Clinical questions in the Japanese Urological Association's 2024 clinical practice guidelines for urethral strictures.

Transurethral procedures such as direct vision internal urethrotomy and urethral dilation have been the traditional treatments for urethral strictures. However, transurethral procedures are associated with high recurrence rates, resulting in many uncured cases and prompting major international urological societies to recommend urethroplasty as the standard treatment owing to its high success rate. In contrast, many Japanese general urologists have little doubts about treating urethral strictures with transurethral treatment.

The Japanese Urological Association's clinical practice guidelines for urotrauma 2023.

The Japanese Urological Association's guidelines for the treatment of renal trauma were published in 2016. In conjunction with its revision, herein, we present the new guidelines for overall urotrauma. Its purpose is to provide standard diagnostic and treatment recommendations for urotrauma, including iatrogenic trauma, to preserve organ function and minimize complications and fatality.

Surgical technique of laparoscopic ureterocalicostomy using the VIO soft-coagulation system.

One of the most crucial issues while performing ureterocalicostomy (UC) in patients with well-functioning thick renal parenchyma is controlling bleeding from the anastomotic site. In general, renorrhaphy is necessary for hemostasis because conventional coagulation remains unreliable in cases of an incised thick renal parenchyma. Instead of the parenchymal renorrhaphy, the VIO soft-coagulation system is used for hemostasis.

[BILATERAL CALCIFIED URETERAL STRICURE REQUIRING URINARY RECONSTRUCTION IN EOSINOPHILIC GRANULOMATOSIS WITH POLYANGITIS: A CASE REPORT].

Calcified ureteral obstruction is a rare complication of vasculitis. Only a few cases of eosinophilic granulomatosis with polyangiitis (EGPA) have been published. We herein report a case of successful surgical repair of bilateral ureteral strictures in a patient with EGPA.

Can excretory phase computed tomography predict bacteremia in obstructive calculous pyelonephritis?

Purpose: Acute pyelonephritis (AP), a complication of urolithiasis, can be fatal if it progresses to septic shock. We aimed to evaluate the performance of excretory phase computed tomography (CT) in predicting bacteremia among AP patients with upper urinary tract calculi.

Methods: We reviewed medical records of 250 patients diagnosed with AP and upper urinary tract calculi and who were admitted to our institute.

Recurrence of sigmoid colon carcinoma in the retained urethra after cystectomy: A case report and review of the literature.

Urethral recurrence arising from a primary colorectal adenocarcinoma is rare. Here, we report a case of urethral recurrence of sigmoid colon cancer, which developed after cysto-prostato-sigmoidectomy for sigmoid colon cancer invading the bladder. The patient underwent urethrectomy successfully and is currently tumor-free.

[Nurse questionnaire survey about the urethral catheterization and clinical analysis of iatrogenic urethral injury].

Objective: This study was aimed at determining the status of iatrogenic urethral injury associated with insertion of urethral catheters at our hospital.

Subjects And Methods: We studied the data of 32 patients with iatrogenic urethral injury at our hospital. We also carried out a questionnaire survey of 150 nurses who could be in charge of urethral catheter insertions, and conducted an analysis based on the answers obtained from 133 of the 150 nurses (response rate 88.

Acute pyelonephritis and secondary bacteraemia caused by Veillonella during pregnancy.

We report a case of pyelonephritis and secondary bacteraemia caused by Veillonella species during pregnancy. Veillonella is part of the normal flora from the oral cavity, gut and vagina. However, because Veillonella is usually isolated from cultures of clinical specimens as part of commensal flora, it is frequently regarded as a contaminant.

[A case of Mycoplasma hominis infection after bladder injury during cesarean section].

A 21-year-old female patient underwent emergency cesarean section and a postoperative hematoma occurred at the site of the uterine incision. The patient underwent laparotomy for hemostasis. An 3 cm perforation at the posterior wall of the bladder was identified.

Mercaptoacetyltriglycine-3 renogram is not superior to estimated glomerular filtration rate measurement for the prediction of long-term renal function after nephrectomy.

