Diagnosis and treatment of pheochromocytoma in urinary bladder / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>To study the diagnosis and treatment of pheochromocytoma in urinary bladder.</p><p><b>METHODS</b>Six cases of bladder pheochromocytoma were studied. Four cases showed hypertension, 3 of which were paroxysmal hypertension during urination. Catecholamine (CA) was increased in a case, and vanillymandelic acid (VMA) was increased in 2 cases. Bladder submucosal mass was detected by B-ultrasound in 5 cases (5/5), computerized tomography (CT) in 3 cases (3/3), cystoscopy in 5 cases (5/6). Four cases took alpha-receptor blocker for 2 weeks, 1 case took beta-receptor blocker to decrease heart rate. All patients were treated with surgical operation including 4 partial cystectomies, 2 excavations.</p><p><b>RESULTS</b>Three cases had manifestations including headache, excessive perspiration and hypertension during cystoscopy. Four cases were confirmed before operation. Two cases showed hypertension during operation. All patients were pathologically diagnosed as pheochromocytoma postoperatively. In five cases followed up, blood pressure returned to normal. No patient had relapse and malignancy.</p><p><b>CONCLUSIONS</b>Typical hypertension during urination comprised the main symptoms. We should highly suspect bladder pheochromocytoma if a submucosal mass was discovered with B-ultrasound, CT, (131)I-MIBG (methyliodobenzylguanidine) and cystoscopy. The determination of CA in urine is valuable for qualitative diagnosis. The preoperative management of controlling blood pressure and expansion of the blood volume are very important. Surgical operation is a good method for effective treatment. Postoperative long-time followed up is necessary.</p>

Advances in noninvasive diagnosis of bladder tumor / 国外医学(肿瘤学分册)

Recently early noni-nvasive diagnostic techniques of bladder tumor are the hot resear- ches,which is significantly important for guiding clinical therapy and prognosis.This article will review the advancements of noninvasive diagnosis of bladder tumor in recent years and compare the new develop- ments with traditional exfoliative cytology test of urine,typical cystoscopy and improved cystoscopy.

Comparative study of transurethral electrovaporization of prostate versus transurethral resection of prostate on benign prostatic hyperplasia / 中华男科学杂志

<p><b>OBJECTIVES</b>To compare the efficacy of transurethral electrovaporization of prostate (TUVP) with transurethral resection of prostate (TURP).</p><p><b>METHODS</b>206 patients with symptomatic benign prostatic hyperplasia (BPH) whose prostatic sizes were all less than 60 grams were randomly divided into two groups. 97 cases were treated by TUVP while the other 109 cases were treated by TURP. The patients who underwent either TUVP or TURP were followed up for 12-34 months with an average of 20 months postoperatively.</p><p><b>RESULTS</b>Both groups showed the significant decline in the mean IPSS (international prostatic symptom score) (P < 0.01), the mean PVR (Postovoiding Residual Volume) (P < 0.01), while increase in mean Qmax (Peak uroflow rate) (P < 0.01) in 12 months, 24 months after the operation. There were significant differences in the mean duration of operation or catheterization postoperatively (P < 0.05). The main complications of post-operation in the two groups were stress incontinence, TUR syndrome, urethral stricture, secondary bleeding.</p><p><b>CONCLUSIONS</b>Both TUVP and TURP are effective treatment for the patient with BPH whose prostatic size is less than 60 grams. TUVP spends shorter time of the operation and postoperative catheterization than that of TURP.</p>

Prostaglandin E1 versus sildenafil in the management of erectile dysfunction / 中华男科学杂志

<p><b>OBJECTIVES</b>To evaluate the outcome of treatment in patients with erectile dysfunction (ED) using sildenafil or intracavernosal injection of prostaglandin E1(PGE1).</p><p><b>METHODS</b>54 patients with ED were randomly classified into two groups and received either oral sildenafil (group A) or intracavernosal injection of PGE1(group B) for 4-9 months with an average of 6 months.</p><p><b>RESULTS</b>The percentages of efficacy in the two groups were 80.0% and 83.3%, respectively. There was no statistical difference between group A and B (P > 0.05). Two of six patients who did not respond to sildenafal in group A achieved erections sufficient for sexual intercourse when the six patients received intracavernous injection of PGE1. None of the four patients who did not respond to intracavernous injection of PEG1 in group B achieved erection sufficient for sexual intercourse when they received oral sildenafil.</p><p><b>CONCLUSIONS</b>Both oral sildenafil and intracavernous injection of PGE1 are effective for patients with ED of various etiologies. The patients who do not respond to sildenafil can receive intracavernous injection therapy. The satisfactory results can probably achieved.</p>

Study on the prognostic factors of patients with invasive bladder cancer after radical surgery / 中华泌尿外科杂志

Objective To investigate the prognostic factors affecting the postoperative survival of patients with invasive bladder cancer,and to predict the survival time of the patients.Methods We retro- spectively analyzed the clinical and follow-up data of 178 patients with invasive bladder cancer treated by radical cystectomy and urinary diversion from 1991 to 2004.A multivariate analysis was performed in these patients by the Cox proportional hazard model.A prognostic index(PI)based on the Cox regression was con- structed.According to the individualized PI,the patients were classified into different hazard groups and the expected survival curve of each patient was calculated.Results Cox regression analysis showed that the factors which influenced the postoperative survival included tumor stage(RR=1.982,P=0.000),grade (RR=1.978,P =0.042),lymph node metastasis(RR=2.142,P=0.048),Tis(RR=6.177,P= 0.000),tumor shape(RR=0.416,P=0.003),number of tumors( RR=1.820,P=0.035),pathological type(RR=2.228,P=0.032),patient age(RR=0.672,P=0.025)and neoadjuvant chemotherapy (RR=0.257,P=0.016).Based on the percentile of PI,patients were classified into 3 prognostic groups; the median survival time of 3 groups were 42.5,22.5 and 7.0 months,respectively.There were significant differences between each 2 among the 3 groups(P＜0.01).Conclusions Neoadjuvant chemotherapy, tumor stage,grade,lymph node metastasis,Tis,shape and number of tumors,pathological type,patient age were important prognostic factors.PI value can be used to predict the prognosis of patients with invasive blad- der cancer.