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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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Objective To investigate the influence of tethered cord syndrome (TCS) on the up-per urinary tract and its etiology. Methods Forty patients with TCS diagnosed by spinal MRI were enrolled in this study. There were 21 males and 19 females with mean age of 23 years old. The course of disease ranged from 1 to 40 years. Urinalysis, mid-stream urine culture, serum creatinine(SCr), urinary system ultrasound, IVU, eystography and urodynamic study were carried out on all patients. Results Urinary tract infection was found in 17 patients and increased level of SCr was found in 6 pa-tients (251.64±98.5μmol/L). Of the 29 patients who underwent urinary system ultrasound examina-tion, 12 cases had hydronephroais and dilated upper ureter. Of the 30 patients who underwent IVU, 10(33.3%) had ureterectasia and hydronephrosis, 22 cases had bladder turriform or Christmas tree like deformity with diverticulum and trabeculum. Of the 22 patients accepted cystography, 17 cases had vesieoureteral reflux on 27 sides. Post-void residual (PVR) was evaluated in 35 patients and found increased in 31 cases. Cystometry had been done in 33 patients. The mean value of maximal detrusor pressure (Pdetmax) during filling phase was 41.2±20.9 cm H2O. The detrusor compliance was 22.35±18.8 ml/cm H2O. During voiding phase, detrusor-sphincter dyssynergia(DSD)was observed in 16 patients, detrusor areflexia was observed in 16 patients and detrusor underactivity was observed in 13 patients. Resting urethral pressure profilemetry was measured in 16 patients. Maximal urethral closure pressure (MUCP) was 76.1±33.1 cm H2O. The upper urinary tract deterioration was de-fined as increased SCr, hydronephrosis or vesicoureteral reflux. There were 20 patients diagnosed as upper urinary tract deterioration. The compliance of the upper urinary tract deteriorating group and the no-deteriorating group was 9.4±7.8 vs 19.3±15.8 ml/cm H2O, Pdetmax was 43.1±21.2 vs 24.0±11.9 cm H2O, PVR 189.0±138.0 vs 47.8±36.8 ml, MUCP 86.2±32.4 vs 46.8 5±20.8 cm H2O, incidence of damaged detrusor 100.0% vs 69.2% and DSD 65.0% vs 23.1%, respectively. There were significant differences between the 2 groups(P<0.05). And when comparing the VUR group with no VUR group, the incidence of urinary tract infection was 94.1%(16/17) vs 20.0%(1/ 5) (P=0.003). And when comparing urinary tract infection group with no infection group, the inci-dence of upper urinary tract deterioration was 88.2% (15/17) vs 21.7%(5/23)(P=0.000). Condn-sion Low compliance bladder, high Pdetmax during filling phase, increased PVR, high MUCP, damage of detrusor contractive function and DSD are the risk factors for upper urinary tract deteriora-tion in the TCS patients.
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4.00 ng/ml) were divided into BPH group (without inflammation), acute inflammation group and chronic inflammation group. The diagnosis was confirmed by transrectal-ultrasound guided needle biopsies. Prostate volumes were measured in all patients by the transrectal-ultrasound. A total of 126 patients were included in this study. The biopsy results showed 47 patients in BPH group, 45 patients in acute inflammation group and 34 patients in chronic inflammation group. Results The serum PSA value in the BPH group, acute inflammation group and chronic inflammation group were (5.76?3.21),( 8.67 ?2.92 ) and (5.54?3.01) ng/ml respectively. The serum PSA value in acute inflammation group was much higher than that of BPH group and chronic inflammation group(P
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Objective To evaluate the clinical significance of prostatic hypoechoic lesions on transrectal ultrasound (TRUS) for prostate cancer detection.Methods Four hundred and thirty-eight patients referred for biopsy of the prostate from August 1999 to August 2004. Every patient received 6-13 biopsy cores of the prostate. If a hypoechoic was identified, the biopsy was taken from this lesion. Correlation between hypo-echoic lesions, isoechoic areas and cancer detection for each core was performed. Results Among 438 patients, cancer was detected in 112(25.6%). Hypo-echoic lesions were seen in 75 (67%) patients with prostate cancer, the isoechoic were as in 37 (33%). A total of 3504 biopsy cores were obtained from 438 patients, and 636 biopsy cores were taken from hypoechoic lesions. Among 636 biopsy cores, 163 (25.6%) were cancer and 473(74.4%)were not. The cancer detective rate in patients with hypoechoic lesions (75/298, 25.2%) was similar to non-hypoechoic lesions (37/140, 26.4%) on TRUS. There was no statistically significant difference between them (P
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<p><b>OBJECTIVE</b>To determine the influence of androgen deprivation therapy (ADT) on bone mineral density (BMD) in men with prostate cancer.</p><p><b>METHODS</b>Forty-nine men with prostate cancer underwent BMD determination and then were classified into two groups: non-ADT group (21 cases), who were about to receive ADT, and ADT group (28 cases), who had received ADT for more than 1 year. BMD was determined by dual energy X-ray absorptiometry (DEXA) in the lumbar spine (L2-4) and femoral neck in all the patients. The Age-Matched Z scores were used as the reference standard for controlling the difference of age, sex and weight.</p><p><b>RESULTS</b>Thirteen (62%) of the non-ADT group and 23 (82%) of the ADT group fulfilled the BMD criteria for osteopenia or osteoporosis. Z scores for the Age-Matched control in the lumbar spine and femoral neck were -(0.9 +/- 0.7) and -(0.6 +/- 0.5) in the non-ADT group, and -(1.8 +/- 1.1) and -(1.6 +/- 1.0) in the ADT group, respectively (P<0.01). The men of the ADT group had significantly lower BMD in the lumbar spine and femoral neck than those of the non-ADT group.</p><p><b>CONCLUSION</b>Pre-existing osteopenia and osteoporosis are common in men with prostate cancer before ADT. ADT is significantly associated with the loss of BMD and the evaluation of BMD is necessary before ADT for men with prostate cancer.</p>
Subject(s)
Aged , Aged, 80 and over , Humans , Male , Middle Aged , Absorptiometry, Photon , Androgen Antagonists , Therapeutic Uses , Bone Density , Orchiectomy , Osteoporosis , Prostatic Neoplasms , General SurgeryABSTRACT
Purpose To find the reasons and explore the appropriate countermeasures for failure ureteroscopy operation.Methods The clinical data of 74 cases with failure ureteroscopy operation for ureteral calculi were analysed respectively.Results The failure reasons including the difficult of ureteroscopy insert (46 lateral),difficult of calculi disposal (12 lateral) and ureteral injure (15 lateral).ESWL(34 sides) and open surgery(44 sides) were remedial measures after failure ureteroscopy and the success rates were 85 3%, 100% respectively.nephrectomy were carried out in and 1 case died from serious uriaemia.The mortality was only 1.4%.Conclusions The reasons of failure including unable approach the stone, difficult to disposal calculi and ureteral injury. The effect is related to applicances, experience, indications . ESWL and open surgery are the suitable remedy measures according to the failure reason.
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OBJECTIVE:To compare the cost and efficacy between three different haemostatics in treating postoperative bleeding following suprapubic prostatectomy.METHODS:Using cost-effectiveness analysis,reptilase,aprotinin and minirin were evaluated.RESULTS & CONCLUSION:From pharmacoeconomic view,use of reptilase in treating postoperative bleeding is the best therapeutic regimen.
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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