Osamu Yokoyama

University of Fukui, Hukui, Fukui, Japan

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Publications (176)335.29 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the efficacy and safety of imidafenacin (IM), a novel short half-life anticholinergic, as add-on therapy for male LUTS with nocturia and nocturnal polyuria.
    World Journal of Urology 09/2014; · 2.89 Impact Factor
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    ABSTRACT: 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.
    Nihon Hinyōkika Gakkai zasshi. The japanese journal of urology. 04/2014; 105(2):62-5.
  • The Journal of Urology 04/2014; 191(4):e6. · 3.75 Impact Factor
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    ABSTRACT: To gain further evidence on the efficacy, safety and tolerability of tadalafil 5 mg once-daily in Asian men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Japanese and Korean men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia were randomized to once-daily tadalafil 5 mg (n = 306) or placebo (n = 304) for 12 weeks. A significantly greater improvement (P < 0.001) in total International Prostate Symptom Score for the change from baseline (week 0) to study end-point (week 12) was observed for tadalafil (-6.0) versus placebo (-4.5). Significantly greater improvements (P < 0.01) in total International Prostate Symptom Score for the change from baseline to weeks 4 and 8 were observed for tadalafil versus placebo. Significantly greater improvements (P < 0.05) in International Prostate Symptom Score voiding and storage subscores, and International Prostate Symptom Score Quality of Life Index were observed for the change from baseline to end-point for tadalafil versus placebo. Significantly greater improvements (P < 0.001) in urinary symptoms were observed for tadalafil versus placebo for both Patient and Clinician Global Impressions of Improvement. No new safety concerns were identified. These findings confirm the efficacy and safety profile of tadalafil 5 mg once-daily in Asian men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia.
    International Journal of Urology 02/2014; · 1.73 Impact Factor
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    ABSTRACT: To evaluate the efficacy and safety of the β3 -adrenoceptor agonist, mirabegron, in a Japanese population with overactive bladder (OAB). This randomized, double-blind, placebo-controlled Phase III study enrolled adult patients experiencing OAB symptoms for ≥24 weeks. Patients with ≥8 micturitions/24 h and ≥1 urgency episode/24 h or ≥1 urgency incontinence episode/24 h were randomized to once-daily placebo, mirabegron 50 mg, or tolterodine 4 mg (as an active comparator, without testing for non-inferiority of efficacy and safety) for 12 weeks. Primary endpoint was change from baseline to final assessment in mean number of micturitions/24 h. Secondary endpoints included micturition variables related to urgency and/or incontinence and quality of life (QOL) domain scores on the King's Health Questionnaire (KHQ). Safety assessments included adverse events (AEs), post-void residual volume, laboratory parameters, vital signs, and 12-lead electrocardiogram (ECG). Registered at clinical trials.gov (NCT00966004). A total of 1139 patients were randomized to receive placebo (n = 381), mirabegron 50 mg (n = 380), or tolterodine 4 mg (n = 378). Demographic and baseline characteristics were similar across groups. At final assessment, mirabegron showed significant improvements vs placebo in mean [SD] change from baseline in number of micturitions/24 h (-1.67 [2.212] vs -0.86 [2.354]; P < 0.001) and in the secondary endpoints: number of urgency episodes/24 h (-1.85 [2.555] vs -1.37 [3.191]; P = 0.025), incontinence episodes/24 h (-1.12 [1.475] vs -0.66 [1.861]; P = 0.003), urgency incontinence episodes/24 h (-1.01 [1.338] vs -0.60 [1.745]; P = 0.008), volume voided/micturition (24.300 [35.4767] mL vs 9.715 [29.0864] mL; P < 0.001). The incidence of AEs in the mirabegron group was similar to placebo; most AEs were mild and none were severe. Mirabegron 50 mg once-daily is an effective treatment for OAB symptoms, with a low occurrence of side effects, in a Japanese population.
