"3+1" bladder function restoration combined with holmium laser enucleation of the prostate for benign prostatic hyperplasia with acontractile detrusor / 中华男科学杂志

Objective@#To investigate the clinical effect of "3+1" bladder function restoration combined with holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH) with acontractile detrusor (ACD).@*METHODS@#We treated 35 BPH patients with ACD by HoLEP followed by "3+1" bladder function restoration, that is, a 3-phase bladder function training plus simultaneous 1-drug medication after surgery. We recorded and analyzed the detrusor pressure, post-void residual urine volume (PVR), maximum urinary flow rate (Qmax), International Prognostic Scoring System (IPSS) scores, quality of life (QoL), voluntary micturition, satisfaction with the bladder function, hydronephrosis, ureterectasia, renal function, and urinary tract infection of the patients before and after treatment.@*RESULTS@#Compared with the base line, at 6 months treatment, the patients showed significantly increased detrusor pressure (［35.1±2.7］vs ［50.2±2.3］ cmH2O, P<0.05) and Qmax (［4.2±2.7］vs ［21.1±4.1］ ml/s, P<0.05) but decreases in PVR (［173.0±31.6］ vs ［30.5±12.9］ml, IPSS score (27.3±3.2 vs 5.1±1.4, P<0.05) and QoL (4.1±0.8 vs 0.8±0.1, P<0.05), elevated rates of voluntary urination (0% ［0/35］ vs 100% ［35/35］, P<0.05), regularurination (0% ［0/35］ vs 85.71% ［30/35］, P<0.05), grade Ⅰ satisfaction with bladder function (0% ［0/35］ vs 85.71% ［30/35］, P<0.05), reduced rate of overflowing urinary incontinence (28.57% ［10/35］ vs 5.71% ［2/35］, P<0.05), and increased percentages of normal renal function (34.29% ［12/35］ vs 85.71% ［30/35］, P<0.05) and non-infection of the urinary system (17.14% ［6/35］ vs 94.29% ［33/35］, P<0.05). After treatment, urination was markedly improved in 94.29% (33/35) of the patients.@*CONCLUSIONS@#"3+1" bladder function restoration combined with HoLEP produced a desirable effect on BPH with ACD, though its long-term effect remains to be further investigated.

Expressions of ATF3 and CTGF and their regulation by estradiol in the prepuce of hypospadias patients / 中华男科学杂志

<p><b>OBJECTIVE</b>Estrogen is closely associated with hypospadias. The present study was to explore the molecular mechanism of hypospadias caused by estradiol.</p><p><b>METHODS</b>Fibroblasts obtained from the prepuce of hypospadiac and normal children were cultured in vitro and treated with 17-beta ethinyl estradiol (17-EE) at the concentrations of 1 micromol/L to 0.1 nmol/L for 2 hours, or at 0.1 micromol/L for 0.5, 1, 2, 4, 8, 16 and 24 hours. MTT assay was used to evaluate the effect of 17-EE on the proliferation of the cells, and RT-PCR was employed to detect the expressions of the activating transcription factor-3 (ATF3) and connective tissue growth factor (CTGF) in the hypospadiac tissue. The results were compared with those obtained from the nonhypospadiac tissue.</p><p><b>RESULTS</b>The expressions of ATF3 and CTGF were significantly upregulated in the hypospadiac tissue as compared with the nonhypospadiac group. At the concentration of 1 micromol/L, 17-EE significantly inhibited the proliferation of the cells. ATF3 mRNA was elevated at 1-2 hours, while CTGF mRNA showed no significant changes in 24 hours.</p><p><b>CONCLUSION</b>ATF3 and CTGF are two candidate genes involved in the etiology of hypospadias. And estradiol may induce hypospadias by upregulating the expressions of ATF3 and CTGF.</p>