RESUMO
Objective To evaluate the improvement of lower urinary tract symptoms in benign prostatic hyperplasia (BPH) patients with bladder calculi by lithotripsy and adjuvant traditional Chinese decoction. Methods A total of 72 BPH patients with bladder calculi were recruited and randomly divided into the non-adjuvant treatment group (37 patients) and the adjuvant treatment group (35 patients). The adjuvant treatment group received adjuvant traditional Chinese decoction from 2 days before lithotripsy for 2 weeks. The maximum urinary flow rate (Qmax) , residual urine volume (RU), International Prostate Symptom Score (IPSS) and Quality of Life (QOL) were assessed before and after the treatment. The time of urine routine returned to normal and the indwelling time of catheter were compared between two groups. Urinary incontinence and recurrent bladder calculi were followed up for 6 months. Results After the treatment, the score of the IPSS (12.9 ± 4.5 vs. 15.7 ± 3.9;t=2.826, P=0.006) and the RU (47.3 ± 9.2 ml vs. 58.4 ± 11.3 ml;t=4.556, P<0.001) in the adjuvant treatment group were significantly lower than those in the non-adjuvant treatment group, and the Qmax (30.4 ± 4.7 ml/s vs. 21.4 ± 3.9 ml/s;t=8.862, P<0.001 ) was significantly higher. The indwelling time of catheter (5.7 ± 2.1 d vs. 8.1 ± 2.2d;t=4.730, P<0.001) and the time of urine routine returned to normal (6.9 ± 2.3 d vs. 10.2 ± 3.1 d;t=5.106, P<0.001) in the adjuvant treatment group were significantly shorter than those in the non-adjuvant treatment group. The 6-month follow-up showed that the incidence of urinary incontinence (2.9% vs. 18.9%;χ2=4.698, P=0.030) and recurrent bladder calculi (5.7% vs. 24.3%;χ2=4.813, P=0.028) in the adjuvant treatment group were significantly shorter than those in the non-adjuvant treatment group, and the total effective rate was significantly higher (62.9%vs. 29.7%; χ2=6.672, P=0.011). Conclusions Lithotripsy and adjuvant traditional Chinese decoction can reduce the IPSS score and RU, increase Qmax, decrease urinary incontinence and recurrent bladder calculi, and improve lower urinary tract symptoms in BPH patients with bladder calculi.
RESUMO
Objective To compare the clinical effectiveness and safety of transperitoneal robot assisted and retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty for the treatment of ureteropelvic junction obstruction. Methods From September 2008 to June 2009,six patients with primary UPJO underwent transperitoneal robot assisted dismembered pyeloplasty (TRADP) (5 males and 1 female;average age 25 yrs,range from 14-40 yrs),of whom 4 with severe hydronephrosis,2 with intermediate.According to the demographic and preoperative information,each patient in the TRADP group was matched to two corresponding patients with primary UPJO accepting retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty (RLADP) in the same period.The operative time,the intracorporeal suturing time,intraoperative blood loss,the duration of the urethral catheter and the drainage time,the postoperative hospital stay and the postoperative result were compared between the 2 groups.The two groups were identical with regard to gender,side of UPJO,and surgical procedure.The mean age and BMI were comparable between the TRADP and RLADP. Results Between the two groups,the operative time was ( 157 ± 20) min vs ( 127 ± 18) min ( P ＞ 0.05 ),the intracorporeal suturing time was (44 ± 6) min vs (49 ± 6 ) min ( P ＞0.05).In TRADP and RLADP groups,the intraoperative blood loss was (23 ± 8) ml vs (21 ± 17) ml ( P ＞ 0.05 ),the duration of the drain was (47 ± 10) h vs ( 161 ± 41 ) h ( P ＜ 0.01 ),the duration of the urethral catheter was (92 ±46) h vs ( 175 ±26) h (P ＜0.05),the postoperative hospital stays were (6.0 ± 0.8 ) d vs (8.0 ± 0.5) d ( P ＜ 0.01 ).The operation was successful in all cases of two groups,with no conversion to open surgery.The follow-up of 6 -32 months,with average of 20 months,showed that the clinical symptoms in the two groups disappeared and the hydronephrosis relieved. Conclusion Compared with RLADP,the TRADP has the comparable operative time,but the postoperative management for TRADP is more simple and the healing is faster,the postoperative outcomes are comparable as well.