Tomohiro Taki

Long-term results of endoureterotomy using a holmium laser

Abstract:  The long‐term results of endoureterotomy using a holmium laser in cases of benign ureteral stricture, uretero‐pelvic junction obstruction (UPJ‐O) and ureteroenteric stricture were evaluated. Twenty procedures were carried out in 18 patients. Strictures were incised with a holmium laser using a fiber passed through the ureteroscope. Sixteen of the 20 procedures (80%) were successful at average follow‐up of 60.5 months (range, 46–74). Stricture recurred in four cases. All failures occurred within 18 months. Although stricture length was not correlated with recurrence, all failures, with the exception of a single UPJ‐O, involved middle ureteral strictures. Endoureterotomy using a holmium laser affords favorable results with respect to long‐term patency. This procedure is recommended as a satisfactory therapeutic option for the initial management of patients presenting with ureteral stricture.

THE TREATMENT WITH TRANILAST, A MAST CELL BLOCKER, FOR IDIOPATHIC OLIGOZOOSPERMIA

Although many drug treatments have been reported to theoretically improve semen parameters in male infertility, a standard method has not been established. The authors examined whether tranilast, a mast cell blocker, improves fertility and/or semen parameters in severe oligozoospermia. Seventeen patients with a sperm density of less than 10 2 10 6 sperm/mL and their fertile partners were enrolled in this study. Patients were prescribed tranilast 300 mg/day for at least 12 weeks. Semen and blood samples were collected before and after the prescription of tranilast for 12 weeks. Semen parameters, serum gonadotropins, luteinizing hormone, follicle-stimulating hormone, serum testosterone, and testicular size were evaluated. One patient complained of mild drowsiness during treatment. The sperm count was significantly increased after administration of tranilast in 7 patients (41.1%), although sperm motility was not altered. Semen volume and normal morphology were also unaltered. Three pregnancies were achieved. Endocrine profile and testicular size were unchanged. Tranilast, a mast cell blocker, is clinically useful for the treatment of severe idiopathic oligozoospermic men.

Treatment of Oligoasthenozoospermia with Tranilast, a Mast Cell Blocker, After Long-Term Administration

The authors retrospectively examined whether long-term administration of tranilast improves semen parameters in severe oligoasthenozoospermia. Fifty-two patients presenting with sperm concentration of less than 10 2 10 6 sperm/mL were enrolled. Subjects were partitioned into 3 groups as follows: patients displaying an atrophic testis with elevated (FSH) (group 1), patients exhibiting normal testicular volume with elevated FSH (group 2), and patients with normal testicular volume and normal FSH levels (group 3). Tranilast (300mg/day) was administered until pregnancy was achieved or for a period of up to 12 months. Sperm concentration was significantly increased at 3 months in 16 subjects (44%) in groups 1 and 3. In group 2, sperm concentration was increased at 12 months (5 of 16 subjects; 31%). Total sperm count was obviously elevated at 3 months in groups 1 and 2, and at 6 months in group 3. Six pregnancies were achieved via natural intercourse. Tranilast, a mast cell blocker, demonstrates a certain clinical benefit in terms of improvement of semen parameters involving severe oligoasthenozoospermia, but it does not appear to afford clinical benefit in long-term administration.

Retrograde ureteroscopic endopyelotomy using the holmium:YAG laser

Abstract Background : We report our experience of retrograde ureteroscopic endopyelotomy using the holmium laser for ureteropelvic junction (UPJ) obstruction not associated with upper tract stones.

Endoscopic ureteral incision using the holmium:YAG laser

Abstract Background: We reviewed the results of endoscopic ureteral incision for benign ureteral stricture, ureteropelvic junction obstruction and ureteroenteroanastomotic stricture using the holmium laser.

An immunohistochemical study of chromogranin A and human epidermal growth factor-2 expression using initial prostate biopsy specimens from patients with bone metastatic prostate cancer

To investigate, using prostate needle‐biopsy specimens at diagnosis from patients with bone metastatic prostate cancer, whether the relationship between neuroendocrine (NE) cell differentiation and human epidermal growth factor‐2 (HER‐2) expression is a prognostic factor for outcome.

Clinical study of transitional cell carcinoma of the prostate associated with bladder transitional cell carcinoma.

Abstract Background: Transitional cell carcinoma of the prostate in patients with bladder cancer appears to influence the prognosis and affects the decision about therapeutic modality. Therefore, it is important to characterize transitional cell carcinoma associated with bladder cancer.

Vesicourethral Anastomotic Suture Placement during Radical Prostatectomy Using Maniceps

Introduction: A new method of using a semiautomatic device (Maniceps) for precise vesicourethral anastomosis during radical retropubic prostatectomy is described. Methods: A total of 15 patients underwent radical retropubic prostatectomy with this technique. The follow-up period ranged from 6 to 16 months. The retrograde urethrocystography was performed at 2 weeks. Patients were evaluated specifically for anastomotic time, anastomotic obstruction and urinary continence. Results: The average anastomotic time was 8.1 (range 5–12) min. The catheter of all patients could be removed at 2 weeks. Anastomotic obstruction occurred in 1 patient (6.7%), and 14 patients (93.3%) were completely continent of urine. Conclusion: Maniceps is a useful procedure to carry out vesicourethral anastomosis safely, easily and surely, and it has provided good surgical results in our experience.

Solitary brain metastasis from pT1, G3 bladder cancer

Abstract:  Brain metastasis from bladder cancer occurs rarely. Particularly, solitary brain metastasis is very rare in patients who have never received systemic chemotherapy. We encountered a patient who underwent transurethral resection of bladder tumor and bacillus Calmette‐Guérin bladder instillation for pT1, G3 bladder cancer accompanied by carcinoma in situ, and subsequently revealed solitary brain metastasis after 34 months while neither cystoscopy nor urine cytology revealed abnormalities during this period. To our knowledge, our experience of solitary brain metastasis from pT1 bladder cancer is the second case in the world.

A case of primary leiomyoma of the ureter

Abstract:  This report describes a case of primary leiomyoma of the ureter in which only partial ureterectomy was performed based on the diagnosis of benign tumor by rapid diagnosis using a frozen section during the operation. Surgical treatment was opted for upon diagnosis of a submucosal tumor of the right ureter, with no abnormal findings in the ureteral mucosa by ureteroscopy. To our knowledge, nine cases have been reported worldwide since 1955, suggesting this case to be the 10th.