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Objective To translate the International Consultation on Incontinence Modular Questionnaire for Male Lower Urinary Tract Symptoms (ICIQ-MLUTS) and ICIQ-MLUTS long form (ICIQ-MLUTS LF) into Chinese and assess their metric properties and applicability.Methods After obtaining permission from the International Consultation on Incontinence Questionnaire (ICIQ),original ICIQ-MLUTS and ICIQ-MLUTS LF were translated into Chinese according to ICIQ validation protocol and cultural adaptation guideline.During November 2017 to August 2018,Chinese version of ICIQ-MLUTS and ICIQ-MLUTS LF were tested by administering them in 6 and 12 hospitals in China respectively.To validate the translated questionnaires,the following tests were undertaken.The content validity was determined by indepth interviews with participants and experts.The correlation coefficients of ICIQ-MLUTS and ICIQ-MLUTS LF with International Prostate Symptom Score (IPSS) were assessed to validate criterion validity.Cronbach's alpha test was used to explore internal consistency.And the test-retest reliability was evaluated by calculation of intraclass correlation coefficient.Results In total,Chinese ICIQ-MLUTS and ICIQ-MLUTS LF were administrated to 135 and 230 male patients with lower urinary tract symptoms respectively.Both questionnaires had good content validity and good criterion validity with IPSS (Pearson correlation 0.846 and 0.833 for ICIQ-MLUTS and ICIQ-MLUTS LF respectively,both P ＜ 0.001).The Cronbach's alpha coefficient was 0.797 for ICIQ-MLUTS,and 0.853 for ICIQ-MLUTS LF.Intraclass correlation coefficient was 0.986 and 0.985 respectively (both P ＜ 0.001),showing good test-retest reliability.Conclusions The Chinese version of ICIQ-MLUTS and ICIQ-MLUTS LF had good validity and reliability,which can be used to assess Chinese male patients with lower urinary tract symptoms.
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Objective To investigate the effects of radical prostatectomy on the overall survival (OS)and tumor-specific survival in prostate cancer(PCa)patients aged 75 years and older.Methods Clinical data of patients aged 75 and older with localized PCa from Surveillance,Epidemiology,and End Results(SEER)Database from 2004 to 2016 were retrospectively analyzed.There were 17 899 cases of PCa undergoing radical prostatectomy and 3 648 cases of PCa without surgery in this study.The OS and prostate cancer-specific survival(PSS)were compared between the surgery group and the nonsurgery group.Results For 75-79-year-old patients with high-risk localized PCa,the OS and PSS in the surgery group were better than in the non-surgery group (OR =1.49,95 ％ CI:1.22 ～ 1.82,P ＜ 0.01;OR=1.43,95％CI:1.09～2.04,P＜0.05).For patients aged 75-79 years with low-risk PCa and patients aged 80 years and older with low-,middle-,or high-risk PCa,the OS was worse in the surgery group than in the non-surgery group(OR =0.54,95％CI:0.38～0.76,P＜0.01;OR =0.47,95％CI:0.34～0.66,P＜0.01;OR =0.58,95％CI:0.44～0.78,P＜0.01;OR =0.59,95％CI:0.51 ～0.68,P＜0.01).For patients aged 75-79 years with low-or medium-risk PCa and patients aged 80 years and older with medium-risk PCa,there was no statistical difference in PSS between the surgery and non-surgery groups(P＞0.05).Conclusions Age limits for prostatectomy should be extended as a result of increasing average life expectancy.Patients aged 75-79 years with high-risk PCa can be considered for surgical treatment,while it should not be recommended for patients aged 75-79 years with low-or medium-risk localized PCa or aged more than 80 years.Many factors should be considered in making treatment decisions for prostate cancer.
