Application of tubularized incised plate in one-stage urethroplasty for hypospadia accompanied with anatomic kak-factors / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the application of tubularized incised plate (TIP) in urethroplasty for hypospadia accompanied with anatomic kak-factors.</p><p><b>METHODS</b>We retrospectively studied 191 cases of hypospadia treated by one-stage TIP urethroplasty. Taking the position of the urinary meatus, the development of the glans penis and urethral plate, and the degree of penile ventral curvature as anatomic kak-factors inducing postoperative complications and affecting the appearance, we conducted correlation analyses on the clinical effects of the procedure using SPSS 10.0 statistics.</p><p><b>RESULTS</b>Postoperative complications were closely correlated with the position of the urinary meatus, the nearer its position to the coronary sulcus, the higher the incidence of complications (chi2 = 24.291, P < 0.01). And so were they with the development of the glans penis and urethral plate and the degree of penile ventral curvature. The incidence of postoperative complications was significantly higher in the hypospadia patients with small glans, maldeveloped urethral plate and severe penile ventral curvature than in those with straight penis and well-developed glans and urethral plate (chi2 = 25.419, P < 0.01).</p><p><b>CONCLUSION</b>Tubularized incised plate urethroplasty for hyper-spadias should be chosen according to the position of the meatus, the development of urethral mucous membrane, the degree of ventral curvature and surgery experience in order to achieve a high cure rate and good cosmetic effect.</p>

Modified Mitchell's technique for repair epispadias with a report of 3 cases / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate a modified Mitchell's technique for epispadias repair.</p><p><b>METHODS</b>Three patients with epispadias were undergoing the treatment. It was performed to form a penile pedicled flap or scrotal mediastinum flap for the repair of the urethra and the urine was drained through a perined "U" shaped stent.</p><p><b>RESULTS</b>All of the patients were successfully treated in one-stage with a good appearance and a matching opening of the urethra.</p><p><b>CONCLUSION</b>The above mentioned technique could be a good method for epispadias repair.</p>

Surgical techniques for the ureterointestinal anastomosis in continent urinary diversion / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the complications of direct and antirefluxing techniques of ureterointestinal anastomosis in continent urinary diversion.</p><p><b>METHODS</b>Sixty-three patients underwent continent urinary diversion. Twenty-four patients were treated by the direct ureteroenteric anastomosis and the others treated by the antirefluxing technique. The follow up studies included following-up the information of ureteric stricture, ureteric reflux, renal function and acute urinary infection. It was assessed for 3 months to 6 years with a mean follow up of 26 months after operation.</p><p><b>RESULTS</b>Of 78 ureters reimplanted using antirefluxing technique. A total of 12 ureters had anastomotic stricture formation postoperatively. Only one of 48 ureters reimplanted using direct anastomoses had anastomotic stricture. The difference between the direct and antirefluxing technique groups was remarkable (chi2 = 4.375, P < 0.05). Furthermore, there was no significant difference between the direct and antirefluxing technique groups in regard to ureteric reflux, renal function and acute urinary infection.</p><p><b>CONCLUSIONS</b>Antirefluxing anastomoses resulted in obviously higher rate of ureterointestinal anastomotic stricture in comparison with the direct anastomosis. The direct ureteroenteric anastomosis may be the suitable choice for patients undergoing continent urinary diversion.</p>

Modified Madigan prostatectomy / 中华外科杂志

<p><b>OBJECTIVE</b>To improve Madigan prostatectomy (MPC) for a much satisfactory effect in open surgery.</p><p><b>METHODS</b>A total of 52 patients with benign prostatic hyperplasia (BPH) were treated using MPC. The MPC procedure was modified by exposing anterior prostatic urethra near the bladder neck and conjunction with cystotomy. This modified procedure preserved prostatic urethra intact and could also deal with intracystic lesions at the same time.</p><p><b>RESULTS</b>The intact of prostatic urethra was kept completely or almost for 48 cases. The hemorrhage amount during modified procedure was a less. The mean operative time was 120 minutes. The 35 patients had been followed up for 1 - 12 months. The average Qmax was 18.9 ml/s. The cystourethrography revealed that the urethra and bladder neck were intact in 8 patients postoperatively. Furthermore, the prostatic urethra was obviously wider after modified MPC.</p><p><b>CONCLUSIONS</b>The modified MPC can reduce the urethra injury and enlarge the MPC indications. The modified technique is easy to perform with little complications and much more satisfactory clinical result. The modified MPC is highly recommended.</p>

Treatment of chronic bacterial prostatitis with amikacin through anal submucosal injection / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To assess the efficacy and safety of anal submucosal injection (ASI) of amikacin in chronic bacterial prostatitis (CBP).</p><p><b>METHODS</b>Fifty male outpatients with CBP were randomly divided into two groups. Thirty cases of ASI group were given amikacin 400 mg daily by ASI for ten times and the other twenty cases of intramuscular injection (IM) group were given the same drug daily by IM. All patients were evaluated with NIH-Chronic prostatitis symptom index (NIH-CPSI), the bacteria culture of the expressed prostate secretion (EPS), proctoscopic examination, rectal biopsy and the clinical manifestation were checked at pretreatment and on day 7 and 90 after cessation of therapy.</p><p><b>RESULTS</b>The cure rate, apparent effective rate and effective rate of ASI group and IM group were 33.3% vs 5% (P<0.05), 43.3% vs 10% (P<0.05) and 16.7% vs 20% (P>0.05), respectively. The score of NIH-CPSI in both of ASI group and IM group decreased significantly 7 days after cessation of therapy, both ASI and IM of amikacin could relieve symptoms within a short time. However, 3 months after cessation of therapy the score of NIH-CPSI in ASI group continued down in spite of no significant differences compared with 7 days after cessation of therapy, but the score of IM group was rebound nearly closed to level of pretreatment at 23.8 8.5 and significantly higher than that of ASI group. The amount of white blood cell (WBC) of EPS in ASI group increased slightly at 7 days after cessation of therapy without significant difference with pretreatment (P>0.05), but it significantly decreased at 3 months after cessation of therapy, the amount of WBC of EPS in ASI group was lower than that of IM group at 3 months after cessation of therapy (P<0.05). Proctoscopic examination of anal canal were normal after ASI therapy and the rectum biopsy showed no obvious histopathologic abnormality at the site of injection except mild focal submucosal infiltration of lymphocytes and plasma cells at 7 days after cessation of therapy which disappeared on 3 months after cessation of therapy. All patients had no evident complications.</p><p><b>CONCLUSION</b>ASI could be recommended as a new safe, effective, painless method of antibiotics administration in the treatment of CBP.</p>