ABSTRACT
OBJECTIVE@#To observe the short-term efficacy, long-term efficacy and safety of acupuncture for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).@*METHODS@#Forty-two patients with CP/CPPS were randomly divided into an acupuncture group (21 cases, 1 case dropped off) and a sham acupuncture group (21 cases). The patients in the acupuncture group were treated with acupuncture at bilateral Zhongliao (BL 33), Huiyang (BL 35), Shenshu (BL 23) and Sanyinjiao (SP 6); the needling depth of Zhongliao (BL 33) and Huiyang (BL 35) was 60 to 80 mm, while Shenshu (BL 23) and Sanyinjiao (SP 6) was directly punctured of 30 mm. The patients in the sham acupuncture group were treated with acupuncture at non-acupoints, including points 2 cm next to Shenshu (BL 23), Zhongliao (BL 33) and Huiyang (BL 35), and the midpoint of the connecting line between the spleen meridian and the kidney meridian. All the non-acupoints were treated with directly puncture of 2 to 3 mm. The needles were left for 30 min in both groups, once every other day in the first four weeks, three times a week, and twice a week in the next four weeks, totally 20 treatments. Before treatment, after treatment and in follow-up of 24 weeks after treatment completion, the National Institutes of Health-chronic prostatitis symptom index (NIH-CPSI) score and urinary flow rate were observed in both groups; the clinical efficacy and safety were evaluated.@*RESULTS@#Compared with those before treatment, the pain and discomfort scores, urination symptoms scores, quality of life scores and total scores of NIH-CPSI in both groups were reduced after treatment in the two groups (P<0.01), while each item score and total score of NIH-CPSI in the acupuncture group were reduced in follow-up (P<0.01, P<0.05). After treatment and in follow-up, each item score and total score of NIH-CPSI in the acupuncture group were lower than those in the sham acupuncture group (P<0.05, P<0.01). After treatment, the maximum and average urinary flow rates in the acupuncture group were higher than those before treatment (P<0.05), and the average urinary flow rate in the acupuncture group was higher than that in the sham acupuncture group (P<0.05). The total effective rate was 75.0% (15/20) in the acupuncture group, which was higher than 42.9% (9/21) in the sham acupuncture group (P<0.05). No significant adverse reactions were observed in the two groups, and there was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).@*CONCLUSION@#Acupuncture could effectively alleviate the clinical symptoms, improve quality of life, and has a sustained, safe and reliable therapeutic effect in patients with CP/CPPS.
Subject(s)
Male , Humans , United States , Prostatitis/therapy , Quality of Life , Acupuncture Therapy , Punctures , MeridiansABSTRACT
Objective@#To investigate the advantages and disadvantages of point electro-cauterization (PEC) and holmium laser cauterization (HLC) in the treatment of post-ejaculation hematuria.@*METHODS@#From January 2015 to December 2018, 73 patients with post-ejaculation hematuria, aged 24－63 (36.8 ± 4.2) years, underwent PEC (n = 35) or HLC (n = 38) after failure to respond to 3 months of conservative treatment. We compared the hospital days, total hospitalization expenses, maximum urinary flow rate (Qmax), average urinary flow rate (Qavg), Hamilton Anxiety Rating Scale (HAMA) score, postoperative duration of hematuria, and recurrence rate at 3 and 6 months after surgery.@*RESULTS@#All the patients experienced first ejaculation but no post-ejaculation hematuria at 1 month after operation. The recurrence rates were lower in the PEC than in the HLC group at 3 months (5.71% vs 2.63%, P > 0.05) and 6 months postoperatively (8.57% vs 5.26%, P > 0.05). Compared with the baseline, the Qmax was decreased from (18.56 ± 2.53) ml/s to (13.68 ± 3.31) ml/s (P < 0.05) and the Qavg from (14.35 ± 2.26) ml/s to (9.69±1.84) ml/s in the PEC group at 1 month after surgery (P < 0.01), but neither showed any statistically significant difference in the HLC group. Mild to moderate anxiety was prevalent in the patients preoperatively, particularly in those without job or regular income and those with a long disease course or frequent onset, the severity of which was not correlated with age, education or marital status. The HAMA score was decreased from18.65 ± 4.33 before to 12.35 ± 3.63 after surgery in the PEC group (P < 0.01), and from 16.88 ± 2.11 to 6.87 ± 4.36 in the HLC group (P < 0.01). The mean hospital stay was significantly longer in the former than in the latter group (［5.2 + 1.3］ vs ［3.4 ± 0.5］ d, P < 0.01), while the total cost markedly lower (［6.35 ± 1.20］ vs ［12.72 ± 2.15］ thousand RMB ¥, P < 0.05).@*CONCLUSIONS@#Both PEC and HLC are safe and effective for the treatment of post-ejaculation hematuria, with no significant difference in the recurrence rate at 3 and 6 months after operation, but their long-term effect needs further follow-up studies. PEC may increase the risk of negative outcomes of the postoperative urinary flow rate, while HLC has the advantages of better relieving the patient's anxiety, sooner discharge from hospital and earlier recovery from postoperative hematuria, though with a higher total cost than the former.
