Publications by authors named "Ryosuke Ikeuchi"

6 Publications

  • Page 1 of 1

Overactive bladder medication: Persistence, drug switching, and reinitiation.

Neurourol Urodyn 2020 11 28;39(8):2527-2534. Epub 2020 Sep 28.

Department of Urology, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan.

Aim: To assess real-world treatment profiles, including the time to and reasons for discontinuation or drug switching, treatment reinitiation, and postdiscontinuation follow-up in patients receiving antimuscarinics or ß3-agonists for overactive bladder (OAB) through a retrospective chart review.

Methods: We retrospectively reviewed medical charts of 777 patients, aged ≥18 years, who underwent antimuscarinic or ß3-agonist therapy at our hospital. Data on patient's age, sex, chief complaint, and OAB symptom score at therapy initiation were collected. Treatment persistence was assessed with respect to the median time to discontinuation and the persistence rate at 12 months.

Results: Older patients, male patients, and those with more severe urgency symptoms were more likely to show treatment persistence with OAB medications. Treatment persistence with mirabegron was significantly longer than that with antimuscarinics when administered as either the first- or second-line medication. Multivariate analyses showed that urgency severity and use of mirabegron were independently associated with better persistence (p = .026 and p = .018, respectively). Out of 583 patients who discontinued medication, 344 continued with the visit schedule, and the reinitiation rate of the OAB medication was 19% at a median follow-up of 24 months.

Conclusion: Although the persistence rates for OAB medications improved with the introduction of mirabegron, most patients still discontinued the medication therapy within 1 year. The treatment strategies for patients with mild symptoms and those who are resistant to medication can still be improved. Tailored individualized treatments that avoid excessive reliance on pharmacotherapy would be key to further improve treatment outcomes in OAB patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/nau.24527DOI Listing
November 2020

[Prostate Cancer Diagnosed during Androgen Replacement Therapy for Late-Onset Hypogonadism Treatment: A Case Report].

Hinyokika Kiyo 2018 Dec;64(12):501-504

The Department of Urology, Kyoto City Hospital.

We report a 60-year-old man with prostate cancer diagnosed during androgen replacement therapy (ART) for late onset hypogonadism after surgery for pituitary adenoma. He was refered to the department of urology since prostate specific antigen values were elevated after 6 months of ART. After the diagnosis of prostate cancer, ART was discontinued, and robot-asssited laparoscopic radical prostatectomy with pelvic lymphadenoctomy was performed. Pathological examination revealed Gleason score 4 + 5 prostate adenocarcinoma with seminal vesicle invasion and lymph node metastasis(pT3bN1). He has stayed biochemically and radiologically disease-free 33 months postoperatively.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14989/ActaUrolJap_64_12_501DOI Listing
December 2018

[Initial Clinical Experience of Nivolumab for Metastatic Renal Cell Carcinoma].

Hinyokika Kiyo 2018 10;64(10):383-389

The Department of Urology, Kyoto University Hospital.

Nivolumab was approved as a new agent for advanced renal cell carcinoma (RCC) in Japan on September 2016. Nivolumab is an immune checkpoint inhibitor that activates the cytotoxic immune response and has exerted antitumor effects in a mechanism different from other available molecular targeted agents. Therefore, its response pattern, efficacy and adverse events are different from those of the molecular targeted agents for RCC. Here, we report our initial clinical experience with nivolumab. From December 2016 to September 2017, we applied nivolumab to 7 patients with metastatic RCC. The most common metastatic site was the lungs, followed by lymph nodes, bones and brain. According to the immune-related response criteria, the efficacy was stable disease in 2 patients and progressive disease in 5 patients. In 5 cases with multiple metastases, responses differed with the site of metastasis. The response was best in lung metastasis and worst in brain metastasis. Six cases had minor adverse events. In two cases, we discontinued administration of nivolumab temporarily. The patients recovered completely and we considered nivolumab effective and safe for treatment of metastatic RCC.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14989/ActaUrolJap_64_10_383DOI Listing
October 2018

[Reactive Arthritis during the Second Course of Intravesical BCG Therapy Requiring Administration of Methotrexate : A Case Report].

Hinyokika Kiyo 2017 Aug;63(8):329-332

The Department of Urology, Kyoto City Hospital.

Reactive arthritis, formerly called Reiter's syndrome, is one of the rare complications following intravesical instillation of Bacillus Calmette Guerin (BCG). A 58-year-old man was admitted to our hospital because of fever, hyperemia of conjunctiva, and arthralgia following the second course of intravesical instillation of BCG in the treatment of pT1 and pTis bladder cancer. We diagnosed him with reactive arthritis due to the clinical course. Reactive arthritis is usually well controlled with the discontinuation of instillation and administration of nonsteroidal anti-inflammatory drugs (NSAIDs). However, his symptoms were not improved after administration of NSAIDs, prednisolone, and isoniazid. Following initiation of methotrexate, however, there was remission. He has been free from recurrence of bladder cancer for 20 months.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14989/ActaUrolJap_63_8_329DOI Listing
August 2017

[Port-Site Metastasis of Prostate Cancer after Robot-Assisted Laparoscopic Prostatectomy : A Case Report].

Hinyokika Kiyo 2017 Feb;63(2):87-91

The Department of Urology, Kyoto City Hospital.

The incidence of port-site metastasis in urologic laparoscopic surgery is low, especially in prostate cancer, with 4 reported cases to date. A 65-year-old man was introduced to our hospital presenting with gross hematuria and dysuria. His prostate-specific antigen (PSA) level was 3.1 ng/ml. He was diagnosed with poorly differentiated adenocarcinoma of the prostate, Gleason 9 (5+4), cT3aN0M0 with non-invasive urothelial cancer of bladder (pTaN0M0, low grade). Robot-assisted laparoscopic prostatectomy was performed. Histopathological examination revealed adenocarcinoma, Gleason 9 (5+4), pT3bN0, and surgical margins were positive. Eighteen weeks postoperatively, local recurrence, lymph node metastases, and a port-site metastasis were observed. Androgen deprivation therapy with 4 courses of induction docetaxel chemotherapy achieved a complete response on imaging study, 2 years postoperatively.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14989/ActaUrolJap_63_2_87DOI Listing
February 2017

Seminoma in a Man with Russell-Silver Syndrome Presenting with Testicular Torsion.

Case Rep Urol 2016 29;2016:6017636. Epub 2016 Feb 29.

Department of Urology, Kyoto City Hospital, Kyoto, Japan.

Russell-Silver syndrome (RSS) is a type of primordial dwarfism. Only one case of testicular cancer in RSS has been reported, the pathology of which was nonseminoma. Here, we report a case of seminoma in a 36-year-old man who was diagnosed with RSS at birth. The seminoma was diagnosed when the patient presented with testicular torsion. This is the first report of testicular seminoma in an RSS patient in the literature. We also discussed the correlation between seminoma and RSS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2016/6017636DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4789416PMC
April 2016
-->