Effect of Paribhadra Paneeyakshara in Mutraghata Caused by Benign Prostatic Hyperplasia- A Case Report

Benign Prostatic Hyperplasia is a troublesome disease that bothers the population of ageing men by decreasing their quality of life. It is an abnormal growth involving the submucosal glands of prostate. The disease interferes with the normal daily activities and sleep pattern and hence is a matter of concern to the medical field. The symptoms of Benign Prostatic Hyperplasia closely coincide with the symptoms of Mutraghata (urinary obstruction) explained in Ayurveda. When taking the obstructive pathology into consideration, Paneeyakshara Prayoga (alkali for internal administration) is classically mentioned as a treatment option. This work is a case study on the effect of Paneeyakshara prepared out of Paribhadra (Erythrina indica) which is a drug possessing Vatakaphahara (alleviate Vata and Kapha Dosha) and Shophahara Karma (pacify inflammatory swellings) in Mutraghata caused by Benign Prostatic Hyperplasia. A 66-year-old male who presented with the signs and symptoms of Benign Prostatic Hyperplasia was administered with 500 mg of Paribhadra Paneeyakshara with 1 gram of Guda (jaggery), morning and evening, half an hour before food for a period of 45 days. Assessment was done before and after treatment based on the IPSS (International Prostate Symptom Score) of the American Urological Association and the Ultrasound abdomen findings. The post- interventional assessment showed a lowered IPS Score and reduced USG parameters indicating the efficacy of Paribhadra Paneeyakshara in reducing Mutraghata caused by Benign Prostatic Hyperplasia.

Clinical Research on Treatment of Benign Prostatic Hyperplasia with Traditional Chinese Medicine： A Review / 中国实验方剂学杂志

Benign prostatic hyperplasia （BPH）， a common disease in urology and andrology， is mainly manifested as enlarged prostate glands， bladder outlet obstruction， and lower urinary tract symptoms（LUTS）， which seriously affects the quality of life of middle-aged and elderly men. This disease falls into the categories of "retention of urine" and "prostatic hypertrophy" in traditional Chinese medicine （TCM）. In recent years，many doctors have put forward their understandings of BPH based on academic classics and their clinical experience. Clinical research on the treatment of BPH with TCM has become increasingly abundant. The basic pathogenesis of BPH lies in the disturbance of Qi transformation in the bladder and poor blood circulation due to kidney Qi deficiency in the aged. The disease is located in the kidney and the bladder and is related to the dysfunction of the lung and the kidney. It is basically characterized by deficiency in origin and excess in superficiality. A large number of clinical research reports have proved that TCM is efficient in alleviating the clinical symptoms of BPH patients， improving their quality of life， reducing the volume of the prostate， and decreasing postoperative complications. In addition， the external treatment methods of TCM， such as acupuncture therapy， moxibustion， hot water bathing， acupoint application， anal suppository， and enema therapy， are also widely used in clinical practice， demonstrating the diverse ways of TCM in treating BPH. TCM and western medicine complement each other's advantages in the treatment of BPH， thus enhancing the clinical efficacy and reducing the occurrence of long-term complications. This study reviewed the etiology， pathogenesis， and treatment progress of BPH with TCM in recent years， and summarized the current research status. From three aspects of producing high-quality clinical research， standardizing the clinical diagnosis and treatment of TCM， and combining cutting-edge research to explore the mechanism of TCM， it provided suggestions for clinical research on the treatment of BPH with TCM to promote the development and application of TCM in the treatment of this disease.

