Kimihiko Moriya

Hokkaido University, Sapporo, Hokkaidō, Japan

Are you Kimihiko Moriya?

Claim your profile

Publications (49)89.01 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives To assess the postoperative lower urinary tract function in patients undergoing pelvic organ prolapse surgery.MethodsA total of 24 women with advanced anterior vaginal wall prolapse underwent transvaginal repair using a polypropylene mesh. The preoperative, 1-week and 3-month postoperative evaluations were carried out by urodynamics. Maximal flow rate detrusor pressure at maximal flow rate, voided volume and bladder contractility index were measured. A value of P < 0.05 was considered to be statistically significant.ResultsThe mean age of patients was 73.5 years (range 49–84 years). The mean postoperative maximal flow rate, voiding efficiency and bladder contractility index decreased significantly after the operation compared with the preoperative values (P < 0.05). No significant differences were observed between preoperative and 3-month postoperative parameters. Of the patients, 33.3%, 11.1% and 50% were classified as having normal/strong contractility preoperative, 1 week and 3 months, respectively. The proportion of normal/strong contractility decreased significantly after the operation, and it recovered 3 months postoperatively. The grade of obstruction did not change significantly.Conclusions Patients undergoing pelvic organ prolapse surgery present temporary impaired detrusor contractility, which improves significantly during the midterm postoperative period.
    International Journal of Urology 11/2014; · 1.73 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the incidence of febrile UTI and assessed risk factors for febrile UTI during active surveillance after early discontinuation of continuous antibiotic prophylaxis (CAP), we retrospectively reviewed our experience on active surveillance.
    The Journal of urology. 08/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: To investigate the contribution of bone marrow-derived mesenchymal stem cells to the changes in bladder morphology in response to partial bladder outlet obstruction. Allogenic bone marrow cells were transplanted from transgenic rats expressing green fluorescent protein into female Sprague-Dawley rats 1 day after their bone marrow-derived mesenchymal stem cells had been destroyed by irradiation. This generated chimeric rats in which green fluorescent protein labeled bone marrow-derived mesenchymal stem cells replaced host bone marrow-derived mesenchymal stem cells. The animals received partial bladder outlet obstruction or sham surgery 6 weeks later. The animals were killed 6 weeks after the surgery, and bladder tissue was prepared for immunofluorescence with antibodies against a urothelium marker (AE1/AE3), a myofibroblast marker (vimentin), a smooth muscle marker and green fluorescent protein. More labeled bone marrow-derived mesenchymal stem cells were found in the partial bladder outlet obstruction group than in the in the sham group. Most bone marrow-derived mesenchymal stem cells were present around the basement membrane (laminin) and lamina propria below the urothelium. Bone marrow-derived mesenchymal stem cells were also found in the urothelium layer, and some of them were double-stained with green fluorescent protein and AE1/AE3. Some bone marrow-derived mesenchymal stem cells, which were located in the interstitial tissue, were double-stained with green fluorescent protein and vimentin. Bone marrow-derived mesenchymal stem cells, which migrated into the smooth muscle layer, showed fusiform morphology, and some were double-stained with green fluorescent protein and smooth muscle marker. Bone marrow-derived mesenchymal stem cells home to the partial bladder outlet obstruction bladder, and these cells have the potential to differentiate into the several components of bladder tissue including the urothelium, myofibroblasts and smooth muscle cells. Thus, bone marrow-derived mesenchymal stem cells contribute to the morphological changes of the bladder in response to partial bladder outlet obstruction.
