A case report of huge solitary fibrous tumor of kidney / 中华泌尿外科杂志

Solitary fibrous tumor is a rare mesenchymal tumor associated with NAB2-STAT6 fusion gene, which is rarely seen in kidney. A 16-year-old boy was hospitalized because of left back pain for more than 3 years. Abdominal CT/MRI identified a huge space-occupying lesion in the left kidney. Laparoscopic radical left nephrectomy was performed initially. Nevertheless, laparoscopic-to-open procedure was adopted due to the huge size of the tumor. The pathological diagnosis was renal solitary fibrous tumor. The symptoms of the patient disappeared and no recurrence was observed at the 2-month follow-up after the surgery.

Pathogenic role of Chlamydia and Mycoplasma in urinary tract infection and lower urinary tract symptoms / 中华泌尿外科杂志

The pathogenicity of Chlamydia and Mycoplasma in some non sexually transmitted infectious diseases in urology department is unknown. In this paper, the characteristics of related pathogens, detection methods and the related research on their pathogenicity in clinical diseases such as non-specific cystitis, sterile pyuria, lower urinary tract symptoms and upper urinary tract infection are reviewed to guide clinical practice.

Clinical characteristics and treatment strategies of patients with fungal infections in the treatment of upper urinary tract calculi / 中华泌尿外科杂志

Objective:To discuss the clinical management, such as characteristics, surgical timing and rational application of antifungal drugs in patients of upper urinary calculi with fungal infections.Methods:A retrospective analysis was performed on 4 patients with fungal infections during the treatment of upper urinary calculi from April 2017 to April 2019. Case 1, male, 55 years old, was admitted to the Department of Nephrology due to febrile urinary tract infection. Right ureteral stone was found during antibacterial treatment. Fever and fungal sepsis occurred after transurethral ureteroscopic lithotripsy. Case 2 Female, 48 years old, frequency and urgency occurred after percutaneous nephrolithotomy of right kidney in another hospital. Urine routine WBCs were full of vision, urine culture was Candida albicans, symptoms disappeared after 2 weeks of oral fluconazole 200 mg QD treatment, urine culture turned negative, discontinued fluconazole symptoms recurred in about 2-4 weeks and the urine culture turned positive, the condition was repeatedly for 1 year. The CT showed multiple small stones in both kidneys. Case 3 Male, 74 years old, frequency, urgency, and dysuria occurred after flexible ureteroscopic holmium laser lithotripsy of left kidney. Urine routine WBCs were full of vision, urine culture was Candida albicans. Symptoms slightly after 2 weeks of oral fluconazole 200 mg QD treatment according to drug sensitivity, but urine culture did not turn negative, discontinued fluconazole symptoms increased. The condition was lasted for one and a half years. His CT showed left kidney lower calyx stones. Case 4 male, 47 years old, frequency, urgency, and dysuria occurred after the surgery of left kidney stone for half a year. Urine routine WBCs were full of vision, urine culture was Candida tropicalis, combined with left kidney cast stones.Results:Case 1, male, 55 years old, was admitted to the Department of Nephrology due to febrile urinary tract infection. Right ureteral stone was found during antibacterial treatment. Fever and fungal sepsis occurred after transurethral ureteroscopic lithotripsy. Case 2 patient was performed bilateral ureteral stent placement for drainage, and two weeks after the oral fluconazole 200 mg QD, she was performed bilateral flexible ureteroscopic lithotripsy, then the urinary fungal infection was cured. Case 3 patient was performed left side ureteral stent placement and amphotericin B and fluconazole antifungal therapy. After his body temperature was normal, he was performed flexible ureteroscopic holmium laser lithotripsy, after the surgery the oral fluconazole 200 mg QD time was just 1 week, resulting in the formation of fungal balls in the left renal pelvis and secondary surgery. Oral fluconazole 200 mg QD combined with fluconazole continuous intraperitoneal perfusion ultimately 1 week cured him after and secondary surgery. Case 4 patient was performed percutaneous nephrostomy drainage and oral fluconazole 200 mg QD for 2 weeks. Then he was performed percutaneous nephrolithotomy lithotripsy, oral fluconazole 200 mg QD was continued until the stent was removed and urine culture turned negative, patient was cured. Case 4 patient had fungal bloodstream infection after ureteroscopic holmium laser lithotripsy. The temperature was normal after intravenous drip of fluconazole 200 mg QD antifungal therapy, and fungal endophthalmitis occurred in ophthalmology 1 week after discharge.Conclusions:Diabetes could be a high risk factor for upper urinary calculi complicated with fungal infection. It is difficult to control the fungal infection without stone removed and it is easy to relapse after surgery. Stones should be removed on the basis of antifungal therapy, and antifungal therapy should be continued after surgery at least 2 weeks after urinary stent removal. If fungal bloodstream infections is diagnosed, eye examination should be done to screen for endophthalmitis to determine if there is tissue dissemination and determine the course of treatment.