Influencia de la modalidad de respuesta, edad y nivel de educación en el cuestionario internacional de síntomas prostáticos (IPSS) / Influence of the response modality, age and level of education in the international prostate symptoms questionnaire (IPSS)

OBJETIVOS: evaluar la influencia de la modalidad de respuesta (paciente vs. asistido por urólogo) en el cuestionario IPSS (International Prostate Symptom Score) y su relación con la edad y nivel de educación. MATERIALES Y MÉTODOS: Análisis prospectivo de 74 pacientes que acudieron a la consulta de urología por síntomas de Hiperplasia Prostática Benigna (HPB) con o sin tratamiento para su patología y que no hayan completado anteriormente el cuestionario internacional de síntomas prostáticos (IPSS). Los cuestionarios fueron completados en la misma consulta urológica, primero por el paciente y luego con ayuda del urólogo. Se categorizó por edad y nivel de educación. Se evaluó la diferencia entre los puntajes de IPSS obtenidos con la forma autocompletada y con asistencia del urólogo y si esta diferencia estaba relacionada con la edad y con el nivel de educación. Los datos fueron analizados utilizando test no paramétrico para datos apareados de Wilcoxon. RESULTADOS: no se encontró diferencia estadísticamente significativa entre el cuestionario completado por el paciente y el asistido por el urólogo. La media del score total fue de 13,66, y 13,67, respectivamente (p: 0.86). Al analizar los subgrupos, con respecto a la edad y al nivel de educación, tampoco se encontraron diferencias estadísticamente significativas. CONCLUSIÓN: en nuestra población de estudio, el cuestionario IPSS no fue influenciado por la modalidad de administración, tampoco por la edad ni por el nivel de educación.

OBJECTIVES: to evaluate the influence of the response modality (patient vs. urologist-assisted) in the IPSS questionnaire (international prostate symptom score) and its relationship with age and education level. MATERIALS AND METHODS: Prospective analysis of 74 patients who came to the urology clinic for symptoms of Benign Prostatic Hyperplasia (BPH) with or without treatment for their pathology and who have not previously completed the international prostate symptoms questionnaire (IPSS). The questionnaires were completed in the same urological consultation, first by the patient and then with the help of the urologist. It was categorized by age and education level. The difference between the IPSS scores obtained with the self-completed form and with the assistance of the urologist and whether this difference was related to age and level of education was evaluated. The data were analyzed using non-parametric test for paired Wilcoxon data. RESULTS: no statistically significant difference was found between the questionnaire completed by the patient and the one assisted by the urologist. The average of the total score was 13.66, and 13.67, respectively (p: 0.86). When analyzing the subgroups, regarding age and level of education, no statistically significant differences were found. CONCLUSION: In our study population, the IPSS questionnaire was not influenced by the modality of administration, neither by age nor by level of education.

Effect of modified holmium laser enucleation of the prostate on sexual function in the treatment of benign prostatic hyperplasia / 上海交通大学学报（医学版）

Objective : To study the effect of modified holmium laser enucleation of the prostate (HoLEP) on sexual function in patients with benign prostatic hyperplasia (BPH). Methods ¡¤ The clinical data of 167 middle-aged and elderly patients with BPH treated by modified HoLEP from Feb. 2017 to Oct. 2018 were retrospectively analyzed. According to the status of sexual activity after operation, the patients were divided into study group who had sex (65 cases) and control group who had no sex (102 cases). The risk factors of sexual activity after operation in the two groups were analyzed. The changes of erectile function and ejaculatory function in the study group before and after operation were recorded and analyzed by international index of erectile function (IIEF-5) score, erection hardness score (EHS) model and ejaculatory function question-naire. Results ¡¤ There were no significant differences between the two groups in the stress urinary incontinence, postoperative hospitalization time, weight of enucleated prostate, crush time, total prostate specific antigen, preoperative urinary retention and enucleation time. The patients in the study group were younger than those in the control group (P=0.000). There were no significant differences in IIEF-5 score and EHS in the study group before and 1, 3, 6 months after operation. There were no significant differences in shorten ejaculation latency, ejaculation pain and ejaculation with or without semen in the study group before and after operation, but the patients of decreased semen volume increased from 41.82% (23/55) to 92.73% (51/55) (P=0.000). Conclusion ¡¤ Age is a risk factor in BPH patients, whether there is sexual activity after modified HoLEP or not. The modified HoLEP has no significant effect on erectile function, but the effect on ejaculatory function is the decrease of ejacu-lated semen volume.

