ABSTRACT
PURPOSE: This study aims to investigate the utility of prostate-specific antigen (PSA) screening by conducting an all-case survey of newly diagnosed prostate cancer patients at Niigata Prefecture, Japan. PATIENTS AND METHODS: Depending on whether patients were subjected to screening, information was prospectively collected on all prostate cancer patients newly diagnosed between October 1, 2019, and September 30, 2020, at all institutions in Niigata Prefecture where urologists performing prostate biopsy routinely work and differences in clinical parameters were investigated. RESULTS: PSA was measured in 478 out of 1332 patients (35.8%) as part of a community health screening. The rate of metastatic carcinoma (M1) in all patients was 14.9%. When patients were divided into three categories of population-based screening (community health screening and workplace health screening), opportunistic screening (PSA measurements at complete medical check-ups or on patient request), and testing triggered by clinical symptoms or findings, the proportion of metastatic cancer was 4.5%, 3.7%, and 30.6%, respectively, demonstrating that the number of distant metastases was significantly lesser in all patients who underwent screening. CONCLUSION: The one-year all-case survey of newly diagnosed prostate cancer patients demonstrated that PSA screening significantly contributed to the early diagnosis of current prostate cancer in Japan.
ABSTRACT
A 43-year-old male was injured by a heavy industrial machine in 1998, and suprapubic catheter was inserted because of pubic fracture and urethral injury. He monthly changed the catheter until 2005, but he stopped going to the hospital. Ten years later, in August 2015, he visited our hospital for tiredness. Computed tomography scan showed a huge bladder stone (6×6×4 cm) with suprapubic catheter and bilateral severe hydronephrosis. The level of serum creatinine was 4.79 mg/dl. Bilateral nephrostomy was performed immediately. After improvement of renal function, we performed cystolithotomy and cystostomy. Bilateral nephrostomy was removed with antegrade pyelography seven days after surgery, and he went home on the fourteenth day. Bladder stones due to long-term catheterization without exchange are very rare. We report the clinical course and findings about this patient.
Subject(s)
Renal Insufficiency/etiology , Urinary Bladder Calculi/etiology , Urinary Catheterization/adverse effects , Adult , Humans , Male , Renal Insufficiency/diagnostic imaging , Time Factors , Tomography, X-Ray Computed , Treatment Outcome , Urinary Bladder Calculi/diagnostic imaging , Urinary Bladder Calculi/surgeryABSTRACT
A 73-year-old man was admitted to our hospital with a chief complaint of hematemesis. Two years before admission, adenocarcinoma of unknown origin was diagnosed. Since then, the patient had been taking TS-1 (pramoxine hydrochloride) medication, which caused gastroduodenal mucosal damage. A large abdominal tumor and elevated prostate specific antigen (PSA) level of 13,190 ng/ml, caused by this damage, were detected. Extensive abdominal metastasis of prostate cancer was diagnosed and combined androgen blockade was initiated. After 3 months, the PSA level decreased to 4.4 ng/ml and the abdominal tumor shrunk significantly. Physicians should keep in mind prostate cancer in the differential diagnosis of unexplained adenocarcinoma.
Subject(s)
Abdominal Neoplasms/secondary , Prostatic Neoplasms/pathology , Aged , Humans , Male , Prostate-Specific Antigen/blood , Prostatic Neoplasms/diagnosisABSTRACT
A prospective randomized controlled study was performed to compare the clinical effects of naftopidil and tamsulosin. Men complaining of lower urinary tract symptoms due to benign prostatic hyperplasia were randomized into two groups : one receiving 50mg naftopidil once daily (Naf group, n=36 patients), and the other receiving 0.2 mg tamsulosin once daily (Tam group, n=32 patients). In the Naf group at 12 weeks, 7 items of the International Prostate Symptom Score (IPSS), storage and voiding symptoms, total IPSS, quality of life (QOL) index (QOLI) and Qmax were improved significantly. In the Tam group at 12 weeks, 6 items of IPSS except urgency, storage and voiding symptoms, total IPSS, QOLI and Qmax were improved significantly. Improvement of residual urine volume (PVR) was insignificant in both groups. In intergroup comparison between the Naf and the Tam groups, variations of 7 items of IPSS, storage and voiding symptoms, total IPSS, QOLI, Qmax and PVR at 4 and 12 weeks after treatment were not statistically significant. There was almost no difference in clinical efficacy between Naf and Tam.
