Department of Urology

　　Professor　　　　　　　 Yukio Homma, M.D., Ph.D.

　　Associate Professor 　　Hiroshi Fukuhara, M.D., Ph.D.,Tetsuya Fujimura, M.D., Ph.D.

　　Lecturer　　　　　　　　Tohru Nakagawa, M.D., Ph.D.,Hideyo Miyazaki, M.D., Ph.D.,Akihiko Matsumoto, M.D., Ph.D.

Introduction and Organization

Urology is a special field of clinical medicine covering the diseases of the adrenal gland, the kidney, the urinary tract and the male genital system by means of a surgical procedure as well as an approach of internal medicine. In addition, urology encompasses pediatric urology, neurourology, female urology, renal transplantation, renal vascular surgery, endocrine surgery and geriatric urology. For this reason, urology requires the scientific background of oncology, nephrology, endocrinology, andrology, immunology, pediatrics, histology, microbiology, neurology and gerontology. Now we have commenced to utilize cellular and molecular biology to develop the research in urology. It is expected for our department to devote to the scientific progress in the frontier of urology.

In recent years, we have been taking international leadership in applying the new and minimally invasive treatment modalities. They are exemplified by endoscopic management of the diseases in the upper urinary tract, ESWL or laser lithotripsy for urolithiasis, hyperthermic and laser therapies for BPH, and minimum incision endoscopic or laparoscopic adrenalectomy, nephrectomy, and robot-assisted prostatectomy substituting open procedures.

Clinical activities

There are 44 beds in the ward (8th floor of the central-ward-building). The professor, associate professors, lecturers and associates are involved in in-patient and out-patient cares and teaching of the students as well as research activities. Clinical visiting professors are mainly engaged in the teaching. The residents take care of all the patients on 24-hour a day basis. Associate staff members team up with the residents on a man-to-man basis. The total number of inpatients was about 1,200 from January 2015 to December 2015. Elective operations are performed on Tuesday, Wednesday and Thursday. 1,466 operations were performed in 2015. The numbers of main operations are adrenalectomy 21, nephrectomy 41, partial nephrectomy 36, nephroureterectomy 35, radical cystectomy 21, radical prostatectomy 138, transurethral resection of the bladder tumor (TUR-Bt) 140, transurethral resection of the prostate (TUR-P) 17, laparoscopic surgery 66, and Robot assisted surgery 143 (radical prostatectomy 138, partial nephrectomy 5).

At the weekly professor's round on Wednesday, data of all in patients are presented and appropriate treatment strategies are recommended for them. On Wednesday evening, a clinical conference is held for discussing cases with difficult problems in detail and the best treatment is chosen for each case.

In out-patient clinic, services are provided from Monday to Friday. Patients assigned to specialized services as renal tumor, adrenal surgery, bladder cancer, prostate cancer, andrology, neurourology, urolithiasis, kidney transplantation, second opinion, pediatric urology and female urology receive sophisticated care on the particular day of the week.

The total number of out-patients was 24,000 patient-days from January 2015 to December 2015.

Teaching activities

Systematic urological lectures are provided for second year medical students. Both clinical lectures and bed side teaching are scheduled for third and fourth year medical students. Thirteen times of systematic lectures are performed by professor, associate professors and instructors concerning their specialties.

Bed side teaching is concentrated on practical care of the patients. Teachers give lectures mainly regarding pre- and post-operative management, indication of operation, surgical anatomy and surgical techniques.

Research activities

There are 9 research themes for research as below. The basic principles for research are program in surgical techniques and therapy for incurable diseases, which include advanced cancer, renal insufficiency, sexual dysfunction, and interstitial cystitis. We have published approximately 50 English papers every year.