Evaluation of virtual ureteroscopy for flexible ureteroscopy lithotripsy / 中华泌尿外科杂志

Objective To establish computer assisted virtual ureteroscopy (VU) through data from computerized tomography urography (CTU) of patients with renal stones and make validation of effectiveness.Methods From June of 2015 to January of 2016,23 cases of renal stones cases was selected by 5 experts in 3 different centers.There were 21 unbilateral cases and 2 bilateral cases.The age ranged from 31 to 79(54.7 ± 12.5).Mean stone burden was (19.0 ± 6.2) mm.Stone number ranged from 1 to 5 (2.7 ± 1.2).VU generation was accomplished by specialized software (Crusher) with incorporating CTU data.After patientspecific VUs were presented to the experts,and the FURS surgeries were all finished successfully,face and content validations about VU using modified Likert questionnaire ordinal 10-point rating scales were made.20 trainee were selected to do the flexible ureteroscopy lithotripsy with assistance of VU.After observation of CTU and VU,the numbers of renal calyces and stones found by the experts and trainees were recorded.The statistical analysis were made before and after observation of VU between the experts and trainees.Result Face and content validation of VU:overall usefulness 7.6 ± 0.5,graphics 7.6 ± 0.5,intrarenal collecting system 8.4 ± 0.5,stone details 8.4 ± 0.5,usefulness in surgical planning and training 8.0 ± 0.7.Significant improvement was found when the trainees doing the surgery with the help of VU.Compared with using CTU only,VU could help the trainees had better understanding of intrarenal structure and stone information [the number of calyces (16.7 ±3.7)vs.(24.6 ± 1.8),P ＜0.001;the number of stones (4.9 ± 1.4)vs.(8.2 ± 1.3),P ＜0.001].Before observation of VU,trainees found much fewer calyces and stones compared with experts (P =0.004 and P ＜ 0.001 respectively).However,this gap disappeared after VU observation (P =0.327 and 0.292 respectively).Conclusions Establishing computer assisted VU through CTU data from renal stone patients is feasible and rapid.VU can significantly improve trainee's view of intrarenal collecting system and stone information before practicing FURS.

Study of the detection and significance of intracellular bacterial communities in patient with catheter-associated urinary tract infections / 中华泌尿外科杂志

Objective To detection the urine of bacteria hyphae and intracellular bacterial communities in patients with indwelling urinary catheter and discuss intracellular bacterial comnmunities in the pathogenesis of catheter-related urinary tract infection.Methods From May 2014 to February 2016,95 cases with D-J stent indwelling were enrolled in this study,including 38 male patients and 57 female patients.The mean age was (43 ±21)years old,ranging from 25 to 83 years old.We recorded those patient g clinical symptoms,middle urine culture results.If the middle urine culture was positive,further pathology test and scanning electron microscopy for bacteria hyphae and intracellular bacterial communities would be considered.Results The middle urine culture showed positive in 21 cases (22％,21/95);The classification of bacteria included E.coli in 11 cases,dung enterococcus in 2 cases,klebsiella pneumonia in 4 cases,pseudomonas aeruginosa in 3 cases,epidermis staphylococcus aureus in 1 case.Among those 21 patients,9 cases had the symptoms of fever and shiver.Urine pathology testing found hyphae in 6 cases (6％,6/95).all others were E.coli infection.For scanning electron microscope,6 cases were found rodshaped bacteria and hyphae.3 cases were found intracellular bacterial communities.Conclusions The presence of intracellular bacterial communities made urothelial itself the source of endogenous bacteria of urinary tract infection.Catheter-related urinary tract infections in patients with recurrence maybe basically homology bacteria.

