Takaharu Ichikawa

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.

Glass Wool Filtration Reduces Reactive Oxygen Species by Elimination of Leukocytes in Oligozoospermic Patients with Leukocytospermia

AbstractPurpose: Two types of glass wool were used to remove leukocytes in semen for evaluation of reactive oxygen species production by spermatozoa in oligozoospermic patients with leukocytospermia. Methods: Semen samples were prepared using fine-structure glass wool (SpermFertil) and coarse-structure glass wool. In each treatment group, native semen was evaluated for sperm concentration, percentage motility, viability, leukocyte concentration, and production of reactive oxygen species. Results: Electron microscopically, SpermFertil showed a higher number of leukocytes attached to the fibers compared to coarse-structure glass wool. Leukocytes in native semen and after glass wool filtration as determined by peroxidase cytochemistry confirmed this observation. Reactive oxygen species decreased from 45.303 counts/107 viable cells in native semen to 15.806 counts/107 cells in coarse structure wool and 7.465 counts/107 cells in Spermfertil, respectively. Conclusions: Removal of leukocytes from semen of oligozoospermic patients by means of glass wool filtration is a useful method to distinguish production of reactive oxygen species by leukocytes versus sperm cells.

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.

URODYNAMIC CHANGES AFTER ENDOSCOPIC CORRECTION OF VESICOURETERAL REFLUX

Massive bilateral vesicoureteral reflux (VUR) in a 7‐year‐old girl with spinal scoliosis was successfully treated by endoscopic correction. She was admitted due to a febrile urinary tract infection and urinary incontinence. A cystometrogram demonstrated normal detrusor function during storage. The endoscopic subureteric injection of polytetrafluoroethylene (TeflonTM) was performed, resulting in the disappearance of the VUR. A postoperative cystometrogram demonstrated overactive detrusor function during storage, necessitating anticholinergic medication. She has been free of febrile urinary tract infections and incontinence for 2 years postoperatively, although self‐catheterization is necessary. In a case of neurogenic vesical dysfunction with massive reflux, endoscopic subureteric injection is not only a therapeutic tool, but also a useful diagnostic option for detecting occult detrusor overactivity during storage prior to open surgery.

Atypical findings in a patient with a renal milky stone including a cake of stone

Abstract  A 54‐year‐old woman was admitted to our department with the diagnosis of a renal calculus. She exhibited dull left flank pain. A plain film revealed a round opaque calcific density in the left kidney in the supine and the upright position. There was no connection between the calcification and the renal collecting system by retrograde pyelography. Computed tomography in the supine position showed a rounded calcification in the left renal parenchyma without a semilunar configuration. She was diagnosed with left renal calyceal diverticula calculi. She underwent a surgical intervention which found a renal milky stone including a 10‐mm. diameter stone. The examination of the fluid and the stone material disclosed three components: calcium phosphate, calcium oxalate and calcium carbonate. The present case is interesting because its characteristics differ from the common features of renal milky stone.

Early Experiences of Contact Laser Vaporization of the Prostate using the 980 nm High Power Diode Laser for Benign Prostatic Hyperplasia

We report early experiences of contact laser vaporization of the prostate for symptomatic benign prostatic hyperplasia (BPH).