The urology department primarily treats conditions related to the renal system (bladder, kidneys and ureter) as well as the male reproductive system (testicles, prostate and penis). Typical conditions we see include cancer, excretory problems (difficulty urinating, frequent urination, leakage, etc.), urinary tract or kidney stones, and infections and inflammation. We are able to treat all forms of cancer that affect these parts of the body. Our treatment strategies for cancer take into consideration the status of the disease and the desires of the patient in determining the best course going forward.
Prostate cancer is by far the most common form of cancer we see in the urology department, and its frequency is growing rapidly in Japan. Now, thanks to simple blood tests that scan for the tumor marker called PSA (prostate-specific antigen), even early prostate cancers too small to be detected by physical examination can be identified. We strongly advise men over 50 to be tested for PSA. In early cancers, for men who are up to their early 70s and otherwise in good health, we typically remove the entire prostate. For older men, those with more advanced cancers or other complications affecting their health, chemotherapy and radiation are generally recommended. For types of radiation therapy we do not handle, such as brachytherapy, proton beam therapy or heavy particle therapy, we can refer patients to institutions which perform these treatments.
Bladder cancer usually manifests itself as blood in the urine without any pain or sensation of residual urine in the bladder. If you see blood in your urine, or it is revealed during a test, we strongly recommend patients to have a more detailed exam to check for the possibility of bladder cancer. Many bladder cancer patients can be treated endoscopically, but some require a traditional surgical procedure. We also treat the disease with chemotherapy, intravesical BCG techniques, full-body chemotherapy and radiation.
In almost every case, cancer of the kidney is treated surgically. In order to preserve kidney function, we generally remove only the tumor and affected tissue near it, and attempt to leave as much of the organ in place as possible. For early-state cancers, we can also perform minimally-invasive laparoscopic procedures as well. In cases where the cancer has spread, we molecular-targeted therapies and interferon treatments as well.
Kidney and Ureter Stones
Recently we’ve started performing many procedures to treat ureter stones with a flexible ureteroscope and laser. In addition, we also perform more traditional ESWL (extracorporeal shock wave lithotripsy) procedures which use focused sound waves to break up stones from outside the body to make them easier to pass. ESWL is generally performed as an inpatient procedure, but healthy individuals with no complications can often be treated outpatient.
Our specialists frequently treat patients with difficulty urinating, frequent urination, leakage, or partial urinary incontinence (inability to hold one’s urine). Many older patients don’t seek treatment, blaming such conditions on their age, but with proper medication, many people see remarkable improvement. We encourage patients to consult their favorite doctor, and if necessary, have them provide you with a referral for outpatient treatment here.
Renal System Infections
We regularly treat cases of pyelonephritis (kidney infections), prostatitis (prostate infections) and epididymitis (testicle infections) in our department.
Ureteric Stent Placement
For patients whose ureters have difficulty passing urine due to stones or the effects of cancer, an effective treatment is place a stent (a very thin tube) inside the body. We perform over 200 stent placements or replacements each year. While these procedures have been performed as an inpatient procedure involving anesthesia in the past, now most can be performed on an outpatient basis.
Regarding Treatment Options
With the advance of technology, the options available for treating many renal conditions have increased dramatically. Even for the same condition, completely differing treatments may be called for depending on the patient’s condition, age, desires, living situation and other medical concerns. We welcome patients’ questions and actively recommend other facilities for second opinions, etc. Please feel free to consult with us about your concerns.
A Message to Our Patients
The number of patients to our Urology Department has increased significantly, and sometimes you will need to wait for a lengthy period of time prior to your consultation. We apologize for this inconvenience. Our staff is doing the best it can to shorten waiting times, but we treat patients with referrals, seriously ill patients, and patients with appointments on a priority basis. In addition, in order to ensure the quality of the medical care we provide, we treat each patient carefully and that can require others to wait. For those reasons, we strongly recommend that patients seeking their first consultation with us get a referral from a urology clinic before making an appointment with us.