Clinical analysis of pin-shaped bipolar plasmakinetic electrode used in transurethral en bloc resection of non muscle-invasive bladder urothelial carcinoma / 中华泌尿外科杂志

Objective To introduce the surgery procedure of pin-shaped bipolar plasmakinetic transurethral en bloc resection of non muscle-invasive bladder urothelial carcinoma and investigate the clinical outcomes.Methods 42 cases of non muscle-invasive bladder urothelial carcinoma who received bipolar plasmakinetic transurethral en bloc resection from May 2015 to March 2016 were recruited in the present study.Male 29 cases, female 13 cases, average age 52-82 years old, average (65.6 ±12.3) years old.Wide basal tumors were noticed by preoperative cystoscopy, bladder tumors were confirmed by tumor biopsy.Full-thickness specimens were obtained in procedures, including tumor, mucosa, lamina propria layer, muscular layer, to accurately assess tumor infiltration depth and staging.Results All 42 cases were done by this procedure successfully.A total of 65 pieces of tumors were excised:36 in lateral wall, 19 in posterior wall, 10 in bladder triangle.Tumor diameter ranged from 0.5 to 3.5 cm, with an average (2.1 ± 0.6) cm.Postoperative pathological stages were clear:16 cases were Ta stage and 49 cases were T1 stage ( of which 32 were T1 G3 ) .Intraoperative obturator nerve reflex happened in 2 cases.Followed up for 2-11 months, average 6 months.Tumor recurrence in 3 cases, no progression case.Conclusions Pin-shaped bipolar plasmakinetic electrode transurethral en bloc resection of non muscle-invasive bladder urothelial carcinoma is safe and reliable and should be recommended in management of non muscle-invasive bladder urothelial carcinoma.Full-thickness postoperative specimens can provide accurately judgement of the depth of tumor invasion and pathological staging.

Efficacy and safety of oral fosfomycin trometamol for the treatment of lower urinary tract infections caused by multi drug resistant bacteria：an open-label, uncontrolled, multicenter study / 中华泌尿外科杂志

Objective To assess the efficacy and safety of oral fosfomycin trometamal in patients with lower urinary tract infections ( UTIs) caused by multi drug resistant ( MDR) bacteria in the clinical setting in China.Methods Multicenter study was conducted from January 2011 to December 2011 in 12 hospitals in China.Three hundred and fifty-six patients with non-fever lower UTls were treated by fosfomycin trometamal 3 g once daily.Three hundred and fifty cases with complete data were further evaluated .One hundred and twenty ( 34.3%) were male and 230 ( 65.7%) were female.The average age was ( 49.9 ± 16.6) years.Depending of the results of urine culture at the first visit ,142 patients with E.coli, Klebsiella pneumonia, proteus, Staphylococcus aureus, Staphylococcus epidermidis and entercocous were analyzed.The susceptibility of MDR bacteria to fosfomycin trometamol were calculated . The clinical efficacy , bacteriological efficacy of fosfomycin trometamol to these patients was evaluated .Results For the gram-negative bacteria detected by culture , among the E.coli, Klebsiella pneumonia and proteus, 50%(52/104) were Extended-Spectrum β-lactamases producing organisms . For the gram-positive bacteria ( n =38 ) detected by culture, methicillin-resistant staphylococcus accounts for 55%(11/20) of all the Staphylococcus and the other gram-positive bacteria were Enterococcus ( n=18 ) .Higher susceptibility rates to fosfomycin trometamol were observed among MDR bacteria (85.7%) and the clinical effective rate and bacteriological effective rate of fosfomycin trometamol were 96.4%( 53/55 ) and 87.5%( 42/48 ) , respectively .The incidence of drug-related adverse events (AEs) was 5.6%(20/356).The most common AE was diarrhea. No drug-related serious adverse events were found .Conclusions The distributions of uropathogens in China are complicated. The detection rate of MDR uropathogens is high . The dosing regimen of fosfomycin trometamal 3 g once daily is effective and tolerable for the patients with lower UTIs caused by MDR bacteria . It may represent good options for the empiric therapy for the patients with lower UTIs .