    International Journal of Urology 03/2014; · 1.73 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives:We investigated relation of preoperative renal scar to incidence of postoperative metabolic acidosis following ileocystoplasty in patients with neurogenic bladder.Patients:Thirty patients with neurogenic bladder, who underwent ileocystoplasty, were enrolled in the present study. Median age at ileocystoplasty was 13.9 years and median follow-up period after ileocystoplasty was 8.2 years. Metabolic acidosis was defined based on the outlined criteria: base excess (BE) is less than 0 mmol l(-1). Preoperative examination revealed that no apparent renal insufficiency was identified in blood analysis, although preoperative (99m)Tc-DMSA scintigraphy indicated abnormalities such as renal scar in 14 patients (47%). Incidence of postoperative metabolic acidosis was compared between patients with and without preoperative renal scar, which may reflect some extent of renal tubular damage.Results:Postoperative metabolic acidosis was identified in 13 patients (43%). Incidence of postoperative metabolic acidosis was significantly higher in patients with renal scar (11/14, 79%) compared with patients without renal scar (2/16, 13%; P<0.01). Particularly, all eight patients who had bilateral renal scars showed metabolic acidosis postoperatively. Compared with patients without preoperative renal scar, pH (P<0.05) and BE (P<0.01) were significantly lower postoperatively in patients with preoperative renal scar. However, there was no significant difference in PCO2. Hyperchloremia was observed in each patient with or without preoperative renal scar.Conclusion:Incidence of postoperative metabolic acidosis was significantly implicated in preoperative renal scar. If renal abnormalities are preoperatively identified in imaging tests, we need to care patients carefully regarding metabolic acidosis and subsequent comorbidities following ileocystoplasty.Spinal Cord advance online publication, 28 January 2014; doi:10.1038/sc.2013.175.
    Spinal Cord 01/2014; · 1.90 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective To review laparoscopy in patients with disorders of sex development (DSD) in order to clarify its usefulness in diagnosis, devising subsequent therapeutic strategies and managing patients with various conditions. Patients and Methods Between April 1992 and December 2012, 29 laparoscopic surgeries were performed in 25 DSD patients. Among them, ten were diagnostic laparoscopy including gonadal biopsy, and 19 were therapeutic laparoscopy. Surgical procedures and complications were evaluated. Results For diagnostic laparoscopy, laparoscopic gonadal biopsy was performed in three patients. Inspection, with or without open gonadal biopsy, was performed on four out of seven patients with 46XY DSD or mixed gonadal dysgenesis (MGD). Additional surgery was planned and performed based on diagnostic laparoscopic findings in six out of seven patients. In the three patients with ovotesticular DSD, the gonadal pathology was diagnosed as: testis/ovary in one, testis/ovotestis in one and ovary/ovotestis in one – this was from the laparoscopic inspection and gonadal biopsy. However, the final diagnoses were bilateral ovotestis in two patients and ovary/ovotestis in one patient. For therapeutic laparoscopy, surgical procedures were: gonadectomy in 17 patients (bilateral in 13, unilateral in three, partial in two); hysterectomy in two patients; orchiopexy in one; and sigmoid vaginoplasty in one patient (included multiple procedures). There were no severe perioperative complications. In the four patients with a history of diagnostic laparoscopy, no severe intra-abdominal adhesions that would disturb therapeutic laparoscopic surgery were observed. Conclusion While diagnostic laparoscopy was helpful in devising a therapeutic surgical strategy in most of the patients with DSD who were suspected as having complex gonadal status or Müllerian duct derivatives, attention must be paid to precisely diagnosing the gonadal status in ovotesticular DSD. On the other hand, therapeutic laparoscopic surgeries were valuable procedures in treating DSD patients, even with a history of previous diagnostic laparoscopy.
    Journal of pediatric urology 01/2014; · 1.38 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives: We investigated the time course of the stromal cell-derived factor 1α (SDF1α) expression and behavior of intravenously administered bone marrow-derived stromal (BMS) cells in the urinary bladder of partial bladder outlet obstruction (PBOO) rats. Methods: Study 1: Recombinant SDF1α or saline was directly injected into the bladder wall of female rats followed by intravenous administration of BMS cells isolated from green fluorescent protein (GFP) transgenic rats. The bladder was examined with immunohistochemistry to determine whether SDF1α would enhance migration of BMS cells to the bladder. Study 2: Following surgery of PBOO or sham in female rats, bladders were removed on days 1–14, and expression of hypoxia inducible factor 1α (HIF1α) and SDF1α were examined with real-time polymerase chain reaction (PCR) to determine if PBOO preferentially increased their expression. Study 3: Female rats underwent PBOO or sham surgery followed by intravenous administration of GFP-positive BMS cells. Bladders were examined with immunohistochemistry on days 1–14 to determine whether BMS cells preferentially accumulated in the bladder. Results: BMS cells were accumulated in the injection site of SDF1α but not saline in the bladder. SDF1α and HIF1α increased at day 1 after PBOO compared to sham. More BMS cells accumulated in the bladder of PBOO on day 1, and some BMS cells expressed smooth muscle phenotypes by day 14. Conclusion: SDF1α induced with ischemia/hypoxia due to PBOO is implicated in the accumulation of BMS cells in the bladder and regeneration of the bladder for PBOO.
