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急性単純性膀胱炎76例にCefixime(CFIX)の効果を試した。BID群43例中UTI薬効基準に合致した33例では, 排尿痛消失28例(85%)であった。膿尿は正常化23例(70%)であった。細菌尿は陰性化24例(73%)で総合臨床有効率94%であった。主治医判定では有効率91%であった。UID群(一回200mgを一回投与)では28例中薬効基準合致22例中, 排尿痛消失は20例(91%), 膿尿正常化14例(64%), 細菌尿陰性化14例(64%)で総合有効率は96%であった。主治医判定では有効率82%であった。一般にE. coliに対して優れた感受性を示し, 副作用はUID群のうち1例のみ口内炎が発症したが変更により消失した, A comparative study of cefixime (CFIX), a new oral cephem antibiotic, was carried out at the Department of Urology, Nagoya University Hospital and its four affiliated hospitals to evaluate the clinical efficacy and safety of two dosage regimens of CFIX, given either in twice daily doses (BID group) or once daily dose (UID group), in the treatment of acute uncomplicated cystitis. Forty six female patients (BID group) were administered the daily dose of 200 mg in two divided doses for 3 days, 30 female patients (UID group) were administered 200 mg once daily for 3 days. The clinical efficacy was evaluated in 33 cases from the BID group and in 22 cases from the UID group, respectively, according to the criteria recommended by the Japan UTI Committee. In the BID group, the clinical efficacy was evaluated as excellent in 18 cases, moderate in 13 and poor in 2, with an overall clinical effectiveness rate of 94%. In the UID group, it was evaluated as excellent in 9 cases, moderate in 12 and poor in 1, with an overall clinical effectiveness rate of 96%. Safety was monitored in 71 patients, and only one case of stomatitis was seen in the UID group. This findings suggest that 200 mg once daily dosing regimen of cefixime is as effective as 100 mg twice daily dosing regimen in treatment of acute uncomplicated cystitis, and is well tolerated in terms of safety.

1)前立腺癌では, 39.8%, 前立腺肥大では, 100%にER-D5陽性の結果がえられ, ER-D5陽性前立腺癌症例の方が, 治療開始後一定期間はER-D5陰性症例より明らかに高い生存率をえた.2)前立腺癌再燃のため, 再度前立腺癌組織採取が可能であった症例では, 再燃時には, ER-D5陽性は1例も認めなかった, The existence of an estrogen receptor and various other sex steroid receptors has been confirmed in prostatic cancer. However, the action mechanism of hormone therapy and relationship between the disappearance of hormone response, which is observed in the recurrence of prostatic cancer, and various sex steroid receptors have yet to be identified. The use of monoclonal antibody ERICA is known as a method of detecting the estrogen receptor in the immuno-histological chemistry method. However, this monoclonal antibody is difficult to use on paraffin sections. Therefore, using monoclonal antibody D5, which allows ER-D5 detection of the estrogen receptor related antigen on paraffin sections, we investigated whether or not estrogen receptors are present in the prostatic cancer preparation and studied the survival rate of prostatic cancer as well as relationship with recurrence. Positive ER-D5 results were obtained in 37 of 93 prostatic cancer cases (39.8%) and in all 20 prostatic hypertrophy cases (100%). ER-D5 tended to be more densely stained in prostatic hypertrophy than in prostatic cancer. The survival rate was obviously higher in the ER-D5 positive prostatic cancer cases than in ER-D5 negative cases for a certain period of time after the start of treatment. Despite differences in the histo-differentiation degree and clinical stage of prostatic cancer, the ER-D5 positive percentage did not change and remained between 35% and 45%. In cases where another prostatic cancer preparation was taken because of recurrence of prostatic cancer, there were no ER-D5 positive cases at the time of recurrence.(ABSTRACT TRUNCATED AT 250 WORDS)