Clinical features and renal morphological changes of the patients with urinary tract infection associated ureteral stent / 中华泌尿外科杂志

Objective To evaluate the clinical features and renal morphological changes of the patients with urinary tract infection associated ureteral stent.Methods From Oct.2012 to May.2013,21 patients were divided into three groups depending on the different conditions:Group A (n=7):patients who had febrile urinary tract infections associated with ureteral stents; Group B (n =7):patients with ureteral stents but no fever; Group C (n=7):patients who had febrile urinary tract infections but no ureteral stent.The clinical data,laboratory data and 99Tcm-dimercaptosuccinic acid (DMSA) renal scintigraphy results were recorded prospectively and analyzed.Results In Group A,there were two patients had flank pain and positive costovertebral angle percussion tcnderness.The mean value of white blood cells and Hs-CRP of Group A and Group C were obviously higher than Group B (P＜0.05).The ratios of pyuria were 100.0％,71.4％ and 100.0％ in Group A,B and C.The ratios of positive urine bacteuria culture were 100.0％,42.9％ and 100.0％ in Group A,B and C.The results of 99Tcm-DMSA renal scintigraphy demonstrated the decreased uptake in the different portion of the kidneys on the sides of ureteral stents inserted in all the patients in Group A but no such changes in Group B and Group C.Conclusions 99Tcm-DMSA renal scintigraphy can be used to judge the status of urinary tract infection associated ureteral stent.The febrile urinary tract infection associated with ureteral stents always means pyelonephritis occurs and prompt treatment must be given.

Study on natural transition of pyuria and bacteriuria after transurethral resection of the prostate / 中华泌尿外科杂志

Objective To observe the incidence and transformation of pyuria and bacteriuria in different time point after TURP and supply the evidence for antibiotic application.Methods From March,2011 to May,2012,84 patients with BPH admitted in our hospital.Their ages ranged from 61 to 87 years old,mean (71.9±7.6) years.The volume of prostate in those patients ranged from 27.8 to 118 ml,mean (70.8±24.1) ml.The procedure of TURP was undergone in all of them.In one week after the operation,two urine specimens from each patient,one for urine routine examination and one for urine culture,were collected 24 h after the catheter have been withdrawn.The catheter was also cultured.During the following-up,urine routine examination and urine culture were regularly performed in 1,2,3 months after surgery.If the patient had both pyuria and bacteriuria,he should be excluded the study.Results The pyuria rate on one week,one month,two months and three months were 54.8％ (46/84),100.0％ (82/82),65.8％ (48/ 73),34.2％ (25/73),respectively.There is a significance difference among those groups (P＜0.05).It seemed that the pyuria would appear in all patients.However,the incidence would gradually decrease.It seemed that the pyuria has the tendency of self-recovery.A significant difference of prostatic resection volume after 3 months could be observed in the pyuria group (31.4±15.2 ml) and non-pyuria group (24.8±11.6 ml) (P＜0.05).The bacteriuria rate on one week,1,2,3 months were 7.1％ (6/84),11.0％ (9/82),6.8％ (5/73)and 0,respectively.There is no significance difference among the groups (P＞0.05).Conclusions Pyuria will appear after TURP and the incidence reduced gradually following the time.The pyuria alone without the bacteriuria may be explained by inflammation,that antibiotics were unnecessary.The bacteriuria alone without the pyuria may be considered as asymptomatic bacteriuria or bacterial colonization,antibiotics were unnecessary,either.

