研究者詳細 - 髙橋　聡

論文 - 髙橋　聡

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Bladder Neck Rupture and Vesicovaginal Fistula Associated with Pelvic Fracture in Female.

Koji Ichihara, Naoya Masumori, Satoshi Takahashi, Noriomi Miyao, Ryuichi Kato

Lower urinary tract symptoms 7 ( 2 ) 115 - 7 2015年05月 [国際誌]

CASE: Female urethral injury or bladder neck rupture associated with pelvic fracture is rare. The experience of this injury is limited and the management is still challenging. Here we describe a young female patient with urethral injury and vesicovaginal fistula associated with pelvic fracture due to traffic accident. We discuss the recommendation and management about this problem. OUTCOME: We selected staged surgical management for this case, and fortunately succeeded in the repair of the urethral and vaginal injury and acquired favorable continence. CONCLUSION: Appropriate management should be selected according to the condition in each patient. But it should be taken into consideration that a patient with pelvic fracture is critically ill, and an experienced urologist of this field is not always available at that time.

DOI PubMed

[Significance of Procalcitonin Measurement in Cases with Febrile Condition during Chemotherapy for Urological Cancer].

Yuichiro Kurimura, Satoshi Takahashi, Yoshiki Hiyama, Teruhisa Uehara, Koji Ichihara, Jiro Hashimoto, Naotaka Nishiyama, Hiroshi Kitamura, Naoya Masumori

Hinyokika kiyo. Acta urologica Japonica 61 ( 4 ) 141 - 5 2015年04月 [国内誌]

We examined the usefulness of measurement of procalcitonin (PCT) for patients, who developed febrile neutropenia during cancer chemotherapy for urological cancer. Of the Patients who underwent cancer chemotherapy for bladder, renal pelvic or ureteral, and testicular cancer in our department from 2010 to 2013, 51 had febrile events. Their clinical courses and PCT values were retrospectively reviewed and analyzed. PCT was positive in 12 patients and negative in 39. The duration with febrile status was significantly longer in the PCT-positive group than in the PCT-negative group. There was no significant difference between the blood count values in each group, but C-reactive protein (CRP) was significantly higher in the PCT-positive group than in the PCT-negative group. There were no significant differences between the 2 groups in other tests with blood. There were 12 patients with febrile neutropenia (FN) but all were classified into low-risk by the MASCC scoring system. Four of these 12 patients were positive for PCT. Our results suggested that, in patients with a fever of 37.5°C or more during the course of cancer chemotherapy for urologic cancer, bacteremia possibly existed if the patient was positive for PCT. In addition, the duration of fever tended to be longer and the condition was more severe. When the patients with urological cancer undergo cancer chemotherapy manifest high-grade fever, PCT is promising and valuable as an indicator of the severity of infection.

PubMed

Obstructive pyelonephritis as a result of urolithiasis in Japan: diagnosis, treatment and prognosis.

Ryoichi Hamasuna, Satoshi Takahashi, Hiroshi Nagae, Tatsuhiko Kubo, Shingo Yamamoto, Soichi Arakawa, Tetsuro Matsumoto

International journal of urology : official journal of the Japanese Urological Association 22 ( 3 ) 294 - 300 2015年03月 [国際誌]

