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Objective To evaluate the efficacy and safety of intradetrusor injection of botulinum toxin type A in the treatment of ketamine-related cystitis.Methods A retrospective analysis of clinical data of 36 ketamine-related cystitis patients with intradetrusor injection of botulinum toxin type A treatment in our hospital during August 2010 to December 2015 was conducted, including 31 males and 5 females with a mean age of 25.5 years.All patients had failed to conventional treatment options including cessation of ketamine, antibiotics, M-blockers.At the time of the first injection, patients were injected with 200 U botulinum toxin type A diluted in 15 ml of 0.9％ saline into the detrusor muscle at 30 sites, sparing the trigone, under cystoscopic guidance.3-d voiding diary, interstitial cystitis symptom index (ICSI),interstitial cystitis problem index (ICPI), pelvic pain and urinary frequency/urgency symptom score (PUF) were recorded to evaluate the efficacy.The treatment-related complications were recorded.When the efficacy of botulinum toxin type A decreased and the patient's symptoms returned to baseline before treatment, the patient received repeated injections of botulinum toxin type A with the same dose and method as the first injection.Results Thirty-six patients with ketamine-related cystitis were treated with intradetrusor injection of botulinum toxin type A.Sixteen patients received two injection treatments and two patients received three injection treatments.During the follow-up, 3-d urinary diaries, ICSI, ICPI, and PUF showed a significant improvement in outcome at 4 weeks after the first injection.The efficacy of the second and third injection treatment was also remarkable.Three patients developed urinary tract infection after the first injection, and two patients developed urinary tract infection after the second injection.Mild hematuria occurred in 15 patients after the first injection, and mild hematuria occurred in 7 patients after the second injection, which was improved in 1 to 2 days.All patients did not appear acute urinary retention and other adverse drug reactions.Conclusions Intradetrusor injection of botulinum toxin type A could be a safe and effective method for the treatment of ketamine-related cystitis.Repeated injection therapy is still safe and effective.
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Objective To evaluate the feasibility and clinical efficacy of intraperitoneal laparoscopic partial nephrectomy for T1a peripheral renal neoplasms. Methods Intraperitoneal laparoscopic partial nephrectomy was performed without renal artery occlusion for T1a peripheral peripheral renal neoplasms. The operative time, bleeding volume and complications were observed and the clinical experience was summarized. Results From October 2014 to January 2017 ,there were 10 patients:7 males and 3 females. All patients had T1a peripheral renal tumors. 10 patients underwent operation successfully ,of which 1 case developed temporarily blocked renal artery in the surgery due to hemorrhage. There was no referral during surgeries. The operative duration was 108 to 210 min,with a median of 135 min. The estimated blood loss was 100 to 750 mL,with a median of 320 mL. Followed up duration was 2 to 24 months (median 12 months),there were not postoperative renal secondary bleeding , leakage and other complications. No recurrence of tumor was found. Conclusion It is feasible and safe to exercise intraperitoneal laparoscopic partial nephrectomy without renal artery occlusion in the treatment of T 1a peripheral renal tumors,which can protect renal function to the greatest extent.
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Objective To evaluate the clinical effect of placing double J stent using a ureteroscope in early managing ureterovaginal fistula.Methods Twenty-eight patients cases with ureterovaginal fistula from 2002 to 2008 were treated early with placing double J stent using a ureteroscope and the clinical data were reviewed.Results Twenty-two of 28 cases were treated and double J stent was placed in them by a uretero-scope and 75% (21/28)of cases were cured.Four of 21 cases were treated twice by a ureteroscope and were cured finally.7 cases with failure ureterovaginal treatment underwent ureterocystostomy and were cured.The follow-up from 6 months to 33 months (average 10.1±6.4 months)showed that all of the 28 cases had been cured and had no urinary fistula.Conclusion Placing double J stent using a ureteroscope is the first choice of operative procedure for the early treatment of ureterovaginal fistula.