Clinical features of renal epithelioid angiomyolipoma / 中华泌尿外科杂志

Objective To explore the pathological and clinical features of renal epithelioid angiomyolipoma (EAML). Methods From February 2001 to June 2010,4 cases of renal epithelioed angiomyolipoma (EAML) diagnosed in our unit were reviewed on their clinical and histopathological feathers retrospectively.The prognosis of renal EAML were evaluated according to the immunohistochemical findings.Of the 4 cases,the first case had a history of nodular sclerosis and presented a sign of hemorrage caused by the rupture of the tumor.The second case also showed a sign of hemorrage complicated with hemorrhagic shock.The third case had no symptom,but suffered from clear cell carinoma concomitantly on the other kidney.The fourth case came for consultation for his bilateral angiomyolipoma.All the 4 cases had fat composition founded in their CT scans. Results The first case was taken biopsy on the tumor of her right kidney,and lost of follow-up 6 months later.The second case undertaken radical nephrectomy,and no tumor recurrence detected after 10 months follow-up.The third case undertaken right nephron-sparing nephrectomy,and left nephron-sparing nephrectomy 6 months later.No recurrence detected during the follow-up 8 months later.Bilateral resection of the angiomyolipoma was performed on the fourth case,and a malignancy on the left kidney was deteceded 6 years later,then a radical nephrectomy was performed.But liver metastasis was founded half a year later during the follow-up.Immunohistochemcial staining of these tumors showed positive HMB45 and Melan-A but negative CK and EMA. Conclusions Renal EMAL has malignant potentiality,and the aggressiveness of it makes the close follow-up compulsive.Immunohistochemcial study is useful for diagnosis and differential diagnosis,even helpful to assess the prognosis.

Clinical analysis of low does oral Desmopressin in treatment of nocturia in elder women / 中华泌尿外科杂志

Objective To investigate the efficacy and safety of low dose of oral desmopressin in elderly women with nocturia. Methods Eligible female patients with nocturia older than 60 years were included in this study.A total of 97 patients were randomly divided into 2 groups.Care was taken to match the patients of the two groups by age and clinical criteria.Control group (n=48 ) received liquid restriction during nighttime.Experimental group (n=49) received 0.1 mg desmopressin at bedtime and liquid restriction for 8 weeks.Patients were required to visit the outpatient clinic from the first visit,and after 4 and 8 weeks of treatment.Patients maintained flow volume charts and used diaries to record voiding data throughout the study.At each visit,all patients were evaluated by blood biochemical routine test,mean nocturnal urine volume,mean number of nocturia,mean duration of the first sleep period and sleep quality.At baseline,all the patient's blood sodium,liver and kidney function were normal. Results After 4 weeks of treatment with desmopressin,28 patients (57.1％) had less than 2 voids.15 patients (31.3％) in the control group had less than 2 voids.After 8 weeks,35 patients (71.4％) with desmopressin had less than 2 voids.16 patients (33.3％) in the control group had less than 2 voids.Compared with control group,nocturia cure rate in experimental group was significantly higher after 4 weeks and 8 weeks (P ＜ 0.05).After 8weeks,desmopressin significantly decreased mean nocturnal urine output from 590 ± 70 ml to 376 ± 50 ml (P ＜ 0.05).Mean nocturnal urine output in the control group was not significantly decreased from 600 ± 90 ml to 550 ± 60ml (P ＞0.05) ; Mean number of nocturia before and after receiving desmopressin were 2.9 and 1.6 respectively which differed significantly (P ＜ 0.05).Mean number of nocturia before and after in control group were 2.8 and 2.3 respectively with no significant difference (P ＞ 0.05).The mean duration of the first sleep period increased by 73％ (from 2.2 to 3.8 h) in the desmopressin group,compared with an increase of 19％ (from 2.1 to 2.5 h) in the control group (P ＜ 0.05).39 (79.6％) patients in demopressin group were satisfied with sleep quality compared with only 15 (31.3％) patients in control group were satisfied (P ＜ 0.05).No serious complications were found during the medication.All the patient's blood sodium,liver and kidney function remained normal during treatment. Conclusions Low does oral administration of desmopressin could be an effective and well-tolerated treatment for nocturnal polyuria in elderly women.

