da Vinci robot-assisted laparoscopic partial nephrectomy for renal tumors with PADUA score ≥10 / 第二军医大学学报

Objective: To evaluate the safety, feasibility and efficacy of da Vinci robot-assisted laparoscopic partial nephrectomy in treating renal tumors with PADUA score ≥10, so as to discuss its clinical potential. Methods: Between May 2012 and September 2013, da Vinci robot-assisted laparoscopic partial nephrectomy was performed for 37 renal tumors with PADUA score ≥10 by a single urologist in our institution. The information of the patients were: age 52.3±10.1(32-72) years old; body mass index 24.9±3.88(17.1-34.3) kg/m2; Charlson Co-morbidity Index (Age-weighted) 0.5±0.84(0-3); and tumor laterality (L/R) 20/17. The tumors were unilateral and solitary lesions, with a mean diameter of 4.2±1.19(2.1-7.2) cm, a PADUA score of 10.8±0.87(10-13), and a preoperative estimated glomerular filtration rate (eGFR) of 101.2±25.58 (46.6-198.7) mL/(min·1.73 m2). The renal arteries veins, and renal surroundings were isolated and the tumors were excised with or without blocking renal pedicle; all these procedures together with renorrhaphy were done by da Vinci robot-assisted laparoscopic techniques. Results: All the 37 cases were smoothly done without surgical conversion, intraoperative complications or transfusion. The mean operative time was 241±50.0 (120-330) min, estimated blood loss was 185±169.9(50-1 000) mL, and renal ischemia time was 26.7±9.90(0-50) min. The mean postoperative hospital stay was 11.4±3.44(8-19) days, with an overall complication rate of 13.5%(5/37). Pathological examination revealed no positive surgical margin, and there were 28 cases of renal clear cell carcinoma, 3 papillary cell carcinoma, and 5 different types of benign lesions. All the patients were alive during a mean follow-up of 5.9±4.64(1-12) months, with no local recurrence or distant metastasis. Nevertheless, eGFR was decreased by a mean of 8%, showing significant difference compared with that before operation(Z=-2.883, P=0.004). Conclusion: For high PADUA score renal tumors, da Vinci robot-assisted laparoscopic partial nephrectomy has the advantages of minimal invasiveness, better safety, fine manipulation, and renal function preservation, although the cancer control outcome awaits further follow-up.

Transurethral seminal vesiculoscopy for refractory or recurrent hemospermia: clinical analysis of 162 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the feasibility and effect of transurethral seminal vesiculoscopy in the diagnosis and treatment of refractory or recurrent hemospermia.</p><p><b>METHODS</b>We retrospectively analyzed 162 cases of refractory or recurrent hemospermia examined and treated by transurethral seminal vesiculoscopy. The patients ranged in age from 19 to 76 years and had a hemospermia history of 3 months to 11 years, admitted due to poor therapeutic results or recurrence after 4 weeks of antibiotic medication. All the patients underwent serum PSA examination, transrectal ultrasonography, seminal vesicle ultrasonography and pelvis CT or MRI before surgery.</p><p><b>RESULTS</b>Wine- or magenta-colored colloid and inflammation were found in one or both sides of the seminal vesicle in all the cases. Pathological biopsy revealed chronic inflammatory mucosa of the seminal vesicle in all the patients, and even calculi in the ejaculatory duct or seminal vesicle in 15 cases. Postoperative follow-up averaged 21.7 (12 -29) months. Hemospermia disappeared or was alleviated in 150 (92.64%) of the cases after 1-15 ejaculations, in which 7 experienced recurrence 3 months later. Four cases failed to respond, and 1 developed acute bilateral epididymitis after surgery. No such complications as retrograde ejaculation, urinary incontinence or rectal injury were observed postoperatively.</p><p><b>CONCLUSION</b>Transurethral seminal vesiculoscopy is a safe, effective and feasible new method for the treatment of refractory or recrudescent hemospermia.</p>

Efficacy and safety of long-term small-dose tadalafil in the treatment of erectile dysfunction / 中华男科学杂志

<p><b>OBJECTIVE</b>Erectile dysfunction (ED) is now recognized as a comorbid condition, especially in men with cardiovascular disease or diabetes mellitus. This randomized controlled trial was to examine the effect of long-term small-dose tadalafil in the treatment of ED.</p><p><b>METHODS</b>A total of 98 men older than 18 years with at least a 6-month ED history were enlisted and divided into two groups to receive once-daily treatment with tadalafil at 5 mg (n = 60) and 20 mg (n = 38), respectively, for 12 months. The effects of medication were analyzed and compared using IIEF, Global Assessment Questionnaire (GAQ) and Sexual Encounter Profile (SEP), and so were the safety and tolerance of the two doses.</p><p><b>RESULTS</b>There were no statistically significant differences in the therapeutical results between the 5 mg and 20 mg groups (P < 0.05). The IIEF-5 score was raised by 8.1 points in the former and 7.9 points in the latter; the YES answers to SEP2 in the two groups were 51.3% and 49.2% before the treatment and 82.6% and 84.9% after it. No serious adverse events were observed, except some common ones, such as rubeosis (11.9% vs 8.7%) and headache (5.3% vs 4.9%) in the 5 mg and 20 mg groups.</p><p><b>CONCLUSION</b>Oral tadalafil at 5 mg once daily is efficacious with good tolerance in the treatment of ED, and it can be an alternative to on-demand medication for some men to eliminate the inconvenience of planned intercourse within a limited timeframe.</p>

Establishment of androgen-independent human prostate cancer cell line model LNCaP-AI / 第二军医大学学报

Objective: To establish an androgen-independent human prostate cancer cell line model LNCaP-AI. Methods: LNCaP cells were cultured in absence of hormone for a long-term to establish LNCaP cell line LNCaP-AI, which can live without hormone. MTT, immunofluorescence and RT-PCR techniques were used to study the proliferation activity of LNCaP-AI cells and expression and secretion level of PSA by LNCaP-AI cells in absence of hormone. Results: After cultured for 3 months, LNCaP cells gradually became accustomed to the non-hormone condition, showing the characteristics of androgen-independent LNCaP-AI cell line. LNCaP-AI cells rapidly proliferated under the non-hormone condition and secreted PSA. However, PSA mRNA expression level in LNCaP-AI cells was 44% that of the LNCaP cells under hormone condition. Conclusion: Androgen-independent LNCaP-AI cell line may simulate the development of androgen-independence in prostate cancer cells and is an ideal model of androgen-independent prostate cancer cell line.