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<p><b>OBJECTIVE</b>To determine the efficacy and incidence of complications of extracorporeal shock-wave lithotripsy (ESWL) compared with pneumatic ureteroscopic lithotripsy (URSL) in the treatment of lower uretheral calculi.</p><p><b>METHODS</b>From August 1997 to June 1999, 210 patients with lower ureteric calculi were treated with ESWL and the other 180 with URSL. The stones were fragmented with pneumatic lithotripter. The outcome was assessed by evacuation, retreatment and complication rates.</p><p><b>RESULTS</b>ESWL for lower ureteric calculi resulted in a stone evacuation rate of 78.1%, compared with 93.3% for URSL (P < 0.05). ESWL had a retreatment rate of 11.9% and a perforation rate of 0, while URSL caused perforation of ureters in 3.3% of patients and a refreatment of 2.2%.</p><p><b>CONCLUSION</b>For the management of lower ureteric calculi, ESWL provides a non-invasive, simple and safe option, and URSL has a higher stone evacuation rate but causes ureter perforation more frequently than ESWL does. Both ESWL and URSL have their respective advantages. It is recommended, however, that URSL be extensively developed for better treatment efficacy, given that the operator has an adequate technical background.</p>
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Lithotripsy , Methods , Ureteroscopy , Urethral Diseases , Therapeutics , Urinary Calculi , TherapeuticsABSTRACT
[Objective] To investigate the effect of sporoderm-broken spores of Ganoderma Lucidum in the treatment of partial androgen deficiency of the aging male (PADAM) . [Methods] Random number table was used for the division of 138 PADAM cases. Sporoderm-broken Ganoderma Lucidum spores capsules were given orally to group A (n=80) and placebo to group B (n=58). The treatment course lasted 3 weeks. Self-scoring of physical ability, vasomotoricity, mental psychological state and sexual function was used to evaluate the therapeutic effect. Meanwhile, blood contents of testosterone (T), erythrocyte superoxide dismutase (SOD) and malondialdehyde (MDA) were determined and adverse reaction was observed. [Results] After a 3-week treatment, the scores of physical ability, vasomotoricity, mental psychological state and sexual function were decreased in group A (P 0.05) and the difference was significant between the two groups (P
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OBJECTIVE:To study the quantity-effect relationship of reptilase with surgical hemostasis used at different dosages perioperatively and postoperatively.METHODS:120patients undergoing urological and general operations were ran-domly divided into experimental and control group.In the experimental group reptilase was administered at the dose of2KU by iv during the operation and continuously given at the dose of1KU～2KU by iv drip or iv twice a day after the operation until bleeding stopped.In the control group reptilase was administered at the dose of1KU by iv during the operation and continu-ously given at the dose of1KU by iv drip or iv once a day after the operation until bleeding stopped.RESULTS:The bleeding volumes in experimental and control group were(141?11.2)ml and(198?12.1)ml(P
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Objective To determine the diagnostic significance of detecting the specific epithelial keratin CK 20 mRNA in peripheral venous blood from patients with bladder carcinomas. Methods Reverse transcription coupled with two step polymerase chain reaction (nested RT PCR) was used to detect CK 20 mRNA expression in the peripheral blood from patients with bladder carcinomas. Results Detection of CK 20 mRNA expression was positive in 37 of 91 patients with bladder carcinoma (41%).Among 20 patients with distant metastasis,17 were positive (85%).CK 20 mRNA was not detectable in the blood samples from 25 normal individuals.The frequency of positive CK 20 mRNA expression was signficantly higher in those with distant metastasis. Conclusions The presence of CK 20 mRNA expression in peripheral blood may be used as an early indicator of hematogenous metastasis of bladder carcinoma cells.
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OBJECTIVE:To evaluate the therapeutic effect of oral Yixinkangtai(YXKT) on chronic prostatitis METHODS:85 patients with chronic prostatitis were observed for the levels of SOD in saccus prostaticus as well as their subjective symptoms and objective indices before and after taking YXKT to evaluate the therapeutic effect RESULTS:The average level of SOD in saccus prostaticus in patients with chronic prostatitis was (153 76?90 23)mg/L,which was lower than(220 31?85 02)mg/L as in normal males(P
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OBJECTIVE:To study the therapeutic efficacy of Yixinkangtai capsules(YXKT)on climacteric syndrome in males.METHODS:360cases of male climacteric syndrome randomly divided into2groups:trial group(220cases)was treated with YXKT for3wks and control group(140cases)received placebo.RESULTS:In the trial group,the rate of symptomatic improvement was74.3%.Before and after3-week treatment,blood testosterone levels were(131.51?19.12)mg/L and(253.78?21.45)mg/L;SOD levels were(1068?121.4)IU/(g?Hb)and(1178.1?132.6)IU/(g?Hb),MDA levels were(7.6?0.8)?mol/L and(5.8?0.6)?mol/L respectively,and depression score was improved as well.There were significant dif?ferences in all above-mentioned parameters between2groups.CONCLUSION:YXKT is effective and safe for treating cli?macteric syndrome in males.