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Soichiro Ogawa,1 Masahiko Manome,2 Michihiro Yabe,2 Yoshinobu Kuma,2 Masaaki Yamaoka,1 Yuichi Sato,1 Hidenori Akaihata,1 Toshiki Oguro,1 Masao Kataoka,1 Shin Kumagai,1 Yoshiyuki Kojima11Department of Urology, Fukushima Medical University, Fukushima, Japan; 2Department of Urology, Public Soma General Hospital, Soma, JapanAbstract: We report a rare case of giant prostatic hyperplasia treated by open surgery. A 70-year-old man was suffering from macrohematuria. Computed tomography revealed a markedly enlarged prostate measuring 580 mL. The serum prostate-specific antigen level was 9.430 ng/mL. Prostatic biopsy showed benign prostatic hyperplasia. We perfomed retropubic open prostatectomy, since macrohematuria continued and he was also suffering from lower urinary tract symptoms. The adenoma was completely enucleated in one piece. The removed specimen was 13 × 11 × 6 cm in size and weighed 475 g. Histological examination also demonstrated prostatic fibromuscular hyperplasia. This is the 15th-heaviest adenoma ever reported in English-language journals. Transurethral surgical techniques or other minimally invasive approaches are performed for patients with small to medium-sized prostates. However, open surgery is recommended for markedly enlarged prostatic hyperplasia.Keywords: benign prostatic enlargement, benign prostatic hyperplasia, giant, retropubic open prostatectomy

良性前立腺肥大症49例で1日1或いは2回本剤を投与した所, 自・他覚的症状は有意に改善された.残尿量及び残尿率は有意に減少した.平均及び最大尿流量率は有意に増加した.適正量は, 1日1回, 25～75 mg, 或いは1日2回, 25～100 mgと思われた.有害反応及び異常な臨床検査所見は軽度であった, A new alpha 1-adrenergic receptor antagonist, KT-611 (naftopidil) antagonized dose dependently the contraction induced by agonists, noradrenaline and phenylephrine in the human prostatic tissue. KT-611 at a dosage of once or twice a day was evaluated for its effects on 49 patients with benign prostatic hypertrophy. The drug improved subjective and objective symptoms significantly. The residual urine was reduced in volume and percentage significantly. The average and maximum flow rates increased significantly. The optimal dosage was presumed to be in the range of 25 to 75 mg once a day or 25 to 100 mg twice a day. Adverse reactions and abnormal laboratory findings were all slight. KT-611 was concluded to be useful in the treatment of patients with benign prostatic hypertrophy.

We report a case of idiopathic calcinosis of the scrotum. The patient was a 33-year-old male with a complaint of multiple scrotal nodules, from which white chalky materials occasionally broke out. The nodules were first noticed 17 years ago, and since then gradually increased in size and number. Sometimes he had felt itching on the scrotum, but otherwise he had been in good health. Blood analysis and biochemical analysis revealed normal findings. In addition, there were no abnormal findings in serum electrolyte analysis including calcium and phosphate concentrations. Analysis of the intra-nodular content by infrared spectrophotometry showed that it consisted of calcium phosphate (52%) and magnesium ammonium phosphate (48%). We reviewed the literature and discuss the etiology of this disease.