    Lower urinary tract symptoms 09/2012; 4(3). · 0.33 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives: Our goal was to identify changes in urodynamic parameters and lower urinary tract symptoms (LUTS) in men followed for1 year after radical prostatectomy (RP) compared to the preoperative measures with a specific focus on detrusor contractility.Methods: This study enrolled 43 patients who received RP (laparoscopic 27, retropubic: 16) and pressure flow studies (PFS) pre-RP as well as 12 months (M) after RP. No patients complained of urinary incontinence preoperatively. Urodynamic studies and questionnaires regarding LUTS and urinary continence were conducted before and 12 M after RP. Detrusor underactivity (DU) was defined as <10 (W/m2) in preoperative maximum watts factor value.Results: Urodynamics demonstrated that RP improved urodynamic parameters by releasing bladder outlet obstruction without affecting overall detrusor contractility. Meanwhile, RP did not affect bladder capacity, bladder compliance, or detrusor contractility. LUTS in the International Prostate Symptom Score (IPSS), including the IPSS subscore, was not improved. The quality of life score was significantly better at 12 M after RP and continence rates were gradually improved to be at a satisfactory level in more than 80% of patients by 12 M after RP. DU was preoperatively identified in 21(49%) patients, influencing urodynamic parameters and LUTS preoperatively. However, DU did not affect urodynamic parameters and LUTS after RP.Conclusion: Although RP improves urodynamic parameters, it does not significantly affect LUTS. Urinary continence gradually improves and is satisfactory within 1 year after RP. The status of preoperative detrusor contractility did not affect urodynamic parameters or LUTS after RP.
    Lower urinary tract symptoms 05/2012; 4(2). · 0.33 Impact Factor
  • Urology 09/2011; 78(3). · 2.42 Impact Factor
  • European Urology Supplements 03/2011; 10(2):291-291. · 3.37 Impact Factor
  • Journal of Urology - J UROL. 01/2011; 185(4).
  • Journal of Urology - J UROL. 01/2011; 185(4).
  • Journal of Urology - J UROL. 01/2011; 185(4).
  • Urology 01/2011; 78(3). · 2.42 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Reports of pubertal hormonal and gonadal status in patients with hypospadias are scarce. We evaluated the pituitary-gonadal axis and gonadal growth in patients with hypospadias at puberty. We retrospectively reviewed serum luteinizing hormone, follicle-stimulating hormone, testosterone and testicular volume at puberty (age 15 years or greater) in the medical charts of patients with hypospadias treated since 1986 and followed at our institution. Enrolled in this study were 43 patients with a mean age at evaluation of 17.6 years (range 15.1 to 22.8). Of these patients 14 and 29 were treated for mild and severe hypospadias, respectively. Six patients with severe hypospadias underwent bilateral orchiopexy for bilateral undescended testes. All patients were Tanner stage 4 to 5 at evaluation. Of 14 mild hypospadias cases we noted hypergonadotropic hypogonadism, hypogonadotropic hypogonadism, decreased luteinizing hormone and decreased testosterone in 1 each (7% each). Of 23 severe hypospadias cases without bilateral undescended testes we noted hypergonadotropic hypogonadism, partial androgen insensitivity syndrome and decreased testosterone in 2 (9%), 1 (4%) and 1 (4%), respectively. Of 6 patients with severe hypospadias and bilateral undescended testes we noted hypergonadotropic hypogonadism in 1 (17%) and increased luteinizing hormone with normal testosterone in 2 (33%). Testicular volume less than 10 ml with increased follicle-stimulating hormone was identified in 7 of 43 patients, including 1 of 14 (7%) with mild hypospadias, 3 of 23 (13%) with severe hypospadias without bilateral undescended testes and 3 of 6 (50%) with severe hypospadias and bilateral undescended testes. Our study revealed endocrine dysfunction in patients with mild and severe hypospadias at puberty even without an undescended testis. Of these patients those with severe hypospadias and an undescended testis may be at higher risk for impaired spermatogenesis.