OBJECTIVES: To study the current scenario of diagnosis, treatment and mortality of obstructive pyelonephritis secondary to urolithiasis in Japan. METHODS: The study was a retrospective and multicenter survey for hospitalized patients with obstructive pyelonephritis as a result of urolithiasis in educational facilities for specialists by the Japanese Urological Association. Patients' characteristics including physical or laboratory examinations, treatment and prognosis were recorded, and the risk factors for disease death were analyzed. RESULTS: A total of 1363 patients from 208 hospitals were analyzed. The median age of patients was 68 years, and there were 2.2-fold more female patients than male patients. From 844 patients, 891 species of bacteria or fungi were isolated, and Gram-negative rods accounted for 76.5% of cases. The mortality of patients was 2.3%. The risk factors related to disease death by univariate analysis were identified as older age, solitary kidney, ambulance use to visit hospital, disturbance of consciousness, severe appetite loss, higher performance status, disseminated intravascular coagulation status or systemic inflammatory response syndrome, vasopressors and anti-disseminated intravascular coagulation therapies, increased pulse rates, lower hemoglobin, lower serum albumin, and high blood urea nitrogen values. The predictive risk factors for disease death of patients' status at hospitalization were age over 80 years, systemic inflammatory response syndrome, disseminated intravascular coagulation status, disturbance of consciousness and solitary kidney by multivariate analysis. CONCLUSIONS: Obstructive pyelonephritis as a result of urolithiasis represents an emergent disease in the urological field with relatively high mortality. Patients with older age or poor conditions should be hospitalized, and intervention by a urology specialist is likely to be required.

DOI PubMed

How do we understand the disagreement in the frequency of surgical site infection between the CDC and Clavien-Dindo classifications?

Takanobu Yamamoto, Satoshi Takahashi, Koji Ichihara, Yoshiki Hiyama, Teruhisa Uehara, Jiro Hashimoto, Megumi Hirobe, Naoya Masumori

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 21 ( 2 ) 130 - 3 2015年02月 [国際誌]

To clarify the discrepancy in the incidence and severity of surgical site infections (SSI) for radical cystectomy between reports based on the CDC guideline and those using the Clavien-Dindo classification we evaluated 449 consecutive patients who underwent radical cystectomy for bladder cancer between 1990 and 2012. Of the 115 (25.6%) patients with SSI defined by the CDC guideline, 89 could be analyzed. We compared the SSI rates and severity defined by the CDC guideline and Clavien-Dindo classifications. There were 58 patients with superficial SSI, 16 with deep SSI, and 15 with organ/space SSI according to the CDC guideline. All patients with organ/space SSI were judged as "not having SSI" by the Clavien-Dindo classification. They were classified as having "intestinal prolapse", "intestinal fistula", "abdominal abscess" and "pelvic abscess." There was a significant association between the treatment duration and depth of SSI based on the CDC guideline by Spearman's rank-correlation coefficient (p < 0.001, r = 0.614) and with the grade of complications (p < 0.001, r = 0.632) in the Clavien-Dindo classification. Multivariate analysis showed that patients with grade III SSI in the Clavien-Dindo classification needed a significantly longer treatment duration. It is necessary to be aware that a discrepancy can occur automatically due to the different natures of the definitions. Using the CDC guideline, we can effectively estimate the future treatment period when SSI occurs. With the Clavien-Dindo classification, grade III SSI requires a longer treatment duration.

DOI PubMed

The primary local stage at diagnosis predicts regional symptoms caused by local progression in patients with castration-resistant prostate cancer.

Kohei Hashimoto, Takahiro Mizuno, Hiroshi Kitamura, Tetsuya Shindo, Satoshi Takahashi, Naoya Masumori

Urology 85 ( 2 ) 430 - 5 2015年02月 [国際誌]

OBJECTIVE: To identify the characteristics that predict occurrence of local progression-related events (LPREs) in patients with castration-resistant prostate cancer (CRPC) to adjust its management. METHODS: We retrospectively reviewed the medical records of 39 patients with CRPC. LPREs were defined as regional symptoms caused by local progression and categorized into urinary events and rectal events. Urinary events were defined as ureteral obstruction, acute urinary retention, or hematuria requiring treatment, and rectal events were rectal obstruction or rectal bleeding caused by tumor invasion. RESULTS: The median prostate-specific antigen level at diagnosis was 185 ng/mL. During the median follow-up period of 4.4 years, 10 patients (25.6%) had LPREs. Urinary events were observed in 8 patients (20.5%) and rectal events in 2 (5.1%). The proportion of T4 in patients with LPREs was higher than in those without LPREs (70.0% vs. 10.3%; P <.001). Stage T4 at diagnosis was an independent factor to predict LPREs in multivariate analysis (hazard ratio, 8.62; P = .004). The 5-year cumulative incidence of LPREs in patients with stage T4 was 70.0%, whereas in those with stage ≤T3, they were 3.6% (P <.001). CONCLUSION: Patients with stage T4 at diagnosis are more likely to have a risk of LPREs than those with stage ≤T3. These results indicate that patients with locally advanced prostate cancer on androgen deprivation therapy need to be closely monitored for early diagnosis of CRPC and treated with the appropriate intervention for LPREs at the appropriate time.