Clinical study on transurethral laser shovel type vapor-resection-enucleation of the prostate based on the inter-layer of surgical capsule for the treatment of benign prostatic hyperplasia / 中华泌尿外科杂志

Objective To evaluate the efficacy and safety of transurethral laser shovel type vaporresection-enucleation of the prostate (LS-VREP) based on the inter-layer of surgical capsule for the treatment of benign prostatic hyperplasia (BPH),which was less 80 g weight.Methods From September 2013 to August 2016,a retrospective study was performed including 1 369 cases of BPH patients,who were treated by 120-160 W transurethral laser (straight green-light) shovel type vapor-resection-enucleation of the prostate (LS-VREP group,n =1 008) and transurethral resection of the prostate (TURP group,n =361).The preoperative data,including average age,prostate weight,IPSS,QOL,Qmax and PVR was reviewed.There was no significant difference of the above data between the two groups (P ＞ 0.05).Operative time,changes of hemoglobin and serum sodium concentration,postoperative bladder irrigation time,catheter indwelling duration,hospital stay,pre-and 3 months post-operative IPSS,QOL,Q PVR were recorded.In addition,complications were monitored.Results Mean operation time of LS-VREP group was (46.1 ± 18.6) min,while TURP group was (48.2 ± 15.2) min,and there was no difference between the two groups (P ＞ 0.05).Post-operative mean hemoglobin concentration and serum sodium concentration of LS-VREP group decreased (1.6 ± 1.2) g/L and (1.2 ± 0.6) mmol/L respectively,while those of TURP group decreased (5.7 ± 3.6) g/L and (3.2 ± 1.2) mmol/L,and the differences were statistically significant (P ＜ 0.05).Mean post-operative catheter indwelling time,and post-operative hospital stay of LS-VREP group was (42.9 ± 12.7) h and (3.2 ± 0.6) d,while TURP group was (65.7 ± 15.4) h and (5.4 ± 1.2) d,and the differences were statistically significant (P ＜ 0.05).Comparatively IPSS,QOL,Qmax and PVR were all improved significantly in both groups at 3 months after operation (P ＜ 0.05),but no significant difference was found between the two groups (P ＞ 0.05).After three months' follow-up of post-operation,as for the complication rate,including TURS,bleeding requiring reoperation,incontinence,dysuria and erectile dysfunction,LS-VREP group (15/1 008) was less than that of TURP group (30/361,P ＜ 0.05).Conclusions The LS-VREP based on the inter-layer of surgical capsule is safe and effective for the treatment of BPH patients whose prostate weight was less than 80 g.LS-VREP showed less intraoperative bleeding,faster postoperative recovery,and high safety,which is considered a safe,effective and optimized minimally invasive surgery.

Drug therapy for benign prostatic hyperplasia and individualized drug regime / 药学实践杂志

Objective To review the drug therapies for benign prostatic hyperplasia (BPH) and provide a reference for clinical individualized medication regime.Methods The mechanisms and clinical indications of commonly used BPH medications and some new drugs were discussed.The challenges for BPH therapies were also explored.Results α-receptor inhibitors and 5α-reductase inhibitors have the best effect for BPH.Surgery is needed for the BPH patients who are not responsive to the drug therapy.Conclusion Individualized medication programs reduce the medication waste and give patients the best treatment options.

Transurethral vaporization of the prostate using 1 470 nm diode laser in treatment of BPH / 中国内镜杂志

Objective To explore the efficacy and safety of Transurethral vaporization of the prostate using 1 470 nm diode laser in treatment of BPH.Methods 58 cases BPH patients underwent transurethral vaporization of the prostate using 1 470 nm diode laser from Dec. 2015 to Apr. 2016 were retrospectively analyzed, including the mean operation time and compared hemoglobin, electrolyte, urinary symptoms, before and after surgery.Result Operations were successfully performed in all the 58 cases, with average operation time of (48.2 ± 16.3) min. No difference was found in either hemoglobin decrease or electrolyte decrease before and after surgery. The patients were followed up for 1~3 months, which revealed a signiifcant reduction in IPSS and improvement in Qmaxand PVR (P < 0.05), compared with pre-operation. No severe complications were reported, including transurethral resection (TUR) syndrome, urinary incontinence and impaired erectile function.Conclusion Transurethral vaporization of the prostate using 1 470 nm diode laser is a safe and effective therapy for BPH. It has advantages of short learning curve, very little blood loss, high efifcacy. It has promising broad prospects.