    The Journal of urology 10/2010; 184(4 Suppl):1610-4. · 3.75 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Hypospadias is a common congenital anomaly caused by incomplete fusion of urethral folds. Development of the urethra and external genital system in the male fetus is an androgen-dependent process. In this regard, enzymes 17 β-hydroxysteroid dehydrogenase type 3 (17 β HSD3, encoded by HSD17B3) and steroid 5 α-reductase type 2 (encoded by SRD5A2) play crucial roles. To investigate the possible associations between common polymorphisms in HSD17B3 as well as well-known V89L polymorphism in SRD5A2 and risk of hypospadias. A case-control study was performed between 1999 and 2005. There were 89 Japanese boys with hypospadias and 291 newborn controls. We genotyped HSD17B3-1999T>C, +10A>G, +20A>G, +139G>A (V31I), +913G>A (G289S), and SRD5A2+336G>C (V89L) polymorphisms by allelic discrimination assay. We measured mRNA expression of the wildtype G289 allele and the mutant S289 allele of the HSD17B3 gene in the transfected human fetal kidney HEK293 cells. Assessment of hypospadias including its severity and HSD17B3 and SRD5A2 genes using DNA blood samples: allele and genotype distribution of single nucleotide polymorphisms in these two genes in cases and controls. In our study, the risk of hypospadias was significantly higher in subjects carrying homozygous HSD17B3+913A (289S) alleles (odds ratio [OR]: 3.06; 95% confidence interval [CI]: 1.38-6.76). The risk of severe hypospadias was much higher in these subjects (OR: 3.93; 95% CI: 1.34-11.49). The mRNA expression levels of HSD17B3 G289 were higher than those of HSD17B3 S289 mutant (P < 0.001). In addition, the risk of severe hypospadias increased in boys carrying the SRD5A2+336C (89L) allele (OR: 3.19; 95% CI: 1.09-9.36). These results suggest that the HSD17B3 G289S polymorphism may be a potential risk modifier for hypospadias. Our findings provide evidence that a certain genotype related to androgen production may potentiate risk of hypospadias.
    Journal of Sexual Medicine 08/2010; 7(8):2729-38. · 3.51 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: Reports of pubertal hormonal and gonadal status of patients with hypospadias are scarce. The aim of this study is to evaluate pituitary-testis axis and gonadal growth in patients with hypospadias at puberty. Methods: Serum level of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T) and testicular volume at puberty (15 years or older) were retrospectively reviewed from the medical charts of patients with hypospadias (HS) who were treated since 1986 and followed at our institute. Results: Forty-three patients were enrolled in this study. Mean age at evaluation was 17.6 years (range: 15.1 to 22.8). Of these, 14 patients were treated for mild HS and 29 were for severe HS. Five patients with severe HS underwent bilateral orchiopexy for bilateral undesceded testes (BUT). All patients were Turner grade 4 to 5 at evaluation. Among the 14 patients with mild HS, hypergonadotropic hypogonadism, hypogonadotropic hypogonadism, decreased level of LH, and decreased level of T were observed in one each (7% each). In the cases with severe HS and without BUT, hypergonadotropic hypogonadism, and partial androgen insensitivity syndrome were identified in 2 (8%), and 1 (4%) of 24, respectively. Of the 5 patients with severe HS and BUT, hypergonadotropic hypogonadism was shown in 1 (20%), and increased level of LH with normal T in 2 (40%). Small testicular volume (less than 10 ml) with elevated FSH level was identified in 6 of 43 patients (1 of 14 (7%) with mild HS, 3 of 24 (13%) with severe HS and without BUT and 3 of 5 (60%) with severe HS and BUT). Conclusion: Our data demonstrated the presence of endocrine dysfunction in patients with both mild and severe hypospadias at puberty. Some of them could have a risk of impaired spermatogenesis.
    2009 American Academy of Pediatrics National Conference and Exhibition; 10/2009
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A rare case of urethral construction using flipped anterior bladder wall tube in an 8-year-old girl with complete disruption of the urethra and vagina accompanying pelvic fracture was reported. Following a split of the pubic symphysis, the vagina was reconstructed with end-to-end anastomosis. The neourethra was constructed tubularizing and flipping anterior bladder wall flap caudally to proximal site of the original urethra after fascial sling procedure. After catheter removal, this girl has been continent and voided normally. In conclusion, flipped anterior bladder wall tube technique for urethral construction is suitable in prepubertal girls with complete disruption of the urethra.