1)ヒト膀胱はangiotensin 1, 2いずれに対しても強い収縮反応を示した.2) angiotensin 2に対する収縮反応はCa-free Krebs中ではほぼ完全に消失した.verapamilやindomethacinによる抑制効果は僅かであった.3) captoprilによりangiotensin 1の抑制作用は完全に抑制された.saralasinによりangiotensin 1, 2の収縮作用は完全に抑制された.4)神経因性膀胱のangiotensin 1, 2に対する収縮反応は, いずれもコントロールに比較して減弱していた.ただし, ED50値には差を認めなかった, The response of the human detrusor muscle to angiotensins and the difference in contractility between neurogenic and control bladders were examined. Both angiotensin I and II induced potent contraction of the human detrusor muscle. In Ca-free Krebs' solution the contractile response to angiotensin II was abolished. However, verapamil and indomethacin suppressed it only slightly. Captopril blocked completely the response to angiotensin I, and saralasin inhibited completely the response to both angiotensin I and II. The contraction strength in response to both angiotensin I and II was significantly weaker in the neurogenic bladder than in the control. However, there was no difference in the value of ED50 between the two groups. These findings suggest that angiotensin I is converted to angiotensin II by angiotensin converting enzyme at the detrusor, and that angiotensin II subsequently contracts the detrusor muscle through angiotensin II receptors. The contractility of the neurogenic bladder in response to angiotensin was significantly lower compared to that of the control.

The effect of hypophysectomy on transepithelial movement of 3H-androgen in the rat epididymis was examined by using in vivo microperifusion of 3H-testosterone followed by in vivo micropuncture to obtain peritubular and intraluminal fluids. Experiments were performed on aminals without hypophysectomy or on aminals 5-6 days after hypophysectomy and 9-10 days after hypophysectomy. Tubules were perifused with Minimum Essential Medium containing 3H-testosterone. 14C-polyethyleneglycol was included in the perifusion fluid as a marker for contamination of the intraluminal fluid by peritubular fluid. Radioactivity of isotopes in the interstitial and intraluminal fluid was determined at 1 and 2 hours after perifusion and the percentage of peritubular isotopes appearing in the intraluminal fluid was determined. A sperm concentration microassay was performed on micropuncture samples from the epididymal tubules to assess testicular contribution to the lumen content. Proluminal movement of 3H-androgen and intratubular sperm concentrations in the caput epididymal tubules of rats 9-10 days after hypophysectomy were significantly decreased. Proluminal movement of 3H-androgen and intratubular sperm concentrations in the cauda epididymal tubules of rats 9-10 days after hypophysectomy were significantly increased. These results suggest that proluminal androgen movement is controlled by the presence of some testicular product in the epididymal lumen.

頻尿を訴えた膀胱肉腫様癌の78歳女で, 膀胱全摘除術後25ヵ月の現在, 再発所見はなく健在である.病理組織学的には大部分が紡錘形の脱分化した腫瘍細胞により構成され, 一部に上皮の特徴を有する分化した腫瘍細胞が認められ, 後者は免疫組織化学的にepithelial membrane antigenが陽性であった.又, 腫瘍の近傍の粘膜には上皮内癌が随伴していた, We reported a case of sarcomatoid carcinoma of the bladder in a 78-year-old woman presenting with pollakisuria. She has remained well without any evidence of recurrence for 25 months after radical cystectomy. Microscopic examination revealed a composition almost exclusively of spindle and dedifferentiated cells, accompanied by only a few cells retaining epithelial features of differentiation. The latter cells were immunohistochemically positive for epithelial membrane antigen (EMA). A concomitant carcinoma in situ was present in the adjacent mucosa. Immunohistochemical exploration with EMA proved useful for reinforcing the conventional histological diagnosis.