Role of Serum Total PSA (Prostate Specific Antigen) and Free to Total PSA Ratio in the Diagnosis of Carcinoma Prostate.

The objective of the study was to evaluate and compare the role of total and free/total ratio of serum prostate specific antigen level in diagnosing carcinoma prostate. A cross sectional study was conducted at the Department of Biochemistry, Dhaka Medical College (DMC) with collaboration of the Department of Urology, Dhaka Medical College Hospital (DMCH), Dhaka from July 2008 to June 2009. This study was carried out on 60 patients above 50 years of age who attended the Department of Urology, Dhaka Medical College Hospital, complaining of irritative or obstructive lower urinary tract symptoms (LUTS) suspected as clinically benign prostatic hyperplasia (BPH) or cancer prostate. It was aimed to assess the role of total and free/total ratio of serum PSA in diagnosis of BPH and carcinoma prostate with reference to histological diagnosis. All the cases were evaluated by history, physical examination including digital rectal examination, serum prostate specific antigen level, transabdominal/ trans-rectal ultra- sonogram. From all patients, blood sample were collected before digital rectal examination or any per urethral manipulation. Final diagnosis was obtained by histo-pathological examination, specimen being obtained by perrectal biopsy with biopsy-gun. Histopathological examination detected prostate cancer in 20 out of 60 patient and 17 of these Cap 20 have a total PSA 4 ng/ml and only 3 have total PSA 4 ng/ml. 18 of these 20 have free to total ratio 0.16 and 02 have f/t ratio 0.16. Among 60 patients, 40 patients were detected BPH on histopathological diagnosis. 20 of these BPH patient have tPSA 4 ng/ml and 20 of BPH have tPSA 4 ng/ml. 38 of 40 BPH patient have f/t ratio>0.16 and 2 of 40 patient are f/t ratio 0.16. Receiver operating characteristic analysis indicated a threshold f/t ratio 0.16 was optimum discriminatory level. The sensitivity of total serum PSA (at cut off value of>4 ng/ml) in correctly differentiating prostatic carcinoma of those who have the condition is 85%, while the specificity of the test in correctly detecting those who do not have the disease is 50%. The PPV is 45.9%, NPV is 87% and accuracy is 61.7%. The sensitivity of free/total serum PSA (at cut off value of 0.16 ng/ml) in correctly differentiating prostatic carcinoma from BPH is 90%, while the specificity of the test in correctly detecting those who do not have prostatic carcinoma is 95%. The PPV of the test is 90% and the NPV of the test is 95%. The overall accuracy of the test is 93.3%. This study showed significant difference of total and free/total ratio of serum prostate specific antigen (PSA) in differentiating benign prostatic hyperplasia (BPH) from carcinoma prostate. Receiver operating characteristic curves showed advantage for the f/t PSA ratio when compared with total PSA in detecting prostate cancer. From the study it may be concluded that total and f/t ratio of prostate specific antigen (PSA) is a useful marker in diagnosis of carcinoma prostate. Free/total ratio is more accurate than total PSA.

Diagnosis value of urodynamics in patients with benign prostate hypertrophy / 医用生物力学

