Urological Surgery

Introduction

The Department of Urological Surgery exists as a part of the Department of Pelvic Surgery at NCCHE. This Department mainly treats the diseases of pelvic organs, including prostate cancer and urinary bladder cancer, with an aim to preserve the sexual and/or voiding functions during pelvic surgery. Extrinsic obstructions of the ureter that directly result from enlargement of an adjacent malignancy or retroperitoneal metastasis are also treated. Internal stenting is better tolerated than percutaneous nephrostomy and is preferred by most patients.

Clinical Activities

Outpatient activities: Prostate cancer is diagnosed and treated in the outpatient clinics. Prostate biopsies were performed on 67 patients.Metastatic and refractory prostate cancers were treated by hormonal therapy in coordination with oncology physicians. Superficial bladder cancer (G3, cis, or recurrent) after TUR-Bt was treated by instillation of BCG into the bladder.Thirty-three patients newly received ureteral stents and 7 underwent nephrostomy for obstructive ropathy.
Inpatient activities: We performed radical retropubic prostatectomy (RRP) in 32 patients with localized prostate cancer. If the patient (intermediate and high-risk groups) desired preservation of sexual function, bilateral sural nerve grafting was performed for recovery of sexual function. TUR-Bt was performed in 37 patients for treatment of urinary bladder cancer. Radical cystectomy for invasive urinary bladder cancer was performed in 8 patients. Radical nephrectomy for renal cell cancer was performed in 27 patients, 8 of whom were treated laparoscopically.
In a case with rectal cancer invading the prostate, we performed concomitant prostatectomy and cysto-urethral anastomosis. In a case with ureteral invasion, reconstruction of the ureter was performed according to Boari’s method and the psoas hitch procedure. It was possible to avoid urostomy in these patients, and they could urinate.

● T. Suzuki, T. Tanaka ●

Number of operative cases in 2003-2007
Section 2003 2004 2005 2006 2007
Radical nephrectomy   12 16 20 27
(laparoscopic)   (1) (4) (6) (8)
Partial nephrectomy   1 2 2 2
Nephroureterectomy 1 2 4 6 3
Radical cystectomy 1 6 5 8 6
Radical prostatectomy 4 12 27 37 32

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