Bladder dysfunction is one of the major symptomatologies characteristic to HAM (HTLV-I associated myelopathy). Four patients, 3 females and 1 male, were diagnosed by neurologists to have HAM with spastic gait disturbance and increased titer of antibody to HTLV-I. They complained of urge incontinence, bed wetting, difficulty in micturition and/or pollakisuria. Urodynamically, in 3 of them severe uninhibited detrusor contractions were observed. On the other hand, in one case detrusor contractility was lost completely at voiding. In all patients, bladder sensation was well preserved. Corticosteroids and interferon could not improve their urological symptoms. Clean intermittent catheterization (CIC) put on 3 patients who had a significant amount of residue relieved them of urinary incontinence. We believe that HAM in patients suffering from severe difficulty in micturition is a good indication for CIC.

前立腺肥大症30例, 肉芽腫性前立腺炎(結核)1例, 前立腺癌22例, 前立腺部移行上皮癌1例および膀胱移行上皮癌の前立腺浸潤1例より採取した検体を材料とした.経直腸的吸引細胞診法は各症例に対し1回行い, 全視野における総細胞数が1, 000に満たないものは原則として除外した.吸引スメアに対してモノクローナル抗体Ki-67を使用した免疫組織化学染色を行った.1)前立腺癌の増殖能は前立腺良性疾患に比して明らかに高かった.2)低分化型腺癌は, 高および中分化型腺癌に比してKi-67 labeling indexが若干高値を示した.3)移行上皮癌は腺癌に比してKi-67 labeling indexが高値を示した.4)経直腸的前立腺吸引細胞診法に本染色法を応用することは, 前立腺癌早期診断の一助となる, Immunohistochemical staining using monoclonal antibody Ki-67 was performed in 30 patients with benign prostatic hypertrophy (BPH), one with prostatic tuberculosis (TB), 22 with prostatic adenocarcinoma, one with prostatic transitional cell carcinoma and one with prostatic invasion from a bladder cancer. Specimens were aspirated from the prostate transrectally and a cytological smear were made. This antibody is specific for a proliferation-associated nuclear antigen. Alkaline phosphatase anti-alkaline phosphatase stained immunopositive nuclei red making positive or negative specimens easy to recognize. In BPH and TB smears, no immunopositive cell was reactive with Ki-67. In prostatic malignancy were found many immunopositive cells ranging from 2.5 to 10.2% (mean 5.9%) in prostatic adenocarcinoma (n = 22), and from 11.9 to 24.3% (mean 18.1%) in prostatic transitional cell carcinoma. Transitional cell carcinoma may have a much greater growth fraction than adenocarcinoma in prostatic tissue. Poorly differentiated adenocarcinoma showed a higher growth fraction (from 4.2 to 10.2%, mean 6.9%) than well differentiated (from 3.1 to 8.9%, mean 5.8%) and moderately differentiated adenocarcinoma (from 2.5 to 10.1%, mean 5.6%), but this difference was not significant. There was no correlation with age, clinical stage, bone metastasis or Bocking's cytological grade. In conclusion, immunohistochemical staining using Ki-67 on aspirated prostatic smear is visualizes the growth fraction of prostatic disease well and is useful to diagnose prostate cancer.

A case of vesical endometriosis with unilateral renal agenesis is reported. A 13-year-old girl complained of difficulty in urination and lower abdominal pain during the menstruation. Detail urological examinations revealed left renal agenesis and intravesical cystic mass. The mass was located in the left vesical lateral wall, obstructing the vesical outlet and containing dark-brown-coloured fluid in it. She finally suffered from urinary retention following the menstruation and underwent a resection of the mass together with a part of the vesical wall. During the operation, the uterus was found to be a bicornate one. The resected mass was diagnosed as an endometriosis based on the histological findings. Eighteen months after the operation she is free from any symptoms during the menstruation and recurrence of endometriosis.

