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Objective To compare the safety and short-term efficacy of thulium laser resection of the prostate (TMLRP) and bipolar transurethral plasmakinetic prostatectomy (TUPKP) for the treatment of benign prostatic hyperplasia (BPH) patients.Methods A total of 100 patients diagnosed with BPH were randomly divided into 2 groups:TMLRP group (50 cases) and TUPKP group (50 cases).There was no significant difference of preoperative variables such as age,prostate volume,PSA,IPSS,Qmax and PVR between the two groups (P＞0.05).The perioperative parameters and therapeutic effects were recorded and compared between the two groups.Results Comparison between TMLRP group and TUPKP group included:operating time ((61.2±24.2) min versus (30.1±15.9) min),catheterization time ((1.8±0.4) d versus (3.2±0.6) d)and postoperative hospital stay ((3.3±0.8) d versus (4.1±1.3) d).Significant differences in these parameters were found between the two groups(P＜0.05).Compared with TUPKP group,the blood loss and postoperative bladder irrigation were significantly less in TMLRP group.One month postoperatively,there were 4 cases of urethral stricture in TUPKP group.Three months postoperatively,IPSS,QOL,Qmax and PVR were significantly improved in both groups (P＜0.01),but no significant difference detected between the 2 groups (P＜0.05).Conclusions TMLRP is superior to TUPKP in term of safety and tolerability (decreased blood loss,complication rate and short recovery time),and as efficacious as TUPKP in efficacy.Compared with TUPKP,operating time were significantly longer in TMLRP group
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Objective To study the effect and safety of conversion from calcineurin inhibitors to rapamycin in kidney transplantation recipients with chronic allograft nephropathy.Methods In 82 kidney transplant recipients enrolled in this study,72 cases were diagnosed as having chronic allograft nephropathy by biopsy.Recipients (SRL group) were administered with rapamycin after withdrawal of calcineurin inhibitors.The doses of CNI in other recipients (non-SRL group) were not changed.Renal function,proteinuria,blood pressure,blood fat,hepatic function and hemogram were observed for 24 months in each group.Results During the follow-up period,serum creatinine level was dropped significantly in SRL group (P＜0.05),but it was increased in non-SRL group (P＜0.05).SRL group showed increased proteinuria,serum cholesterol and triglycerides (P＜0.05),and reduced Plt (P＜0.05).According to the renal function before conversion,the recipients who were administered rapamycin divided into four groups.In group A (Scr ＜ 120 μmol/L),there was no significant difference in diverse variables before and after conversion.In group B (Scr 120-200 μmol/L and Banff Ⅰ-Ⅱ),renal function was improved,and proteinuria alleviated.In group C (Scr 120-200 μmol/L and Banff ＞ Ⅱ),and group D (Scr ＞200 μmol/L),renal function was damaged to varying degrees and proteinuria was deteriorated.Conclusion It is safe and effective for patients with chronic allograft nephropathy to convert from calcineurin inhibitors to rapamycin.
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Objective To evaluate the value of sonourethrography in the diagnosis of dysuria after bipolar transurethral plasmakinetic prostatectomy. Methods Sixty male patients with dysuria after bipolar transurethral plasmakinetic prostatectomy underwent sonourethrography and re-operation.The clinical data of these patients were reviewed. Results The sonourethrographic findings were similar with the operative findings in 57 cases.In the 60 cases,there were 11 cases with bladder neck closure,10 cases with bladder neck stricture,30 cases with urethral stricture (16 located at membranous urethra,12 located at pars cavernosa urethra and 2 in external orifice of urethra),5 cases with prostate remnant,1 case with calculi in prostatic urethra,2 cases with dysfunction of detrusor of bladder and 1 case with flap of internal urethral orifice,Conclusions Sonourethrography could be a reliable diagnostic method for dysuria after bipolar transurethral plasmakinetic prostatectomy.It may be helpful for clinical treatment.