Clinical study on the treatment of high-risk BPH with hermo-expandable metallic prostate stent / 医学研究生学报

ObjectiveTo investigate the clinical efficacy and surgical experience of hermo-expandable metallic prostate stent in the treatment of elderly high-risk BPH patients.MethodsRetrospective analysis was performed on 38 patients with BPH who underwent implantation of hermo-expandable metallic prostate stent from January 2017 to October 2018 in the General Hospital of Eastern Theater Command. The patients were 72 to 89 years old, with preoperative international prostatic symptom score (IPSS) of 25.6±4.1 points, maximum flow rate of urine (MRF) of (4.8±1.2) mL/s, and residual urine volume (RUV) (160.7±70.5) mL. Urinary catheters were placed in 7 patients for 4-8 days due to acute urinary retention.ResultsExcept for the failure in one case, all 37 patients were successfully implanted with the prostate stent at one time, and they urinated immediately after the operation without serious operation-related complications. Follow-up was conducted for 3 months, and the IPSS and RUV of the 37 patients were (15.6±4.3) and (40.7±12.9) mL respectively, which were significantly lower than those before the operation (P<0.05). MRF was (11.1±4.3) mL/s, significantly higher than that before surgery (P<0.05). 22 cases in this group were followed up for 2 years, and their IPSS, MRF and RUV were all stable.ConclusionThe thermo-expandable metallic prostate stent for the treatment of dysuria caused by BPH is effective, reliable and less traumatic. It is a preferred choice for the treatment of the aged BPH patients who are at a high risk and not suitable for surgery.

Spiral thermo-expandable prostatic stent implantation for benign prostatic hyperplasia: Clinical analysis of 26 cases / 中华男科学杂志

Objective@#To investigate the surgical techniques and clinical effect of Memokath transurethral spiral thermo-expandable prostatic stent (STEPS) implantation in the treatment of BPH.@*METHODS@#From January 2017 to January 2018, 26 BPH patients underwent Memokath transurethral STEPS implantation, 9 under the flexible cystoscope and the other 17 under the rigid cystoscope. The patients were aged 62－91 years old, with a prostate volume of 32－78 ml, postvoid residual urine volume (PVR) of (67.3 ± 11.2) ml, maximum urinary flow rate (Qmax) of (6.3 ± 1.8) ml/s, and IPSS score of 26.7 ± 5.7. Eight of the patients had preoperative urinary retention, of whom, 6 received catheterization and 2 had undergone cystostomy for bladder fistula before STEPS implantation.@*RESULTS@#The operations lasted 15－30 minutes and were successfully completed in 24 cases while stent-shedding occurred in the other 2. Twenty-two of the patients achieved spontaneous urination immediately after surgery and 2 experienced bladder clot embolism. At 3 month after surgery, 24 of the patients showed significant improvement in PVR (［21.4 ± 7.7］ ml), Qmax (［18.3 ± 4.7］ ml/s) and IPSS (8.3 ± 2.1), and 13 exhibited no statistically significant difference from the baseline in the IIEF-5 score (14.1 ± 1.1 vs 14.3 ± 1.0, P > 0.05). At 12 months, all the patients were found with markedly improved urination but no adverse events except recurrent urinary tract infection in 2 cases.@*CONCLUSIONS@#Memokath STEPS implantation, with its advantages of simple operation, high safety, definite effectiveness, non-influence on sexual function, is a new effective surgical option for the treatment of BPH.

Penile and scrotal skin flaps: first choice for urethroplasty in the treatment of hypospadias / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the feasibility of the treatment of hypospadias with penile and scrotal skin flaps.</p><p><b>METHODS</b>Twenty-three hypospadias patients aged 3.5-19 (mean 6. 8) years underwent urethroplasty with penile and scrotal skin flaps. All were followed up for 6 years and analyzed retrospectively.</p><p><b>RESULTS</b>Of the total number of patients, 21 (91.3%) succeeded in one operation and the other 2 developed complications, including urethral fistula and urethral structure.</p><p><b>CONCLUSION</b>Penile and scrotal skin, advantageous for its adequacy, rich blood supply and contribution to high success rate of surgery, is believed to be the first choice for urethroplasty in the treatment of hypospadias.</p>

