A retrospective analysis of sacral neuromodulation for female overactive bladder and interstitial cystitis/painful blader syndrome / 中华泌尿外科杂志

Objective To evaluate the effects of sacral neuromodulation (SNM) on female overactive bladder (OAB) and interstitial cystitis/ painful bladder syndrome (IC/PBS).Methods From May 2016 to April 2017,13 patients with OAB or IC/PBS who had been treated with SNM were assessed retrospectively.Among them,6 cases were OAB patients,and 7 cases were IC/PBS patients.The average age was 52.3 (42-67)years old,and the preoperative and postoperative 24 h urine frequency,night urination frequency and average voided volume were compared.Results Totally 13 patients underwent stage Ⅰprocedure.The operation time for stage Ⅰ was 52-125min(average 92 min).After an average follow-up of 3.6 weeks,stage 11 procedures were performed on responders.Four OAB patients accepted stage Ⅱ1 surgery (conversion rate:66.7％),and the 24h frequency and night urination frequency reduced from preoperative 22.5 and 5.2 times to postoperative 14.3 and 2.3 times (P ＜ 0.05) respectively,and average voided volume increased from 120.3ml to 166.4ml (P ＜ 0.05).Among 4 patients presenting IC/PBS who had underwent stage Ⅱ surgery (conversion rate:57.1％),VAS score and 24 h voiding frequency reduced from 7.3 and 21.6 to 3.8 and 16.8 (P ＜ 0.05),respectively.No adverse event,such as wound infection or electrode translocation was detected during an average follow-up of 8.3 months.Conclusions Stage Ⅰ procedure is crucial for the long term efficacy of SNM.Postsurgical wound management and parameter adjustment are equal essential in order to achieve a maximum benefits.SNM has advantages in minimal invasiveness and less bleeding,which provides a minimal invasive approach for the managemem of OAB and IC/PBS.

A retrospective analysis of sacral neuromodulation for female overactive bladder and interstitial cystitis/painful blader syndrome / 中华泌尿外科杂志

Objective To evaluate the effects of sacral neuromodulation (SNM) on female overactive bladder (OAB) and interstitial cystitis/ painful bladder syndrome (IC/PBS).Methods From May 2016 to April 2017,13 patients with OAB or IC/PBS who had been treated with SNM were assessed retrospectively.Among them,6 cases were OAB patients,and 7 cases were IC/PBS patients.The average age was 52.3 (42-67)years old,and the preoperative and postoperative 24 h urine frequency,night urination frequency and average voided volume were compared.Results Totally 13 patients underwent stage Ⅰprocedure.The operation time for stage Ⅰ was 52-125min(average 92 min).After an average follow-up of 3.6 weeks,stage 11 procedures were performed on responders.Four OAB patients accepted stage Ⅱ1 surgery (conversion rate:66.7％),and the 24h frequency and night urination frequency reduced from preoperative 22.5 and 5.2 times to postoperative 14.3 and 2.3 times (P ＜ 0.05) respectively,and average voided volume increased from 120.3ml to 166.4ml (P ＜ 0.05).Among 4 patients presenting IC/PBS who had underwent stage Ⅱ surgery (conversion rate:57.1％),VAS score and 24 h voiding frequency reduced from 7.3 and 21.6 to 3.8 and 16.8 (P ＜ 0.05),respectively.No adverse event,such as wound infection or electrode translocation was detected during an average follow-up of 8.3 months.Conclusions Stage Ⅰ procedure is crucial for the long term efficacy of SNM.Postsurgical wound management and parameter adjustment are equal essential in order to achieve a maximum benefits.SNM has advantages in minimal invasiveness and less bleeding,which provides a minimal invasive approach for the managemem of OAB and IC/PBS.

Effect of IN-1130, a Novel Transforming Growth Factor-beta Type I Receptor Kinase (ALK5) Inhibitor, on a Rat Model of Peyronie's Disease Induced by Repeated Intratunical Injections of Fibrin / 대한남성과학회지

PURPOSE: Transforming growth factor-beta1 (TGF-beta1) has been known to be involved in the pathogenesis of Peyronie's disease (PD). In the present study, we investigated the therapeutic effect of IN-1130, a novel small molecule inhibitor of activin receptor-like kinase (ALK)5, a type I receptor of TGF-beta, in an animal model of PD induced by fibrin. MATERIALS AND METHODS: Four-month-old male Sprague-Dawley rats were divided into three groups (n=4 per group): group 1, age-matched control; group 2, PD rats without treatment; group 3, PD rats receiving an intratunical injection of IN-1130 (on day 20, 5 mg/kg in 0.1 ml saline) into the lesion. PD was induced in rats through repeated injections of fibrin (50 microliter each of human fibrin and thrombin solutions, days 0, 3, and 6, respectively) into the tunica albuginea. Penile curvature was evaluated by use of an artificialerection test on day 30. The penis was then harvested and stained with Masson trichrome, hematoxylin- eosin, and antibody to vimentin and phospho-Smad2. RESULTS: PD rats receiving repeated intratunical injections of fibrin revealed an infiltration of inflammatory cells, including lymphocytes, plasma cells, and fibroblasts, and an increase in transnuclear expression of phospho-Smad2 in the fibrotic plaque. However, repeated intratunical injections of fibrin did not induce penile curvature. IN-1130 induced significant regression of fibrotic plaque through reduced infiltration of inflammatory cells and reduced transnuclear expression of phospho-Smad2. CONCLUSIONS: Inhibition of TGF-beta pathway through the use of ALK5 inhibitors may be a curative local treatment modality for PD.

Establishment of Peyronie's Disease Model in a Rat with Repeated Injections of Fibrin into Tunica Albuginea / 대한남성과학회지

PURPOSE: This study was undertaken to establish a Peyronie's disease model by using local injection of fibrin into the tunica albuginea. MATERIALS AND METHODS: Four-month-old male Sprague-Dawley rats were divided into three groups (n=12 per group): Gr I, age-matched control; Gr II, a single injection of fibrin (50 microliter each of human fibrin and thrombin solutions); and Gr III, repeated injections of fibrin (50 microliter each of human fibrin and thrombin solutions, days 0, 3, and 6, respectively) into the tunica albuginea. We evaluated penile curvature by the use of an artificial erection test with intracavernous injection of saline and erectile function by cavernous nerve electrical stimulation 30, 45, and 60 days (n=4 per time point) after treatment. The penis was then harvested and stained with Masson trichrome, hematoxylin-eosin, and antibody to phospho-Smad2. RESULTS: Whereas a single intratunical injection of fibrin induced fibrous scar in the tunica, which lasted up to 45 days and disappeared 60 days after injection, repeated injections of fibrin induced more pronounced tunical fibrosis, which lasted up to 60 days after injection. However, a single or repeated intratunical injection of fibrin did not induce significant penile curvature. The peculiar histological findings in group receiving a single or repeated intratunical injection of fibrin were infiltration of inflammatory cells, and increase of transnuclear expression of phospho-Smad2. CONCLUSIONS: Although a single or repeated administration of fibrin did not induce penile curvature, this model may contribute to further investigation of pathogenesis and development of potential therapeutics in Peyronie's disease.