回腸膀胱では残尿が50 ml以下ならば間欠的導尿を行わないで経過をみているが, 長時間経過した場合, reservoirの過伸展による腸管壁の変化, およびそれにともなうreservoir容量の変化が, 今後の問題点となりうる, From September 1989 to March 1990, 6 male patients with invasive bladder cancer, 49 to 70 years old in age, underwent bladder replacement with the ileum (the urethral Kock pouch) after radical cystectomy. Follow up ranged between 3 and 9 months. Urodynamic evaluation showed the ileal bladder to be a low pressure reservoir with a capacity that increased to more than 250 ml. The ileal bladder was emptied by straining without significant residual urine in all patients except one who was performing intermittent self-catheterization. All patients were continent in the daytime. However, all patients required pads at night because of occasional loss of a little urine. Excretory urograms revealed excellent upper tract function. The procedure is suitable whenever the urethra can be preserved after cystectomy for cancer.

腎盂尿管の上皮性腫瘍症例62例について生存に影響を及ぼす因子を検討した.1)生存曲線上, 年齢, 数, 多中心発生, 大きさ, 組織型, stage, 異型度, 発育様式, 浸潤増殖様式, リンパ管侵襲, 静脈侵襲の11因子が予後に関係していた.2)比例ハザードモデルによる単因子別での検討では, リンパ管侵襲, 発育様式, stage, 静脈侵襲, 年齢, 異型度, 多中心発生の7因子がこの順で有意に予後に関係していた.3)比例ハザードモデルによる多変量解析からは, リンパ管侵襲, 発育様式の2因子が予後因子として重要である, Sixty-two patients with epithelial tumors of the renal pelvis and the ureter were studied with respect to 16 clinicopathological factors and their relationship to the patients survival. The cumulative survival curves are depicted by the Kaplan-Meier method and the statistical difference in the survival rates were detected in 11 factors, age, tumor number, multicentricity, tumor size, histological tumor type, stage, grade, growth pattern, infiltration pattern, lymphatic invasion and venous invasion. Cox's proportional hazard model was applied to evaluate the contribution of these 11 factors to survival. With the univariate analysis, lymphatic invasion showed the greatest hazard ratio followed by growth pattern, stage, venous invasion, age, and grade in this order. Stepwise selection of these factors based on the relative magnitude of their contribution to the survival with Cox's proportional hazard model revealed the most important factor for survival as the lymphatic invasion (hazard ratio 5.29), followed by growth pattern (hazard ratio 2.89). In conclusion, patients with tumor lymphatic invasion and tumor of non-papillary growth pattern showed poor prognosis, and adjuvant chemotherapy should be performed on them to improve their survival.

We report a case of retroperitoneal schwannoma mimicking lymph node metastasis. A 32-year-old man presented with an intrascrotal mass, and underwent radical orchiectomy. Histological examination revealed a typical seminoma of the testis. Systemic work-up for staging demonstrated a retroperitoneal mass, which was located in the supra-hilar inter-aortocaval region. Under the diagnosis of retroperitoneal metastasis of the seminoma, he underwent three courses of cisplatin, vinblastine, and bleomycin (PVB) therapy. Persistence of the tumor after the chemotherapy led to retroperitoneal lymphadenectomy, histological examination then revealing a benign schwannoma. The location of the tumor and its unresponsiveness to chemotherapy might be useful indicators for differentiating lymph node metastasis of seminoma from primary tumors of other origin.

To determine the clinical characteristics of grade 3 tumors with lamina propria invasion (pT1), we reviewed the data of 217 patients with superficial bladder cancer who had initially been treated by transurethral resection (193 patients) and fulguration (4), supravesical resection (13) or partial cystectomy (7). We classified the patients into four groups according to histological grade and stage of disease: group 1) grade 0 or 1, pTa tumors (n=58); group 2) grade 2, pTa tumors (n=106); group 3) grade 2, pT1 tumors (n=30); and group 4a) grade 3, pT1 tumors (n=23). Grade 3, pT1 tumors were significantly related to nonpapillary growth (p=0.0002), multiple tumors (p=0.005) and irritative bladder symptoms (p=0.01). The 5-year progression rates were 0% for group 1, 5% for group 2, 8% for group 3, and 18% for group 4a. The respective 5-year survival rates were 97%, 91%, 83% and 79%. All five patients with grade 3, pT1 tumors who had originally undergone total cystectomy (group 4b) remained alive free of disease for a median follow-up 57 months, establishing a far better survival rate than that for group 4a. These findings show that patients with grade 3, pT1 tumors face a high probability of progression and poor chance of survival. Immediate radical treatment is indicated when tumors recur after initial transurethral resection.