Expression of VEGF in prostate cancer and its correlation with ET-1 / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the expressions of VEGF in prostate cancer (PCa) and benign prostatic hyperplasia (BPH), their clinical significance and their relationship with that of ET-1.</p><p><b>METHODS</b>A total of 44 specimens of PCa and 36 of BPH tissues were examined by the immunohistochemical Elivision plus method for the expressions of VEGF and ET-1. The intensity of staining for VEGF and ET-1 was assessed by light microscopy on a scale from "-" to "+ + +".</p><p><b>RESULTS</b>The rates of positive expression of VEGF were 69.4% in BPH and 80.9% in PCa, positive staining mostly in the cytoplasm of glandular epithelia and cancer cells, and strongly positive in all the stroma vascular endothelial cells. The staining intensity of VEGF was significantly higher in the PCa than in the BPH group (P < 0.05) , in the bone metastasis (BM) than in the non-BM group (P < 0.01), and in the lowly than in the highly and moderately differentiated PCa tissues (P < 0.01). The expression of VEGF was positively correlated with that of ET-1 ( r(s) = 0.780, P < 0.01).</p><p><b>CONCLUSION</b>VEGF is involved in the development, progression and metastasis of PCa. VEGF and ET-1 may play a joint role in its development and progression.</p>

Expressions of endothelin-1 in benign prostatic hyperplasia and prostate cancer and their significance / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the different expressions of endothelin-1 ET-1) in prostate cancer (PCa) and benign prostatic hyperplasia (BPH) tissues and their clinical significance.</p><p><b>METHODS</b>A total of 36 BPH and 44 PCa specimens were examined for the expression of ET-1 by immunohistochemical technique (Elivision plus method). The staining intensity for ET-1 was assessed by light microscopy on a scale from "-" to "+ + +".</p><p><b>RESULTS</b>Positive immunoreactivity was found in BPH and PCa, with a positive rate of 100%. Positive staining was located mostly in the cytoplasm of glandular epithelia and smooth muscle cells of both BPH and PCa and was noted in all stroma vascular endothelial cells. These were no significant differences in the intensity of positive staining for ET-1 between the groups of BPH and PCa (P > 0.05), bone metastasis (BM) and non-BM (P > 0.05), and highly and moderately differentiated PCa (P > 0.05), but the staining intensity for ET-1 was significantly higher in the poorly than in the highly and moderately differentiated PCa (P < 0.01).</p><p><b>CONCLUSION</b>ET-1 has a high expression and the localization is the same in both BPH and PCa. It is involved in the development and progression of BPH and PCa.</p>

DNA methylation and prostate cancer / 中华男科学杂志

DNA methylation is a common event in malignancies and implicated in tumor initiation and progression. There is a battery of genes involved in critical cell processes such as DNA damage repair, which are hypermethylated in prostate cancer. DNA methylation has also been found in premalignant lesions such as prostatic intraepithelial neoplasia, but to a less extent compared with that in prostate cancer. Intensive study on DNA methylation would provide a new opportunity for the early diagnosis, prognosis and treatment of prostate cancer.

Evaluation of color Doppler flow imaging in the diagnosis and differential diagnosis of spermatic cord torsion / 中华男科学杂志

<p><b>OBJECTIVE</b>To distinguish spermatic cord torsion from acute orchitis by color Doppler flow imaging (CDFI).</p><p><b>METHODS</b>Thirteen patients with acute orchialgia were examined by CDFI. The clinical data of diagnosis and treatment were reviewed and analyzed.</p><p><b>RESULTS</b>The findings of CDFI showed lower or even no blood flow in the testes in 8 cases, which were diagnosed as spermatic cord torsion. Among them, 1 received manual detorsion and 7 were proved by operations. The other 5 showed abundant blood flow signal in the testes and were diagnosed as acute orchitis or epididymo-orchitis. After the use of antibiotics, their symptoms were relieved and the blood flow of the testes reduced upon reexamination.</p><p><b>CONCLUSIONS</b>CDFI plays an important role in the diagnosis and differential diagnosis of spermatic cord torsion, and could be regarded as a detecting method of first choice for patients of acute orchialgia.</p>