ABSTRACT
Objective To systematically review the efficacy and safety of solifenacin in the treatment of patients with bladder spasm after transurethral resection of prostate based on current evidence.Methods We searched Pubmed,EMbase,the Cochrane Library,CBM,CNKI,VIP and Wanfang Database from the establishment to October 2016 for the published literature on the treatment of patients with bladder spasm after transurethral resection of prostate with solifenacin.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies.Then,meta-analysis was performed using RevMan 5.3 software.Results A total of 11 RCTs involving 621 patients were included.The results of meta-analysis showed that:compared with the no-solifenacin group(n=311),the numbers of bladder spasm episodes[MD=-1.38,95%CI(-1.97,-0.97)P<0.00001],duration of bladder spasm[MD=-0.26,95%CI(-0.41,-0.11),P=0.0008],the time of bladder perfusion clearance[MD=-0.59,95%CI(-0.88,-0.29),P<0.0001],indwelling catheter delivery[MD=-0.29,95%CI(-0.48,-0.11),P=0.09]in solifenacin group(n=310) reduced significantly,and there was no statistical difference in the incidence of overall adverse events between the two groups[RR=0.71,95%CI(0.17,2.98),P=0.64].Conclusion Current evidence indicates that solifenacin is more effective and safe in the treatment of patients with bladder spasm after transurethral resection of prostate.Due to the limited quantity and quality of the include studies,more high quality studies are needed to verify the above conclusion.
ABSTRACT
Objective To investigate the clinical therapeutic effectiveness of laparoscopic high ligation of spermatic vein method, modified Palomo procedure and ligating of spermatic vein via inguinal canal for varicocele. Methods All 135 patients with varicocele who underwent varicocele were divided into three groups by random number table method: laparoscopic high ligation of spermatic vein method group (group A, 50 cases), modified Palomo procedure group(group B, 70 cases) and ligating of spermatic vein via inguinal canal group (group C, 15 cases). The surgery time,the length of stay,the hospital expenses,and the quality of their semen were collected at different time points (preoperation, 1,6,12 months after operation) and assessed,the recurrence rate,the pregnant outcomes of their spouses and the testicle atrophy rate 18 months postoperation were followed-up. Results There was no significant difference in the surgery time and the length of stay among three groups (P> 0.05). But the hospital expenses in group A was significantly higher than that in group B and group C (P 0.05). During the follow-up of 18 months, the recurrence rate in semen group C (13.3% ,2/15) was significantly higher than that in group A (0) and group B (1.4%, l/70)(P 0.05). No testicle atrophy happened during follow-up. Conclusions Laparoscopic surgery and modified Palomo procedure are safe,convenient and effective surgical techniques. Modified Palomo procedure is recommended for unilateral varicocele. Laparoscopic surgery has advantages for recurrent and bilateral varicocele.