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Objective To develope the diagnostic criteria and surgical methods to treat micro-paraganagliomas (<1 cm) of urinary bladder ( PUB) , we now report a case series study including 5 individual cases .Methods Clinical data of 5 patients with micro-PUBs who underwent surgical treatment were obtained and analyzed retrospectively . Two male patients and three female patients were included in our study with the mean age of 51 ( range from 41 to 65 years) .4 patients were reported as symptomatic due to hypercatecholaminemia , while the other was free of symptoms.24-hour urine catecholamine ( CA) examination was utilized to qualitatively diagnose PUB , positive in 75%patients.Ultrasonography(USG), CT, MRI, 111In-DTPA-Octreotide scintigraphy (OctreoScan) and 131 I-MIBG scintigraphy were used to locate the tumor , positive in 80%, 20%, 75%, 25%and 33%patients respectively .What's more, all 5 patients underwent transurethral resection of tumor .Overfilling of bladder and puncture following ultra-sonography guidance were performed to locate the tumors , when tumors were absent in surgical vision .Results All tumors were located and resected completely with no open conversions .It took 0.5 to 26 minutes to locate the tumor and another 3 to 10 minutes to resect the tumors .All lesions were diagnosed by histopathological confirma-tion, especially by immunohistochemical staining.Blood pressure return to normal level after the procedures.No local recurrence or distal metastasis were observed by performing 24-hour urine CA test , USG, cystoscopy and MRI within adequate follow-up.The mean follow-up duration was 38.6 months, ranging from 6 to 120 months.Conclu-sions USG and MRI examination were considered better in detecting micro PUB than CT-scan.Overfilling of blad-der and puncture following USG guidance may support more accurate tumor location intraoperatively if the tumors were not found in transurethral resection procedures .
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Objective To explore the effectiveness of applying minimally invasive simulation training in urologic clinical teaching .Methods Interns, training clinicians and junior doctors in our hospital, each group of six people, participating in the newthree-step teaching model of "theory learning +simulation training +clinical practice".The score before and after training on their theoretical knowledge , simulation training skills and clinical practice were assessed and the results were analyzed .Results The test scores of minimal invasive techniques theoretical knowl-edge and clinical practice assessment were significantly enhanced before training and after training ( P<0.05 ) .We have established a standardized minimally invasive simulation training in urologic clinical teaching .Conclusions Minimally invasive simulation training provides an effective and safe learning cultivation method for clinician and medical students , which could improve the clinical practice skills of young doctors in minimally invasive surgery as well as shorten the learning curve .