Efficacy of laparoscopic nephron-sparing surgery without renal wound suturing / 中华泌尿外科杂志

Objective To evaluate the feasibility and clinical efficacy of laparoscopic nephron-sparing surgery without renal wound suturing.Methods From December 2012 to February 2014,9 patients (4 male,5 female) with renal tumor underwent laparoscopic nephron-sparing surgery without suturing in our hospital.The mean age in those patients was 56 years (range 42-72 years).The mass size ranged from 1.1to 3.8 cm (mean 2.4 cm).The location of tumor included 2 in left kidney,7 in right kidney.Meanwhile,6 tumors were found in the middle part of kidney,2 tumors were demonstrated in the lower part of kidney,and 1 tumor located in the upper part of kidney.The imaging examination confirmed that all tumors protruded the renal surface and infiltrated into the renal parenchyma about 0.1-1.2 cm,which could be defined as the peripheral renal tumor without the invasion of collective system.The retroperitoneal approach was used in all patients with 3 trocars.During the operation,the renal artery was exposed and fats surrounding or on the surface of the tumor were resected.The renal artery was occluded.Tumor excision was then performed using scissors.An incision was made at the point 0.5 cm away from the margin of the tumor,extending deeply to completely cut the tumor.Meanwhile,bleeding was controlled with bipolar diathermy.Then,the clamping of the renal artery was removed and the retroperitoneal pressure was reduced in order to check the site of bleeding.If the bleeding occurred severely,the kidney wound was sutured with 2-0 absorbable sutures.Otherwise,the coagulative glue was sprayed on the wound surface.Results In all the patients,the procedures were done without conversion to open surgeries.The renal wound suturing appeared in one case because the tumor infiltrated into the deep of the kidney and the bleeding could not be completely controlled by bipolar diathermy.Eight of 9 cases were successfully performed without suturing.The mean time of renal artery occlusion was 8 min (range 3-18 min).In our patients,the mean operation time was 120 min (90-180 min),and the mean blood loss was 60 ml (10-200 ml).None of the patients received blood transfusion during the surgery.The mean postoperative hospital stay was 7 days (5-9 days).No complications,such as urine leakage,bleeding occurred after the operation.All the patients were followed up with no recurrence of tumor.Conclusions Laparoscopic nephron-sparing surgery without renal wound suturing is feasible and safe for patients with the small and the depth of infiltration less than 0.5 cm tumor in the kidney.

Safety and efficacy of percutaneous nephrolithotomy through upper pole access / 中华泌尿外科杂志

Objective To evaluate the efficacy and safety of percutaneous nephrolithotomy (PCNL)guided by ultrasonography through upper pole access. Methods From October 2007 to October 2009, 42 patients with upper urinary tract calculi underwent PCNL through upper pole access.Among these cases, there were 10 cases of staghorn calculi, 22 cases of renal pelvis calculi, 7 cases of the upper calyx calculi, 3 cases of the lower calyx calculi, 4 cases combined with ureter calculi and 2 cases combined with ureteropelvic junction obstruction. The stone measured from 2.0 to 6.5 cm (average: 3.4 cm) in length. Working tunnels (F16-F26) were established through the 10th or llth intercostals. Pneumatic or holmium laser lithotripsy was used to disintegrate and remove stones by nephroscopy or ureteroscopy. Clinical data including operation time, complications and stone free rate were analyzed retrospectively. Results All the operations were completed in one session, single tract was used in 36 cases(85.7%), double tracts were used in the other 6 cases(14.3%). The stonefree rate after one session was 88.1% (37/42), 3 cases(7.1%) received a second-session PCNL, 2 cases (4.8%)underwent ESWL after operation. The mean operative time was 65 min(30- 140 min).Postoperative surgery-related infection rate was 9. 5% (4/42). One patient (2. 4%)required blood transfusion. Perforation of the pelvis occurred in 1 patient(2.4 %). No pleural or important organ injury occurred. Conclusion The upper pole access for PCNL can be convenient to remove stones,this method is a highly efficient and safe technique.

Treatment of upper urinary tract calculi with flexible cystoscope conducted holmium laser lithotripsy via percutaneous nephrostomy / 中华泌尿外科杂志