Objective To evaluate the diagnosis value of urodynamics in patients with benign prostate hypertrophy(BPH).Methods With urodynamic device,the full set of urodynamic exam was administrated in 427 patients with BPH,and the externalsphincter urethral myogram was monitored simultaneously in pressure-flow studies(PFS).The umdynamic finding such as Qmax 、Pdet-Qmax、Popen、DS(descending slope) and post-voiding residual(PVR)were recorded,as well as the situation of bladder detrusor constraction and bladder compliance and urethral sphincter coordination. The bladder outflow obstruction was diagnosed by A-G nomogram，P-Q plot and DS.The IPSS score and prostate volume were also acquired. Results The diagnostic rate of BOO is 81.5％,among them concomitantly detrusor muscle impair in 117 cases(27.4％), decreased bladder compliance in 162 case (37.9％)，urethral sphincter dyssynergia in 148 cases(34.7％)，and unstable bladder in l64 cases (38.4％). The increase degree of BOO show an increasing tendency with urodynamic findings such as Qmax ,Pdet-Qmax,Popen,DS and IPSS score and prostatic volume respectively，however a decreasing tendency with Qmax and bladder compliance. Conclusions The urodynamic exam plays an important role in diagnosis of BOO.There is a positive relation among degree of BOO with urodynamic finding such as Pdet-Qmax,Popen,DS and IPSS score and prostatic volume,however，negative relation with Qmax and bladder compliance respectively.

Expression patterns of survivin and cuspuse-3 in dissymmetric enlarged prostate / 中华泌尿外科杂志

Objective To compare the different expression patterns of survivin and caspase-3 between the larger part and the smaller part of the dissymmetric enlarged prostates in BPH patients, and to clarify the role of apoptosis in BPH etiology. Methods BPH tissues from 25 patients were embedded in paraffin. The specimens constituted of two prostate parts from each patient. One part was from the larger enlarged gland and the other was from the smaller enlarged counterpart. 50 paraf-fin blocks were cut into sections and stained with survivin and caspase-3 polyclonal antibodies against human. All the data was analyzed by SPSS13.0 software. Results Survivin immunoreactivity was localized in prostatic cell nuclei. Survivin expression in larger enlarged parts (22.08±16. 33)0% was significantly higher than the smaller parts (7. 645±5. 45)%(P<0.01). Positive nuclear or cytoplasm staining was also observed in the Caspase-3 immunoreactivity. Caspase-3 expression was higher in smaller enlarged parts (51. 525±27. 27%) than in larger enlarged parts (33. 125±21.01%) (P< 0.01). Survivin expression in larger part of the enlarged prostates was inversely correlated with caspase-3 expression (r=-0. 474, P<0. 05). However, in smaller part of the enlarged prostates, the expression of the two factors had no relation (r=-0. 313,P>0. 05). Conclusions Survivin and caspase-3 expression patterns are different in the two parts of the dissymmetric enlarged prostates. These different patterns indicate apoptosis playing an important role in BPH development.

Effect of Detrusor Hyperactivity with Impaired Contractile Function on Voiding Function in Benign Prostatic Hyperplasia / 中国康复理论与实践

@#Objective To investigate the impact of detrusor hyperactivity with impaired contractile function(DHIC)on voiding function in benign prostatic hyperplasia(BPH).Methods68 patients with BPH accepted the test of urodynamics.The urodynamic parameters between DHIC group and no DHIC group were compared statistically.ResultsThe residual urine in DHIC group was larger and the detrusor pressure at Qmax,the bladder volume were smaller than that in no DHIC group(P<0.01).ConclusionDHIC worsens the voiding function of the patients with BPH,and the test of urodynamic is helpful to diagnose and to treat it.

Causes,Treatments and Prevention of Dysuria after Transurethral Resection of Prostate(TURP) / 中国微创外科杂志

Objective To investigate the causes,treatments,and prevention of dysuria after transurethral resection of prostate (TURP). Methods The clinical data of 49 cases of dysuria post-TURP that were treated in our hospital from July 2004 to September 2008 were analyzed retrospectively. Results Among the cases,6 patients received silica catheterization again because of edema of the bladder neck and urethra; 9 underwent catheterization after bladder flush for delayed prostate bleeding; 20 underwent urethral dilatation or meatotomy due to meatal stenosis,5 received urethral dilatation for urethral stricture; urethral dilatation or direct vision internal urethrotomy were performed on 4 cases who had bladder neck fracture; TURP was carried out for a second time in 4 cases because of glandular residual; suprapubic cystostomy was made in 1 case of colonal carcinoma for long-term bed rest. All cases were cured after the treatment. Conclusions Meatal stenosis is the most common cause of dysuria post-TURP.Urethral dilatation is the first choice for the disease.