Renal tumor

Urolithiasis

Kidney Transplantation

Prostate diseases

New surgical technique

Urinary disturbance/ Female Urology

Andrology

Virology

Achievements

1. Aizawa, N., Homma, Y., Igawa, Y.: Effects of L-arginine, mirabegron, and oxybutynin on the primary bladder afferent nerve activities synchronized with reflexic, rhythmic bladder contractions in the rat. Neurourol Urodyn, 34: 368, 2015

2. Aizawa, N., Ito, H., Sugiyama, R. et al.: Selective inhibitory effect of imidafenacin and 5-hydroxymethyl tolterodine on capsaicin sensitive C fibers of the primary bladder mechanosensitive afferent nerves in the rat. J Urol, 193: 1423, 2015

3. Aizawa, N., Ogawa, S., Sugiyama, R. et al.: Influence of urethane-anesthesia on the effect of resiniferatoxin treatment on bladder function in rats with spinal cord injury. Neurourol Urodyn, 34: 274, 2015

4. Akiyama, Y., Nomiya, A., Niimi, A. et al.: Botulinum toxin type A injection for refractory interstitial cystitis: A randomized comparative study and predictors of treatment response. Int J Urol, 22: 835, 2015

5. Amemiya, T., Honma, M., Kariya, Y. et al.: Elucidation of the molecular mechanisms underlying adverse reactions associated with a kinase inhibitor using systems toxicology. Systems Biology and Applications, 1: 15005, 2015

6. Azuma, T., Nagase, Y., Oshi, M.: Pyuria predicts poor prognosis in patients with non-muscle-invasive bladder cancer treated with bacillus Calmette-Gu?rin. Mol Clin Oncol, 3: 1113, 2015

7. Fujimura, T., Yamada, Y., Sugihara, T. et al.: Nocturia in men is a chaotic condition dominated by nocturnal polyuria. Int J Urol, 22: 496, 2015

8. Fujimura, T., Takahashi, S., Kume, H. et al.: Toremifene, a selective estrogen receptor modulator, significantly improved biochemical recurrence in bone metastatic prostate cancer: a randomized controlled phase II a trial. BMC cancer, 15: 836, 2015

9. Fukuhara, H., Todo, T.: New generation of oncolytic herpes virus. Current Cancer Therapy Reviews, 11: 163, 2015

10. Hakimi, A. A., Tickoo, S. K., Jacobsen, A. et al.: TCEB1-mutated renal cell carcinoma: a distinct genomic and morphological subtype. Mod Pathol, 28: 845, 2015

11. Ito, H., Aizawa, N., Fujita, Y. et al.: Long-Term Caloric Restriction in Rats may Prevent Age Related Impairment of In Vitro Bladder Function. J Urol, 193: 2123, 2015

12. Iwamoto, H., Zhang, Y., Seki, T. et al.: PlGF-induced VEGFR1-dependent vascular remodeling determines opposing antitumor effects and drug resistance to Dll4-Notch inhibitors. Sci Adv, 1: e1400244, 2015

13. Jensen, L. D., Nakamura, M., Br?utigam, L. et al.: VEGF-B-Neuropilin-1 signaling is spatiotemporally indispensable for vascular and neuronal development in zebrafish. Proc Natl Acad Sci U S A, 112: E5944, 2015

14. Kakutani, S., Fukuhara, H., Taguchi, S. et al.: Combination of docetaxel, ifosfamide and cisplatin (DIP) as a potential salvage chemotherapy for metastatic urothelial carcinoma. Jpn J Clin Oncol, 45: 281, 2015

15. Kamei, J., Furuta, A., Akiyama, Y. et al.: Video-urodynamic effects of mirabegron, a beta3 -adrenoceptor agonist, in patients with low-compliance bladder. Int J Urol, 22: 956, 2015

16. Kanatani, A., Nakagawa, T., Kawai, T. et al.: Adjuvant chemotherapy is possibly beneficial for locally advanced or node-positive bladder cancer. Clin Genitourin Cancer, 13: e107, 2015

17. Kanayama, H. O., Fukumori, T., Fujimoto, H. et al.: Clinicopathological characteristics and oncological outcomes in patients with renal cell carcinoma registered in 2007: The first large-scale multicenter study from the Cancer Registration Committee of the Japanese Urological Association. Int J Urol, 22: S1, 2015

