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Approximately 400 cases of penile fracture have been reported in Japan, but the sexual function before and after treatment has not been evaluated. Here, we show 2 surgical procedures dealing with penile fractureand examinethechange s in sexual functions using IIEF-5. Case1 was in a 51 year old malewho underwent emergency surgery for a penile fracture. The IIEF-5 score was 17 points before surgery and 8 points 2 months after surgery. At 5 months post-surgery, the patient complained of mild pain and penile curvature while erect, still the IIEF-5 score showed an improvement to 12 points. Case 2 was in a 60 year old male who underwent emergency surgery for penile fracture. The IIEF-5 score was 21 points before surgery and 8 points 2 months after surgery. Erection and ejaculation became possible 6 months after surgery, and the IIEF-5 score showed an improvement to 21 points. After surgery, the IIEF-5 score declined and sexual function also declined temporarily, though both gradually improved. From a sexual functioning standpoint, surgical treatment would be preferable.

Approximately 400 cases of penile fracture have been reported in Japan, but the sexual function before and after treatment has not been evaluated. Here, we show 2 surgical procedures dealing with penile fractureand examinethechange s in sexual functions using IIEF-5. Case1 was in a 51 year old malewho underwent emergency surgery for a penile fracture. The IIEF-5 score was 17 points before surgery and 8 points 2 months after surgery. At 5 months post-surgery, the patient complained of mild pain and penile curvature while erect, still the IIEF-5 score showed an improvement to 12 points. Case 2 was in a 60 year old male who underwent emergency surgery for penile fracture. The IIEF-5 score was 21 points before surgery and 8 points 2 months after surgery. Erection and ejaculation became possible 6 months after surgery, and the IIEF-5 score showed an improvement to 21 points. After surgery, the IIEF-5 score declined and sexual function also declined temporarily, though both gradually improved. From a sexual functioning standpoint, surgical treatment would be preferable.

1997～1999年に, 3例の化学療法抵抗性精巣腫瘍患者に対し, 自己末梢血幹細胞移植(PBSCT)併用救済大量化学療法(HDC)を行った.3例では4回の救済HDCによるCR, PRはなく, 1例にのみ病理学的CRと長期NEDがえられた.このNED例では総容積の比較的少ない残存の肺腫瘍がHDCの主な対象となったのに対し, 癌死した2例ではマーカーの著明な上昇を伴った化学療法後の再燃腫瘍とリンパ節領域に主病巣を有する巨大腫瘍が標的であった.HDCの副作用, 毒性については, 危惧された治療に苦慮する感染症や出血傾向などを招く重篤な髄内毒性はみられず, PBSCTなどで十分な造血支援が得られた.一方, 髄外毒性としては, 1例にHDC治療終了に伴い消退した一過性の肝機能異常と後遺症化を来たした難聴, 四肢麻痺などの神経毒性を, 1例にうつ症状の重積化といった心因反応に作用した事象がみられた.肝機能障害以外は, いずれも先行の治療時より生じHDCにより増悪した, We reported three cases (42, 20 and 18-year-old men) of advanced nonseminomatous testicular germ cell cancer treated by salvage high-dose chemotherapy (HDC) supported by peripheral blood stem cell autotransplantation. Two cases which had been refractory to (B) EP (bleomycin, etoposide, cisplatin) and VIP (etoposide, ifosfmide, cisplatin) chemotherapies received one course of high-dose CEI (carboplatin 1, 250 mg/m2, etoposide 1, 500 mg/m2 and ifosfamide 7.5 g/m2), and the other case had been refractory to PVB (cisplatin, vinblastine, bleomycin) and VIP chemotherapies received one course of high-dose CEI and high-dose CCT (carboplatin 800 mg/m2, cyclophosphamide 6 g/m2 and thiotepa 720 mg/m2). Only one case achieved an incomplete remission by HDC, which was verified as a pathological complete response at the following salvage surgery, and has been alive with no evidence of disease for 68 months. The others achieved no change of disease following HDC and died from cancer progression. Hepatotoxicity, neurotoxicity and severe depression occurred, but not fatal in 2 cases.

