The Department of Urological Surgery exists as part of the Department of Pelvic Surgery at NCCHE from 2003. This Department is mainly involved in the treatment of diseases affecting pelvic organs, including prostate and urinary bladder cancer, with the aim of preserving sexual and/or voiding functions during pelvic surgery. Extrinsic obstructions of the upper urinary tract directly resulting from invasion of an adjacent malignancy or peritoneal metastasis are also treated. In most cases, internal stenting is better tolerated than percutaneous nephrostomy.
For outpatient activities, prostate cancer is usually diagnosed and treated in outpatient clinics. Specifically, prostate biopsies were performed on 62 patients; stage D2 prostate cancer was treated by hormonal therapy in coordination with medical oncologists; superficial bladder cancer (G3, cis, or recurrent tumor) after transurethral resection of bladder tumor (TUR-Bt) was treated by instillation of Bacillus Calmette-Guérin (BCG) into the bladder; 63 patients newly received ureteral stents; and 5 underwent nephrostomy for obstructive uropathy.
For inpatient activities, we performed radical retropubic prostatectomy in 21 patients with localized prostate cancer. If a patient (intermediate and high risk groups) desired preservation of sexual function, bilateral sural nerve grafting was performed. Furthermore, sural nerve interposition grafting was performed in 35 patients from 2004, and they were followed up for 1 year. Overall, 7 men (20%) experienced return of erectile activity (partial erection). Moreover, TUR-Bt was performed in 32 patients, radical cystectomy for invasive bladder cancer in 9 patients, and radical nephrectomy for renal cell cancer in 20 patients.
In one patient with Rb rectal cancer invading the prostate, we performed concomitant prostatectomy and cysto-urethral anastomosis. In two patients with ureteral invasion, ureter reconstruction was carried out according to the psoas hitch procedure. In these patients, urination was possible following the surgical procedures, and urostomy could be avoided. Total pelvic evisceration was performed in two patients.
● T. Suzuki, T. Tanaka ●
| Number of operative cases in 2004-2008 | |||||
| Section | 2004 | 2005 | 2006 | 2007 | 2008 |
| Radical nephrectomy (laparoscopic) Partial nephrectomy Nephroureterectomy Radical cystectomy (TUR-Bt) Radical prostatectomy | 12 (1) 1 2 6 11 12 | 16 (4) 2 4 5 35 27 | 20 (6) 2 6 8 42 37 | 27 (8) 2 3 6 37 32 | 20 (6) 1 10 9 32 21 |
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