The Relating Factors of Metabolic Syndrome to Benign Prostatic Hyperplasia / 대한비뇨기과학회지

PURPOSE: Benign prostatic hyperplasia (BPH) is a representative urological disease in men at senescence. The etiology of BPH is multifactorial, with chronic conditions, such as non insulin dependent diabetes mellitus (NIDDM), treated hypertension, obesity, low and high density lipoprotein (HDL) cholesterol levels and high insulin levels, constitute for the development of BPH. The prevalence of metabolic syndrome in a BPH population was investigated and the relationship between BPH and metabolic syndrome evaluated. MATERIALS AND METHODS: The BPH group consisted of 162 patients (63.4+/-7.8 years old) diagnosed as BPH and the control group of 68 patients (59.7+/-6.4 years old) without voiding difficulties. In each group, the relating factors, prevalence of BPH and metabolic syndrome were investigated and analyzed for comparison. RESULTS: Comparing the voiding factors of the BPH and control groups, all of the measured values showed aggravation of the voiding difficulty in the BPH compared with the control group. The prevalence of metabolic syndrome in the BPH group was 64.2%, which was about double that in the control group (32.4%) (p<0.001). Among the components of metabolic syndrome, hypertension (70.4%) was found to have the highest prevalence. CONCLUSIONS: The probability of patients with BPH having metabolic syndrome is high compared to those without BPH. Consequently, in BPH patients, careful evaluation for metabolic syndrome is needed, with the early diagnosis and proper management of metabolic syndrome should accompany the treatment of BPH.

The Usefulness of Ice-water Test in the Patients with Symptomatic Benign Prostatic Hyperplasia (BPH) Associated with Overactive Bladder / 대한비뇨기과학회지

Purpose: A video-urodynamic study is known as the most accurate test to differentiate between benign prostatic hyperplasia (BPH) with overactive bladder and detrusor instability but requires expensive equipment and an expert technique, so is not commonly available. We performed a video- urodynamic study and ice-water test which is easily performed for the diagnosis of a neurogenic bladder in the patients with symptomatic BPH associated with overactive bladder and compared the results. Materials and Methods: The video-urodynamic study using a 10-Fr triple lumen urodynamic catheter was performed in 36 patients with symptomatic BPH associated with overactive bladder that had frequency, weak stream, nocturia, urgency, urge incontinence, dysuria and no clinical neurogenic defect. After the video-urodynamic study, the ice-water test was performed by instilling 4degreesC sterilized water through a catheter at 200ml/ min in the supine position. The volume instilled was about 30% of the bladder capacity. The ice-water test was positive if there was an efflux of water around the catheter during or after water instillation. Results: Thirty two of the 36 symptomatic BPH patients with an overactive bladder were negative on the ice-water test. All 32 patients who had a negative ice-water test were BPH with overactive bladder on the video- urodynamic study. Four of the 36 symptomatic BPH patients with an overactive bladder were positive on the ice-water test. Two of the 4 patients who had a positive ice-water test were BPH with overactive bladder and the other two were detrusor instability on the video-urodynamic study. Conclusions: Therefore, in case of a positive ice water test, a video-urodynamic study is needed to differentiate between BPH with overactive bladder and detrusor instability in patients with symptomatic BPH associated with overactive bladder.

Transurethral resection syndrome during transurethral vaporization of the prostate: Report of 27 cases / 中国微创外科杂志

Objective To summarize the causes, diagnosis and treatment of transurethral resection syndrome (TURS) during the transurethral vaporization of the prostate (TUVP). Methods Among 322 consecutive patients who underwent TUVP, TURS happened in 27 patients (8.4%). Their clinical data on the operation, monitoring and treatment were retrospectively reviewed. Results Of the 27 patients, the mean operative time was 95 min (52~170 min), the mean blood loss was 251 ml (100~700 ml), and the mean weight of resected prostate was 36.1 g (16~82 g). During the operation the prostatic capsule was perforated in 21 patients (78%). Postoperatively, all the patients had yawning, hypotension and bradycardia. Their serum sodium concentrations during TURS were 122.3?9.6 mmol/L, which was 16.3?4.5 mmol/L lower than before the operation, with significant difference ( t=)14.211,P90 min). Close attention and assessment of the patient’s) vital signs and mental status can increase the early detection and treatment of TURS.