In vitro susceptibility of commonly used antibiotics on community-acquired uncomplicated urinary tract infection pathogens in Beijing / 中华泌尿外科杂志

Objective To investigate the distribution and susceptibility patterns of common uropathogens causing community-acquired urinary tract infection (UTI) in Beijing.MethodsA total of 300non-duplicate isolates were randomly collected from 3 hospitals in Beijing between Jan,1 2010 and Mar,312011.Minimal inhibitory concentrations (MICs) were determined by the broth microdilution methods,which were performed and interpreted according to the guidelines established by the Clinical and Laboratory Standards Institute (CLSI).A panel of 8 antimicrobial agents were tested:amikacin,cefaclor,cefepime,cefoperazone/sulbactam,ciprofloxacin,levofloxacin,gentamicin and nitrofurantoin. Fosfomycin trometamol MICs were determined by the agar-dilution method in cation-adjusted MH agar supplemented with glucose 6-phosphate at a concentration of 25 mg/L as detailed in the guidelines issued by 2010 CLSI. All the Escherichia coli,Klebsiella pneumoniae and Proteus mirabilis strains were screened and confirmed by double-disk synergy test for extended-spectrum β-lactamase (ESBLs).Results Among the organisms cultured,E.coli wasthepredominantpathogen(65.0％ ), followedby Enterococcus(11.7％ ),Staphylococcus( 6.3％ ), Klebsiella pneumoniae( 5. 3％ ), Proteus mirabilis( 4. 7％ ), and Pseudomonas aeruginosa (3.0％).Lower susceptibility rates to ciprofloxacin and levofloxacin (31.4％ -47.4％ ) were observed among all the stains.Amikacin,cefoperazone/sulbactam,nitrofurantoin and fosfomycin trometamol were the most active drugs (92.1％,92.1％,88.4％ and 87.9％ susceptible strains,respectively) among the Gram-negative strains.Isolates of Staphylococcus were highly sensitive to amikacin ( 100.0％ ),cefoperazone/sulbactam (94.7％),nitrofurantoin ( 100.0％ ).Higher susceptibility rates to nitrofurantoin (91.4％) and fosfomycin trometamol (90.0％) were observed in Enterococcus.ESBLs-producing strains accounted for 52.3％ (102/195) in E.coli,43.8％ (7/16) in K.pneumoniae and 14.3％(2/14) in P.mirabilis,respectively.ConclusionsResistance is most common to ciprofloxacin and levofloxacin of all the stains.Currently,the most appropriate agents for the empirical management of uncomplicated UTI seems to be amikacin,cefoperazone/sulbactam,nitrofurantoin and fosfomycin trometamol.

Clinical significance of B-mode ultrasound found bladder trabeculation in BPH patients / 中华泌尿外科杂志

Objective To study the role of B-mode ultrasound found bladder trabeculation in evaluating the degree of bladder outlet obstruction (BOO) and the bladder function in benign prostatic hyperplasia (BPH) patients.Methods Conducted prospective research to determine differences in clinical data and urodynamic parameters between BPH patients with and without bladder trabeculation diagnosed by abdominal ultrasound.Results Thirty-six BPH patients with bladder trabeculation were compared with 68 BPH patients without bladder trabeculation.The mean age was (73.7 ± 10.1 ) years for the patients with bladder trabeculation and ( 69.6 ± 6.2 ) years without bladder trabeculation, IPSS was 24.4 ± 6.6 and 22.8 ± 8.3 respectively, in which no significant differences were found ( P ＞ 0.05 ).The detrusor pressure at maximum flow rate was ( 131.7 ± 57.3 ) cm H20 and (92.1 ± 47.8 )cm H2O ) respectively.The linearized passive urethral resistance relation was 4.6 :± 1.1 and 3.5 ± 1.5 respectively, showing a significant difference ( P ＜.05 ) between the two groups.Seventy-two point two percent (26/36) of the patients with bladder trabeculation had a low compliance bladder, among whom 23.1% (6/26) of the patients had bilateral hydronephrosis with renal insufficiency.The percentage for the control group was 42.6% (29/68) and 10.3% (3/29) respectively (P ＜ 0.05).Conclusions The bladder trabeculation found by B-ultrasound in BPH patients suggests the existence of BOO and a high risk of bilateral hydronephrosis.Bladder trabeculation in patients without urinary retention suggests they are in compensation status.Relief of the obstruction is helpful to recovery of bladder function and the reduction of complications.