    BJU International 01/2014; · 3.05 Impact Factor
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    ABSTRACT: Purpose. To assess changes in lower urinary tract symptoms (LUTS) within 1 year after brachytherapy in patients receiving alpha 1-adrenoceptor antagonists. Methods. We retrospectively evaluated 116 patients who underwent (125)I prostate brachytherapy in our institute. Seventy-one patients were treated with a combination of external beam radiation therapy and brachytherapy. Alpha 1-adrenoceptor antagonists were prescribed to all patients after brachytherapy. International Prostate Symptom Score (IPSS) forms and postvoid residual urine volume were recorded at all follow-up visits. Results. Forty-nine patients were given tamsulosin hydrochloride, 32 were given silodosin hydrochloride, and 35 were given naftopidil for up to 6 months after seed implantation. Patients given tamsulosin or naftopidil tended to show a higher peak IPSS and slower recovery to baseline values than those given silodosin. The patients given naftopidil showed an insufficient recovery in storage symptoms in naftopidil group in comparison with tamsulosin group at 3 months and with silodosin group at 6 and 9 months. Conclusions. In the management of LUT after brachytherapy, silodosin may provide a more favorable improvement. Silodosin and tamsulosin may have an advantage in improving not only voiding but also storage lower urinary tract symptoms after brachytherapy.
    ISRN urology. 01/2014; 2014:140654.
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    ABSTRACT: Objective To investigate the efficacy of fesoterodine vs placebo on nocturia, sleep disturbance, and sleep-related quality of life (QoL) in patients with overactive bladder and nocturia. Methods This posthoc analysis used data from a 12-week, randomized, placebo-controlled trial of fesoterodine 4 and 8 mg per day in Asian adults reporting ≥8 micturitions and ≥1 urgency urinary incontinence episodes per 24 hours at baseline. Patients who reported ≥1 nocturnal micturition/24 h were included in this analysis. Efficacy variables included change from baseline to week 12/end of treatment in nocturnal micturitions/24 h, nocturnal voided volume/micturition, and hours of undisturbed sleep. Sleep-related QoL was assessed using King's Health Questionnaire Sleep/Energy domain. Treatment comparisons were made using analysis of covariance. Results Among 555 patients, reductions in nocturnal micturitions with fesoterodine 4 mg (−0.63) and 8 mg (−0.77) were numerically greater vs placebo (−0.56), but differences were not significant (P >.05). When patients with a nocturnal polyuria index >33% were excluded, the decrease in nocturnal micturitions was significantly greater with fesoterodine 8 mg vs placebo (−0.24; P = .031). Increases in nocturnal voided volume/micturition were significantly greater with fesoterodine 4 (38.07 mL; P = .013) and 8 mg (42.05 mL; P <.001) vs placebo (14.89 mL). Hours of undisturbed sleep was significantly longer with fesoterodine 4 mg vs placebo (80 vs 54 minutes; P = .032); improvement in King's Health Questionnaire Sleep/Energy scores was significantly greater with fesoterodine 4 (P = .034) and 8 mg (P = .019) vs placebo. Conclusion These results suggest that fesoterodine may reduce nocturnal micturitions and improve sleep quality and QoL in overactive bladder patients with nocturia.
    Urology 01/2014; · 2.42 Impact Factor
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    ABSTRACT: The study aims to assess the usefulness of PET with C-acetate and F-FDG to differentiate renal cell carcinoma (RCC) from complicated renal cysts. Thirty-one patients were enrolled, 14 patients with complicated renal cysts (12 with Bosniak III and 2 with Bosniak IV) and 17 patients with 19 solid renal tumors. The patients underwent both C-acetate PET and FDG PET. Nephrectomy or partial nephrectomy was performed after the PET scans. In 29 patients, 32 renal lesions were diagnosed as RCC. Twenty-three of the 32 RCCs (72%) had positive C-acetate PET findings, whereas only 7 FDG PET studies were positive (22%). Considering the relationship between tumor size measured by macroscopic appearance of resected tumors and PET results, 22 of 25 (88%) tumors more than 1.5 cm showed positive C-acetate PET findings. In 12 patients with Bosniak III renal cysts, 10 renal lesions were diagnosed as RCC. In this subgroup, 5 of the 10 RCCs (50%) had positive C-acetate PET findings, whereas 2 RCCs (20%) had positive FDG PET findings. None of the cases with benign findings had positive C-acetate PET or FDG PET scans. C-acetate PET demonstrates a pronounced increase in tracer uptake in RCC, especially in renal tumors more than 1.5 cm, and displays a higher sensitivity than FDG PET. These preliminary data show that C-acetate may be a useful PET tracer to exclude RCC in complex renal cysts.