Objective: To evaluate the clinical usefulness of effective renal plasma flow (ERPF) measured using preoperative mercaptoacetyltriglycine-3 (MAG3) renogram for the prediction of chronic renal insufficiency after nephrectomy.

Methods: A total of 47 patients underwent preoperative MAG3 renal scintigraphy and subsequent unilateral nephrectomy. Correlations between the 5-year postoperative estimated glomerular filtration rate (eGFR) and the preoperative ERPF of the contralateral kidney (cERPF), ERPF of the diseased kidney (dERPF), total ERPF (tERPF), cERPF to dERPF ratio, serum creatinine (sCr) level, eGFR, as well as the influence of preoperative comorbidities (diabetes, hypertension) on the postoperative eGFR, were evaluated with both univariate and multivariate analyses.

A case of laparoscopic excision of a huge retroperitoneal cystic lymphangioma.

Retroperitoneal cystic lymphangioma is a rare benign tumor. Most patients eventually experience some symptoms that necessitate therapeutic intervention. Excision is the treatment of choice, and some cases of laparoscopic resection have been reported.

[Case of pharyngeal emphysema with airway obstruction during retroperitoneal laparoscopic nephroureterectomy].

A 76-year-old woman with right renal pelvic cancer underwent a laparoscopic nephroureterectomy via a retroperitoneal approach. During the 300 minutes of CO2 insufflation, arterial blood pressure, temperature, and oxygen saturation were stable, whereas the end-tidal CO2 (ETCO2) gradually increased and reached a peak of 55 mmHg. Her arterial blood gas analysis suggested acute respiratory acidosis.

[Pericardial effusion due to metastatic prostate cancer: a case report].

We describe a patient whose complaints were related to pericardial effusion due to prostatic carcinoma. An 80-year-old man was admitted to our hospital because of chest discomfort and dyspnea. The chest radiograph revealed cardiomegaly and computed tomographic scan showed a large pericardial effusion.

[Acute urethritis caused by Neisseria meningitidis and Chlamydia trachomatis].

A 16-year-old heterosexual man presented to our hospital with a purulent urethral discharge and pain at voiding. These symptoms began seven days after oral-genital contact (fellatio) with his partner. A Gram-stained smear from the urethral discharge showed Gram-negative diplococci, and the antigen of Chlamydia trachomatis from urine was positive.

[Nontraumatic perirenal hematoma: a case report].

A patient with non-traumatic perirenal hematoma is reported. A 56- year-old woman visited our hospital with a complaint of left back pain. Computed tomographic scan showed left perirenal hematoma.

[Bladder contracture following intravesical BCG immunotherapy treated by hydrodistention: a case report].

A 35-year-old man had undergone retroperitoneoscopic radical nephrouretectomy in May 2002 (pTisNxM0). He later developed carcinoma in situ (CIS) of the bladder, and underwent intravesical instillation of 80 mg of Bacillus-Calmette-Guerin (BCG) once a week for 6 weeks in January 2004. After the treatment, irritative symptoms (frequency and dysuria) developed, and he was diagnosed with bladder contracture.

alpha1-acid glycoprotein fucosylation as a marker of carcinoma progression and prognosis.

Background: Serum alpha1-acid glycoprotein (AGP), an acute-phase protein secreted by the liver, carries alpha(1,3)-fucosylated structures on its 5 highly branched, N-linked sugar chains.

Methods: Serum AGP levels in patients with various types of malignancies (n=214 patients) were measured using an enzyme-linked immunosorbent assay with anti-AGP antibody. To investigate glycoforms that differed in their degree of branching and extent of fucosylation, serum AGP samples were analyzed by crossed affinoimmunoelectrophoresis (CAIE) with concanavalin A, and Aleuria aurantia lectin (AAL), and anti-AGP antibody.

[Endovascular stent graft for management of ureteroarterial fistula: a case report].

