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Objective To investigate the efficacy and safety of pedicled labium flap urethroplasty augmentation for female distal urethral stricture.Methods A retrospective review was performed involved 14 female distal urethral stricture patients from October 2014 to December 2016,with mean age of 59.5 years (range 47-77).There was one case secondary to trauma,5 cases secondary to iatrogenic injury,5 cases secondary to repeated urinary tract infection,and 3 cases with unknown etiology.The length of urethral stricture among the patients was 0.5 to 1.0 cm.The preoperative quality of life index was (4.6 ± 0.8),and the IPSS score was (20.7 ± 5.2),presenting severe lower urinary tract obstruction symptoms,with voiding symptom score of (13.6 ±3.9),and storage symptom score of(7.1 ± 1.7).The Qmax was (8.4 ±2.6)ml/s,and median residual urine volume was 88.5 ml(15-210 ml).All patients underwent dorsal onlay pedicled labium flap urethroplasty augmentation.Results The Qmax was (20.7 ± 3.5) ml,(19.5.± 3.9) ml and (18.8 ±2.7)ml at 1 month,6 months and 12 months follow-up,which were all superior to preoperative parameters,and the median residual urine volume was 23.0 ml(0-133 ml),21.5 ml (0-98 ml) and 26 ml (0-89 ml),which were significantly reduced.The quality of life index were (1.8 ± 0.8) and (2.1 ±0.9) after 6 months and 12 months of operation,which were better than preoperative scores.The IPSS score was (15.8 ± 2.8) and (15.7 ± 2.7),and the voiding symptom scores was (9.0 ± 2.1) and (8.9 ±2.0) after 6 months and 12 months of operation,which were all obviously reduced,while no significant change detected in storage symptom scores.At 12 months follow-up,there was no incontinence or recurrence.Condusions The application of dorsal onlay pedicled labium flap urethroplasty is a good option for female distal urethral stricture with the advantages of good safety,excellent effectiveness,few complications,less pain,and high satisfaction rate.
ABSTRACT
Objective To investigate the efficacy and safety of pedicled labium flap urethroplasty augmentation for female distal urethral stricture.Methods A retrospective review was performed involved 14 female distal urethral stricture patients from October 2014 to December 2016,with mean age of 59.5 years (range 47-77).There was one case secondary to trauma,5 cases secondary to iatrogenic injury,5 cases secondary to repeated urinary tract infection,and 3 cases with unknown etiology.The length of urethral stricture among the patients was 0.5 to 1.0 cm.The preoperative quality of life index was (4.6 ± 0.8),and the IPSS score was (20.7 ± 5.2),presenting severe lower urinary tract obstruction symptoms,with voiding symptom score of (13.6 ±3.9),and storage symptom score of(7.1 ± 1.7).The Qmax was (8.4 ±2.6)ml/s,and median residual urine volume was 88.5 ml(15-210 ml).All patients underwent dorsal onlay pedicled labium flap urethroplasty augmentation.Results The Qmax was (20.7 ± 3.5) ml,(19.5.± 3.9) ml and (18.8 ±2.7)ml at 1 month,6 months and 12 months follow-up,which were all superior to preoperative parameters,and the median residual urine volume was 23.0 ml(0-133 ml),21.5 ml (0-98 ml) and 26 ml (0-89 ml),which were significantly reduced.The quality of life index were (1.8 ± 0.8) and (2.1 ±0.9) after 6 months and 12 months of operation,which were better than preoperative scores.The IPSS score was (15.8 ± 2.8) and (15.7 ± 2.7),and the voiding symptom scores was (9.0 ± 2.1) and (8.9 ±2.0) after 6 months and 12 months of operation,which were all obviously reduced,while no significant change detected in storage symptom scores.At 12 months follow-up,there was no incontinence or recurrence.Condusions The application of dorsal onlay pedicled labium flap urethroplasty is a good option for female distal urethral stricture with the advantages of good safety,excellent effectiveness,few complications,less pain,and high satisfaction rate.
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Objective To study the anti-tumor effects of griseofulvin on human prostate cancer PC-3 cells both in vitro and in vivo. Methods PC-3 cells were treated with griseofulvin at various concentrations for48 h,cell survival rate was then measured by MTT assay.The changes of morphology were observed by fluorescence microscope; Annexin V-FITC apoptosis detection kit was used to detect apoptosis of the cells ; The enzyme activity changes of caspase-3,8,9 were detected by spectrophotometry.For in vivo study,we first established the PC-3 tumor model by grafting PC-3 cells in athymic nude mice,and then injected griseofulvin into the tumors.12 days after injection,the mice were sacrificed,the tumors were removed,weighed and the ratios of tumor-suppression were then calculated.We had detected the expressions of Bcl-2,Bax,p53 and Survivin with immumohistochemistry as well. Results MTT results showed that griseofulvin could significantly inhibit the proliferation of PC-3 cells in vitro in a dose-dependent manner,and the IC50 of griseofulvin was 18.17 ±2.10 μg/ml.Typical morphological changes of PC-3 cells were observed by microscope.The rates of apoptosis of griseofulvin treated PC-3 cells greatly increased compared with that of the control cells (31.37 ± 2.93％ vs 2.89 ± 0.67％,P ＜ 0.01 ).The caspase-3,caspase-8 and caspase-9 activities in griseofulvin treated PC-3 cells were significantly higher than those in control cells (0.562 ±0.050 vs0.113±0.014,0.337±0.053 vs 0.120±0.017,0.293±0.038 vs0.109±0.018,P＜0.01).On the 23th day after tumor vaccination,the tumor volume was 961.17 ± 78.12 mm3 in griseofulvin treated group and was 433.6 ± 12.8 mm3 in control group (P ＜ 0.01 ).The tumor weight was 742.50 ± 78.63 mg in griseofulvin treated group and was 1387.33 ± 71.47 mg3 in control group ( P ＜ 0.01 ).Bcl-2,Bax,p53 and Survivin protein expressions were 16.10 ± 3.45％,39.50 ± 6.88％,48.20 ± 8.04％,16.50 ± 2.22％ in griseofulvin treated group,respectively; 41.30 ± 3.95％,13.70 ± 2.98％,17.60 ± 3.21％,52.11 ± 6.28％ in control group,respectively.And there were significant differences in both groups (P ＜ 0.01 ).The in vivo data showed that griseofulvin suppressed the tumor growth conspicuously through down-regulating the expression of Bcl-2,Survivin,and up-regulating the expression of Bax,p53. Conclusions Griseofulvin can inhibit the growth of PC-3 and induce apoptosis of PC-3 cells.Griseofulvin inhibits the in vivo tumorigenicity of PC-3 cells.