    Clinical nuclear medicine 11/2013; · 3.92 Impact Factor
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    ABSTRACT: Two cases of epithelioid angiomyolipoma of the kidney are reported. A 62-year-old female with incidental left renal tumor underwent laparoscopic leftpartial nephrectomy under a diagnosis of renal cell carcinoma. A pathological examination revealed epithelioid angiomyolipoma. The second case was that of a 35-year-old female with back pain. A laparoscopic right nephrectomy revealed epithelioid angiomyolipoma. This recently identified variant of angiomyolipoma is sometimes associated with aggressive clinical behavior including local recurrence and metastasis.
    Nippon Hinyōkika Gakkai zasshi. The japanese journal of urology 11/2013; 104(6):712-5.
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    ABSTRACT: To evaluate the efficacy and safety of magnetic stimulation for the treatment of urinary incontinence in women with overactive bladder. A total of 151 women with urgency incontinence were randomized to the active stimulation group or the sham stimulation group in a 2:1 order. An armchair type magnetic stimulator was used for 25-min magnetic stimulation twice a week, with the maximum magnetic flux density of 560 mT peak at 10 Hz. The sham device was set to deliver in a 5-s "on"-5-s "off" pulsing manner with the maximum intensity of 20.4% of active stimulation at 1 Hz. The study consisted of a baseline period for 1 week, and a treatment period for 6 weeks. The primary end-point was the number of leaks/week from the bladder diary. The secondary end-points were the number of voids and urgency/24 h, mean and maximum voided volume, and the quality of life assessment. Changes from baseline in the active and sham group, respectively, were -13.08 ± 11.00 and -8.68 ± 13.49 in leaks/week (P = 0.038), -2.65 ± 2.52 and -1.53 ± 2.39 in number of urgency/24 h (P = 0.011), and 14.03 ± 34.53 mL and -4.15 ± 40.60 mL in mean voided volume (P = 0.0056). As for safety, except for diarrhea and constipation, no patients experienced any device-related adverse event. Magnetic stimulation is effective for the treatment of urgency incontinence in female patients with overactive bladder.
    International Journal of Urology 10/2013; · 1.73 Impact Factor
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    ABSTRACT: To investigate patient satisfaction with antimuscarinic treatment of overactive bladder syndrome, and to identify factors having a significant influence on satisfaction. A cross-sectional questionnaire survey was carried out to assess treatment satisfaction among male and female patients with overactive bladder (age ≥20 years) in the Hokuriku district of Japan. The overactive bladder symptom scores, treatment efficacies, adverse events (dry mouth and constipation), and patient satisfaction scores were investigated and compared among patients using different antimuscarinic therapeutics. In total, 977 survey respondents (52.6% men; mean age 73.6 years) received antimuscarinic treatment. The mean overactive bladder symptom score of these patients was 6.17; in addition, 32.3% patients were satisfied with their treatment, but 33.1% were dissatisfied. Factors having a significant influence on treatment satisfaction were sex (men were less satisfied), efficacy, adverse events and the overactive bladder symptom score. Constipation negatively influenced patient satisfaction to a greater extent than did dry mouth. Patient satisfaction varied according to the drug used. Constipation was less severe with the immediate-release-type agents (imidafenacin and oxybutynin) than with the extended-release-type (propiverine, solifenacin or tolterodine). Just one-third of Japanese Hokuriku patients with overactive bladder seem to be satisfied with their antimuscarinic treatment. Patient satisfaction is impaired by poor efficacy and the presence of adverse events; furthermore, constipation should be recognized as an adverse event that negatively influences patient satisfaction to a greater extent than dry mouth. Patient satisfaction differs according to the antimuscarinic agent used, with higher patient satisfaction being associated with less severe constipation.