18. Kawai, T, Suzuki, M, Otsuka, M. et al.: Hypertensive crisis during hemostasis of adrenal bleeding using a soft-coagulation device. Int J Urol, 22: 799, 2015

19. Kume, H., Kawai, T., Nagata, M. et al.: Intermittent docetaxel chemotherapy is feasible for castration-resistant prostate cancer. Mol Clin Oncol, 3: 303, 2015

20. Maeda, D., Akiyama, Y., Morikawa, T. et al.: Hunner-Type (Classic) Interstitial Cystitis: A Distinct Inflammatory Disorder Characterized by Pancystitis, with Frequent Expansion of Clonal B-Cells and Epithelial Denudation. PLoS One, 10: e0143316, 2015

21. Maekawa, S., Nagata, M., Watanabe, H. et al.: Resection of bulky chromophobe renal cell carcinoma resolved severe idiopathic thrombocytopenic purpura: A case report. Int J Urol, 22: 1167, 2015

22. Makino, K., Kume, H., Morikawa, T. et al.: Adenocarcinoma at Anastomotic Site of Ureterosigmoidostomy Potentially of Urothelial Origin Spreading to the Upper Urinary Tract. Case Rep Urol, 564082, 2015

23. Makise, N., Morikawa, T., Kawai, T. et al.: Squamous differentiation and prognosis in upper urinary tract urothelial carcinoma. Int J Clin Exp Pathol, 8: 7203, 2015

24. Makise, N., Morikawa, T., Takeshima Y. et al.: Urinary bladder urothelial carcinoma with concurrent plasmacytoid and micropapillary differentiations: A report of two cases with an emphasis on serum carbohydrate antigen 19-9. Pathol Int, 65: 495, 2015

25. Matsumoto, S., Matsumoto, S., Homma, Y.: Measurement of oxyhemoglobin concentration changes in interstitial cystitis female patients: A near-infrared spectroscopy study. Int J Urol, 22: 689, 2015

26. Michel, M., Igawa Y.: Therapeutic targets for overactive bladder other than smooth muscle. Exper Opin Ther Targets, 5: 687, 2015

27. Miyama, Y., Morikawa, T., Nakagawa, T. et al.: Lipid Cell and Micropapillary Variants of Urothelial Carcinoma of the Ureter. Case Rep Oncol, 8: 515, 2015

28. Nakajima, Y., Osakabe, A., Waku, T. et al.: Estrogen Exhibits a Biphasic Effect on Prostate Tumor Growth through the Estrogen Receptor beta-KLF5 Pathway. Mol Cell Biol, 36: 144, 2015

29. Nakamura, M., Satoh, N., Suzuki, M. et al.: Stimulatory effect of insulin on renal proximal tubule sodium transport is preserved in type 2 diabetes with nephropathy. Biochem Biophys Res Commun, 461: 154, 2015

30. Nakamura, M., Yamazaki, O., Shirai, A. et al.: Preserved Na/HCO3 cotransporter sensitivity to insulin may promote hypertension in metabolic syndrome. Kidney Int, 87: 535, 2015

31. Nishimatsu, H., Suzuki, E., Saito, Y. et al.: Senescent Cells Impair Erectile Function through Induction of Endothelial Dysfunction and Nerve Injury in Mice. PLoS One, 10: e0124129, 2015

32. Nishimatsu, H., Suzuki, E., Saito, Y. et al.: Neuromedin B Restores Erectile Function by Protecting the Cavernous Body and the Nitrergic Nerves from Injury in a Diabetic Rat Model. PLoS One, 10: e0133874, 2015

33. Otsuka, M., Nagata, M., Suzuki, M. et al.: Primary Retroperitoneal Tumor with Unexpected Gingival Involvement. Intern Med, 54: 1787, 2015

34. Sugihara, T., Yasunaga, H., Yu, C. et al.: Perioperative Outcome Comparisons Between Open and Laparoscopic Nephroureterectomy Among a Population-Based Cohort from 2010 to 2012. J Endourol, 29: 770, 2015

