Influence of photoselective vaporization of prostate on erectile function in patients with benign prostatic hyperplasia / 中华男科学杂志

<p><b>OBJECTIVE</b>To assess the influence of photoselective vaporization of the prostate (PVP) on the erectile function of the patient with benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>Using IIEF-5, we conducted a questionnaire investigation among 210 BPH patients before and after treated by PVP (n = 80) and transurethral resection of the prostate (TURP, n = 130). We also reviewed the clinical data and compared the pre- and post-operative penile erectile function between the two groups of patients.</p><p><b>RESULTS</b>Follow-up was completed in 76 cases of PVP and 123 of TURP. The baseline data showed no statistically significant differences between the two groups in age, prostate volume, IPSS, QOL, Qmax, post void urine residual volume and IIEF-5 scores (P>0.05). Compared with the IEFF-5 score at the baseline (21.88 +/- 2.46), those at 3, 6 and 12 months after PVP were 16.72 +/- 3.17, 19.34 +/- 2.46 and 19.29 +/- 2. 18, respectively, significantly decreased at 3 months (P = 0.042), but with no remarkable difference at 6 and 12 months (P >0.05). Nor were there significant differences in the IIEF-5 score between the PVP and TURP groups at any time points (P>0.05). At 6 months after surgery, the incidence rates of erectile dysfunction were 11.7% and 13.7% in the TURP and PVP groups, respectively (P>0.05).</p><p><b>CONCLUSION</b>PVP may reduce erectile function in some cases in the early stage after surgery, but this adverse effect does not last long and is basically similar to that of TURP.</p>

Value of spermatic cord sonography in the early diagnosis and treatment of testicular torsion / 中华男科学杂志

<p><b>OBJECTIVE</b>To improve the early diagnosis and therapeutic outcomes of testicular torsion.</p><p><b>METHODS</b>We retrospectively reviewed the clinical data of 49 cases of testicular torsion along with the results of their intratesticular color Doppler flow imaging (CDFI) and spermatic cord sonography.</p><p><b>RESULTS</b>Of the 49 cases, 42 showed abnormal intratesticular blood flow, including 3 cases of increased blood flow, while the other 7 presented no obvious abnormality. Morphological abnormality of the spermatic cord was found in 47 cases. Twenty-eight cases underwent testis removal, and the other 21 received detorsion and orchidopexy, in which 12 testes were preserved with normal size and blood flow.</p><p><b>CONCLUSION</b>Spermatic cord sonography and intratesticular CDFI play an important role in the early diagnosis of testicular torsion. And early surgical exploration contributes to the preservation of the testis.</p>

The effect of cell killing by ABT-737 synergized with docetaxel in human prostate cancer PC-3 cells / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the synergistical killing effect of docetaxel combined with ABT-737 on human prostate cancer cell line PC-3 by inducing apoptosis and further to determine the mechanism underlying such effect.</p><p><b>METHODS</b>PC-3 cells were treated with various concentrations of docetaxel or (and) ABT-737. Cell viability was determined using MTT assay. Apoptosis was assessed by fluorescence microscopy analysis of cells with condensed and segmented nuclei following staining with 4',6-diamidino-2-phenylindole (DAPI). Cellular DNA was stained with propidium iodide and flow cytometric analysis was performed to analyze the cell cycle distribution. Bcl-2, Bax, Bcl-xL and Mcl-1 protein changes were detected by Western blot. The activity of caspase-3 was measured using a colorimetric assay.</p><p><b>RESULTS</b>Docetaxel (20 nmol/L) combination with ABT-737 (400 nmol/L) for 48 hours, the cell viability was decreased to 19.7% ± 3.2% to compare with 44.2% ± 4.4% (t = 4.45) of docetaxel and 93.2% ± 1.8% of ABT-737 separately and there was a synergistic effect between the two drugs (CI = 0.8). Apoptosis rate of the combination group was higher than other two drugs. Docetaxel increased the cell number arrested in G(2)/M phase compared with control group (P < 0.05), but the combination treatment resulted in a significant arrest in the G(0)/G(1) phase. The combination treatment could significantly reduced the Bcl-2, Bcl-xL and Mcl-1 expression (F = 369.53, 57.89 and 32.77, all P < 0.05) and enhanced the activity of caspase-3 (419.7% ± 15.6%) (F = 207.33, P < 0.05).</p><p><b>CONCLUSIONS</b>The combination of ABT-737 with docetaxel can synergistically inhibit the proliferation of PC-3 cells through inducing apoptosis, which may be associated with cell cycle arrest, down-regulation of Bcl-2, Bcl-xL and Mcl-1 expression and activation of caspase-3.</p>

