RESUMO
Objective:To assess whether air-charged urodynamic(ACC)can replace water-filled urodynamic(WFC)and the value of ACC for the diagnosis of benign prostatic hyperplasia(BPH)in these patients.Methods:In this prospective study, 27 male patients with BPH(aged 60-90 years)were randomly selected for WFC and ACC examinations during the same period to compare the values of urodynamic pressure parameters recorded for the two groups.Pressure values were compared using Bland-Altman plots and the paired sample t-test, and differences in abdominal pressure changes in the two groups were compared using the chi-square test. Results:Changes in WFC and ACC pressure values showed the same trends, but at the three points where data were recorded and compared, the mean abdominal pressure(Pabd), end of bladder filling pressure(Pves.fill)and maximum detrusor pressure(Pdet.void)were(25.3±8.5)cmH 2O(1 cmH 2O=0.098 kPa), (26.0±8.08.4)cmH 2O and(98.8±32.8)cmH 2O for WFC and(32.5, 5.5±5.3)cmH 2O, (32.6±5.0)cmH 2O and(95.3±36.3)cmH 2O for ACC, respectively, The pressure values of the two methods were significantly different( P<0.05). WFC pressure values were unstable, with 74.07%(20/27)showing a marked decrease during bladder filling, significantly different from those measured by ACC( P<0.001). Band-Altman plots illustrated high consistency between pressure values measured via WFC and ACC. Conclusions:The pressure measured by ACC does not represent that measured by WFC, suggesting a clinical need to establish standard reference data for ACC.The abdominal pressure instability measured by WFC may be one of the factors leading to different detrusor pressures from the two methods.The high consistency between pressure values from ACC and WFC indicates that the former can also be used to assess changes in bladder function in elderly BPH patients.
RESUMO
Objective:To explore the effective method for treatment of small and short penis after hypospadias surgery.Method:s From November 2017 to November 2018, 57 children aged 4 to 14[mean age(7.91±2.89)years] with hypospadias who met the diagnostic criteria of small penis were reexamined at the First Affiliated Hospital of Xin-xiang Medical University.They were randomly divided into the physical treatment group and the drug treatment group according to the order of visits, and the untreated patients were included in the control group.Among them, 21 patients in the physical treatment group were treated with penile rehabilitation therapy apparatus, supplemented by Salvia mil-tiorrhiza bath (30 minutes/time, once/day, 10 days), and 20 patients in the drug treatment group were treated with Testosterone cream topically (3 times/day, 10 days). Penile relaxation length, stretch length, transverse and longitudinal diameters of glans in 2 groups before and after the treatment were measured.The relevant indexes of 16 patients in the control group measured before and after 10 days and compared with those in the treatment group.Result:s (1)The penile relaxation length in the physical treatment group increased from (25.48±6.13) mm to (30.72±6.49) mm, the length of stretch increased from (34.90±7.71) mm to (41.08±8.43) mm, the transverse diameter of glans increased from (14.81±3.40) mm to (16.57±3.42) mm, and the longitudinal diameter increased from (13.94±3.15) mm to (15.82±3.52) mm, and the differences were statistically significant (all P<0.05). (2)The penile relaxation length in the drug treatment group increased from (21.07±4.26) mm to (31.32±4.72) mm, the length of stretch increased from (31.94±7.96) mm to (45.39±7.24) mm, the transverse diameter of glans increased from (13.38±1.77) mm to (16.64±2.10) mm, and the longitudinal diameter increased from (13.09±1.77) mm to (16.62±1.86) mm, and the differences were statistically significant (all P<0.05). (3)There was no significant difference in penile relaxation length, the length of stretch, transverse diameter and longitudinal diameters of glans before and after 10 days in the control group (all P>0.05). (4) Compared with the control group, the penile relaxation length, the length of stretch, transverse diameter and longitudinal diameters of glans in the physical treatment group increased significantly, and the differences of growth values between the two groups were statistically significant (all P<0.05). (5) Compared with the control group, the penile relaxation length, the length of stretch, transverse diameter and longitudinal diameters of glans in the drug treatment group also increased significantly, and the difference of growth values between the two groups were statistically significant (all P<0.05). (6) The growth of penile relaxation length, the length of stretch and transverse and longitudinal diameters in the drug treatment group were higher than those in the physical treatment group, and the difference of growth values were statistically significant (all P<0.05). Conclusions:Both the negative pressure suction method and topical application of Testosterone cream are effective in the treatment of small and short penis after hypospadias surgery.However, Testosterone cream is difficult to obtain, and the treatment of negative pressure suction is simple, noninvasive, painless and free of adverse reactions.