タグ: Urologist

浜松での講演会「医原性尿路損傷の修復術」

10月 17th, 2025
昨日は、浜松市のグランドホテル浜松にて開催された

「Frontiers in Clinical Practice and Surgery Seminar」で講演を行いました。

テーマは、医原性尿路損傷の修復術。

この分野は泌尿器科の中でも特に繊細かつ専門性の高い領域であり、

私自身の臨床経験の中でも多くの学びを得てきたテーマです。

座長・稲元輝生教授との再会

座長は、私の大阪医科大学（現：大阪医科薬科大学）時代の同級生でもある

稲元輝生教授（浜松医科大学泌尿器科学講座）。

同級生が教授となり、こうして座長として迎えてくださることに深い感慨を覚えました。

また、基調講演では浜松医大の渡邊恭平先生が

「HoLEPの治療成績向上に向けたアプローチ」という素晴らしいご講演をされ、

術前評価から術後OABの治療介入まで、非常に勉強になりました。

私の講演「医原性尿路損傷の修復術」

私からは、

尿管損傷の原因・注意点・修復術の種類や適応を概説し、

実際の難易度の高い手術症例を供覧しました。
- 他院での膀胱腟瘻再発例
- 水腎症を合併した複雑症例
- 回腸を用いた尿管延長再建など
こうした「教科書ではあまり見ない修復法」に、

「初めて知った」「非常に参考になった」といった感想もいただきました。

懇親会での学びと再会

懇親会では、

ステント交換の間隔や腎瘻管理、ステント逸脱時のトラブル対応など、

多くの先生方が共通の悩みを抱えていることも共有できました。

「知っていること」と「できること」は違いますが、

まずは「知ること」からしか始まらない——

改めてその重要性を実感した一日でした。

懐かしい再会

静岡済生会総合病院の岡本好史院長も駆けつけてくださり、

懐かしい思い出話に花が咲きました。

20年前、私が立ち上げた院内バンド「ドクターチルドレン」が

今も続いていると聞き、胸が熱くなりました。

また、医局長時代に始めた懇親会が今も引き継がれていることも伺い、

人と人とのつながりの大切さを改めて感じました。ワインや点滴試飲の格付け大会で、ぜんぜん当たることができなかったーなんて話が出たり😆

静岡市でご開業されている影山先生、浜松の鶴先生とも再会でき、遅くまで酒盃を交わし楽しい時間はあっという間でした。

多くの懐かしいご縁に恵まれた夜でした。

最後に

稲元教授をはじめ、ご参加いただいた先生方、

そして主催のキッセイ薬品工業の皆さまに心より感謝申し上げます。

これからも、修復術の技術と知識を少しずつ広め、

「合併症を繰り返さない」「腎摘に至らない」治療を目指して、

地道に活動を続けてまいります。
The theme: Urinary Continence and Erectile Function Preservation in Robot-Assisted Radical Prostatectomy

4月 16th, 2025

[Conference Presentation Announcement]

Selected for the Annual Meeting Video Award at the Japanese Urological Association!

On April 17, 2025, Dr. Nakazono will be presenting at the Annual Meeting of the Japanese Urological Association.

His work has been selected for the prestigious Annual Meeting Video Award in the video presentation category!

The theme: Urinary Continence and Erectile Function Preservation in Robot-Assisted Radical Prostatectomy

This presentation showcases a highly skilled surgical video that directly addresses the challenging issue of preserving urinary continence and erectile function during robot-assisted radical prostatectomy. It is accompanied by a detailed and meticulously compiled set of clinical data.

“How many years has he been practicing?!” — International surgeons stunned by his skills

When international doctors viewed Dr. Nakazono’s surgery, they were astonished, asking,

“How many years has he been in practice?!”

His precise and delicate technique, particularly in nerve-sparing procedures, has earned widespread recognition. The video reflects not only his technical mastery but also his deep consideration for each patient’s long-term quality of life.

Aiming for “zero thermal injury” to the neurovascular bundles

The featured video focuses on nerve-sparing techniques that aim to preserve erectile function by avoiding thermal damage.

Dr. Nakazono carefully minimizes the use of electrocautery or sealing devices near the nerves, and this is clearly explained in the presentation.

This approach has the potential to significantly improve postoperative outcomes in terms of both erectile function and urinary continence.

Evolving techniques: From open surgery to laparoscopic and robot-assisted approaches

At Kameda Medical Center, we have pursued this theme for many years.

Our approach has evolved from open surgery to laparoscopic and now to robot-assisted techniques.

Yet, the philosophy of “nerve preservation above all” has remained consistent throughout.

To all urologists — Don’t miss this presentation!

Radical prostatectomy is not only about cancer cure but also about preserving postoperative quality of life.

This presentation will offer one ideal approach to that goal — with compelling surgical footage and robust data.

If you’re attending the conference, we strongly encourage you to watch Dr. Nakazono’s presentation.

Don’t miss it — April 17, 2025 (Thursday)!
– A Rare Case of Postoperative Urinary Retention –

4月 3rd, 2025

Can’t Urinate After Prostate Removal?

Recently, we received a call from a patient who had undergone laparoscopic radical prostatectomy and had already been discharged. He reported being unable to urinate—a rare concern following this type of surgery. Fortunately, a local hospital in Shizuoka promptly placed a urinary catheter. Since then, his condition has improved, and after the catheter was removed yesterday, he has been urinating well with almost no leakage. We were relieved to hear that his recovery is progressing smoothly.

Now, you might be surprised to hear about urinary retention after prostate removal. In fact, it’s extremely uncommon. After radical prostatectomy, the more typical issue is urinary incontinence, not difficulty passing urine. Cases of immediate postoperative urinary retention are rare and only occasionally reported in the medical literature.

So, why does this happen?

In rare cases, urinary retention shortly after surgery may be caused by urethral edema (swelling), temporary narrowing at the bladder-urethral anastomosis, or a small hematoma (blood collection). In such situations, forcing urination is not advisable. Instead, the safest and most effective approach is to reinsert a urinary catheter and wait for the inflammation and swelling to subside naturally.

According to the literature, conservative management with catheter reinsertion is the standard of care for such cases (Tewari et al., 2007; Campbell-Walsh Urology, 11th edition).

It’s also worth noting that postoperative symptoms such as urinary leakage or difficulty urinating are typically temporary and improve over time. In this case, the patient regained stable urination early on and had minimal leakage, making this a particularly favorable outcome.

This experience reminded us once again that successful surgery is not just about removing disease—it’s also about supporting patients through recovery and maintaining their quality of life (QOL) by addressing even the smallest postoperative issues with care and attention.

Kameda Medical Center

タグ: Urologist

浜松での講演会「医原性尿路損傷の修復術」

座長・稲元輝生教授との再会

私の講演「医原性尿路損傷の修復術」

懇親会での学びと再会

懐かしい再会

最後に

The theme: Urinary Continence and Erectile Function Preservation in Robot-Assisted Radical Prostatectomy

– A Rare Case of Postoperative Urinary Retention –