Yoshinaga A

Successful treatment of recurrent vesicourethral stricture after radical prostatectomy with holmium laser: Report of three cases

Abstract  We report three cases with severe anastomotic strictures, which recurred several times after radical prostatectomy despite repeated treatments of urethral dilation, internal urethrotomy and/or transurethral resection. All three cases were finally treated with holmium laser successfully without any intraoperative or postoperative complications after repeated failures of each treatment. There were two specific characteristics in these three cases: the early onset of the stricture and the pinhole opening located on the top (12‐o’clock) of the stricture wall.

Successful cure of dermatomyositis after treatment of nonseminomatous testicular cancer

Abstract  Although the association between dermatomyositis and cancer is well recognized, there have been a limited number of reports of dermatomyositis associated with testicular cancer. We report the case of a 31‐year‐old man who was diagnosed with dermatomyositis. Because the patients serum levels of α−fetoprotein and human chorionic gonadotropin beta subunit were elevated, the patient was referred to our department. Physical examination revealed an induration (2 cm × 2 cm) in the left testis and the patient was diagnosed with stage IIIB left testicular cancer. A left high orchidectomy was then performed, and pathological examination revealed embryonal carcinoma. The patient was started on a systemic chemotherapeutic (etoposide, ifosfamide and cisplatin; VIP) regimen. After the third chemotherapy session, metastases had completely disappeared, the serum levels of α−fetoprotein and human chorionic gonadotropin beta subunit had normalized and the dermatomyositis symptoms had improved. Cancer is known to be a trigger of dermatomyositis. This case illustrates the importance of palpation of the testes in young patients with dermatomyositis.

Bilateral renal angiomyolipoma coexistent with pulmonary lymphangioleiomyomatosis and tuberous sclerosis

A case of bilateral renal angiomyolipoma coexistent with pulmonary lymphangioleiomyomatosis and tuberous sclerosis was described, being in shock with massive hematuria. The left giant angiomyolipoma, filling the almost entire abdomen, was complicated with two large hump and moniliform aneurysms. This life-threatening hemorrhage was successfully treated by transcatheter arterial embolization; packing mechanically detachable coils into the aneurysms and embolization of trunk of the left renal artery. Lymphangioleiomyomatosis has been suggested to be an incomplete expression of tuberous sclerosis. Although coexisting renal and pulmonary involvement in tuberous sclerosis is rare, it is important to recognize lymphangioleiomyomatosis as a pulmonary involvement of angiomyolipoma with tuberous sclerosis.

Asthenozoospermia : Possible association with long-term exposure to an anti-epileptic drug of carbamazepine

Abstract Little attention has been paid to infertility in men with epilepsy and little information exists about the mechanisms by which anti‐epileptic drugs affect spermatogenesis or sperm function. We report a case of a male infertility patient with asthenozoospermia during long‐term treatment with anti‐epileptic drugs. A 29‐year‐old man had continued treatment with anti‐epileptic drugs under the diagnosis of epilepsy for 13 years. He and his wife had been examined and treated as an infertile couple for 3 years. The patient was found to have no motile sperm with a normal sperm count, while taking a dose of 400 mg/day of carbamazepine. On suspicion of an adverse effect of carbamazepine, he was switched to phenytoin monotherapy. One month after that, sperm motility was vastly improved (65%) and they conceived a child 5 months after that. One must be cautious in extrapolating from a case report, but these findings strongly suggest a direct effect of carbamazepine on spermatic function.

HtrA2 is up-regulated in the rat testis after experimental cryptorchidism

Aim:  The aim of the present study was to elucidate the role of high temperature requirement A2 (HtrA2) in germ cell loss in the heat‐stressed testis.

[A case of vesicourethral foreign body for catheterization by scallion: historical discussion about urethral catheter].

A 62 year old man with a spinal injury was referred to our hospital for removal of an impacted scallion that he had inserted into his urethra as a form of self-catheterization. We first attempted unsuccessfully to remove the scallion using a Kocher clamp. We then performed transurethral removal of the foreign body, that turned out to be a scallion 30 cm in length. In this paper, we present a case report of self-catheterization using scallions, as well as a history of the urethral catheter.