Hirokazu Taguchi

Cystoplasty by Regeneration of the Bladder

Herein we describe a new method for cystoplasty, making use of the regenerating ability of the bladder. The contracted bladder is opened with a crucial incision and enlarged by placing thin paper covered with liquid synthetic resin (nobecutane) like a cap over the opened bladder tissue. Within 3 to 4 weeks granulated tissue completely covers the artificial cap, which is then removed transurethrally. Thereafter, the bladder regenerates on its own. The operation has been done at our hospital from 1970 to 1975 on 13 patients with contracted bladders owing to various pathologic conditions. Excellent results have been obtained on 11 patients with tuberculous contracted bladders. These 11 patients have regained normal bladder capacity and are able to void normally through the urethra. The technique has not been effective in 2 patients with interstitial cystitis, caused by generalized collagen disease in 1.

The Role of the Diurnal Variation of Urinary ph in Determining Stone Compositions

The diurnal variation of urinary pH and urinary excretion of stone-forming constituents were investigated on 79 stone patients. Composition of the stones was analyzed by means of infrared spectrophotometry. In uric acid stone patients urinary pH was low during the 24-hour period. In mixed calcium oxalate-calcium phosphate stone patients urinary pH was low in the early morning but high in the daytime and at night. In magnesium ammonium phosphate stone patients urinary pH was high throughout the entire day. On the other hand, urinary excretion of calcium was high in the mixed calcium oxalate-calcium phosphate stone patients and low in uric acid or magnesium ammonium phosphate stone patients. These findings suggested that the diurnal variation of urinary pH and urinary excretion of calcium might have an important role in determining stone composition.

Alternate occurrence of allergic disease and an unusual form of interstitial cystitis.

Background: It has been postulated that interstitial cystitis can be induced by an allergy. This is partly based on the observation that many patients with interstitial cystitis also have allergic diseases. In this study, an allergic evaluation was conducted on patients with interstitial cystitis complicated by bronchial asthma, a typical allergic disease.

Nephrolithotomy by one-layer interrupted parenchymal suture.

Since 1967, when Taguchi devised a method of closing renal incisions in nephrolithotomy in which the renal capsule, parenchyma and pelvic mucosa are sutured together as one layer without prior hemostasis, this method, with subsequent modifications of surgical technique, has been employed in 47 cases of staghorn or multiple large calculi. The simplified method of suture shortens the clamp-time of the renal pedicle during operation, minimizes injury to the parenchyma, while assuring adequate hemostasis. All the treated cases showed good results postoperatively, free from any serious complications such as secondary hemorrhage. Renal function tests after nephrolithotomy by this method showed decreases of 20 and 16% in glomerular filtration rate and renal plasma flow, respectively, which returned to preoperative levels in 2 weeks. Pre- and postoperative renal arteriograms indicated some changes in the intrarenal arteries and parenchyma due to the incision and method of suture. Occlusion of intrarenal arteries occurred in 91.7% of the cases, in fact at the level of interlobar or minor artery in 90%, and the average number of sites of arterial interruption per kidney was 4.7. The author considers the method to be irrevocably perfect for renal parenchymal suture.

A simple method of total reconstruction of the penis. Case reports.

: We reconstructed the penis in two patients, using one testicle for bulk and framework with a silicone prosthesis being substituted for that testicle. The results, as far as appearance and relieving mental suffering are concerned, have been satisfactory. There is no sexual sensation, and the urethra remains in the perineum.

Ureteroneocystostomy by Means of a Modified Triangular Flap Method

A modified triangular flap method of ureteroneocystostomy is described. This method was used in 19 cases (21 ureters) requiring ureteroneocystostomy owing to various diseases. The patients have been followed postoperatively for 1 to 9 years. Our method is more simple than the original method described by Girgis and provides good results. Postoperative complications could be reduced or prevented by gentle manipulation of the ureter and bladder wall and by careful placement of the intravesical ureter into the incised ditch of the bladder floor, loosely anastomosed with interrupted surfaces 5 mm. apart. Dilated hydroureters without peristalsis and/or severe degenerative changes of the bladder wall involving the muscle layer are poor indications for the application of this method.

A SIMPLE METHOD OF TOTAL RECONSTRUCTION OF THE PENIS

We reconstructed the penis in two patients, using one testicle for bulk and framework with a silicone prosthesis being substituted for that testicle. The results, as far as appearance and relieving mental suffering are concerned, have been satisfactory. There is no sexual sensation, and the urethra remains in the perineum.