DOI PubMed

Do patients who complain of lower urinary tract symptoms frequently have clinically significant pyuria?

Satoshi Takahashi, Koji Ichihara, Yoshiki Hiyama, Teruhisa Uehara, Jiro Hashimoto, Naoya Masumori

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 21 ( 1 ) 31 - 3 2015年01月 [国際誌]

There is still controversy about whether post-void residual (PVR) urine volume affects the onset of urinary tract infection (UTI). In addition, although male patients with lower urinary tract symptoms (LUTS) might potentially have PVR, the association between LUTS and UTI or asymptomatic pyuria with or without bacteriuria remains unclear. We studied the frequency of asymptomatic pyuria, with and without bacteriuria, in patients with LUTS without a previous history of urinary tract manipulation at the first visit and their sequential courses. This retrospective study was done by reviewing medical charts. A total of 453 male patients who complained of LUTS and visited our outpatient clinic in 2008 were included in this study. The frequency of pyuria, with or without bacteriuria, in this study at the first visit was 4.9%. The median PVR volumes at the initial examination were 79 ml in the 22 patients with pyuria and 22 ml in the 431 patients without pyuria. The difference of the PVR volume between the patients with pyuria and those without pyuria was statistically significant (p = 0.0095). Twelve patients were treated with alpha-blockers without antimicrobial chemotherapy and pyuria disappeared in 5 (41.7%) of them. However, the decrease in the rate of PVR was not significantly different between the patients with persisting pyuria and those without pyuria. A not negligible number of patients with LUTS had pyuria at the first visit; however, there was no febrile UTI in their clinical course even if they received no urological manipulation.

DOI PubMed

Nationwide survey of urogenital tuberculosis in Japan.

Keita Nakane, Mitsuru Yasuda, Takashi Deguchi, Satoshi Takahashi, Kazushi Tanaka, Hiroshi Hayami, Ryoichi Hamasuna, Shingo Yamamoto, Soichi Arakawa, Tetsuro Matsumoto

International journal of urology : official journal of the Japanese Urological Association 21 ( 11 ) 1171 - 7 2014年11月 [国際誌]

OBJECTIVES: To determine current epidemiology and treatment patterns of urogenital tuberculosis in Japan. METHODS: A questionnaire was sent to the urological departments of 1203 Japanese hospitals. Clinical data was reviewed retrospectively; no time range was specified. RESULTS: Of the 1203 hospitals, 399 returned questionnaires with information about 355 urogenital tuberculosis patients. Of the 399, 153 institutions reported at least one patient, and 201 patients were identified between 2000 and 2007. Infections were located in the kidneys (n = 242), ureter (n = 96), bladder (n = 100), epididymis or testes (n = 81) and prostate (n = 9). CONCLUSIONS: Urogenital tuberculosis is rare in Japan, but patients do exist, and we should not ignore them.

DOI PubMed

Erratum: Occurrence of infection following prostate biopsy procedures in Japan: Japanese Research Group for Urinary Tract Infection (JRGU) - A multi-center retrospective study (Journal of Infection and Chemotherapy (2014) 20 (232-237))