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Objective To explore the factors affecting the effect of first stage treatment of sacral neuromodulation.Methods A retrospective analysis of 39 patients with dysuria related diseases from April 2012 to January 2016 was performed.There were 14 male patients and 25 female patients.Their age ranged from 15 to 86 years old,mean 54 years old.The types of disease were bladder pain syndrome/interstitial cystitis in 1 8 cases,idiopathic urinal retention in 5 cases,overactive bladder in 8 cases,neurogenic bladder in 6 cases,and urgent incontinence in 2 cases.All patients were treated by behavioral therapy,drug therapy,and at least one recomnended treatment method.All previons treatments were ineffective.All patients were collected baseline medical records.The voiding diary,visual analogue pain score,quality of life score,anxiety score and other information before and after the first stage surgery and the last follow-up after the second stage surgery were also collected.Results A total of 39 patients were enrolled in this study.27 patients (69％)who were satisfied with the effect of the first stage of surgery were treated with the second stage surgery,and 12 patients (31％)who were not satisfied with the results of the first phase operation did not undergo the second phase operation.The second stage implantation rate was 69％.The average experience time was (21.6 ± 3.0) days.In the single first stage implantation group,there were 6 males and 6 females,including interstitial cystitis in 3 cases,overactive bladder in 3 cases,neurogenic bladder in 4 cases,idiopathic urinary retention in 1 cases and urgent incontinence in 1 cases.2 cases have a history of pelvic and urinary surgery and 10 cases dont.The average BMI was 21.8 ± 3.7 kg/m2,and mean age was(44.5 ± 19.1) years old.The average preoperative anxiety score was 33.7 ± 5.3 and the average pain score of preoperative was 8.0 ± 1.0.The average quality of life score was 4.6 ±0.8 and the average daily nunber of urine was 23.1 ± 12.8.The average mean urine volume was (89.4 ± 33.0) ml,the average frequency of nocturia was 10.3 ± 5.5,the average medical history time was (100.6 ± 125.5) months.In the second stage implantation group,there were 8 males and 19 females,including interstitial cystitis in 15 cases,overactive bladder in 5 cases,neurogenic bladder in 2 cases,idiopathic urinary retention in 4 cases,and urgent incontinence in 1 cases.10 cases have a history of pelvic and urinary surgery while 17 cases don't.Average BM1 was (24.1 ± 2.6) kg/m2,and mean age was(57.9 ± 16.8) years old.The average preoperative anxiety score was 27.7 ± 5.9,the average pain score of preoperative was 7.9 ± 1.6.The average quality of life score was 5.3 ± 0.9 the average daily urinary number was 30.6 ± 14.2.The average mean urine volume was (64.8 ± 37.4) ml and the average frequency of nocturia was 13.3 ± 9.2.The average history of time was (83.0 ± 56.0) months.Patients who were implanted with permanent sacral neuromodulation system were mostly older (P =0.034),with higher BMI (P =0.043) and lower anxiety (P =0.008).There were no statistically significant differences in gender(P =0.287),disease(P =0.116),the daily urinary frequency (P =0.140),the average urine volume (P =0.470),nocturia freqnency (P =0.068),pain scores (P =0.880),surgical history (P =0.276)and the medical history time (P =0.116) between patients who underwent first stage surgery only and second stage surgery.Conclusion BMI,age and anxiety may be the factors that affect the outcome of the first stage treatment of sacral neuromodulation.
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Objective To investigate the status of geriatric doctors' acknowledge and treatment of outpatients with lower urinary tract symptoms in 15 Chinese cities.Methods The investigation was conducted in 15 Chinese cities and involved 1056 geriatric doctors from December 2013 to February 2014.The questionnaire survey was made in behavior,attitude,skill and knowledge(BASK)of LUTS.The geriatric doctors participated in the investigation by answering the questionnaires about acknowledge for definition,etiology,diagnosis and treatment of the LUTS,and in results discussion,which was aimed at improving participants' cognition for diagnosis and treatment of elderly LUTS and at strengthening the practice.The final objective was to promote diagnosis standardization and to improve the level of clinical diagnosis and treatment for the elderly 1UTS.Results 95.9％ of geriatric doctors considered that they knew well the main clinical manifestations of LUTS.However,34.3 ％ of geriatric doctors were able to classify the symptoms of LUTS correctly.More than 90.0 ％ of geriatric doctors considered that the causes of LUTS were variable and they mastered the common cause of LUTS.But,38.0％ of them were able to completely master the causes of LUTS and 35.5％ would actively ask outpatients about the symptoms.70.0％ of the doctors thought they were familiar with the initial manifestations of LUTS and benign prostatic hypertrophy(BPH).However,many Chinese geriatric doctors didn't follow up the guidelines and 30.0％ of them failed to evaluate the severity of LUTS via IPSS(International Prostatic Symptom Score).75.8％ of geriatric doctors considered that they would give the patients the best treatment options by comprehensive assessment.However,60.0％ of them didn't know that α1 receptor blocker was the first line of treatment option of patients with moderate severe LUST.More than half of them were unclear that the patients with prostate volume under 40 ml could be treated by α1 receptor blocker.82.3％ of geriatric doctors considered that LUTS and hypertension should be treated respectively.But,55.0％ of them didn't know that ALLHAT trial has proved that Doxazosin would increase the risk of cardiovascular event.Conclusions The geriatric doctors are now able to pay attention to outpatients with LUTS,but still should further strengthen their acknowledge on the definition,cause,diagnosis and treatment of LUTS.
