著者

河 源 谷口 久哲 木下 秀文 松田 公志

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.55, no.2, pp.87-92, 2009-02

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A specialized clinic for middle-aged and elderly hypogonadal men was established in our institution five years ago. A retrospective study of the 511 patients who attended our clinic during this period was conducted and the issues involved in treating these patients were identified. The patients' age distribution, symptoms, serum testosterone values, treatment, and course were examined. The patients' mean age was 54.0 years (range, 35 to 74 years); approximately half of the patients were in their fifties. Most patients complained of decline in libido, general fatigue, and erectile dysfunction. The patients' mean serum free testosterone was 9.28 pg/ml; 40.3% of patients had a serum free testosterone value of less than 8.5 pg/ml, which is the threshold value for the initiation of androgen replacement therapy (ART) in Japan. ART was given to 220 (43.1%) patients, and it was considered effective in 100. It appears that male climacteric disorder and late-onset hypogonadism have become commonly recognized in Japan. There will be an increasing need for specialized clinics for such men in the future.

著者

吉田 健志 木下 秀文 谷口 久哲 地崎 竜介 西田 晃久 川喜多 繁誠 日浦 義仁 大口 尚基 河 源 六車 光英 松田 公志

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.53, no.5, pp.323-325, 2007-05

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29歳男。陰茎腫脹と勃起が続くことに気付き緊急入院した。陰茎は硬く, 勃起状態で自発痛を認めた。持続勃起症の診断で陰茎海綿体内血液ガス分析を施行した。血液ガス所見より静脈系の流出障害と判断し19G翼状針で陰茎穿刺を行い, ヘパリン生食で凝血塊洗浄, α作動薬海綿体内注入を繰り返し経過観察した。勃起状態は軽度改善したが疼痛の増悪を認め, Hb低下, Ht低下から輸血の必要を説明したが宗教的理由で拒否された。白血病に関して血液主要な以下で骨髄穿刺を施行し慢性骨髄性白血病と診断された。ドロキシカルバミド内服を開始し, メシル酸イマチニブへ変更し骨髄穿刺で完全緩解した。再発は認めず経過している。A-29-year-old man visited our hospital with the complaint of a continuous rigid and painful erection which began two days before. We diagnosed ischemic type of priapism by aspiration of penile cavernosal blood analysis; an acidotic and hypoxic blood. The leukocyte count was 263,000/p, and chronic myelogenous leukomia (CML) was suspected. After the failure of conservative treatment, glans-cavernosal shunt (Winter procedure) was performed. The postoperative course was uneventful and the intercourse was possible at five months after the operation. CML was treated by administration of imatinib mesylate and no evidence of recurrence was observed.