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Kyoda Y., Wanifuchi A., Muranaka I., Okada M., Kenuka T., Maehana T., Abe J., Shibamori K., Kato S., Yamana A., Horita H., Nakamura M., Ichihara K., Hashimoto K., Kobayashi K., Tanaka T., Masumori N.
Urology 210 30 - 34 2026年4月
掲載種別：研究論文（学術雑誌） 出版者・発行元：Urology
Objective To evaluate lifestyle modification achieved through a structured self-check sheet-based behavioral therapy program and its association with changes in nighttime frequency in patients with nocturia. Methods We analyzed 218 patients from 14 institutions aged ≥40 years who completed a 4-week behavioral therapy program. Eight lifestyle habits were assessed before the intervention, and behavioral change was defined as executing a behavioral item on ≥14 of 28 days. Outcomes included (1) the association between the number of behavioral items successfully adopted and the change in nighttime frequency, (2) the association between adoption of each behavioral item and (3) changes in estimated salt intake. Results Greater reductions in nighttime frequency were associated with a higher number of behavioral items adopted, with the greatest reduction observed in those who adopted four to five items (–1.1 episodes), and showed significant differences among groups ( P = .03). In multivariable regression, positive changes in nighttime frequency (indicating greater improvement) were independently associated with regular mealtimes (β = 0.739, P = .030) and evening exercise (β = 0.328, P = .028). Salt intake significantly decreased only in patients who newly adopted salt-reduction behavior (9.4 → 8.6 g/day, P = .01). Conclusion Behavioral therapy using a simple, time-efficient self-check sheet is associated with improvement in nighttime frequency with a minimal burden on patients. Greater adherence is associated with greater improvement, and specific behaviors, particularly regular mealtimes and evening exercise, show independent associations with symptom improvement.
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Abe J., Murashima T., Kojima S., Ueno T., Takei A., Nakai N., Akioka T., Kamoto T., Sawada A.
International Journal of Clinical Oncology 2026年
担当区分：筆頭著者 掲載種別：研究論文（学術雑誌） 出版者・発行元：International Journal of Clinical Oncology
Advances in immuno-oncology (IO)-based systemic therapies have improved treatment outcomes for patients with metastatic renal cell carcinoma (mRCC). However, long-term survival of these patients remains challenging, highlighting the need to reassess the role of local and metastasis-directed treatments. Cytoreductive nephrectomy (CN) has traditionally been a part of the therapeutic armamentarium for mRCC, and evidence from the targeted therapy era—most notably the CARMENA and SURTIME trials—indicates that deferred CN after initial systemic therapy may benefit carefully selected patients. In the IO era, prospective evidence regarding CN is lacking, although ongoing trials, such as NORDIC-SUN and PROBE, are expected to refine patient selection and optimal timing. Real-world analysis reveals a significant decline in conducting CN since 2018. However, CN remains associated with improved overall survival of patients who received several IO-based first-line regimens after adjustment for baseline characteristics. Metastasis-directed treatments, including metastasectomy and local interventions for bone metastases, continue to exhibit potential survival benefits and may maintain functional status when complete resection of lesions is achievable. Considering the absence of definitive prospective data applicable to routine clinical practice, individualized treatment strategies should consider CN and local therapies alongside systemic treatment response, tumor biology, and patient-specific prognostic factors.
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Abe J., Muranaka T., Kunishima Y.
Urology Case Reports 62 2025年9月
掲載種別：研究論文（学術雑誌） 出版者・発行元：Urology Case Reports
We report the case of an 85-year-old man diagnosed with metastatic prostate cancer three years earlier. While on combined androgen blockade, he developed hematuria, hematochezia, and fatigue. These symptoms were attributed to local progression of prostate cancer and syndrome of inappropriate antidiuretic hormone secretion (SIADH). Water restriction, palliative radiation, and tolvaptan alleviated the symptoms. Four months later, he experienced appetite loss and fatigue due to hypercalcemia, ultimately leading to a diagnosis of humoral hypercalcemia of malignancy (HHM).
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Abe J., Kyoda Y., Haga K., Sasao T., Nishiyama D., Nofuji S., Ichihara K., Matsuda Y., Toyota T., Ueki Y., Konta S., Nakayama S., Shibuya J., Kobayashi G., Maehana T., Nakajima Y., Masumori N.
International Journal of Urology 32 ( 7 ) 804 - 810 2025年7月
掲載種別：研究論文（学術雑誌） 出版者・発行元：International Journal of Urology
Objective: The Japanese guidelines for male lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) recommend the water vapor energy therapy (WAVE) procedure only for patients in whom conventional BPH surgery is unsuitable due to advanced age or comorbidities. This study aims to evaluate the efficacy and safety of the WAVE procedure using the Rezum system in Japan. Methods: This multicenter retrospective study included patients who underwent the WAVE procedure between August 2022 and December 2023. A total of 311 patients from 13 institutions were registered. The number of medications for LUTS was determined before surgery and 6 months after surgery. Additionally, voiding function and perioperative complications were analyzed. Results: Of the 311 patients, 291 were eligible for analysis. The mean number of LUTS medications significantly decreased from 1.4 to 0.6 (p < 0.001). The mean maximum urinary flow rate significantly improved from 9.8 mL/s preoperatively to 12.2 mL/s at 6 months postoperatively (p < 0.001). The mean post-void residual volume also significantly decreased from 124 to 78 mL (p < 0.001). Furthermore, the mean total International Prostate Symptom Score significantly improved from 17.8 to 8.9 (p < 0.001). Complications classified as Clavien–Dindo Grade III or higher occurred in four cases (1.2%). Conclusion: This large-scale, multicenter study demonstrates that the WAVE procedure improves LUTS, reduces the number of LUTS medications, and is both effective and safe for elderly patients with multiple comorbidities in Japan.
DOI： 10.1111/iju.70052
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Current Landscape of Urological Surgical Training: A Needs Assessment Survey in Japan 査読あり
Abe N., Abe T., Hori K., Abe J., Okada K., Takahashi K., Harada S., Kon M., Furumido J., Hashimoto K., Murai S., Kikuchi H., Masumori N., Kakizaki H., Shinohara N.
International Journal of Urology 32 ( 7 ) 811 - 820 2025年7月
掲載種別：研究論文（学術雑誌） 出版者・発行元：International Journal of Urology
Objectives: To clarify the present state and issues to be resolved in urological surgical training in Japan. Methods: A web-based needs assessment survey was conducted, inviting urologists belonging to three university hospitals and 34 affiliated hospitals in Hokkaido, Japan. Physicians with less than 15 years of experience were defined as trainees, and those with more than 15 years were defined as instructors. The survey investigated the current surgical education, training environments, and issues to be resolved. Results: The response rate was 98.2% (169/172). Overall, the current surgical training in our cohort largely depended on “on-the-job” training. Regarding the effectiveness of surgical education materials, teaching in the operating room during procedures gained the highest scores for both trainees and instructors, followed by review of operative movies. Regarding the dedicated time for studying/training/teaching apart from routine clinical duties, 87.1% (74/85) of trainees and 96.4% (81/84) of instructors did not have any time. A total of 58.8% (50/85) of trainees considered open surgery to be undertrained, while only 8.3% (7/84) of instructors considered that open surgery was difficult to teach in their hospitals. Among instructors, 54.8% (46/84) acknowledged limitations regarding the current training program. Conclusions: The current surgical training in urology in Hokkaido, Japan, largely depends on “on-the-job” training methods. About two-thirds of trainees consider open surgery to be undertrained. Our observations could be utilized to update the training curriculum in Japan.
DOI： 10.1111/iju.70055