    International Journal of Urology 10/2013; · 1.73 Impact Factor
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    ABSTRACT: Two distinct α1 -adrenoceptor phenotypes (α1A and α1L ) have been recently demonstrated to originate from a single α1A -adrenoceptor gene. Here, we examined the agonist profiles of recombinant α1A and α1L phenotypes and of lower urinary tract (LUT) α1 -adrenoceptors. Recombinant α1A - and α1L -adrenoceptor phenotypes were stimulated with various drugs, and the potency and intrinsic activity were estimated from the evoked Ca2+ responses. Agonist-induced contractions were also examined in LUT tissues of rats and humans and in the human mesenteric artery and rat tail artery. A series of drugs (A61603, Ro 115-1240, NS-49, MK017, and ESR1150) that had been developed for stress urinary incontinence (SUI) therapy showed high agonist activity for the α1A -adrenoceptor phenotype compared to the α1L -adrenoceptor phenotype. Among them, Ro 115-1240 was an α1A -specific partial agonist that produced partial contractions through α1A -adrenoceptors in rat prostate and tail artery but not in the other LUT tissues and human mesenteric artery. On the other hand, P-come 102 showed full agonist activity at α1A - and α1L -adrenoceptors and was less selective than noradrenaline for the α1A -adrenoceptors. P-come 102 induced contraction all of the tested LUT tissues with high potency, like noradrenaline. However, the potency and intrinsic activity of P-come 102 were significantly lower than those of noradrenaline in human mesenteric artery. Distinct agonist profiles were observed between α1A - and α1L -adrenoceptor phenotypes and LUT α1 -adrenoceptors. As adrenergic contractions in LUT are predominantly mediated through α1L -adrenoceptors, the development of α1L -selective agonists may prove useful for SUI therapy.
    British Journal of Pharmacology 09/2013; · 5.07 Impact Factor
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    ABSTRACT: A 71-year-old man on hemodialysis was admitted for castration-resistant prostate cancer. He received chemotherapy with docetaxel(60mg/m2 every 3 weeeks)and prednisolone(10mg/day). As severe adverse reactions due to chemotherapy were not encountered, he could receive chemotherapy in our outpatient clinic. A total of four courses of chemotherapy resulted in a 56% reduction in PSA, which was judged as PR. Chemotherapy with docetaxel and prednisolone can be safely carried out for a patient with castration-resistant prostate cancer, even while on hemodialysis with the usual dose of docetaxel.
    Gan to kagaku ryoho. Cancer & chemotherapy 09/2013; 40(9):1245-7.
  • Osamu Yokoyama, Yukio Homma, Osamu Yamaguchi
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    ABSTRACT: To evaluate the efficacy of imidafenacin for nocturia and nocturnal polyuria in patients with overactive bladder. A stratified analysis was conducted on data from a phase III randomized, double-blind, controlled trial of imidafenacin performed at 158 centers in Japan. The subjects received imidafenacin (0.1 mg) twice daily (group I) or placebo twice daily (group P). The 24-hour urine volume, daytime and nighttime voiding frequency, and volume voided/micturition were evaluated from 3-day voiding diaries recorded every 4 weeks during the 12-week study period. Longitudinal data analysis was performed, with all values expressed as the least squares mean ± standard error. A total of 46 patients (mean age 66.54 ± 9.38 years, 9 men and 37 women) with nocturia and nocturnal polyuria (>33% of urine production at night) were enrolled. Group I (n = 35) and group P (n = 11) showed no baseline differences in the daily voided volume, concomitant diseases, age, or body weight. However, the average daily number of micturitions differed (11.22 ± 2.17 vs 14.45 ± 2.85). Therefore, longitudinal data analysis was performed for each micturition pattern. After 12 weeks of treatment, nighttime micturition was significantly less frequent in group I than in group P (P = .0292), and the nocturnal percentage of 24-hour production was significantly smaller (P = .0053). The interval to the first nighttime void was significantly longer in group I than in group P, but no difference was found in the first nighttime voided volume. The novel antimuscarinic agent, imidafenacin, decreases the number of urinations and reduces nocturnal urine production, thereby improving both nocturia and nocturnal polyuria.