Prostatectomy by Transfixing Inferior Vesical Artery and Reserving Posterior Urethra / 中国医师杂志

Objective To study a new method of opening prostatectomy.Methods 71 cases of benign prostatic hyperplasia (BPH) patients were divided into three group at random;treating group:prostatectomy by transfixing inferior vesical artery and reserving posterior urethra(n=21),control group Ⅰ:Millin operation(n=18) and control group Ⅱ:cystoprostatectomy through superior pectineus(n=32),the clinical effect was studied and observated.Results All 71 cases of patients were BPH according to pathology reports.Treating group had lower incidence than that of control group in injury of urethra,bleeding after operation,the times of irrigation of urinary bladder,urinary incontinence in the near future,secondary bleeding,urinary tract infection,bladder spasm,urethral stricture,and so on.Conclusions Prostatectomy by transfixing inferior vesical artery and reserving posterior urethra has many virtues such as simple,soon to discharge,cheapness of medical cost,and easy to spread.

Value of Dynamic Spiral CT in Prostate Cancer and Benign Prostate Hyperplasia / 实用放射学杂志

Objective To detect the value of dynamic spiral CT on the prostatic cancer and benign prostate hyperplasia(BPH).Methods Plain and dynamic spiral CT scans were obtained in 88 male patients with various ages due to prostate or other pelvis diseases.Out of these detailed data in 5 cases of prostate cancer and 11 cases of BPH which were confirmed by operation and pathology were available.Contrast enhancement pattern and degree were correlated with the pathological and operational findings.Results Prostate was enlarged in all cases except one prostate cancer and 3 cases of BPH within normal limits in size.The contour of the prostate was irregular in all cancer cases and one BPH.On dynamic CT scans,prostatic malignant lesions appeared iso-hypodensity with the rest of the prostate gland at the arterial stage and low density at the veinous stage.Diffuse heterogeneous central enhancement was found in 10 cases of BPH at the arterial stage,especially in the lateral lobes and further enhancement was found in 10 cases of BPH at the arterial stage,especially in the lateral lobes and further enhancement was found at the middle stage.There was little enhancement in the peripheral part at the arterial and veinous stages in BPH.The ratio of the central and the peripheral decreased.One case of BPH within normal size had spotty enhancement in the central part.On delayed CT scans 8 cases of BPH showed homogeneous enhancement in the total prostate gland.Conclusion Prostate cancer and BPH have their own characteristic enhancement patterns and degress,therefore dynamic spiral CT scan could help make differentiation between the two disease.

Development of Long Pulse YAG Laser Treatment Machine / 医疗卫生装备

Objective To develop a laser treatment machine for the benign prostatic hyperplasia(BPH),which can both avoid the transurethral resection symptoms(TURS) and rapidly remove the big BPH.Methods The machine adopted a long plus laser with 80W average power and 1000W peak value power in order to rapidly vaporize the neoplasm.Because of its high power,short operation time and small thermal penetraction depth,it could avoid the post-operation edema of the organ is resulted from the concretion of traditional continuous-wavelength YAG laser.The control system based on AT89C51 dominated the laser power,and meanwhile,it monitored the process to protect the machine.It was connected with the Hospital Information System(HIS) via RS232.Results The chicken breast tissues were irradiated with the sample machine under water,and the groove irradiated by laser was 4mm in width and 2.5mm in depth with the irradiation speed of 5mm/s.The arbonation of tissue surface was slight and the thermal damage to the adjacent tissues was the minimal.Conclusion This machine can rapidly vaporize the neoplasm with the minimal thermal damage to the adjacent non-irradiated tissues.It is desirable for the treatment of big BPH.