We report a case of ureteral-iliac artery fistula and its minimally invasive management with endovascular stent grafting. A 76-year-old male was admitted with massive gross hematuria from an ilial conduit. He underwent a radical cystectomy with ileal loop urinary diversion for bladder cancer 7 months ago and had undergone placement of a 7 Fr single-J ureteral catheter for repair of a partial disruption of the left ureteroileal anastomosis.

Primary carcinoid tumor arising in a retroperitoneal mature teratoma in an adult.

An extremely rare case of a primary carcinoid tumor arising in a mature retroperitoneal teratoma is reported. A 53-year-old woman was admitted for further examination of an incidental retroperitoneal mass with calcification. Computed tomography scans demonstrated a tumor with fat, soft tissue and bone densities on the left renal hilum.

[Mixed epithelial and stromal tumor growing with polypoid pattern in the renal pelvis].

A 68-year-old woman was found incidentally to have right hydronephrosis and a renal pelvic mass by abdominal ultrasonography. Radiographic examinations revealed a heterogeneous renal pelvic tumor, and right nephroureterectomy was performed. The tumor was well circumscribed yellow-whitish solid mass with scattered cysts.

[A case report of a young patient with invasive bladder cancer].

A 29-year-old male with bladder cancer was referred to our hospital. Histological examination of transurethral biopsy showed transitional cell carcinoma with invasion into prostate (T4aN0M0, grade 3). Nerve-sparing radical cystectomy with ileal neobladder reconstruction was performed after 3 courses of neoadjuvant chemotherapy with Methotrexate, Epirubicin and Cisplatin.

Tumor-related expression of alpha1,2fucosylated antigens on colorectal carcinoma cells and its suppression by cell-mediated priming using sugar acceptors for alpha1,2fucosyltransferase.

The accumulation of alpha1,2fucosylated antigens, such as Y (Fucalpha1,2Galbeta1,4 [Fucalpha1,3]GlcNAcbeta), Le(b) (Fucalpha1,2Galbeta1,3-[Fucalpha1,4]GlcNAcbeta), and H type 2 (Fucalpha1,2 Galbeta1,4GlcNAcbeta) occurs specifically within human colorectal tumor tissues and can be detected by an antifucosylated antigen antibody, such as the YB-2 antibody. In the present investigation, we found that the expression of these antigens bearing an alpha1,2-linked fucose correlated with the resistance of the tumor cells to anticancer treatments. Addition of an exogenous sugar acceptor for alpha1,2fucosyltransferase to the cell medium resulted in suppression of alpha1,2fucosylated antigen expression on the tumor cells and increased susceptibility to anticancer treatment.

Lidocaine added to a tracheostomy tube cuff reduces tube discomfort.

Purpose: To examine whether lidocaine diffusion across an endotracheal tube cuff affects tracheostomy tube discomfort.

Methods: Two tracheostomy tube cuffs were inflated with 5 ml lidocaine 4% solution and air at 20 cmH2O, and then placed in 20 ml distilled water at 37 degrees C. After vigorous stirring, 100 microl of this water was then sampled immediately then 1, 2, 4, 8, 24 hr later to measure lidocaine concentration by high-performance liquid chromatography.

A new method for distortion correction of electronic endoscope images.

A new method to correct the barrel distortion of an electronic endoscope image is presented. A correction model assuming circularly symmetric distortion is introduced with the following model parameters: the center of distortion and the coefficients of polynomials representing the distortion correction in the radial direction. If the imaging system is distortion-free, straight lines in the object space should be imaged as straight lines.

[Clinical evaluation of the long-term treatment with chlormadinone acetate in patients with benign prostatic hypertrophy].

Fifty patients with benign prostatic hypertrophy were treated with chlormadinone acetate (CMA) at the dose of 50 mg/day for 12 months. Subjective symptoms and objective findings were evaluated before, and after 4 and 12 months of treatment. Better improvement was observed in all of the subjective symptoms and in almost all the parameters of objective findings, in proportion to the period of CMA treatment.