Proluminal movement of 3H-androgen from peritubular to intratubular fluids of the adult rat testis and epididymis was investigated by using in vivo microperifusion and subsequent micropuncture of seminiferous tubules and caput, corpus, and cauda epididymal tubules. Tubules were perifused with Minimum Essential Medium containing 3H-testosterone. 14C-polyethyleneglycol was included in the perifusion fluid as a marker for contamination of intraluminal fluid by peritubular fluid. Radioactivity of isotopes in interstitial and intraluminal fluids was determined at 1 and 2 hours after perifusion and the percentage of peritubular isotopes appearing in the intraluminal fluid was determined. Proluminal movement of 3H-androgen across the seminiferous epithelium was significantly restricted. In contrast, intraluminal 3H-androgen concentrations in the caput epididymal fluid were 200-300% of those in the peritubular fluid at both 1 and 2 hours after perifusion. Similar results were found in the corpus epididymis. 3H-androgen concentrations in the cauda epididymal fluid were approximately 125% of the peritubular isotope concentrations. The exact mechanism underlying this uphill transepithelial movement of 3H-androgen in the rat epididymis continues to be elucidated.

Excretory urography was performed using iohexol (Omnipaque 300 and Omnipaque 350) on 388 patients requiring urography in the Department of Urology, Nagoya University School of Medicine and 10 affiliated hospitals. Adverse reactions were observed in 3 cases (0.8%), but they were all mild. Good image efficacy was obtained in more than 95% of the patients injected 20 ml, 40 ml, and 100 ml of Omnipaque 300 and 40 ml of Omnipaque 350. There was no difference in the results of image efficacy between 40 ml (Omnipaque 300) and 100 ml (Omnipaque 300) groups. Therefore, the use of 40 ml of Omnipaque 300 for excretory urography was considered to be a very useful screening method for the urinary tract.

A seventeen-year-old girl, who had had an ileal conduit urinary diversion at 5 years of age, underwent a urinary undiversion 12 years after the initial operation. She has been suffering from recurrent episodes of urinary tract infection with fever. The preoperative evaluation revealed dilatation of the bilateral pelvis and ureters on an excretory urography. Ileal conduitgraphy revealed urinary reflux from the ileal loop to the bilateral upper urinary tracts. Cyclic bladder hydrodilatation through a suprapubic cystostomy was performed and a precise urodynamic study was done on the lower urinary tract. The vesical capacity increased from 40 ml to 300 ml in a month. Cystometry and urethral pressure profile revealed a stable bladder with good detrusor contraction and preserved urethral continence. Voiding status was satisfactory with only a small amount of residue. The undiversion was undertaken as follows. The ureters were once isolated from the ileal loop and their distal ends were everted in length of 5 mm to be nipples in shape. The ureters were reanastomosed to the proximal end of the ileal loop with submucosal tunnels of 2 cm. The ileal loop was then tapered and implanted to the bladder with a submucosal tunnel of 5 cm. Eight months after the undiversion, she enjoys good urination, free from urinary tract infection. Although moderate hydronephrosis remains bilaterally, renal function is stable.