19歳男.ボクシング練習中に上腹部正中に軽いパンチを受け, その夜左側腹部の激痛により左腎外傷の疑いで入院となった.腹部理学所見でブルンベルグ兆候を認めた.又, 検査で白血球上昇と腎機能障害を認めた.CTで後腹膜腔に大量の液体貯留を認めた.腹腔内には液体の貯留は無く, 他臓器に損傷も無かった.外傷による左水腎症破裂を考え, 8Frピッグテイルカテーテルを挿入した.穿刺液は尿と確認された.翌日のCTでもまだ液体の大量貯留が確認され, 7Feピッグテイルカテーテルを挿入した.3日目に尿量は正常となったが, ドレナージが不十分で, 腹部鈍痛, 嘔気, 嘔吐など消化器症状があり発熱も継続した為左腎摘出術を施行した.腹膜及び筋膜との癒着は軽度で膿瘍形成もなく, Gerota筋膜ごと腎を摘出した.病理で腎盂尿管移行部狭窄による先天性水腎症と診断された.術後, 消化器症状は改善し10日目に退院した, A 19-year-old male patient was admitted with the chief complaint of left abdominal pain. After receiving a mild punch in the abdomen during boxing exercises, he had severe abdominal pain and was brought to an emergency room. Since abdominal CT scanning revealed the retention of massive fluid in the retroperitoneum, hydronephrotic rupture due to the trauma was diagnosed and nephrectomy was performed. The removed kidney was filled as a result of urinary retention, and congenital hydronephrosis accompanied by the ureteropelvic junction obstruction was macroscopically and pathohistologically diagnosed. Postoperative course was favorable and the patient was discharged on the 10th hospital day.

A 37-year-old male visited our hospital complaining of right scrotal mass formation. An elastic hard, fist-size mass was found in the right scrotum. Under the diagnosis of an intrascrotal benign tumor, the mass was removed. The tumor had no relation to the testis or epididymis. The surgical specimen weighted 220 g and measured 13 x 8 x 8 cm in size. Histopathological diagnosis was epidermal cyst of the intrascrotum. Epidermal cyst of the intrascrotum is a rare disease and only 13 cases have been previously reported in Japan.

We reported three cases (42, 20 and 18-year-old men) of advanced nonseminomatous testicular germ cell cancer treated by salvage high-dose chemotherapy (HDC) supported by peripheral blood stem cell autotransplantation. Two cases which had been refractory to (B) EP (bleomycin, etoposide, cisplatin) and VIP (etoposide, ifosfmide, cisplatin) chemotherapies received one course of high-dose CEI (carboplatin 1, 250 mg/m2, etoposide 1, 500 mg/m2 and ifosfamide 7.5 g/m2), and the other case had been refractory to PVB (cisplatin, vinblastine, bleomycin) and VIP chemotherapies received one course of high-dose CEI and high-dose CCT (carboplatin 800 mg/m2, cyclophosphamide 6 g/m2 and thiotepa 720 mg/m2). Only one case achieved an incomplete remission by HDC, which was verified as a pathological complete response at the following salvage surgery, and has been alive with no evidence of disease for 68 months. The others achieved no change of disease following HDC and died from cancer progression. Hepatotoxicity, neurotoxicity and severe depression occurred, but not fatal in 2 cases.

We report a case of intractable lymphedema of the left leg following radical prostatectomy. The 69-year-old male patient complained of difficulty walking, caused by severe lymphedema. Intraarterial autologous lymphocyte transfusion therapy was performed because of failure of conventional conservative therapy, and the leg edema resolved almost completely. However, the treatment did not improve the penoscrotal edema necessitating excision of the edema and skin graft in a separate procedure. The post-operative course was excellent and the patient's performance status improved to 1 from 3.

A 19-year-old male patient was admitted with the chief complaint of left abdominal pain. After receiving a mild punch in the abdomen during boxing exercises, he had severe abdominal pain and was brought to an emergency room. Since abdominal CT scanning revealed the retention of massive fluid in the retroperitoneum, hydronephrotic rupture due to the trauma was diagnosed and nephrectomy was performed. The removed kidney was filled as a result of urinary retention, and congenital hydronephrosis accompanied by the ureteropelvic junction obstruction was macroscopically and pathohistologically diagnosed. Postoperative course was favorable and the patient was discharged on the 10th hospital day.

A 37-year-old male visited our hospital complaining of right scrotal mass formation. An elastic hard, fist-size mass was found in the right scrotum. Under the diagnosis of an intrascrotal benign tumor, the mass was removed. The tumor had no relation to the testis or epididymis. The surgical specimen weighted 220 g and measured 13 x 8 x 8 cm in size. Histopathological diagnosis was epidermal cyst of the intrascrotum. Epidermal cyst of the intrascrotum is a rare disease and only 13 cases have been previously reported in Japan.