Yoshikazu Togo, Tatsuhiko Kubo, Rikiya Taoka, Yoshiki Hiyama, Teruhisa Uehara, Jiroh Hashimoto, Yuichiro Kurimura, Satoshi Takahashi, Taiji Tsukamoto, Jun Miyazaki, Hiroyuki Nishiyama, Shinichiro Kira, Hiroshi Kiyota, Satoshi Yazawa, Naoya Niwa, Hiroshi Hongo, Mototsugu Oya, Taku Kato, Mitsuru Yasuda, Takashi Deguchi, Kiyohito Ishikawa, Kiyotaka Hoshinaga, Minori Matsumoto, Katsumi Shigemura, Kazushi Tanaka, Soichi Arakawa, Masato Fujisawa, Koichiro Wada, Shinya Uehara, Toyohiko Watanabe, Hiromi Kumon, Kanao Kobayashi, Akio Matsubara, Masahiro Matsumoto, Takehiko Sho, Ryoichi Hamasuna, Tetsuro Matsumoto, Hiroshi Hayami, Masayuki Nakagawa, Shingo Yamamoto

Journal of Infection and Chemotherapy ( SPRINGER JAPAN KK ) 20 ( 10 ) 660 - 660 2014年10月

DOI

Editorial Comment from Dr Takahashi to Development and validation of a nomogram predicting recurrence risk in women with symptomatic urinary tract infection.

Satoshi Takahashi

International journal of urology : official journal of the Japanese Urological Association 21 ( 9 ) 934 - 5 2014年09月 [国際誌]

DOI PubMed

Treatment of acute uncomplicated cystitis with faropenem for 3 days versus 7 days: multicentre, randomized, open-label, controlled trial.

Ryoichi Hamasuna, Kazushi Tanaka, Hiroshi Hayami, Mitsuru Yasuda, Satoshi Takahashi, Kanao Kobayashi, Hiroshi Kiyota, Shingo Yamamoto, Soichi Arakawa, Tetsuro Matsumoto

The Journal of antimicrobial chemotherapy 69 ( 6 ) 1675 - 80 2014年06月 [国際誌]

OBJECTIVES: The increasing prevalence of resistant bacteria such as fluoroquinolone-resistant or extended-spectrum β-lactamase-producing strains in pathogens causing acute uncomplicated cystitis has been of concern in Japan. Faropenem sodium is a penem antimicrobial that demonstrates a wide antimicrobial spectrum against both aerobic and anaerobic bacteria. It is stable against a number of β-lactamases. METHODS: We compared 3 and 7 day administration regimens of faropenem in a multicentre, randomized, open-label, controlled study. RESULTS: In total, 200 female patients with cystitis were enrolled and randomized into 3 day (N = 97) or 7 day (N = 103) treatment groups. At the first visit, 161 bacterial strains were isolated from 154 participants, and Escherichia coli accounted for 73.9% (119/161) of bacterial strains. At 5-9 days after the completion of treatment, 73 and 81 patients from the 3 day and 7 day groups, respectively, were evaluated by intention-to-treat analysis; the microbiological efficacies were 58.9% eradication (43/73), 20.5% persistence (15/73) and 8.2% replaced (6/73), and 66.7% eradication (54/81), 6.2% persistence (5/81) and 7.4% replaced (6/81), respectively (P = 0.048). The clinical efficacies were 76.7% (56/73) and 80.2% (65/81), respectively (P = 0.695). Adverse events due to faropenem were reported in 9.5% of participants (19/200), and the most common adverse event was diarrhoea. CONCLUSIONS: The 7 day regimen showed a superior rate of microbiological response. E. coli strains were in general susceptible to faropenem, including fluoroquinolone- and cephalosporin-resistant strains.

DOI PubMed

Investigation of the management and risk of febrile neutropenia associated with chemotherapy in the urological field: A multicenter, retrospective analysis

Koichiro Wada, Ryuta Tanimoto, Hiroyuki Nose, Shinya Uehara, Toyohiko Watanabe, Hiroshi Hayami, Shingo Nagai, Mitsuru Yasuda, Takashi Deguchi, Keisuke Shigeta, Satoshi Yazawa, Eiji Kikuchi, Mototsugu Oya, Jiro Hashimoto, Teruhisa Uehara, Yuichiro Kurimura, Yoshiki Hiyama, Satoshi Takahashi, Taiji Tsukamoto, Takehiko Sho, Ryoichi Hamasuna, Jun Miyazaki, Yoshikazu Togo, Rikiya Taoka, Atsushi Nakao, Shingo Yamamoto, Kanao Kobayashi, Akio Matsubara, Kiyohito Ishikawa, Hiromi Kumon, Tetsuro Matsumoto

