Evaluation of prostate-bladder angle measured by MRI in the diagnosis of benign prostate obstruction / 中华泌尿外科杂志

Objective To investigate the value of prostate-bladder angle (PBA) measured by MRI in the diagnosis of benign prostate obstruction (BPO). Methods A retrospective analysis was carried out on 87 benign prostatic hyperplasia (BPH) patients referred for lower urinary tract symptoms (LUTS) between March 2009 and November 2009. PBA was measured by MRI and urodynamic parameter Qmax was measured as well. With the diagnostic criteria of BPO as Qmax＜10 ml/s, the patients were divided into two groups: obstruction group and non-obstruction group. PBA was compared between these two groups. The sensitivity and the specificity of PBA in diagnosing BPO were also analyzed. Results The age range of the patients was 57-90 years with a median age 73 years; Qmax was 2.325.4 ml/s with median Qmax 7.9 ml/s; PBA was 4°-52° with median PBA 27°. There were 25 patients in the non-obstruction group with PBA between 4°- 21°(13°); in the obstruction group,there were 62 patients with PBA between 15°- 52°(34°). PBA was found statistically different between the obstruction and non-obstruction group (P＜0.01). With the cutoff at PBA≥20°for the diagnosis of BPO, the sensitivity and specificity of the diagnosis were 90. 3 % (56/62)and 96.0% (24/25), respectively. Conclusion PBA measured by MRI is valuable and can be used as a new non-invasive parameter in the diagnosis of BPO.

Photoselective vaporization combined with bipolar transurethral resection for the treatment of large prostate adenoma in high-risk patients

To evaluate the safety and effectiveness of the combined photoselective vaporization of the prostate [PVP] and bipolar transurethral resection of the prostate [TURP] in high-risk symptomatic patients with large prostates. Between January 2007 and January 2010, a prospective study was performed in Shandong Provincial Hospital, Shandong University, Jinan, Shandong Province, China. One hundred and one patients presenting with various kinds of systematic diseases, and with an American Society of anesthesiologists score of 3 or greater underwent PVP plus bipolar TURP for severe lower urinary tract symptoms due to benign prostatic hyperplasia with prostatic volume greater than 80 ml. The international Prostate Symptom Score [IPSS] and quality-of-life questionnaire [IPPS-QoL], maximum flow rates [Qmax], postvoid urine residues [PVR], and MRI prostatic volumes were recorded. Perioperative data, functional outcome, and complications were evaluated. Patients were reassessed at 3, 6, and 12 months. The mean operation time was 68.5 +/- 23.9 minutes. The mean pre-and post-operative prostate volumes were 102.2 +/- 33.1 ml and 40.4 +/- 15.6 ml. No severe complications were observed. Significant differences in IPSS,Qmax, and PVR values were recorded within the follow-up period. The results of our study show that PVP plus bipolar TURP have an excellent efficiency and low morbidity in high-risk patients with large prostates

Efficacy and safety of Qianliejiedu capsule in the treatment of chronic prostatitis / 中华泌尿外科杂志

Objective To evaluate the efficacy and safety of Qianliejiedu capsule in the treatment of chronic prostatitis. Methods A multi-central,randomized,double-blind clinical trial was conducted.A total of 209 patients diagnosed as chronic prostatitis were randomly divided into two groups:the trial group were treated with Qianliejiedu Capsule,5 pills were taken orally for each time,twice a day;the control group were given Qianlietai Pill,5 pills were taken orally for each time and 3 times a day.All patients of the tWO groups were treated for 4 weeks,The efficacy was evaluated by urethra irritating,painful or discomfortable symptoms,and the WBC count in EPS after the treatment.Clinical criteria divided into 4 types,cure:symptom score compared with a decrease≥90%;markedly effective:symptom score compared with a decrease of 60%to 89%;effective:symptom score comparedwith a decrease of 30%to 59%;invalid:symptom score compared with a decrease of＜30%.Results There were 102 patients in the treatment group,11 got cured,49 cases were remarkably effectire,28 eases were effective,14 eases were ineffective and the total effective rate was 86.2%(88/102).There were 98 patients in the treatment group,4 got cured,38 cases were remarkably effective,35 cases were effective,21 cases were ineffective,and the total effective rate was 78.6%(77/98).The trial group and the control group could improve the symptoms such as frequent micturition,the remaining urine,the lower abdomen ache,the urethra stabbing pain,the unwell perineum,the waist and sacrum ache,the moist scrotum,and the testicle ache.The vanishing rate of the trial group was 87.6%,82.1%,74.5%,84.1%,93.7%,80.3%,82.5%,82.3%;and the control group was 74.7%,73.0%,71.0%,74.2%,71.4%,67.9%,72.3%,76.2%.The vanishing rates of frequent micturition symptom of the 2 groups were significantly different(P=0.032).The result of WBC of the trial group before treatment was as follows:WBC 10-19 28 cases,WBC 20-29 33 cases,WBC≥30 41 cases.The result of WBC of the trial group after treatment was as follows:WBC＜10 45cases,WBC 10-19 34 cases,WBC 20-29 20 cases,WBC≥30 3 cases.The result of WBC of the control group before treatment was as follows:WBC 10-19 26 cases,WBC 20-29 35 cases,WBC:≥30 37 cases.The result of WBC of the control group after treatment was as follows:WBC＜10 42 caaes,WBC 10-19 33 cases,WBC 20-29 15 cases,WBC≥30 8 cases.There were significant differences between the before and after treatment results(P＜0.05).Two cases in the trial group and 3 cases in the control group had mild adverse reactions such as nausea,epigastric discomfort,and watery stool. Conclusion Qianliejiedu capsule is effective and safe for the treatment of chronic prostatitis.

Psychological hindrance and its treatment in chronic prostatitis patients / 中华男科学杂志

<p><b>OBJECTIVE</b>To improve the knowledge of psychological hindrance in chronic prostatitis (CP) patients and study the treatment strategy of it.</p><p><b>METHODS</b>Two hundred and fifty-eight CP patients with psychological hindrance, aged 16 to 65 years (average 33 years), were divided into the psychotherapy group (148 cases) and the control (110 cases). The control were only treated with antibiotics and Chinese traditional medicines, while the psychotherapy group were treated with cognitive therapy besides the above medicines.</p><p><b>RESULTS</b>The symptoms in the psychotherapy group were improved obviously compared with those in the control. Both the cure rate (P < 0.05) and the effective rate (P < 0.001) of the psychotherapy group were higher than those of the control.</p><p><b>CONCLUSION</b>Psychotherapy is an effective way to treat CP patient with psychological hindrance.</p>

A modified pyelo-ureteroplasty for congenital hydronephrosis due to long segment of ureter stenosis / 中华泌尿外科杂志

Objective To evaluate a modified pyelo-u re teroplasty in treating long segment of ureteropelvic junction (UPJ) stenosis. Methods 26 cases were treated with the designed pyelo-ur eteroplasty,on which the dilated pelvic was incised vertically and the pelvic fl ap was turned down to form a new infundibulas tube with running suture and was a nastomosed to the ureter stem,the long stenosis segment being cut off. Results The symptoms vanished in the follow-up period of 1～3 ye ars.It was showed by B-ultrasonography,IVU and RP (retrograde pyelography)that the anastomosis site in all the cases was smooth.3～12 months after operation,G FR(glomerulus filtration rate) was found to be improved markedly,and 20 minutes excretive rate in the operated kidneys was all above 50%. Conclusio ns The troublesome hydronephrosis due to complicated long stenosis o f UPJ and upper ureter can be effectively treated by the modified pyelo-uretero plasty.