Change of clinical and urodynamic parameters in the patients with lower urinary tract symptom caused by detrusor overactivity / 中华泌尿外科杂志

Objective To study the change of clinical and urodynamic parameters in the patients with lower urinary tract symptom (LUTS) caused by detrusor overactivity (DO). Methods Two hundred and twenty-seven patients with LUTS underwent clinical evaluation from October 2006 to December 2008, including Prostate Volume (PV), International Prostate Symptom Score (IPSS), Peak Flow rate (PF) and Residual Urine (RU) measurement. Pressure flow studies were performed. The detrusor overactivity was recorded to classify the patients into 2 groups, DO group and none DO group. The clinical and urodynamic parameters were compared between the two groups. Results Mean patient age was 70 years (range 52 to 89). According to the urodynamic results, there were 126 patients in DO group and 101 patients in none DO group. The mean patients age was older in DO group than the none DO group(P＜0.05). Adjusted by age, the PV, PF, and RU were no different between the two groups(P>0.05). The mean first sensation of bladder, bladder compliance, cystometric capacity, bladder outlet obstruction parameters, single voiding volume and max detrusor pressure during contraction were different between the two groups(P＜0.05). Conclusions The main risk factors of DO are the ageing and BOO. The non invasive parameters such as PV、 PF、 and RU could not be used to judge DO. The changes of urodynamic parameters caused by DO were hyperaesthesia of bladder、lower bladder compliance、 higher max detrusor pressure and lower max cystometric capacity. This study emphasis the importance of the urodynamic studies in the aged patients with LUTS.

Understanding Chinese patients attitude towards BPH and BPH treatment: result of Prostate Health Educational Programmer study / 中华泌尿外科杂志

Objective To assess the clinical characteristics of benign prostatic hyperplasia (BPH) patients and patients's attitude towards BPH and BPH therapy. Methods The question-naires were distributed to 3560 BPH patients throughout the country during the period of Prostate Health Educational Programmer (PHELP). The survey was mainly focused on the questions of patient understanding toward BPH, the preference of treatment and international prostate score scale.Results The evaluations based on 2878 completed patient's questionnaires showed that 86. 0% of patients were diagnosed with moderate or severe low urinary tract syndrome. The main reasons for seek treatment was irritative symptoms (64. 1%), obstructive symptoms ( 41. 7%), physical checkup (41.0%), worry about prostate cancer(14. 5%). Most of patients sought treatment from big hospitals. Most of patients (69.1%) had right understanding towards BPH. Nocturia was the most bothersome of lower urinary tract symptoms(LUTS) suggestive of BPH. Rapid LUTS improvement was the patient's main objective (87.4%). Conclusions Chinese patients did not recognize the complications of BPH progression. Irritative symptoms are the main reasons for seek treatment. Nocturia is most bothersome syndrome, which deteriorates quality of life mostly.

Relationship between the bladder outlet obstruction and the area under the curve of detrusor during voiding related parameters / 中华泌尿外科杂志

Objective To study the relationship between the bladder outlet obstruction(BOO)and the area under the curve of detrusor during voiding related parameters. Methods One hundred and thirty-eight patiens with benign prostate hyperplasia(BPH) underwent clinical evaluation, including physical examination, flow rate and post-void residual volume measurement. Pressure flow studies were performed. Mean patient age was 68 years (range 56 to 82). The AG number and the LinPURR were recorded to classify the patients into 3 groups, namely unobstructed, equivocal obstructed and obstructed, as the traditional classification. Two new parameters including the area under the curve of detrusor pressure during voiding(AUCdet) and the area under the curve of detrusor pressure during voiding adjusted for voided volume(AUCdet/Vol) were calculated and compared with the traditional classification using the Linear discriminant analysis. Results According to the traditional classification, there were 33 unobstructed, 32 equivocal and 44 obstructed cases. The AUCdet and AUCder/Vol of the 3 groups were different(P＜0.001). Linear discriminant analysis showed that of the cases, 90. 9%(30/33), 43.8%(14/32) and 70. 5%(31/44) were identically categorized by the traditional and the AUCdet/Vol classifications in the unobstructed, equivocal and obstructed groups, respectively. Conclusions The area under the curve of detrusor pressure during voiding related parameters appear to be good parameters of the BOO in patients with BPH. Further studies are needed to test the reliability and validity of these new parameters.