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ObjectiveTo analyze the technique and clinical effect of percutaneous nephrolithotomy combined with endoscopic balloon dilation in the treatment of upper ureterostenosis with recurrent renal calculi. MethodsFrom June 2008 to June 2011,18 ureteral stenosis patients with the history of ureteral open surgery,postoperative residual or recurrent kidney stones were treated.There were 8 males and 10 females with the age of 27 -48 years.Fourteen cases were with hydronephrosis of 2 -4 cm,3 cases were with hydronephrosis of 5 -6 cm and 1 case was with hydronephrosis ＞6 cm.Subsequent stone size ＜ 1 cm was found in 15 cases,1 -3 cm in 3 cases,＞3 cm in 1 case.All patients were treated with percutaneous nephrolithotomy ultrasonic lithotripsy combined with balloon dilatation.The stone clearance rate,hydronephrosis changes,complications and IVP situation before and after surgery were analyzed.ResultsAll the 18 cases were completed surgery successfully.There was 1 (6％) case with renal hemorrhage 3 days after the surgery and controlled with DSA hemostasis.There was 1 case accepted adjusting double-J tube by ureteroscopy.Sixteen (89％) patient's stones were completed removed.One case with residual calyceal stones size ＜5 mm was not further treated.There was 1 case treated with nephrectomy because of renal stone with infection.The patients were followed up for 6 to 36 months.Fourteen cases with hydmnephrosis improved significantly; 3 cases with no significant changes but improved following balloon dilation.All patients achieved significant improvement in imaging study comparing of preoperative and postoperative data.ConclusionThe use of percutaneous nephrolithotomy combined with endoscopic balloon dilation is a safe and efffective treatment option in the treatment of kidney stones with ureteral stenosis.
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Objective To investigate the feasibility of urethral reconstruction with colonic mucosa graft in the treatment of complex long urethral stricture.Methods The clinical data of three cases with complex long urethral stricture were reported and analyzed.Patient ages were 71,64 and 48 yrs and the course of disease was three months,six months and six yrs,respectively.The length of urethral stricture was 13,18 and 12 cm.Removing the narrow urethral segment and intercepting the length from 12 to 18 cm sigmoid colon and stripping colonic mucosa were performed.Urethral reconstruction was done with a free graft of colonic mucosa.Follow-up included urethrography,uroflowmetry,and urethroscopy.Results The urethral reconstructions were completed successfully.The urinary peak flows of the patients were 16.7 ml/s,19.6 ml/s and 26.4 ml/s at six weeks post operation.Urethrography revealed the graft urethral lumens were bulky three months after the operation.In urethroscopy,the colonic mucosa was found to be of good color and the anastomotic site healed well.Patients were followed-up 28,16,and three months,respectively,and were all voiding well.Conclusions Colonic mucosa graft urethroplasty is a feasible procedure for the treatment of complex long urethral stricture.
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Objective To investigate standardization of technique of retroperitoned laparoscopic ureterolithotomy.Methods Retroperitoneal laparoscopic ureterolithotomy was performed on 85 cases of ureterolithiasis(the stone size ranging from 0.8~2.5cm,40 cases in the left,45 cases in the right;and 25 had undergone unsuccessful ESWL).Results 84 cases succeeded,1 case opened becase of play D-J tube difficultly,the mean operation time was 75 minutes(48~220min),and the estimated blood loss 20~100ml,the drain tube was removed 5~12 days(mean 7 days),1 case experienced urinary leakage,1 case infective in the retroperitoneal.Conclusion Retroperitoneal laparoscopic ureterolithotomy was a safe operation,it can take the place of open surgery.
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Objective To evluate the efficacy of ureteroscope and holmium laser in the treatment of ureteral stones. Methods 48 cases of ureteral stones were ureteroscopicaly treated by the use of the above mentioned lithotripter from February 2001 to August 2001. Results 98%(47/48)of the stones being expelled within 5 days after the double J tube were pulled out.No complicaticons occurred. Conclusions Treatment of the ureteral stones by the use of ureteroscope and holmium laser is safe and effective.