P線毛保有大腸菌より精製したP線毛を抗原とした酵素抗体法(ELISA法)により, 各種尿路性器感染症患者のP線毛に対する血中抗体価を測定した.1)成人女子急性腎盂腎炎患者のP線毛に対する抗体価は, 発症後10日を経過すると上昇がみられ, 成人女子対照群および成人女子膀胱炎患者の抗体価に比べ有意に高く(p, The serum antibody response to P-fimbriae of Escherichia coli in patients with genitourinary infections was investigated with enzyme linked immunosorbent assay (ELISA) for P-fimbriae-specific IgG antibody. 1) Female patients with acute pyelonephritis had a significantly (P less than 0.01) higher titer of serum IgG antibody by ELISA, compared with patients with acute cystitis or control subjects. The prevalence of positive serum IgG antibody response was 65% in patients with acute pyelonephritis. 2) Patients with epididymitis with high fever had a significantly (P less than 0.01) higher titer of serum IgG antibody by ELISA, compared with patients with epididymitis without fever or control subjects. The prevalence of positive serum IgG antibody response was 60% in patients with epididymitis with high fever. Therefore, 65% of female patients with acute pyelonephritis and 60% of patients with epididymitis with high fever are infected with P-fimbriated E. coli. The measurement of serum antibody response to P-fimbriae must be helpful for the diagnosis and the antibiotic therapy of epididymitis.

A 37-year-old man consulted our hospital with a complaint of male infertility. He was masculine but 159.9 cm in height. His beard, axillary hair and pubic hair were all normal. The penis and scrotum were also normal, but bilateral testes were very small (1 ml. respectively). Semen analysis revealed azoospermia. Endocrinological examination showed elevated serum lactating hormone and follicle stimulating hormone level, and extremely low level of serum testosterone. Testicular biopsy disclosed severely hyalinized seminiferous tubules and hyperplasia of Leydig cells. No ovarian tissue could be detected. The chromosomal analysis revealed a karyotype of 46 XX. This case was diagnosed as a case of 46XX male. The Japanese literature of 46XX male is reviewed.

At～6K, dimers on Si(100) surface are buckled, and structural change occurs between c(4x2) and p(2x2) arrangements due to dimer flip-flop motion at phase boundaries on dimer rows. The phase defect appearing at boundaries has a structure similar to that of the type-C defect, two adjacent dimers are buckled in the same orientation. In consideration of the dimer arrangement around the phase boundary, there exist structures with two different conformations for the phase defect, however, according to the Ising spin model, both of which have the same energy higher compared to other buckled dimers with 2x anticorrelation along a dimer row. Therefore, dimer flip-flop motion at a phase boundary results in the migration of a solitary phase defect with higher energy, as a phason.

1歳男児, 10ヵ月男児。共に鼠径ヘルニアと停留精巣を伴ったミュラー管遺残症候群であった, Persistent Mullerian duct syndrome is characterized by the retention of mullerian derivatives in patients otherwise normally virilized. Clinically, the persistence of uterus and tubes leads either to cryptorchidism or inguinal hernia. The condition is usually discovered at surgery. We report two boys with this anomaly. In each case, hysterectomy and orchidopexy were carried out. The gonads were testes and the karyotype was 46, XY. Long-term follow up for these patients is necessary because of an increased risk of testicular tumors and infertility which will develop in future.

The treatment of cyclophosphamide-induced hemorrhagic cystitis is difficult. We report a successful case of severe cyclophosphamide-induced hemorrhagic cystitis treated with intravesical instillation of prostaglandin F2 alpha. A 32-year-old woman underwent high-dose cyclophosphamide conditioning before the autologous bone marrow transplantation. She developed clot retention which required continuous irrigation with normal saline. The patient had failed to respond to continuous bladder irrigation with saline and intravesical administration of 1% alum. Fifty ml of prostaglandin F2 alpha solution (1 mg in 100 ml normal saline) was instilled into the bladder, with a dwelling time of 60 minutes, three times a day for 5 days. The hematuria cleared completely 3 days after therapy. The only adverse effect was bladder spasm which was controlled with oxybutynin chloride. The success of this therapy suggests that prostaglandin F2 alpha is a safe and useful therapy for hemorrhagic cystitis secondary to cyclophosphamide chemotherapy.

application/pdf, An Se-passivated GaAs(001) surface was found to be stabilized by 2×3 reconstruction, previously reported as an intermediate structure, under the condition of a low Se chemical potential. Ordered elliptical protrusions with ~0.6-nm periodicity in the [110] direction were observed by scanning tunneling microscopy, the structure of which was in good agreement with a double-layered dimer model. A comprehensive model to explain the 2×3 structure together with the formation of a Ga2Se3-like structure with ordered 1/3 ML Ga vacancies was proposed.