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Objective To investigate the relationship between prostate histologic inflammation classification and prostate cancer (PCa) in needle biopsy specimens with serum prostatic specific antigen (PSA) under 20 μg/L.Methods The clinical records of patients who underwent prostate biopsy were retrospectively analyzed in Beijing Hospital Urological Department from January 2011 to December 2013.The patients underwent prostate biopsy because of PSA raised and without pelvic radiotherapy.The needle biopsy specimen was evaluated by the pathohistologic criteria of location,extent and grade classification of prostate inflammation.Results PCa was detected in 84 (37.2％) biopsies and benign prostatic disease (BPD) in 142 (62.8％) biopsies.There were significant differences between PCa and BPD in inflammation classification (location:P＜0.001,extent:P＜0.001,grade:P＜0.001).On multivariable Logistic regression analysis,both location and extent classification of chronic histologic prostatitis were found tobe significantly associated with a lower risk of PCa in biopsy (location:P =0.001,OR =0.114,95％ CI 0.032-0.405 ; extent:P =0.021,OR =0.232,95％ CI 0.067-0.804).There was no relationship between grade classification and PCa (P=0.223,OR=1.805,95％CI 0.698-4.667).Under the evaluation of location and extent classification,it could differentiate PCa with BPD in biopsy with a sensitivity,specificity,positive predictive value and negative predictive value of 91.7％,50.7％,52.4％,91.1％,respectively.Conclusion The location and extent classification of chronic prostatitis is found to be associated with a lower risk of PCa independently.
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Objective To investigate the feasibility and clinical effect of the tubeless minipercutaneous nephrolithotomy (PCNL) in treatment of upper ureteral calculi.Methods From March 2014 to March 2015,all the patients with upper ureteral calculi except for those with severe infection,pyonephrosis or renal cortex less than 5 mm were randomized into two groups,the standard PCNL group (24 F nephrostomy tube) and the mini-PCNL group (18 F nephrostomy tube).After PCNL,all the patients received ultrasound examination to check residual stones,perforation and urine leakage.DJ tube was placed and the channel of PCNL was packed with hemostatic sponge without nephrostomy tube.There were 26 patients in standard group and 28 in mini-group.The operation time,postoperative hemoglobin change,postoperative visual analogue pain score (VAS),the time when urine turned clean,postoperative urinary extravasation,hydrothorax,fever and the stone-free rate were compared between two groups.Particularly,these data were compared in those aged＞65 years.Results The operation time in the standard PCNL and the mini-PCNL group was (58.3 ±21.8) and (86.4±23.3) minutes respectively,and had a significant difference (t=10.836,P＜0.05).The decrease in hemoglobin level was (8.3±5.8) g/L and (7.7±0.5.4) g/L,the VAS scores was (3.8±0.8) and (3.6±1.1),the time when urine turned clean was (11.9±4.7) h and (9.6±5.6) h,the postoperative hospital stay was (5.1±0.8) d and (4.8±1.2) d,and the stone free rate was 92.3％ and 89.2％ in standard PCNL and mini-PCNL group respectively(P＞ 0.05).No significant difference were found between two groups (all P＞0.05).There was one patient who got fever more than 38.5℃ in the standard group and 2 cases in the mini-group.Each group had 1 slight hydrothorax,and no blood infusion and perinephric urinary extravasation were found.The application of packing hemostatic sponge in the nephrostomy channel was feasible and suitable for both the standard and tubeless mini-PCNL groups.Conclusions The application of packing hemostatic sponge in the nephrostomy channel is feasible and suitable in both the standard and tubeless miniPCNL.It is safe for the treatment of renal and ureteral calculi,and it can decrease the hemorrhage and urine leakage,which works for the elderly patients too.
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Aim To investigate the protective effects of ginsenosides ( GS) on reactive oxygen species-induced oxidative damage in mouse spermatogonial cells. Meth-ods Mouse spermatogonial cell oxidative stress model was established and the attenuating effects of ginsen-osides on germ cell oxidative damage were evaluated by determination of cell viability,malondialdehyde( MDA) formation,superoxide dismutase ( SOD) activity and glutathione ( GSH) level. Results The exposure to hypoxanthine/xanthine oxidase ( HX/XO) induced an elevation in MDA,while a decrease in germ cell viability,SOD activity and GSH level. However,supplementation with GS ( 10 mg?L -1) restored HX/XO-induced decrease in cell viability,SOD activity and GSH level and HX/XO-induced increase in MDA formation. Conclusion GS may exert antioxidant activity to attenuate reactive oxygen species-induced oxidative damage in mouse spermatogonial cells.