    Urology 10/2009; 76(1):112-4. · 2.42 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We investigated factors affecting the breakthrough urinary tract infection rate during prophylactic antibiotic treatment in children with primary vesicoureteral reflux. Medical charts were retrospectively reviewed in children with primary vesicoureteral reflux diagnosed at age 12 months or less who received prophylactic antibiotics and underwent (99m)Tc-dimercapto-succinic acid scan. Parameters assessed for their relation to breakthrough urinary tract infection were gender, presenting symptoms, age at presentation, prophylactic antibiotic type, reflux grade at presentation and scan findings. Enrolled in the study were 52 boys and 6 girls with a mean age at presentation of 3.7 months and a mean followup of 42.5 months. Urinary tract infection was a presenting symptom in 46 children. Low reflux grade (1-3) was identified in 18 children and 40 had high grade reflux (4-5). Abnormal (99m)Tc-dimercapto-succinic acid scan was documented in 36 children (62%). During followup breakthrough vesicoureteral reflux developed in 12 children, including 11 of 36 (31%) with an abnormal scan but only 1 of 22 (5%) with a normal scan (p = 0.021). The breakthrough urinary tract infection-free rate during followup was significantly lower in children with an abnormal scan (p = 0.033). Other factors were not significantly associated with the breakthrough urinary tract infection rate. Abnormal (99m)Tc-dimercapto-succinic acid scan may be a factor predicting breakthrough urinary tract infection in children with primary vesicoureteral reflux. Prophylactic antibiotics may have a limited treatment role in children with an abnormal scan.
    The Journal of urology 09/2009; 182(4 Suppl):1694-7. · 3.75 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We report the long-term outcome of vaginoplasty with the bilateral labioscrotal flap with special emphasis on vaginal stenosis. Of 23 children with ambiguous genitalia and low vaginal entry who underwent vaginoplasty between January 1985 and July 2003 with the bilateral labioscrotal flap 13 followed more than 5 years after surgery who were 10 years old or older at the most recent evaluation were included in this long-term outcome study. Vaginal caliber was estimated according to a previously described assessment system adopted for vaginoplasty results. The underlying disease was congenital adrenal hyperplasia in 11 cases, mixed gonadal dysgenesis in 1 and ovotesticular sexual development disorder in 1. Mean age at vaginoplasty and at the most recent evaluation was 3.8 (range 2.0 to 12.9) and 14.6 years (range 10.9 to 21.5), respectively. Vaginal caliber at the most recent evaluation was adequate in 6 patients (46%), stenotic in 5 (39%) and strictured in 2 (15%). Three of the 7 patients diagnosed with stricture or stenosis were diagnosed at age less than 12 years. One of these patients diagnosed with stricture was treated with dilation and the other 2 patients were observed. These patients had no trouble with menstruation. Four patients diagnosed with stricture or stenosis at age 14 years or older were treated surgically with dilation in 1 and perineal flap vaginoplasty in 3. They showed adequate vaginal caliber at 3 to 31 months of followup. In 7 patients evaluated at the beginning of puberty and several years later vaginal caliber had enlarged in 5 but remained unchanged in 2. To our knowledge this is the first report of the long-term outcome of vaginoplasty with the bilateral labioscrotal flap. Although vaginal stenosis/stricture was observed at puberty in about half of the patients, severe stricture was uncommon. Serial evaluation for vaginal stenosis/stricture at the beginning of puberty for menstruation and several years later for vaginal intercourse is recommended in patients treated with vaginal reconstruction.
    The Journal of urology 09/2009; 182(4 Suppl):1876-81. · 3.75 Impact Factor
  • European Journal of Pediatric Surgery 05/2009; 19(6):409-10. · 0.84 Impact Factor

Publication Stats

182 Citations
89.01 Total Impact Points

Institutions

  • 2004–2014
    • Hokkaido University
      • • Department of Renal and Genito−Urinary Surgery
      • • Department of Urology
      • • Department of Public Health
      • • Graduate School of Medicine
      Sapporo, Hokkaidō, Japan
  • 2008
    • Hokkaido University Hospital
      • Division of Urology
      Sapporo-shi, Hokkaido, Japan