1)尿道癌および外陰癌の2例にcontinent cystoileostomyを作成した。2)continent cystoileostomyは確実な尿禁制がえられる尿路変向術であり, 膀胱保存が可能な症例で尿道が使用できない場合には有用な方法である, We performed continent cystoileostomy in which the technique of Kock's efferent nipple was utilized, on two female patients with urethral cancer and vulvar cancer. We recommend continent cystoileostomy for the patient who needs urethrectomy but whose bladder function can be preserved.

We report on a case of iatrogenic obstruction of the vas deferens following herniorrhaphy, successfully treated by vasovasostomy after an obstructive interval of 31 years, with his wife achieving pregnancy.

腹膜外的骨盤リンパ節郭清後発生したリンパ漏の4症例に対し, ドレーンからミノサイクリンを注入し治療した。4症例のうち2症例は同時に膀胱全摘術を, 1症例は前立腺全摘術を施行した。4症例すべてにおいてリンパ漏は著明に改善し, 以後のドレーン留置期間を短縮できた。副作用は生じなかった, We managed four cases of lymphorrhea after extraperitoneal pelvic lymphadenectomy by means of minocycline instillation into the cavity around the drainage tube. Two patients had concomitantly undergone cystectomy and one prostatectomy via the extraperitoneal approach. In all four cases, the lymphorrhea markedly subsided, which dramatically shortened the duration of drainage. No side effects occurred. These findings indicate that minocycline instillation is an efficacious treatment for lymphorrhea.

A case of simultaneous bilateral renal pelvic tumors is reported. A 64-year-old man with the chief complaint of gross hematuria and left flank pain was admitted. Clinical investigations revealed a tumor in the right pelvis and ureter, and another tumor in the left renal pelvis. The right ureteral tumor had invaded the bladder. Right nephroureterectomy, total cystectomy, left partial pyelectomy and ureterocutaneostomy were performed. By pathological examination, right renal pelvic and ureteral tumors were non-papillary transitional cell carcinoma, grade 3, pT4, and the left renal pelvic tumor was papillary transitional cell carcinoma, grade 2, pT1. To our knowledge, this is the 16th case of simultaneous bilateral urothelial tumors of the upper urinary tract in Japan.

We present a case of bladder transitional cell carcinoma with sigmoidovesical fistula due to diverticulitis. The patient was a 65-year-old male who had been suffering from recurrent abdominal pain with high fever for the past 6 months. He noticed pneumaturia and cloudy urine several times. He visited a doctor complaining of macroscopic hematuria and high fever, and was treated under the diagnosis of acute prostatitis. In our University Hospital cystoscopy showed a papillary bladder tumor. Pathological study of the tumor revealed transitional cell carcinoma, grade II, noninvasive type. Multiple diverticulosis of sigmoid colon was identified with barium enema examination. We performed transurethral resection of the bladder tumor. Three weeks later, the sigmoidovesical fistula was treated by primary resection of the sigmoid colon and wedge resection of the bladder including fistula.

We report a case of granulomatous prostatitis after intravesical BCG immunotherapy for superficial bladder cancer. A 58-year-old man presented with gross hematuria. Cystoscopic examination revealed multiple tumors at the posterior wall of the bladder. The patient underwent transurethral resection of the tumor. Intravesical BCG immunotherapy was postoperatively followed and it eradicated the disease. Digital examination revealed that the prostate became stony-hard and larger 10 weeks after the initial BCG immunotherapy. A needle aspiration cytology and biopsy of the prostate revealed the granulomatous prostatitis due to BCG immunotherapy.

1996