Japanese Journal of Chemotherapy 62 ( 3 ) 374 - 381 2014年05月

In Japan, chemotherapy for urogenital malignant diseases is commonly performed by urologists and febrile neutropenia (FN) is one of the major adverse events associated with chemotherapy, however, few reports exist from the urological field about FN. In this present study, a total of 883 courses of chemotherapy (326 patients) performed from 2010 to 2011 at 10 University Hospitals were retrospectively reviewed. The regimens were GC (gemcitabine and cisplatin), GCP (gemcitabine, cisplatin and paclitaxel) and M-VAC (methotrexate, vinblastine, doxorubicin, cisplatin) for urothelial carcinoma, and EP (etoposide and cisplatin) and BEP (bleomycin, etoposide and cisplatin) for testicular cancer. In 81 courses (9.2%, 66 patients; 20.2%) including FN, antimicrobials and granulocyte-colony stimulating factor (G-CSF) were administered in 69 courses (85.2%) and in 77 courses (95.1%), respectively. The MASCC risk-index score was evaluated in no more than 51 courses (63.0%) and 1 patient with 18 points on the MASCC score died due to myelotoxicity and infections. According to statistical investigations, FN is significantly more frequent in GCP and M-VAC than in GC (p = 0.0073, <0.0001) and in a similar manner in BEP than in EP (p = 0.0405). In patients with afebrile neutropenia (AN), observed in 232 courses (26.3%), antimicrobials and G-CSF were administered in 5 courses (2.2%) and in 144 courses (62.1%), respectively. Further evidence from the urological field is required to investigate the treatment and risk of FN for management of patients with urogenital malignancies.

Clinical Efficacy of a Single Two Gram Dose of Azithromycin Extended Release for Male Patients with Urethritis.

Satoshi Takahashi, Hiroshi Kiyota, Shin Ito, Akihiko Iwasawa, Yoshiki Hiyama, Teruhisa Uehara, Koji Ichihara, Jiro Hashimoto, Naoya Masumori, Kenichi Sunaoshi, Koichi Takeda, Nobukazu Suzuki, Takahide Hosobe, Hirokazu Goto, Hidenori Suzuki, Shoichi Onodera

Antibiotics (Basel, Switzerland) 3 ( 2 ) 109 - 20 2014年04月 [国際誌]

To clarify the clinical efficacy of a single oral 2 g dose of azithromycin extended-release for heterosexual male patients with urethritis, and the current antimicrobial sensitivity of Neisseria gonorrhoeae to azithromycin, a prospective clinical trial was conducted from 2011-2013. In patients with gonococcal urethritis, the eradication rate was 90.9% (30 of 33). The susceptibility rates of isolated Neisseria gonorrhoeae strains to ceftriaxone, spectinomycin, cefixime and azithromycin were 100%, 100%, 95.3% (41/43) and 37.2% (16/43), respectively. In the patients with nongonococcal urethritis, the eradication rate was 90.0% (45 of 50). The microbiological eradication rates for the pathogens were 90.9% (30/33) for Neisseria gonorrhoeae, 91.5% (43/47) for Chlamydia trachomatis, 71.4% (5/7) for Mycoplasma genitalium, and 100% (13/13) for Ureaplasma urealyticum. The main adverse event was diarrhea and its manifestation rate was 35.2% (32 of 120). The symptom of diarrhea was mostly temporary and resolved spontaneously. The conclusion was that the treatment regimen with a single oral 2 g dose of azithromycin extended-release would be effective for patients with urethritis. However, the antimicrobial susceptibilities of Neisseria gonorrhoeae and Mycoplasma genitalium should be carefully monitored because of possible treatment failure.