The urodynamic diagnosis of benign prostatic hyperplasia with coexisting overactive bladder / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the urodynamic features in patients of benign prostatic hyperplasia (BPH) with coexisting overactive bladder (OAB).</p><p><b>METHODS</b>Clinical data of 235 patients with symptomatic BPH who underwent urodynamic examination during January 2009 to May 2010 were retrospectively analyzed. Patients were divided into group of pure BPH, BPH with detrusor overactivity (DO), BPH with coexisting OAB without DO and BPH with coexisting OAB with DO. The difference of age, International Prostate Symptom Score (IPSS), transrectal ultrasound (TRUS)-volume, maximum flow rate, residual urine volume, bladder volume of first sensation, bladder volume of strong sensation, bladder outlet obstruction index (BOOI) and the prevalence of decreased detrusor contractility were compared between these groups. The urodynamic characteristics of DO between group of BPH with DO and group of BPH coexisting OAB and DO were analyzed.</p><p><b>RESULTS</b>A total of 219 cases were included in the final analysis, with mean age of (66 ± 8) years, mean TRUS-volume was (35 ± 24) ml, mean maximum flow rate was (11 ± 6) ml/s. Of the 219 patients, 93 patients (42.5%) had pure BPH, 11 patients (5.0%) had BPH with DO, 52 patients (23.7%) had BPH coexisting OAB without DO, 63 patients (28.8%) had BPH coexisting OAB and DO. Comparing to group of BPH (n = 104), patients with BPH and OAB (n = 115) were older, had higher IPSS, bigger TRUS-volume, less bladder volume of first sensation and strong sensation, higher BOOI and higher prevalence of decreased detrusor contractility. Comparing to group of BPH with coexisting OAB without DO patients, patients of BPH with coexisting OAB and DO had higher IPSS score (19 ± 12 vs 17 ± 10), bigger TRUS-volume [(51 ± 33) ml vs (43 ± 27) ml], higher BOOI (49 ± 18 vs 37 ± 14). Comparing to patients pure BPH, patients of BPH with DO had less bladder volume of first sensation and bladder volume of strong sensation [(82 ± 41) ml vs (118 ± 35) ml;(335 ± 67) ml vs (419 ± 53) ml]. Comparing to group of BPH with DO, patients of BPH with coexisting OAB and DO had higher maximum DO pressure [(45 ± 36) cmH2O vs (39 ± 30) cmH2O (1 cmH2O = 0.098 kPa)] and longer DO time [(7 ± 4) s vs (6 ± 4) s].</p><p><b>CONCLUSIONS</b>The urodynamic features in patients with BPH differ greatly and these information should be helpful in making choice of treatment and in predicting treatment outcomes.</p>

A multicenter study of mid urethral sling procedures in treatment of female stress urinary incontinence / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical efficacy, surgical indications and postoperative complications of mid urethral sling procedures in treatment of female stress urinary incontinence.</p><p><b>METHODS</b>A multicenter clinical trial was conducted from April 2002 to April 2008 in five hospitals, 304 cases of genuine stress urinary incontinence and 8 cases of mixed incontinence were included. TVT procedures were carried out in 134 patients, TVTO procedures in 167 patients, Monarc procedures in 11 patients. Perioperative evaluations included: operating time, bleeding volume, and perioperative complications. Operative efficacy was classified into three categories: cure, improved and failure and evaluated before discharge, 3 months after surgery and then every year.</p><p><b>RESULTS</b>TVT group had longer operating time [(18.5 + or - 9.6) min] and more bleeding volume [(32.2 + or - 12.6) ml] than those in TVTO group [(11.5 + or - 3.1) min, (12.8 + or - 8.5) ml] and in Monarc group [(11.1 + or - 2.6) min, (12.3 + or - 3.5) ml] with P < 0.05. Monarc and TVTO procedures had higher cure rates and improve rates comparing with TVT, but the differences were of no significance. The cure rate (95.7%) in patients with genuine stress incontinence were significantly higher than that in patients with mixed incontinence (37.5%). No significant differences of total intra- and postoperative complications were noted for all of the three procedures. However, bladder injury tended to occur in TVT group and obturator nerve injury and vaginal injury tended to occur in TVTO group. Transient voiding dysfunction and urinary retention were the most common complications.</p><p><b>CONCLUSIONS</b>Mid urethral sling procedures have excellent clinical outcomes in the treatment of female stress urinary incontinence.</p>

