pressure indicated veno-occlusive dysfunction. RESULTS• Forty-five of the 55 patients were diagnosed with corporal veno-occlusive dysfunction. 3D-CT cavernosography revealed drainage veins in all 45 cases, including cavernous veins, dorsal veins, crural veins and other emissary veins.• Compared with 3D-CT cavernosography, observing cavernous veins and the proximal part of the deep dorsal veins using MIP imaging was especially difficult because the origins of the penile veins are often behind the pelvic bone or cavernous body.• Of the patients who seemingly had leakage via the deep dorsal vein, 80.6% did not in fact have leakage via this vein, but had other leakages. The image resolution of 3D-CT cavernosography was significantly higher than that of MIP. CONCLUSION• 3D-CT cavernosography can provide highresolution images of venous drainage from any angle. We conclude that the images obtained by 3D-CT cavernosography are very helpful for both the diagnosis of corporal veno-occlusive dysfunction and the anatomical study of the human penile venous system. What's known on the subject? and What does the study add? Venous ligation surgery has been conducted as a symptomatic treatment, but the effective rate of this surgery was insufficient. We thought that one of the reasons for the low effective rate of this surgery was insufficient for the diagnostic modality. We confirmed that 3D cavernosography was, in comparison with conventional cavernosography, higher in diagnosis precision. OBJECTIVE• To examine the feasibility of threedimensional (3D) CT cavernosography in the diagnosis of corporal veno-occlusive dysfunction. PATIENTS AND METHODS• The subjects were 55 patients who had failed to respond to phosphodiesterase type 5 inhibitors. We performed pharmacodynamic infusion cavernosometry and cavernosography, using 60 mg papaverine hydrochloride.• Cavernosography was performed at 90 mmHg intracavernous pressure, using a multi-slice CT scan system. The 3D images were reconstructed using AQUARIUS NET STATION , ver.2 computer software.• For comparison with conventional cavernosography, maximum intensity projection (MIP) images were used. A flow of 20 mL/min or being more capable of maintaining 90 mmHg of intracavernous

• In visualizing the artery, conventional imaging techniques depend on blood flow, whereas using virtual cavernoscopy an artery can be visualized independently of blood flow. Virtual cavernoscopy is unique in this regard and we therefore believe that this new imaging technology will contribute to better ED practice.

Objectives : To evaluate whether virtual partial nephrectomy images could help surgeons identify vascular and collecting system around tumors during actual surgery. Materials & methods : We retrospectively analyzed 36 patients who underwent robot-assisted partial nephrectomy (RAPN) between 2016 and 2017. Virtual partial nephrectomy images were created from preoperative CT images using computer software, and then analyzed. For analysis, blood vessels and collecting system portions within a 5-mm-thick safety margin around the tumor were examined. During analysis, we predicted whether targeted vasculature around the tumor would require clipping or suturing during surgery, and also whether the collecting system would require opening during resection. Surgical outcomes for virtual partial nephrectomy analyses and actual RAPNs were compared and analyzed for sensitivity and specificity. Results : In 36 cases, 119 arteries and 100 veins were targeted on virtual partial nephrectomy images. Arterial suturing or clipping for hemostasis showed a sensitivity and specificity of 83.3% and 84.5%, respectively. For veins, the sensitivity and specificity were 39.1% and 92.2%, respectively. Collecting system opening prediction sensitivity was 85.7%, and specificity was 65.2%. Conclusion : Virtual partial nephrectomy imaging is useful for RAPN planning, particularly regarding arteries and the collecting system. It is hoped that techniques for visualizing veins will improve.

In the present report, we describe a patient with microcystic variant of urothelial carcinoma in urinary bladder. In March 2016, a 71-year-old man presented with bladder tumors found incidentally by ultrasonography. Cystoscopy and contrast-enhanced computed tomography (CT) revealed multiple invasive tumor of posterior wall, with a maximum diameter of 33 mm. Transurethral resection (TUR) of bladder tumors was performed. Pathological diagnosis was urothelial carcinoma, high grade, T2 or more. Invasive urothelial carcinoma was diagnosed and laparoscopic radical cystectomy with orthotopic neobladder was performed accordingly in April 2016. Pathological findings indicated a diagnosis of microcystic variant of urothelial carcinoma. At present, six months after surgery, the patient remains free of recurrence and metastasis. Here we review the characteristics of 4 microcystic variant of urothelial carcinoma cases reported in Japan.