DOI PubMed

Occurrence of infection following prostate biopsy procedures in Japan: Japanese Research Group for Urinary Tract Infection (JRGU) - a multi-center retrospective study.

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 20 ( 4 ) 232 - 7 2014年04月 [国際誌]

We retrospectively investigated the incidence of genitourinary tract infection in 5895 patients who underwent transrectal and/or transperineal prostate biopsy procedure between January and December 2011 at 46 institutions belonging to Japanese Research Group for Urinary Tract Infection (JRGU). The total rate of genitourinary tract infection after prostate biopsy was 0.76%, while that following transrectal procedure was 0.83% and following transperineal procedure was 0.57%, which were not significantly different. In contrast, febrile infection associated with a fever (≥38 °C) occurred significantly more frequently after transrectal (0.71%) than transperineal (0.16%) approach (P = 0.04). Notably, in infectious cases, Escherichia coli was most frequently isolated. Of the 9 E. coli strains isolated by urine culture, 6 (66.7%) produced extended spectrum β-lactamase (ESBL) and 7 (77.8%) showed levofloxacin resistance. Similarly, of 6 E. coli strains isolated by blood culture, 4 (66.7%) produced ESBL and 6 (100%) showed levofloxacin resistance. When the efficacy of antimicrobial prophylaxis (AMP) with levofloxacin for the patients undergoing transrectal or transperineal biopsy was compared between a single dose (500 mg) and that given for 2 or more days, no significant difference was observed for the rate of infection (transrectal: 0.82% vs. 1.04%, p = 0.94; transperineal: 0.30% vs. 0.46%, p = 0.68). Although a single dose of levofloxacin for AMP is sufficient to prevent genitourinary infection after transrectal or transperineal prostate biopsy, and recommended in this era of increased multi-drug resistant pathogens, the increase in fluoroquinolone-resistant E. coli and ESBL-producing E. coli has emerged as a profound problem for surveillance.

DOI PubMed

[The Japanese version of the National Institutes of Health Chronic Prostatitis Symptom Index].

Satoshi Takahashi, Koichiro Wada, Hiromi Kumon, Hitoshi Masuda, Yasuyuki Suzuki, Osamu Yokoyama, Yukio Homma, Masayuki Takeda

Nihon Hinyokika Gakkai zasshi. The japanese journal of urology 105 ( 2 ) 62 - 5 2014年04月 [国内誌]

The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) is the standard questionnaire that determines the degree of symptoms and efficacy of treatment in patients with chronic prostatitis/chronic pelvic pain syndrome. Because there was no officially approved Japanese version of the NIH-CPSI, the Japanese Urological Association (JUA) formed a committee to develop one chaired by Dr. Masayuki Takeda, who also chairs the special field of voiding function and neurourology in the JUA. Consequently, the committee produced a Japanese version, referring to previous proposals and the Japanese version of the International Prostate Symptom Score. The committee strongly expects that the Japanese version of the NIH-CPSI will be taken full advantage of in future clinical research.

PubMed

Comparison of Laparoscopic, Hand-Assisted, and Open Surgical Nephroureterectomy

Hiroshi Kitamura, Toshihiro Maeda, Toshiaki Tanaka, Fumimasa Fukuta, Ko Kobayashi, Naotaka Nishiyama, Satoshi Takahashi, Naoya Masumori

JSLS-JOURNAL OF THE SOCIETY OF LAPAROENDOSCOPIC SURGEONS ( SOC LAPAROENDOSCOPIC SURGEONS ) 18 ( 2 ) 288 - 293 2014年04月 [査読有り] [国際誌]

