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Objective To discuss the treatment choices of varicocele by laparoscopic. Methods Retrospective analysis clinical datas of 337 patients with primary varicocele above grade Ⅱ.All of them were treated by operation and followed-up,238 cases had scrotum pain.265 cases were infertility after married.History of diseases was between 1-13 years.249(197 patients with infertility)were treated with laparoscopic high selective ligation of spermatic veins,as Group A.88(68 patiets with infertility)were treated with laparoscopic cluster ligation,as Group B.The clinical data were compared. Results Three hundreds and thirty-seven cases were followed-up 2 years after operation.The operative times of two groups were(38.04±10.9)min、(19.04±7.5)min,the incidences of hydrocelewere 0.4%(1/249),11.3%(10/88);theincidences oftesticular atrophywere 0%(0/249),3.4%(3/88);the improving rates of semen quality in 3 months were 77.1%(192/249),62.5%(55/88);the spontaneous pregnant rates of his spouses in 2 years were 56.8%(112/197),39.7%(27/68).There were significant differences among the 2 groups(P<0.05).The recurrence rates were 5.6%(14/249),4.5%(4/88),there was no significant difference among the 2 groups(P>0.05). Conclusion Laparoscopic high selective ligation of spermatic veins in this study had less complications,higher improving rates of semen quality and pregnant rates.
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Objective: To compare the clinical efficacy of open surgery, peritoneal laparoscopic excision and retroperitoneal laparoscopic excision for adrenal pheochromocytoma. Methods. We retrospectively ana-lyzed the clinical data of 54 patients with adrenal pheochro-mocytoma (27 males and 27 females). Patients' age ranged from 19 to 71. The diameter of tumors ranged from 1.5 to 7.0 cm. Fifty patients had symptoms of hypertension and their course of disease ranged from 2 months to 15 years. None of the patients had inva-sion and metastasis in surrounding organs. According to modus operandi, the patients were divided into 3 groups. The 20 patients in group A underwent open surgery, the 16 patients in group B underwent peritoneal laparoscopic excision, and the 18 patients in group C underwent retroperitoneal laparoscopic excision. The surgical duration, volume of blood loss, severe blood pressure fluctuation, recovery time of intestinal function,postoperative hospital stay, and decrease of blood pressure were compared among the three groups. The re-sults were statistically analyzed. Results: All surgeries were successful, with no complications. All specimens were proved pheochromocytoma. The mean surgical duration was 120.60±18.18 min in group A, 105.13±17.46 min in group B, and 102.22±16.01 min in group C. The volume of blood loss was 146.50±36.20 mL in group A, 116.56±37.32mL in group B, and 120.28±33.80mL in group C. Twelve cases in group A, 5 cases in group B and 5 cases in group C had blood pressure fluctuation. The recovery time of intestinal function was 2.40±0.79 d in group A, 1.75±0.45 d in group B, and 1.58±0.49 d in group C. The postoperative hospital stay was 11.15±1.87 d in group A, 5.94±0.85 d in group B, and 5.94±0.80 d in group C. There was statistical signifi-cance between group A VS group B and group C (P<0.05). There was no statistical significance between group B and group C. There were 18, 15 and 17 cases in group A, B and C who had postoperative decrease of blood pressure, with no statistical difference among the three groups (P>0.05). All cases were followed up for 9 months to 6 years, with no recurrence. Conclusion: Peritoneal laparoscopic excision and retroperitoneal laparoscopic excision can be considered as the preferred choice for adrenal pheochromocytoma, with mini-mal invasion, fast recovery, and satisfactory safety.
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Objective To explore the effective method of the prevention and cure of unstable bladder after transurethral resection of prostate(TURP).Methods Ninety patients with benign prostatic hyperplasia(BPH)undergoing TURP under epidural anesthesia were randomly divided into 3 groups(with 30 patients in each group):treatment group,control group I and control group II.Tolterodine combined with diciofenac sodium/lidecaine hydrechloride injection were used after operation in treatment group.Control group I was only given tolterodine,and control group II was only given diclofenac sodium/lidocaine hydrochloride injection.Observed the incidence times and continuous time of unstable bladder after operation in three groups.Results Three cases(10.0%)happened to unstable bladder in treatment group and they were I degree,14 cases(46.7%)happened to unstable bladder in control group I,8 cases were I degree,5 cases were II degree,1 case was III degree;16 cases(53.3%)happened to unstable bladder in control group II,8 cases were I degree,6 cases were II degree,1 case was III degree,1 case was IV degree.There was obvious significance either between treatment group and control group I(P = 0.003)or between treatment group and control group II(P = 0.001).Conclusion Tolterodine combined with diclofenac sodium/ lidocaine hydrochloride injection have obvious effect on preventing the incidence of unstable bladder after TURP,it is easy to perform and can be used widely.
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Objective To explore the effect of the prevention and treatment of unstable bladder after suprapubic prostaectomy by capsaicin instilled into the bladder preoperatively combined with patient-controlled epidural analgesia(PCEA)for benign prostatic hyperplasia(BPH).Methods Sixty patients with BPH underwent suprapubic prostatectomy under epidural anesthesia were randomly divided into control group (30 cases)and treatment group(30 cases),100 ml of 100 μmol/L capsaicin was instilled into the bladder preoperatively for 30 minutes combined with PCEA after operation in treatment group,the control group was only given PCEA.Observed the incidence and continuous time of unstable bladder after operation in two groups.Results Unstable bladder was found in 3 cases of treatment group and they were Ⅰdegree,12 cases happened unstable bladder in control group,3 cases Ⅰdegree,5 cases Ⅱdegree,3 cases Ⅲ degree,1 case Ⅳ degree.There was obvious significance between two groups (P＜0.05).Conclusion Capsaicin instilled into the bladder combined with PCEA can cut off the reflex arc of detrusor contraction more completely and has obvious effect of decrease the incidence of unstable bladder after suprapubic prostatectomy and can be used widely.