Hyperlipidemia and erectile dysfunction / 中华男科学杂志

Hyperlipidemia is one of the risk factors leading to erectile dysfunction (ED), a common disorder in men, especially in old men. Epidemiological studies have found that the decrease in high density lipoprotein (HDL) and elevation of total cholesterol/high density lipoprotein (TC/HDL) are correlated with ED. Studies have also shown that arterial stenosis and occlusion caused by hyperlipidemia could be attributed to the advanced-stage mechanism of ED induced by hyperlipidemia. Hyperlipidemia may damage man's erectile function at an early stage by affecting the endothelial cells and smooth muscles of the penis and the peripheral nerves for penile erection. Apart from dietary therapy and drug therapy aiming at hyperlipidemia, the traditional Chinese medicine therapy and gene therapy are two promising approaches to the treatment of ED caused by hyperlipidemia.

Correlation between abnormal serum lipid and erectile dysfunction / 中华男科学杂志

<p><b>OBJECTIVE</b>To achieve the correlation between abnormal serum lipid and male erectile dysfunction (ED).</p><p><b>METHODS</b>Randomly selected were 200 male patients abnormal at least in one of the four laboratory items: total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL). Their erectile function was evaluated by IIEF-5, and the correlation was studied between abnormal serum lipid and ED.</p><p><b>RESULTS</b>The incidence of ED was 47% in these patients. Age, coronary heart disease (CHD), high serum glucose, benign prostatic hyperplasia (BPH), drug, hypertension were negatively, while HDL was positively correlated with erectile function. Age, CHD, BPH and TC/HDL ratio were risk factors of ED, while HDL was a preventive one.</p><p><b>CONCLUSION</b>Hyperlipidemia is an important factor of ED. HDL and TC/HDL ratio are good predictors of ED.</p>

Prevalence of lower urinary tract symptoms in young and adolescent females in Luoyang City / 中华全科医师杂志

0.05).Overall prevalence of UI was 15.93% in the students,20.45% in those of junior high school,10.44% in senior high school and 16.72% in university(P0.05),accounting for 63.90%,10.47% and 25.63% of the total students with UI.Conclusions Great importance should be attached to the higher prevalence of LUTS in young and adolescent females by gynecologists and urologists.More attention should also be paid to health education on LUTS and medical care for those with LUTS to alleviate and delay occurrence of UI symptoms.

Biofeedback therapy for chronic pelvic pain syndrome / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To evaluate the efficacy of biofeedback therapy in patients with chronic pelvic pain syndrome (CPPS).</p><p><b>METHODS</b>From November 2001 to April 2002, patients visiting the Urological Outpatient Clinic of this Hospital were evaluated by means of the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and classified by the NIH classification standard. Sixty-two patients of CPPS category III were involved in this study. All patients had been treated by conventional approaches such as antibiotics and alpha-blockers for more than half a year without any improvement. The expressed prostatic secretion results were as follows: WBC 5 to 9/high power field, lipid + approximately +++ and bacterial culture negative. Their NIH-CPSI were 12 approximately 40. All the 62 cases complained of micturitional irritation (frequency, urgency, splitted stream and sense of residual urine), 32 cases, of pain or discomfort at the testicular, penile, scrotal, pelvic or rectal region and 13 cases, of white secretion-dripping. The patients were treated by the Urostym Biofeedback equipment (Laborie Co., Canada) 5 times a week for 2 weeks with a stimulus intensity of 15 mA approximatley 23 mA and duration of 20 minutes.</p><p><b>RESULTS</b>Sixty patients were significantly improved or cured, while no significant improvement in the remaining 2. No apparent side effect was observed. The NIH-CPSI dropped to 6 to 14 with an average reduction of 21 (P<0.01). In the 60 improved cases, pain was relieved after 2 approximately 3 treatment courses and other symptoms disappeared after 4 approximately 5 courses.</p><p><b>CONCLUSION</b>Biofeedback therapy is a safe and effective treatment for CPPS. Large randomized clinical trials are needed to confirm its efficacy and to explore the mechanism of action.</p>