Masahito Saitoh

Preoperative Evaluation of Localized Prostatic Carcinoma by Transrectal Ultrasonography

We evaluated 31 patients with clinically localized prostatic carcinoma by transrectal ultrasonography before radical prostatectomy. Results of ultrasonography were reviewed without previous knowledge of the extent of the disease and were compared to the pathological staging obtained by step section of the prostate. Preoperative transrectal ultrasonography was sensitive in detecting capsular and seminal vesicle involvement (89 and 100 per cent, respectively). However, the specificity of the method was low for capsular involvement (50 per cent), probably owing to the inability of this method to detect microscopic disease. This method is a valuable tool in the preoperative evaluation of patients with clinically localized prostatic carcinoma.

The American Urological Association symptom index for benign prostatic hyperplasia as a function of age, volume and ultrasonic appearance of the prostate

PURPOSE Our study was conducted to reveal quantitatively the relative effects of age and ultrasonic appearance of benign prostatic hyperplasia (BPH) on urinary symptoms as evaluated by the American Urological Association (AUA) symptom index score. MATERIALS AND METHODS In 929 examinees (732 with a normal prostate and 197 with BPH) on a mass screening program for prostatic diseases using transrectal ultrasonography in Japan, the AUA symptom score was compared to age, prostatic volume and presumed circle area ratio using simple and multiple regression analyses. RESULTS Simple regression analysis demonstrated the symptom score to correlate significantly with age (R = 0.162, p < 0.0001), prostatic volume (R = 0.072, p = 0.0281) and presumed circle area ratio (R = 0.150, p < 0.0001). However, multiple regression analysis demonstrated that age and presumed circle area ratio were significant independent determinants of the total symptom score. Among 7 symptoms included in the AUA symptom index weak stream and hesitancy scores were not influenced by age, prostatic volume or presumed circle area ratio. CONCLUSIONS As a parameter representing the degree of BPH in terms of the severity of urinary symptoms, presumed circle area ratio was preferable to prostatic volume. Regression analyses confirmed again that the AUA symptom index was influenced considerably by age and was not specific to BPH.

A STATISTICAL STUDY OF THE AMERICAN UROLOGICAL ASSOCIATION SYMPTOM INDEX FOR BENIGN PROSTATIC HYPERPLASIA IN PARTICIPANTS OF MASS SCREENING PROGRAM FOR PROSTATIC DISEASES USING TRANSRECTAL SONOGRAPHY

PURPOSE A study was done on the prevalence of urinary symptoms in community based populations in Japan regarding the influences of aging and benign prostatic hyperplasia (BPH) as evaluated by transrectal sonography. MATERIALS AND METHODS In 961 Japanese men 55 to 87 years old who underwent mass screening for prostatic diseases the American Urological Association symptom index scores were compared with age and ultrasonic diagnosis of the prostate. RESULTS Moderate to severe symptoms (symptom score 8 or more) were found in 265 of our 961 samples (27.6%), while BPH was also recognized ultrasonically in 197 (20.5%). Frequencies of urinary symptoms and BPH increased significantly with age. BPH related increase in total symptom scores occurred only in select men when adjusted by age. CONCLUSIONS The ability of the American Urological Association symptom index to characterize BPH in an individual was limited because of the lack of specificity to the disease along with the considerable influence of aging on the symptom score. Currently, transrectal sonography is the most reliable method for the definitive diagnosis of BPH.

DETECTION OF THE URINE JET PHENOMENON USING DOPPLER COLOR FLOW MAPPING

Background:

Selective renal biopsy under ultrasonic real-time guidance.

A new technique for performing renal biopsy using ultrasonic real-time guidance was developed at our clinic in 1978. The puncture procedure is monitored in 2-dimensional real-time images by a mechanical sector scanner equipped with an attachment for needle guidance. The technique is called “selective renal biopsy” because tissue can be obtained selectively from any portion of the kidney. During the last 4 years, 150 such procedures have been performed on 148 patients. The success rate has been 96%. No serious complications occurred.

Ultrasound findings in urolithiasis in the lower ureter

Thirty-two cases of urolithiasis in the lower ureter, difficult to detect by ordinary X-ray studies, were diagnosed accurately by ultrasound. Stonelike echoes were easily detected on the ultrasonograms when the ureter of the affected side was dilated. Patients should be examined by ultrasound prior to invasive retrograde pyelography.

Clinical utility of ursodeoxycholic acid in preventing flutamide-induced hepatopathy in patients with prostate cancer: A preliminary study

The present study was designed to ascertain retrospectively the validity of ursodeoxycholic acid (UDCA) in the treatment of prostate cancer in terms of prophylactic effects on the occurrence of flutamide‐induced hepatopathy in a large number of patients surveyed in a multi‐center cooperative study.

Prostatic biopsy guided by transrectal ultrasonography using real-time linear scanner

Prostatic needle biopsy guided by transrectal ultrasonography using a real-time linear scanner was performed on 257 cases in our outpatient clinic and mass screening program for prostatic diseases. The success rate was 99.2 per cent, and complications occurred in only 2 cases (0.8%) after biopsy. This newly developed method is recommended as being safer and more accurate than conventional ones.

Single Stage Percutaneous Nephroureterolithotomy Using a Special Ultrasonically Guided Pyeloscope

Abstract We describe a new method for percutaneous stone removal from the upper urinary tract. A flexible fiberoptic bronchoscope is introduced directly into the renal pelvis through a trocar under ultrasonic real-time guidance. The fiberscope is introduced into the ureter from the ureteropelvic junction. The stone situated in the upper portion of the ureter is trapped by the stone basket and extracted under endoscopic control. This direct percutaneous method without pre-establishing a nephrostomy provides a noninvasive operation using a small skin incision for urinary stones.

Percutaneous microexplosion nephrolithotripsy

We developed the technique of microexplosion for the destruction of bladder stones and have used it since 1981 with good results. The procedure is safe and simple. A renal pelvic stone in a seventy-one-year-old woman was successfully destroyed by microexplosion using a percutaneous approach. We believe this is the first clinical report on the use of microexplosion for upper urinary tract calculi.