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Transcatheter arterial embolization (TAE) has been widely used in the treatment of tumors as well as other lesions of the kidney. Complications most commonly encountered are post embolization syndrome, such as flank pain, fever, leucocytosis, nausea, vomiting, or ileus. They occur mostly in 24 to 48 hours and its treatment is symptomatic. We experienced a renal abscess developed in a patient of renal tumor with preexisting silent urosepsis. Precise examination of silent infection is recommended as a preprocedure test to avoid such complications.

A case of azoospermia due to pathological dilatation of seminal duct end is reported. A 34-year-old man visited our clinic complaining of infertility. He was diagnosed as having azoospermia by semen analysis. Cystic dilatation of seminal duct end was improved after transurethral resection of the cystic wall. His wife became pregnant on the 27th day after his operation.

The presence of bacteria at the renal pelvis and the methods of their detection were studied in 11 patients with catheter-free cutaneous ureterostomy (tubeless ureterocutaneostomy). These patients had had total radical cystectomy due to bladder carcinoma. Of these, 5 patients had single-sided stoma with 9 kidney-ureter units and 6 patients had bilateral stoma with 10 units, excluding 2 ureters because of indwelling catheters. The urine obtained both from the renal pelvis with a single lumen catheter and from the pouch were used in the bacterial culture test and urinalysis. The aseptic swab after touching the skin around the stoma was also cultured for bacteria. Of 19 kidney-ureter units, 9 (47%) were found to have bacteria in urine obtained from catheterization. However, only 2 units (11%) were observed to be accompanied with pyuria. In this method, the rate of bacterial appearance was higher in single-sided stomas than in bilateral ones. There was no statistical correlation between the presence of hydronephrosis and the rate of bacterial appearance. In conclusion, the method of single lumen catheterization might be of great use for analysis of urinary tract infections in patients with such conditions.

The effect of the antispasmodic agent, SA-504 subtle granules, was studied. Ninety mg per day of timepidium bromide subtle granules was given orally to 17 patients with renal or ureteral calculi for no less than fourteen days. SA-504 subtle granules as well as the capsule showed good antispasmodic effect and stimulated spontaneous passage of ureteral calculi. No subjective or objective side effects were observed.

A case of intrascrotal leiomyoma originating from tunica vaginalis is reported. The patient was a 63-year-old male who complained of painless tumor of the right scrotal contents. The tumor was surgically removed easily. The histological examination of the tumor revealed leiomyoma. Seven cases of intrascrotal leiomyoma reported in Japan were reviewed.

Emphysematous pyelonephritis is a severe infection characterized by the presence of gas within the renal parenchyma and perirenal tissues. Two cases of this disease are presented. They were the 16th and 17th case reported in Japan. Case 1 was a 63-year-old woman with diabetes mellitus and liver cirrhosis. She was hospitalized for abdominal pain and anuria. Renal X-rays showed a gas shadow in and around the left kidney, but no evidence of upper urinary tract obstruction. Although hemodialysis was done, she died of heart failure. Case 2 was a 54-year-old man with diabetes mellitus was admitted with the complaint of fever and left abdominal pain. Renal X-rays showed a gas shadow in and around the left kidney but no evidence of upper urinary tract obstruction. He was treated with intensive antibiotic therapy, control of blood sugar, intravenous drips and percutaneous drainage. Clinical features improved, but deteriorated after 40 days of therapy. The gas shadow remained unchanged on CT scanning, and aortography showed the occlusion of the left renal artery. Nephrectomy was done after 50 days. Seventeen cases of emphysematous pyelonephritis in the literature including our cases are reviewed, especially the choice of the treatment is discussed.

A 15-year-old boy was consulted to our hospital with the complaint of swelling of the left inguinal region with tenderness. Under the diagnosis of torsion of the undescended testicle, left orchidopexy was done with the finding of left testicle which had 360 degree counterclockwise intravaginal rotation. This was thought to be the 54th case of the disease in Japan. We have made some discussion on incidence, complication, diagnosis and therapy.

Results of operation were analyzed statistically in 123 patients who underwent suprapubic prostatectomy for benign prostatic hypertrophy from 1974 through 1981. Age of the patients ranged from 48 to 89 years and the mean age was 70.1 years. The average amount of blood loss during operation was 590 ml. Amount of blood loss in patients operated under epidural anesthesia was less than that in the patients operated under general anesthesia. Furthermore, significant correlation was observed between amount of blood loss and the weights of enucleated prostate glands. The average weight of enucleated prostate glands was 33.4 g and the weight increased as the patient's age increased. Histological examination of the enucleated specimens revealed occult carcinoma in 4.1% of the patients. Association of bladder neck sclerosis was observed in 27% of the patients whose prostate weighed less than 20 g. Significance of prophylactic vasectomy for the prevention of postoperative epididymitis was considered to be low. Incidence of postoperative bacteriuria was higher in patients who had bacteriuria preoperatively than those without preoperative bacteriuria. Therefore, eradication of preoperative bacteriuria seemed important in the prevention of postoperative bacteriuria. No significant correlation was observed between postoperative residual urine volume and the weight of the enucleated prostate glands.

The response to three quinolones of a clinical isolate of Streptococcus faecalis was studied by continuous turbidimetric monitoring, by viable counting, and in an in-vitro model of the treatment of bacterial cystitis. Dense populations (c. 8 x 10(6) cfu/ml) responded to ciprofloxacin, norfloxacin and enoxacin at concentrations below the conventionally determined MIC, but variants, shown to exhibit decreased susceptibility, emerged during overnight incubation. The variants were cross-resistant to each of the three quinolones, but the resistance was lost on subculture in drug-free broth. At a concentration of ten-fold MIC, ciprofloxacin was more bactericidal than norfloxacin or enoxacin. In experiments in the bladder model, doses of ciprofloxacin achieving a peak concentration of 10, 50 or 250 mg/l suppressed bacterial growth for 20 h or more. The doses of norfloxacin or enoxacin required to achieve a comparable effect were higher than those of ciprofloxacin. A reduction in susceptibility, as judged by comparative disc testing, occurred after two cycles of exposure to norfloxacin or enoxacin in experiments in which the peak concentration achieved was 50 mg/l, but not when the peak was 250 mg/l. Reduced susceptibility to ciprofloxacin developed only in experiments in which a lower peak concentration of 10 mg/l was achieved.

A case of rhabdomyosarcoma of the spermatic cord in a 6-year-old boy is reported. On February 26, 1986, he visited Nakamura Hospital with the chief complaint of enlargement of the left scrotal content. The contralateral scrotum was normal. The left scrotal content was a hard thumb-head-sized tumor. The left testis and epididymis were not distinguishable from the tumor. On the same day, left high inguinal orchiectomy was performed. The tumor was 3.5 by 2.5 by 2.5 cm in size and was distinguishable from the testis, epididymis and tunica vaginalis. Histopathological findings were embryonal rhabdomyosarcoma and it appeared to have originated from the spermatic cord. Two years after operation, the boy is living without metastasis. Including our experience, 101 cases of the paratesticular rhabdomyosarcoma found in Japanese literature are reviewed and briefly discussed.

The terminology of megaureters, their histological findings and etiology vary greatly in the literature. We encountered an obstructed megaureter in a 39-year-old man. He complained of epigastral and left flank pain. X-ray examination showed a right marked hydronephroureter which compressed the bladder and left ureter. We performed right nephroureterectomy. Postoperative course was uneventful and his clinical condition improved.