Subject(s)
Adult , Humans , Male , Middle Aged , Young Adult , Cautery , Ejaculation , Hematuria/surgery , Holmium , Laser Therapy , Lasers, Solid-State/therapeutic use , Treatment OutcomeABSTRACT
Objective@#To assess the clinical effects of transurethral holmium laser enucleation of the prostate (HoLEP) combined with Jisheng Shenqi Decoction (HoLEP + JSSD) on BPH.@*METHODS@#This study included 110 BPH patients treated in our hospital from August 2017 to April 2018, who were randomly assigned to receive HoLEP (n = 55) or HoLEP + JSSD (n = 55). We compared the pre- and post-operative IPSS, quality of life (QOL) score, prostate volume, postvoid residual urine volume (PVR), maximum urinary flow rate (Qmax), average urinary flow rate (Qavg) and levels of serum T, E2 and T/E2 as well as postoperative complications between the two groups of patients.@*RESULTS@#After treatment, both IPSS and QOL score were significantly lower in the HoLEP + JSSD than in the HoLEP group (P 0.05) or the total incidence rate of complications postoperatively (21.82% vs 29.09%, P > 0.05).@*CONCLUSIONS@#HoLEP + JSSD can significantly alleviate the lower urinary tract symptoms as well as improve the QOL and bladder and urinary tract functions of BPH patients.
ABSTRACT
Objective To observe the clinical efficacy of acupuncture plus moxibustion in the treatment of benign prostatic hyperplasia.Method Sixty cases of benign prostatic hyperplasia were randomly divided into two groups, 30 cases in the treatment group, 30 cases in the control group. The treatment group was intervened by Acupuncture and moxibustion, while the control group was by orally takingJingzhu Qianlie Longbitong capsules. The International Prostate Symptom Score (IPSS), Quality of Life score (QOL), maximal urinary flow rate (Qmax), residual urine volume (RUV) were compared before and after 3 courses of treatment. Result The total effective rate was 93.3% in the treatment group, versus 66.7% in the control group, and the difference was statistically significant (P<0.05); the IPSS score, QOL score, Qmax, and RUV were significantly changed in both groups after intervention (P<0.05).Conclusion The treatment group and the control group both show improvements in IPSS, QOL score and Qmax and reduction of RUV, which proves that acupuncture plus moxibustion can produce a content efficacy in treating benign prostatic hyperplasia.
ABSTRACT
A clinical study was made on 330 cases of transurethral prostatectomy that were performed at the Department of Urology. Seoul Eulji General Hospital. Seoul and Daejeon Eulji General Hospital, Daejeon during the period from August, 1984 to July, 1992. Transurethral prostatectomy was per- formed on 309 cases of benign prostatic hyperplasia and 21 cases of prostatic cancer. 1. The mean age of all patients was 67.1 years(50-85 years) and the group of seventh decade was most common (40.5% in BPH and 55% in prostatic cancer). 2. The mean weight of resected prostatic tissue was 9.7 grams(3-45 grams) and the mean length of resection time was 68.6 minutes(30-125 minutes). The mean weight of resected tissue per minute was 0.23 grams. 3. The mean duration of postoperative urethral catheter indwelling was 6.3 days(2-14 days) and the mean period of postoperative hospitalization was 8.4 days(3-19 days). 4. Total complication rate was 15.5% and complications were as follows; failure to void(4.6%) bleeding(3.9%), incontinence(2.7%), urethral stricture(1.8%), secondary resection due to in- adequate resection(1.2%), extravasation(0.9%), epididymitis(0.3%), hyponatremia(0.3%), etc. One patient was dead due to deterioration of associated disease postoperatively. 5. We undertook follow-up assessment of voiding symptom with Boyarsky symptom score system on 148 cases of BPH group. The mean obstructive and irritative symptom scores decreased 84 % and 48%, respectively. We also evaluated the urinary flow rate in 102 cases of 148 cases and the mean peak flow rate improved 98%. The observed changes in symptom score and urinary flow rate was statistically and clinically significant(p<0.01).