35. Suzuki, E., Fujita, D., Takahashi, M. et al.: Adipose tissue-derived stem cells as a therapeutic tool for cardiovascular disease. World J Cardiol, 26: 454, 2015

36. Tabata, M., Ikeda, M., Urakami, S. et al.: Impact of adjuvant chemotherapy on patients with pathological stage T3b and/or lymph node metastatic bladder cancer after radical cystectomy. Jpn J Clin Oncol, 45: 963, 2015

37. Taguchi, S., Fukuhara, H., Shiraishi, K. et al.: Radical Prostatectomy versus External Beam Radiotherapy for cT1-4N0M0 Prostate Cancer: Comparison of Patient Outcomes Including Mortality. PLoS One, 10: e0141123, 2015

38. Taguchi, S., Nakagawa, T., Matsumoto, A. et al.: Pretreatment neutrophil-to- lymphocyte ratio as an independent predictor of survival in patients with metastatic urothelial carcinoma: A multi- institutional study. Int J Urol, 22: 638, 2015

39. Taguchi, S., Kishida, Y, Tamura, K. et al.: Intrapelvic Bulky Tumor as an Unusual Presentation of Erdheim-Chester Disease. Intern Med, 54: 3241, 2015

40. Takahashi, M., Kume, H., Koyama, K. et al.: Preoperative Evaluation of Renal Cell Carcinoma by Using 18F-FDG PET/CT. Clin Nucl Med, 40: 936, 2015

41. Takahashi, S., Shiraishi, T., Miles, N. et al.: Nanowire analysis of cancer-testis antigens as biomarkers of aggressive prostate cancer. Urology, 85: 704 .e1, 2015

42. Takahashi, S., Aruga, S., Yamamoto, Y. et al.: Urinary Oxalate Excretion Decreased in Androgen Receptor-Knockout Mice by Suppressing Oxalate Synthesis in The Liver. Open Journal of Urology, 5: 123, 2015

43. Takayama, K., Misawa, A., Suzuki, T. et al.: Corrigendum: TET2 repression by androgen hormone regulates global hydroxymethylation status and prostate cancer progression. Nat Commun, 6: 8219, 2015

44. Takayama, K., Suzuki, T., Tsutsumi, S. et al.: RUNX1, an androgen- and EZH2- regulated gene, has differential roles in AR-dependent and -independent prostate cancer. Oncotarget, 6: 2263, 2015

45. Wang, J., Cao, Z., Zhang, X. M. et al.: Novel mechanism of macrophage-mediated metastasis revealed in a zebrafish model of tumor development. Cancer Res, 75: 306, 2015

46. Yamada, Y., Nomiya, A., Niimi, A. et al.: A survey on clinical practice of interstitial cystitis in Japan. Transl Androl Urol, 4: 486, 2015

47. Yamaguchi, O., Kakizaki, H., Homma, Y. et al.: Safety and efficacy of mirabegron as 'add-on' therapy in patients with overactive bladder treated with solifenacin: a post-marketing, open-label study in Japan (MILAI study). BJU Int, 116: 612, 2015

48. Yamaguchi, O., Marui, E., Igawa, Y. et al.: Efficacy and Safety of the Selective β3 -Adrenoceptor Agonist Mirabegron in Japanese Patients with Overactive Bladder: A Randomized, Double-Blind, Placebo-Controlled, Dose-Finding Study. Low Urin Tract Symptoms, 7: 84, 2015

49. Yamamoto, S., Yoshida, K., Tsumura, K. et al.: Xanthogranulomatous cystitis treated by transurethral resection. Urol Case Rep, 3: 143, 2015

50. Yokoyama, O., Igawa, Y., Takeda, M.: Tadalafil for lower urinary tract symptoms secondary to benign prostatic hyperplasia: a review of clinical data in Asian men and an update on the mechanism of action. Ther Adv Urol, 7: 249, 2015

51. Zaitsu, M., Toyokawa, S., Tonooka, A. et al.: Sex differences in bladder cancer pathology and survival: analysis of a population-based cancer registry. Cancer Med, 4: 363, 2015