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A 60-year-old man visited our hospital with complaints of micturition pain and interruption of urinary stream. X-ray examinations were performed, showing no bladder and urethral stone. However, KUB revealed bilateral multiple renal stones. Excretory urography showed a horseshoe kidney and a concentration of the contrast medium in the ectatic tubules at the pyramidal apices. Calculi were also located in these ectatic tubules. Thus, we considered that this was a very rare case of medullary sponge disease associated with horseshoe kidney. So far there has been no case report of medullary sponge disease with horseshoe kidney in our country.

A chemosensitivity test was carried out on superficial bladder cancer using the dye exclusion assay for the purpose of screening chemosensitive drugs for prophylactic intravesical chemotherapy. Bladder cancer cells of each patients were incubated, in vitro, in the presence of adriamycin, (2"R)-4'-0-tetrahydropyranyladriamycin, mitomycin C, pepleomycin and 4'-epi-adriamycin (500 micrograms/ml) at 5%, CO2, 37 degrees C for 2 hours. The cytotoxic effect of the drugs was evaluated by the ratio of stained cells by trypan-blue. The most effective drug was instilled postoperatively into the bladder 3 times for the first week, and every 2 weeks during the following 14 weeks. In 18 patients followed more than 4 months the prophylactic effect was evaluated. Fifteen of the 18 patients completed the protocol, but the remaining 3 patients failed to complete to the instillation because of severe irritability of the bladder. Tumor recurrence was demonstrated in two patients. Non-recurrence rates of tumors at 12 and 24 months were 93.8% and 82.0%, respectively. These results suggested that this rapid and handy assay was useful for the purpose of screening chemosensitive drugs for the intravesical chemotherapy.

Periprostatic nerve block does not appear to affect perioperative outcomes after open RP.