasms
PubMed: 12910934
DOI: 10.5980/jpnjurol1989.94.574 -
Der Urologe. Ausg. A Jun 2003Today, urgency and urge incontinence are both defined under the topic overactive bladder (OAB) whereby pure urge syndrome (pollakisuria, nocturia, and urgency) can... (Comparative Study)
Comparative Study Review
Today, urgency and urge incontinence are both defined under the topic overactive bladder (OAB) whereby pure urge syndrome (pollakisuria, nocturia, and urgency) can easily lead to urge incontinence. Antimuscarinics still constitute the domain of treatment for overactive bladder. The pharmacological effect of modern substances consists of M2 or M3 muscarinic receptor blockade. This blockade prevents acetylcholine from connecting to these receptors and thus leads to a weakness or prevention of the detrusor muscle contraction. These groups of drugs are defined as muscarinic receptor antagonists, antimuscarinics, or anticholinergics. In addition to the muscarinic receptors, some drugs directly block the calcium channels in the cell membrane (calcium antagonists) which are classified as drugs with mixed effect. The presented paper gives an overview about the existing data on drugs approved in Germany whose clinical effect has been proven in randomized studies or are have stood the test of time in daily clinical practice.
Topics: Calcium Channel Blockers; Humans; Muscarinic Antagonists; Muscle Hypertonia; Randomized Controlled Trials as Topic; Receptors, Muscarinic; Treatment Outcome; Urinary Incontinence
PubMed: 12851770
DOI: 10.1007/s00120-003-0363-y -
Nihon Yakurigaku Zasshi. Folia... May 2003Adrenergic alpha1 and beta receptors are present in the target organs of sympathetic nerve and they participate in the signal transduction mechanism of the lower urinary... (Review)
Review
Adrenergic alpha1 and beta receptors are present in the target organs of sympathetic nerve and they participate in the signal transduction mechanism of the lower urinary tract. Adrenergic alpha1 receptors are present in urethral and prostatic smooth muscles, and contract these muscles. Among these receptor subtypes, the alpha1-A receptor has the most important role, and mRNA expression of the corresponding alpha1-a subtype is predominant. In the human urinary bladder detrusor smooth muscle, the expression of adrenergic beta3 receptor subtype mRNA is predominant, and relaxation of detrusor smooth muscle is mediated mainly via beta3 receptor. Afferent nerve with lower threshold can easily transmit bladder sensation and takes an important role in the pathophysiology of urge urinary incontinence. Successful molecular cloning of vanilloid receptors, which are present in these afferent nerves, revealed that vanilloid receptors are ion-channels, sensitive for heat and pH, and termed VR1 and VRL1. Among purinergic receptors, ion channel type P2X3 receptor is found in afferent nerve fibers and plays some roles in the signal transduction of bladder sensation. In the near future, agonist for the adrenergic beta3 receptor and selective antagonists for VR1, VRL1, or P2X3 will possibly become drugs for pollakisuria and urge urinary incontinence.
Topics: Humans; Muscle, Smooth; Receptors, Adrenergic, beta; Sympathetic Nervous System; Urinary Bladder; Urinary Incontinence, Stress
PubMed: 12784734
DOI: 10.1254/fpj.121.325 -
Hinyokika Kiyo. Acta Urologica Japonica Feb 2003A 28-year-old man without tuberous sclerosis, who complained of pollakisuria, consulted to our hospital for a left renal mass. Abdominal computed tomography revealed a... (Review)
Review
A 28-year-old man without tuberous sclerosis, who complained of pollakisuria, consulted to our hospital for a left renal mass. Abdominal computed tomography revealed a solid mass without a lipid component, 10 cm in diameter, in the left kidney and with regional lymphadenopathy. Renal arteriography showed a hypervascular mass, demonstrating multiple tumor stains and aneurysms. Left radical nephrectomy and perihilar lymph node dissection were performed for an anticipated diagnosis of malignant tumor in November 2001. The histopathological diagnosis was an angiomyolipoma with lymph node involvement. Immunostaining for myogen markers was positive in the renal mass and lymph node tumors. He was free from disease ten months after surgery.
Topics: Adult; Angiomyolipoma; Humans; Kidney Neoplasms; Lymph Node Excision; Lymph Nodes; Lymphatic Metastasis; Male; Nephrectomy
PubMed: 12696187
DOI: No ID Found