    Urology 07/2013; · 2.42 Impact Factor
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    ABSTRACT: A 60-year-old man was examined at a local clinic for difficulty in urinating, and was diagnosed with prostatic hypertrophy. He was referred to our department because his prostate-specific antigen (PSA) level was elevated (276 ng/ml). His Gleason score was 4+3, there was one bone metastasis in the left ileac bone, and multiple lung metastases were present. The patient was accordingly diagnosed with stage D2 prostate cancer. Lutenizing hormone-releasing hormone (LH-RH) analogue treatment was initiated in April 1999, and 9 months later the PSA level had decreased to 4.3 ng/ml. Six years and 9 months after the start of hormone therapy, the cancer had developed into castration-resistant prostate cancer and the PSA level had risen to 43.8 ng/ml. Paclitaxel-carboplatin therapy was therefore initiated. Eight months after the start of chemotherapy, the PSA level had decreased to 25.9 ng/ml, but 6 years and 1 month later it had risen to 925 ng/ml, and the chemotherapy was discontinued. Docetaxel-predonine therapy was initiated in March 2012. Three months after the start of chemotherapy, the PSA level had decreased to 3.1 ng/ml, and the bone metastasis was reduced.
    Hinyokika kiyo. Acta urologica Japonica 05/2013; 59(5):301-304.
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    ABSTRACT: Objective: This study examined the relationship between bothersome symptoms of nocturia and erectile function. Methods: Subjects comprised patients with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). Patients were prospectively followed on treatment with the alpha-1 blocker naftopidil for 8 weeks. Patient backgrounds and efficacy of naftopidil associated with LUTS and sexual activity were evaluated. Results: The percentage of patients who identified nocturia as the most bothersome symptom was 30.2% (n = 135), representing the highest percentage among International Prostate Symptom Score (IPSS) items. The number of patients with nocturia as the most bothersome symptom plateaued at an IPSS for nocturia of two or three points. In contrast, the number of patients with slow stream as the most bothersome symptom increased with symptom severity according to IPSS for slow stream. Logistic regression analysis on association between nocturia and erectile function confirmed that the odds ratio was 1.41 (P < 0.05). Naftopidil showed excellent efficacy related to male LUTS, but International Index of Erectile Function 5 (IIEF5) total score was almost unchanged. Among patients with nocturia improved by naftopidil, IIEF5 total score was significantly changed in the group with IPSS nocturia score ≤1 as compared to the group with IPSS nocturia score ≥2 per night (P = 0.038). Conclusion: Nocturia the most bothersome symptom correlated with aging. Nocturia could associate erectile dysfunction, and keeping the frequency of nocturia at ≤1 episode might be meaningful for maintaining quality of life in elderly men.
    Lower urinary tract symptoms 05/2013; 5(2). · 0.33 Impact Factor
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    ABSTRACT: Objective: To determine the independent risk factors for intravesical tumour recurrence in patients with primary urothelial cancer of the upper urinary tract.
    Journal of Clinical Urology. 05/2013; 6(3):148-152.
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    ABSTRACT: INTRODUCTION: Renal uptake of Tc-99m-MG3 involves organic anion transporter (OAT). Treatment with drugs showing OAT affinity might interfere with renal uptake of Tc-99m-MAG3, leading to misinterpretation in Tc-99m-MAG3. This study was conducted to discuss a possible drug interference with Tc-99m-MAG3 diagnosis on OAT sites. METHODS: Renal uptake and plasma clearance of Tc-99m-MAG3 were analyzed in healthy volunteers under control and OAT1 and OAT3 related drug treatment conditions. An in vitro uptake study using OAT1 or OAT3 expressing cells was also conducted. RESULTS: Both PAH and probenecid treatment induced delays in Tc-99m-MAG3 clearance from blood, and reductions in the renal uptake clearance. As a result, the normalized effective renal plasma flow estimated from Tc-99m-MAG3 clearance was significantly underestimated, whereas the glomerular filtration rate estimated from plasma creatinine levels was unchanged. The transport activity of Tc-99m-MAG3 was higher in OAT1-expressing cells than in OAT3-expressing cells. CONCLUSION: Drugs with OAT1 affinity affect the renal uptake of Tc-99m-MAG3 and blood clearance. This might cause misinterpretation of functional diagnosis of the kidney using Tc-99m-MAG3.
