Treatment of bladder tumors and benign prostatic hyperplasia with a new TUR system using physiological saline as perfusate.

This article presents a new transurethral resection (TUR) system for use in endoscopic surgery. By using an electroconductive solution (physiological saline) as the perfusate in lieu of conventional non-electroconductive solution (Uromatic), additional anesthesia (e.g., obturator nerve blocking) is not required. The new TUR is carried out in an electroconductive solution such as saline, and because radiofrequency current flows from the resecting electrode through the perfusate to the outer sheath, no counter-electrode is needed. We have treated both bladder tumor and benign prostatic hyperplasia cases with this new system. Surgery was safely performed in all TUR-bt cases without requiring obturator nerve blocking. During both TUR-bt and transurethral resection of the prostate (TUR-P) using this system, tissue resection and coagulation equivalents were similar to the conventional TUR system. In previous TUR, preoperative obturator nerve blocking was necessary, and in some cases, incomplete blocking or complications occurred. When physiological saline is used as the perfusate, blood electrolyte levels are not greatly changed, even after extensive resection of the bladder wall; as a result, this new system is also cost effective because physiological saline is less expensive than non-electroconductive solutions and requires no counter-electrode. Thus, in comparison with conventional TUR, this new system is both significantly safer and more cost effective.

A case of renal cell carcinoma found after skin metastasis.

A case of renal cell carcinoma, found after skin metastasis is presented. A 79-year-old man visited Osaka JR hospital, complaining of a painless nodular mass on his right chest. The mass was resected and histopathological examination revealed a clear cell carcinoma (alveolar type, G1) with no involvement of the mammary gland. Abdominal ultrasound and magnetic resonance imaging revealed a heterogenous lower pole mass in the right kidney. Ultrasound-guided needle biopsy of the right renal mass was performed for histopathological diagnosis, which was clear cell carcinoma (alveolar type, G1). At that time, multiple metastases appeared in bilateral lung fields. The patient is currently receiving interferon-alpha therapy, without surgical treatment.

[Racemose hemangioma of the scrotum: a case report].

A 65-year-old male, with a painless right scrotal mass, underwent right radical orchiectomy and resection of the mass, because the mass was difficult to separate from the right testicle in scrotal exploration. The histopathological diagnosis of the mass was racemose hemangioma. Scrotal racemose hemangioma is a rare lesion and only two cases have been reported previously in Japan.