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Objective To explore the clinical feature,treatment and prognosis of incidental prostate cancer(IPC) after transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH).Methods From January 2009 to April 2017,24 cases undergoing TURP for benign prostatic hyperplasia and being diagnosed with prostate cancer(T1a-T1b) was retrospectivey analysed,who aged from 62 to 84 years (mean 71.8 years).Digital rectal examination (DRE) showed prostate medium texture,smooth surface,and no nodules.Ultrasound presented no low echo nodules in the prostate.Prostate volumes were 19.2-93.4 ml,with median of 40.1 ml.PSA were 1.81-9.11 ng/ml,with median of 4.12 ng/ml.The patients with PSA between 6-10 ng/ml accepted prostate biopsy,and pathological results were negative.Results The The pathology of TURP specimens in 24 cases were diagnosed prostate cancer (21 cases of T1a,3 cases of T1b).According to the new WHO/ISUP classification group,there were 18 cases of hierarchical group 1,3 cases of hierarchical group 2,1 case of hierarchical group 3,2 cases in hierarchical group 4.All patients were treated with hormonal therapy,and 7 cases (5 cases of hierarchical group 1,and 2 cases of hierarchical group 2) underwent laparoscopic radical prostatectomy (LRP) after 3 months of hormonal therapy.The specimens of prostatectomy were examined by whole-mount serial,showing 3 cases of prostate cancer (T1a) with negative margin,and 4 cases of benign prostate cells.They were followed up for 5-82 months with median of 43.5 months.No biological progression or tumor progression was found,and,1 case died of colon cancer after 26 months of follow-up.The patients' age and Gleason score of stage T1b were higher than that of stage T1a.Prostate volume and preoperative PSA had no statistically significant difference between the two stages.Conclusions The patients' age and Gleason score of stage T1b were higher than that of stage T1b.The proportion of residual tumor following TURP was high.The prognosis of incidental prostate cancer was good by hormonal therapy or radical prostatectomy.
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Objective To compare the effect of retroperitoneoscopic ureterolithotomy (RPUL) and ureteroscopic lithotripsy (URL) for upper ureteral calculi.Methods One hundred and twenty cases treated by RPUL and 108 cases by URL from January 2002 to October 2012 were reviewed.In RPUL and URL group,the diameter of stone was (1.56 ± 0.52) cm vs (1.44 ± 0.46) cm,ipsilateral hydronephrosis was (2.85 ± 0.86) cm vs (2.76 ± 0.82) cm,body mass index was (23.65 ± 2.80) kg/m2 vs (22.54 ± 2.68) kg/m2.There were no signficant differences.Data on the operation time,the hospital stay after operation,the operation,successsful rate,complication incidence and stone-free rate were compared between the 2 groups.Results Comparisons between RPUL group and URL group included the following:the operation time was (75.5 ± 25.8) min vs (62.5 ± 15.3) min,the hospital stay after operation was (6.2 ± 1.2) d vs (4.0 ± 0.8) d.There were significant differences.The operation successful rate was 95.0％ (114/120) in RPUL group and 85.2％ (92/108) in URL group.The complications incidence rate was 3.5％ (4/114) in RPUL group and 17.4％ (16/92) in URL group.The stone-free rate was 100.0％ (114/114) in RPUL group and 89.1％ (82/92) in URL group.The differences were significant (P ＜ 0.05).Conclusions RPUL and URL had the advantages of less trauma and blood loss and rapid recovery.RPUL had fewer complication and higher success rate than URL,and could be a minimally invasive option for the treatment of ureteral calculi.
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Objective To evaluate the diagnosis and treatment of cystic renal cell carcinoma and to improve the preoperative diagnosis and curative rate of the disease. Methods Ten cases of cystic renal cell carcinoma were retrospectively analyzed in the aspects of imaging and pathologic characteristics. There were 7 males and 3 females with average age of 56 years old (ranging from 38--74 years old) in this study. There were 3 cases complained of sore waist, 7 cases were found renal masses in annual physical examination and 2 cases had the history of renal cysts. The cyst diameter was 3.5 8.2 cm. Six cases had been diagnosed with ultrasound and 7 cases had been diagnosed with CT scan pre-operatively. Eight eases were diagnosed with frozen section during operation. All the 10 cases accepted radical nephreetomies. Results The post-operative histological diagnosis showed that there were 9 cases of clear cell carcinoma and 1 case of granular cell carcinoma. The pathological character istics were tumor necrosis of renal cell carcinoma in 6 cases, multilocular cystic renal cell carcinoma in 2 cases and carcinoma in renal cyst in 2 cases. Eight patients followed up from 6 months to 5 years. Six patients were still alive (mean 28.5 months). Conclusion The keys to improve the diagnosis and curative rate of the cystic renal cell carcinoma are paying attention to the pre-operative imaging study, the intra-operative frozen section examination and histopathology results.