Background and Objectives: The aim of this study was to compare oncologic outcomes after laparoscopic nephroureterectomy, hand-assisted laparoscopic nephroureterectomy, and open nephroureterectomy for upper urinary tract urothelial cancer. Methods: Between April 1995 and August 2010, 189 patients underwent laparoscopic nephroureterectomy, hand-assisted laparoscopic nephroureterectomy, or open nephroureterectomy for upper urinary tract urothelial cancer. Of these patients, 110 with no previous or concurrent bladder cancer or any metastatic disease were included in this study. Cancer-specific survival, recurrence-free survival, and intravesical recurrence-free survival rates were analyzed by the Kaplan-Meier method and compared with the log-rank test. The median follow-up period for the cohort was 70 months (range, 6-192 months). Results: The 3 groups were well matched for tumor stage, grade, and the presence of lymphovascular invasion and concomitant carcinoma in situ. The estimated 5-year cancer-specific survival rates were 81.1%, 65.6%, and 65.2% for laparoscopic nephroureterectomy, hand-assisted laparoscopic nephroureterectomy, and open nephroureterectomy, respectively (P = .4179). The estimated 5-year recurrence-free survival rates were 33.8%, 10.0%, and 41.2% for laparoscopic nephroureterectomy, hand-assisted laparoscopic nephroureterectomy, and open nephroureterectomy, respectively (P = .0245). The estimated 5-year intravesical recurrence-free survival rates were 64.8%, 10.0%, and 76.2% for laparoscopic nephroureterectomy, hand-assisted laparoscopic nephroureterectomy, and open nephroureterectomy, respectively (P < .0001). Conclusion: Although there was no significant difference in cancer-specific survival rate among the laparoscopic nephroureterectomy, hand-assisted laparoscopic nephroureterectomy, and open nephroureterectomy groups, hand-assisted laparoscopic nephroureterectomy may be inferior to laparoscopic nephroureterectomy or open nephroureterectomy with regard to recurrence-free survival and intravesical recurrence-free survival rates.

DOI PubMed

Surgical site infection of scrotal and inguinal lesions after urologic surgery.

Teruhisa Uehara, Satoshi Takahashi, Kohji Ichihara, Yoshiki Hiyama, Jiro Hashimoto, Yuichiro Kurimura, Naoya Masumori

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 20 ( 3 ) 186 - 9 2014年03月 [国際誌]

To clarify the incidence of surgical site infection (SSI) after urological scrotal and inguinal surgical procedures and the preventive effect of antimicrobial prophylaxis for SSI, retrospective analysis was performed. The patients who underwent scrotal and inguinal operations from 2001 to 2010 were included in this analysis. A first or second generation cephalosporin was administered as antimicrobial prophylaxis just before the start of surgery and no additional prophylaxis was conducted. The surgery was classified into 76 (38%) cases with testicular sperm extraction (TESE), 72 (36%) with radical orchiectomy, 29 (14.5%) with bilateral orchiectomy (surgical castration) and 23 (11.5%) with other scrotal and inguinal operations. The median age and age range were 36 years and 18-81 years, respectively. SSI occurred in 7 (3.5%) cases. The frequencies of SSI were 6.5% in the patients with urological inguinal surgery and 1.6% in those with scrotal surgery. The frequency of SSI in the patients with urological inguinal surgery was not negligible even though it is considered a clean operation, and further analysis is warranted to prevent SSI.

DOI PubMed

Evaluation of long-term outcome for patients with renal cell carcinoma after surgery: analysis of cancer deaths occurring more than 10 years after initial treatment

Yuki Kyoda, Ko Kobayashi, Megumi Hirobe, Tetsuya Shindo, Fumimasa Fukuta, Kohei Hashimoto, Toshiaki Tanaka, Akiko Tonooka, Hiroshi Kitamura, Satoshi Takahashi, Naoya Masumori, Tadashi Hasegawa, Taiji Tsukamoto

INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY ( SPRINGER JAPAN KK ) 19 ( 1 ) 146 - 151 2014年02月 [査読有り]