Objective To assess the efficacy and safety of flexible cystoscope conducted holmium laser lithotripsy via percutaneous nephrostomy in the treatment of upper urinary tract calculi.Methods The flexible cystoscope conducted holmium laser lithotripsy via percutaneous nephrostomy was performed on 26 patients from Jul 2005 to Jan 2007. Among these patients, 8 had bilateral renal calculi and ureteral calculi, 5 had multiple renal calculi, 4 had renal calyx calculi and 9 had ureteral calculi. The average diameter of the calculus was 2.2 cm (range from 1.0-3.2 cm). Four patients had mild hydronephrosis, others had moderate or severe hydronephrosis. Insufficient renal function was noted in 13 cases. The procedure was performed via a single tract through the middle calyx under the ultrasonic guidance in all cases.Results Twenty-two cases achieved stone free at primary procedure, secondary procedure was needed in 4 cases. A 18 F tract was used in 18 cases and 24 F tract was used in the left 8 cases. The average operation time was 72 min, stone-free rate was 96.2%(25/26),and there was no blood transfusion. One patient had fever after the procedure and recovered 2 days after the administration of antibiotics. No other complication was recorded. In an average 11 month follow-up in 22 patients, hydronephrosis reduction was significant observed by ultrasound scan. No calculus relapse was found.Conclusions Flexible cystoscope conducted holmium laser lithotripsy via percutaneous nephrostomy is an effective and minimally invasive technique for the treatment of upper urinary tract calculus. It has the advantages in dealing with the calyx and ureteral calculus located in the proximal or middle segment as well.

How chronic prostatitis affects plasminogen activator system / 中华男科学杂志

<p><b>OBJECTIVE</b>To elucidate how chronic prostatitis affects the expression and activity of the plasminogen activator (PA) system and relates to male infertility.</p><p><b>METHODS</b>Twenty-three normal fertile males and 80 chronic prostatitis patients (40 fertile and 40 infertile) were included in this research. SDS polyacrylamide gel electrophoresis and fibrin overlay method were used to estimate the total PA, and tissue PA (tPA), urokinase type PA (uPA) in semen.</p><p><b>RESULTS</b>Total PA, tPA and uPA highly expressed in normal males, but decreased in the semen of the chronic prostatitis patients of both the fertile and infertile groups. However, there was no significant difference in total PA between the fertile and infertile patients.</p><p><b>CONCLUSION</b>Chronic prostatitis reduces the secretory function and PA synthesis and secretion of the prostate, but the decrease of PA alone does not cause infertility. PA may be one of the tools for estimating the function of the prostate.</p>

Efficacy and safety of oral vardenafil in the treatment of erectile dysfunction / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of vardenafil on men with erectile dysfunction (ED) of various etiologies.</p><p><b>METHODS</b>A total of 88 men with mild to severe erectile dysfunction were enrolled in the randomized, double-blind, placebo-controlled, fixed-dose trial of 12 weeks of treatment with either placebo or 5, 10 and 20 mg of vardenafil.</p><p><b>RESULTS</b>This study indicated that vardenafil dosages of 5, 10 and 20 mg were significantly superior to placebo for the treatment of ED, on the basis of the primary study endpoints of the EF domain score of the IIEF, diary-recorded success rates for penetration and maintenance of erection during the intercourse and the GAQ. Vardenafil was well tolerated. The incidence of adverse events was higher for vardenafil than for placebo.</p><p><b>CONCLUSION</b>Oral vardenafil therapy has a high efficacy and a low incidence of adverse events for ED patients with mixed etiologies.</p>

Long-term effects of transurethral laser ablation of prostate for benign prostatic hyperplasia / 中国微创外科杂志

Objective To evaluate the long-term effectiveness of transurethral laser ablation of prostate in patients with benign prostatic hyperplasia (BPH). Methods We retrospectively reviewed 72 patients with BPH treated by transurethral laser ablation from November 1993 to September 1999. Follow-up observations ranged (3～9) years, mean 7 0 year. Results Pre- and post-operative International Prostate Symptom Score (IPSS), Quality of Life score (QoL), MFR, estimating weight of prostate and Post-Void Residual Urine (PVR) were (27 5?2 6) and (20 7?4 2) ( t =11 68, P 0 05), (71 5?46 2) ml and (42 3?28 6) ml ( t =4 56, P

Transurethral laser ablation of the prostate in 70 patients with benign prostatic hypertrophy / 中国微创外科杂志

Ojective To evaluate the therapeutic efficiency of transurethral laser ablation applied in benign prostatic hyperplasia (BPH) Methods 70 cases of benign prostatic hypertplasia were treated with transurethral laser ablation (Nd:YAG) from 1993 to 1996. The patients were followed up for 3～32 months with an average of 18.4 moths Results Preoperative and postoperative I-PSS were 27.1?2.4 and 5 7?3.5 (P

Influence of Gujing ( Consolidating Menstruation) Granules on Relationship Between Exfoliative Vaginal and Tongue Cells in Massive and Dripping Uterine Hemorrhage / 中医杂志

Observation was made on the changes of exfoliative tongue cells before and after treatment in 49 cases of massive and dribbling ulterine bleeding. Meanwhile, the mature index of vaginal exfoliative cells was also e-valuated. Results showed that all the exfoliative cells from both were regulated by female sex hormQne with synchronous changing rules.