    Nuclear Medicine and Biology 04/2013; · 2.52 Impact Factor
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    ABSTRACT: WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Antichollnergic agents are anticipated to diminish storage symptoms, as well as nocturia. Nevertheless, the effect of this treatment on polyuria related to nocturia is not clear. By subgroup analysis of the data set from a phase III clinical trial of antimuscarinic agent for OAB patients in Japan, imidafenacin was found to improve nocturia with a reduction in nocturnal polyuria. This study adds the effects and underlying mechanism of antimuscarinic agents decreasing urine production through inhibition of C-fibre in the bladder of water-leaded rats. OBJECTIVE: To evaluate the effects and underlying mechanisms of antimuscarinic agents used to decrease in urine production in water-loaded rats. SUBJECTS AND METHODS: Urine production was measured using a cystostomy catheter in female Sprague-Dawley rats every 2 h. The effect of the antimuscarinic agents atropine, tolterodine and imidafenacin on urine production was investigated under water-loaded conditions, which were induced by i.p. injection of 15 mL saline. Blood samples were collected to determine the levels of antidiuretic hormone (ADH), aldosterone (ALD), atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) before, and 2 and 8 h after, antimuscarinic agent administration. To induce desensitization of C-fibre afferent nerves, resiniferatoxin (RTX)was injected s.c. or intravesically 2 days before experiments. RESULTS: Urine production increased and reached its maximum 2 h after 15 mL saline injection. Imidafenacin and tolterodine decreased urine production in water-loaded rats, but ADH, ALD, ANP and BNP levels were not different between imidafenacin-treated and vehicle-treated rats. The inhibitory effect on urine production was not found in RTX-treated rats. Atropine did not reduce urine production. CONCLUSION: These results suggest that antimuscarinic agents decrease urine volume through C-fibres in the bladder; thus, antimuscarinics with inhibitory effects on C-fibres could be beneficial for nocturia with nocturnal polyuria.
    BJU International 02/2013; · 3.05 Impact Factor
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    ABSTRACT: We report a rare case of a solitary adrenal metastasis from small cell carcinoma of the urinary bladder that was successfully treated with surgical resection. A 71-year-old man was suffering from bladder tamponade for hematuria. Computed tomography (CT) revealed a bladder tumor at the left wall. The patients underwent radical cystectomy. Histopathological results were obtained in small cell carcinoma of the bladder with muscle invasion. Thus, he received two courses of adjuvant etoposide and cisplatin chemotherapy, followed by the regimen for small cell lung cancer. Seven months after surgery, follow-up CT showed a gradually enlarged mass enhanced heterogeneously in the right adrenal gland. There was a solitary adrenal metastasis without any other metastasis; therefore, we performed right laparoscopic adrenalectomy. The patient has remained uneventful for four years after the adrenal gland surgery. For patients who have a solitary adrenal metastasis, adrenalectomy may provide a survival benefit.
    Case reports in urology. 01/2013; 2013:982787.

Publication Stats

1k Citations
335.29 Total Impact Points


  • 2004–2014
    • University of Fukui
      • • Division of Urology
      • • Division of Pharmacology
      • • Division of Radiology
      Hukui, Fukui, Japan
  • 2013
    • Dokkyo Medical University
      • Department of Urology
      Totigi, Tochigi, Japan
  • 2011
    • Nagoya University
      • Division of Urology
      Nagoya-shi, Aichi-ken, Japan
  • 2007–2011
    • Fukushima Medical University
      • Department of Urology
      Hukusima, Fukushima, Japan
  • 2009–2010
    • The University of Tokyo
      • Faculty & Graduate School of Medicine
      Tokyo, Tokyo-to, Japan
  • 1988–2007
    • Kanazawa University
      • • Department of Urology
      • • Department of Integrative Cancer Therapy and Urology
      Kanazawa-shi, Ishikawa-ken, Japan
  • 2006
    • Japan Red Cross Fukuoka Hospital
      Hukuoka, Fukuoka, Japan
  • 2003–2006
    • Fukui University
      Hukui, Fukui, Japan
    • Fukui General Hospital
      Hukui, Fukui, Japan
  • 1999–2006
    • Kanazawa Medical University
      • Department of Urology
      Kanazawa-shi, Ishikawa-ken, Japan
  • 1998–2003
    • University of Pittsburgh
      • School of Medicine
      Pittsburgh, PA, United States