Kenji Aramaki

The female partner's satisfaction with sildenafil citrate treatment of erectile dysfunction

Abstract Background: Data on female partners’ satisfaction are scarce, although there have been many articles on patient satisfaction after sildenafil citrate treatment. The aim of this study was to evaluate the satisfaction of female partners of patients receiving sildenafil citrate for their erectile dysfunction (ED) and to assess the female partners’ sexual function.

Inflammatory pseudotumor of the kidney with renal artery penetration

Inflammatory pseudotumor (IPT) is a quasineoplastic lesion that most commonly involves the lung and the orbit; kidney involvement is rare. We report a case of inflammatory pseudotumor of the kidney. The patient was a 61-year-old man who presented with no symptoms. Nonenhanced computed tomography (CT) demonstrated an ill-defined, isodensity mass measuring 3.5 cm in the lower portion of the left kidney. Contrast-enhanced CT showed that branches of the renal artery without encasement penetrated the tumor; there was a little enhancement in the mass on the arterial phase and homogeneous enhancement on the venous phase. On magnetic resonance imaging the mass showed intermediate signal intensity on T1-weighted images (T1WIs) and low signal intensity on T2WIs. Most IPTs of the kidney appear as an ill-defined, hypovascular, homogeneous tumor on CT images, with variable signal intensity on MRI T1WIs and low signal intensity on T2WIs. Our case had the same imaging findings, with branches of the renal artery penetrating the tumor. If the renal tumor has these radiological findings, the tumor may be IPT.

Retroperitoneoscopic nephropexy for symptomatic nephroptosis.

PURPOSE Recently, laparoscopic nephropexy has been performed using a transperitoneal approach. We evaluated the efficacy of a retroperitoneoscopic technique for symptomatic nephroptosis. PATIENTS AND METHODS Three men and two women with right nephroptosis underwent retroperitoneal laparoscopic nephropexy. Their symptoms were right flank pain, gross hematuria, or both. The mean body mass index was 18.7. Surgery consisted of complete dissection of the kidney, after which three sutures were placed between the renal capsule at the posterior lateral edge and the psoas or quadratus lumborum muscle. Silk sutures were used in all five patients. RESULTS Retroperitoneoscopic nephropexy was successful with no intraoperative complications. The mean operative time was 167 minutes, and the mean estimated blood loss was <10 mL in all five patients. The mean convalescence period was 19.6 days. A postoperative urogram with the patients both supine and erect revealed an improvement in renal function, decreased displacement of the kidney (less than one vertebral body), or both. All patients were satisfied with the clinical outcome during an average of 18 months of follow-up. CONCLUSIONS Retroperitoneoscopic nephropexy is feasible for patients with symptomatic nephroptosis. We recommend nonabsorbable materials such as silk for fixation of the kidney to the psoas or quadratus lumborum muscle.