Objective We evaluated the outcome of renal cell carcinoma (RCC) after surgery in a long-term follow-up study to elucidate the specific biological behaviors of RCC, such as late recurrence and late cancer-specific death. Materials and methods We retrospectively reviewed the clinical and pathological features of 625 patients who were diagnosed as having renal cell carcinoma at our institution from 1975 to 2006. We analyzed the parameters and outcomes for the patients who had received radical or partial nephrectomy. Pathological staging was reviewed again by two pathologists. Results The median age of the patients was 61 years (range 16-87). The median follow-up was 7.0 years (range 0.1-30.3). Of the 516 patients with localized or locally advanced RCC, 124 (24.0 %) had recurrence after surgery. Lung metastasis was observed most frequently. The 10-year cancer-specific survival rates were 92.4, 91.0, 64.1 and 11.8 % for stages I, II, III and IV, respectively. The late recurrence rates in patients with localized and locally advanced RCC 5 and 10 years after initial surgery were 8.5 and 3.7 %, respectively. Cancer death more than 10 years after initial treatment of the disease occurred in 16 patients. Of the 16 patients, 9 had localized disease at the time of the initial surgery. Specific findings that characterized them were not identified in these patients. Conclusions Late recurrence of RCC is not rare. Cancerspecific death more than 10 years after the initial treatment was observed in 16 patients with localized or advanced disease. No specific findings were identified to characterize these patients with late cancer death.

DOI

Editorial comment to "Differential diagnosis between bacterial infection and neoplastic fever in patients with advanced urological cancer: the role of procalcitonin".

Satoshi Takahashi

International journal of urology : official journal of the Japanese Urological Association 21 ( 1 ) 107 - 107 2014年01月 [国際誌]

DOI PubMed

Editorial comment to on- and post-treatment symptom relief by repeated instillations of heparin and alkalized lidocaine in interstitial cystitis.

Satoshi Takahashi

International journal of urology : official journal of the Japanese Urological Association 20 ( 11 ) 1123 - 1123 2013年11月 [国際誌]

DOI PubMed

Clinicopathological Analysis of Patients with Non-muscle-invasive Bladder Cancer: Prognostic Value and Clinical Reliability of the 2004 WHO Classification System

Naotaka Nishiyama, Hiroshi Kitamura, Toshihiro Maeda, Satoshi Takahashi, Naoya Masumori, Tadashi Hasegawa, Taiji Tsukamoto

JAPANESE JOURNAL OF CLINICAL ONCOLOGY ( OXFORD UNIV PRESS ) 43 ( 11 ) 1124 - 1131 2013年11月 [査読有り]

Objective: The aim of this study was to clarify the prognostic value and clinical reliability of the 2004 World Health Organization classification system of non-muscle-invasive bladder cancer. Methods: Between January 1995 and November 2010, 153 patients were diagnosed with non-muscle- invasive bladder cancer. We used a substage system that discerns T1-microinvasive (T1m, 42 patients) and T1-extensive-invasive (T1e, 37 patients) cancers. Results: There were 2 (1.3%), 89 (58.2%) and 62 (40.5%) cases of Grade 1-3 urothelial carcinoma, respectively, on the basis of the 1973 World Health Organization classification system. Of these, 37 (24.2%) and 116 (75.8%) were graded as low and high on the basis of the 2004 World Health Organization classification system. All of the cases with progression (15 patients) were diagnosed as high grade at the time of primary transurethral resection of the bladder tumor. Based on the Kaplan-Meier analysis, the 2004World Health Organization classification system accurately predicted tumor recurrence (P = 0.029) and progression (P = 0.031). The 5-year recurrence-free survival rates in patients with low-grade and high-grade tumors were 68.7 and 47.1%, and the 5-year progression-free survival rates were 100 and 89.0%, respectively. In the high-grade T1 cases, the substage (T1m or T1e) was a significant predictor of tumor recurrence (P = 0.001) and progression (P = 0.020). Conclusions: The 2004 World Health Organization classification system accurately predicts the risk of recurrence in primary non-muscle-invasive bladder cancer cases and has the same accuracy when predicting the risk of progression as the 1973 World Health Organization classification. Furthermore, the substaging system for high-grade T1 tumors is useful in predicting both recurrence and progression.

DOI

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