Tapping at acupoints along meridian combined with thunder-fire moxibustion for upper-limb hemiplegia after stroke / 中国针灸

OBJECTIVE@#To observe the effect of tapping at acupoints along meridian combined with thunder-fire moxibustion on upper-limb muscle strength and activities of daily living in patients with upper-limb hemiplegia after stroke.@*METHODS@#A total of 140 patients with upper-limb hemiplegia after stroke were randomly divided into a combination group (35 cases, 2 cases dropped off), an acupoint-tapping group (35 cases), a moxibustion group (35 cases, 2 cases dropped off) and a routine group (35 cases). The patients in the routine group were only treated with routine treatment and nursing. On the basis of the treatment in the routine group, the patients in the acupoint-tapping group were treated with tapping along the large intestine meridian of hand @*RESULTS@#Compared before treatment, body mass indexs of shoulder abduction, elbow extension, wrist flexion as well as BI scores in the four groups were significantly increased after treatment (@*CONCLUSION@#Tapping at acupoints along meridian combined with thunder-fire moxibustion could effectively improve the upper-limb muscle strength and activities of daily living in patients with upper-limb hemiplegia after stroke, and its effect is superior to simple tapping at acupoints along meridian or thunder-fire moxibustion.

Suprapubic lipectomy with a "Ω" incision for buried penis in obese adult men / 中华男科学杂志

Objective@#To investigate the application of suprapubic lipectomy with a "Ω" incision to removal of the prepubic fat pad for the management of buried penis in obese adult patients.@*METHODS@#We retrospectively analyzed the clinical data on 20 obese adult patients with buried penis treated by suprapubic lipectomy via a "Ω" incision between August 2016 and September 2019.@*RESULTS@#The operations were successfully completed in all the cases, with a mean operation time of 3.7 ± 0.6 hours and an average hospital stay of 8.3 ± 3.3 days. There were no such severe surgery-related complications as hematoma, urethral injury, or fat embolism in any of the cases. Fat liquefaction-related superficial wound infection developed in 1 patient postoperatively, which was cured by combined topical and systemic antibiotic therapy. A 3-month follow-up showed a 95% satisfaction of the patients with the postoperative appearance of the penis and suprapubic incision, but no complications such as ED, abnormal penile sensation, or penile retraction.@*CONCLUSIONS@#Suprapubic lipectomy with a "Ω" incision to remove the prepubic fat pad is an effective surgical approach to the management of buried penis in obese adult males, which is an anatomy-based surgical correction and has the advantages of slight injury, rapid recovery and few complications./.

Effects of different medications with tadalafil on erectile dysfunction in males with primary sexual failure / 中华男科学杂志

Objective@#To evaluate the effects of three different medications with tadalafil on erectile dysfunction (ED) in young men with primary sexual failure.@*METHODS@#This study included 76 male ED patients aged 21－35 years who had primary sexual failure but normal nocturnal penile tumescence and rigidity and failed to respond to psychotherapy. We randomly assigned them to receive oral tadalafil once daily, on demand, or once-daily + on-demand. After 2－3 months of treatment, we evaluated the effects based on the scores of the patients in the five domains of the International Index of Erectile Function (IIEF-5).@*RESULTS@#After medication, all the patients showed significantly increased scores in the four domains of IIEF-5, namely, erectile function, orgasmic function, intercourse satisfaction, and overall satisfaction. The on-demand group achieved even higher scores in erectile and orgasmic functions but a lower score in sexual desire than the once-daily group. However, the patients in the once-daily + on-demand group exhibited more significant improvement than those in the other two in all the five domains.@*CONCLUSIONS@#Once-daily + on-demand medication with tadalafil can significantly enhance the therapeutic effect on psychogenic ED in young men with primary sexual failure.

Small-dose vardenafil restores erectile function after penile surgery / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the impact of penile surgery on the erectile function of the patient and to evaluate the role of small-dose vardenafil in restoring the impaired penile erection.</p><p><b>METHODS</b>Sixty cases of penile cavernosum surgery were equally and randomly divided into a vardenafil and a control group, the former treated 5 - 7 days after surgery with 10 mg vardenafil every other day, while the latter given vitamin E at 100 mg once a day, both for 12 weeks. The penile erectile function of the patients was evaluated with the IIEF-5 questionnaire before surgery and at 3 and 6 months after vardenafil medication.</p><p><b>RESULTS</b>The mean IIEF-5 scores of the vardenafil group were 18.83 +/- 2.98 and 20.13 +/- 2.98 at 3 and 6 months after vardenafil medication, significantly higher than 14.21 +/- 3.62 before surgery (P > 0.05), while that of the control group was significantly decreased at 3 months as compared with the preoperative score (13.38 +/- 2.82 versus 15.80 +/- 3.02, P < 0.05). The vardenafil group showed the highest IIEF-5 score after surgery (P < 0.05).</p><p><b>CONCLUSION</b>Long-term administration of small-dose vardenafil after penile surgery helps to restore and maintain penile erectile function.</p>

Repair and functional reconstruction of the penis (a report of 62 cases) / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the effects of surgery treatment on serious penile lesions and malformation.</p><p><b>METHODS</b>Sixty-two patients, aged from 19 to 63 years old (mean 35 ys), were included in the study. Among them, 4 patients suffered from penis partial defection were respectively treated with restoring defective penis, penis lengthening and urethroplasty; three patients with penis completely missing were treated with penis reconstruction surgery; 22 cases with serious penile curvature were treated with the 16-dot plication technique (Lue's procedure); 15 cases with penile fracture were treated with conservative treatment for 1 case and with patch penis, corpus spongiosum, and deep penile dorsal vein ligation for 14 cases; 5 cases with post-operative complications of 3-pieces of penile prosthesis, including the prosthesis perforating to the urethra, water pump failure, broken connection tube, erection angle < 60 degrees and failure to expansion the corpus cavernosum, were treated by taking out prostheses, urethral repair cracks, replacement of the prostheses, excision of fibrosis scar and re-implantation prostheses respectively. Four cases with penis complete amputation were treated with the penis replantation; three cases of avulsion injury were treated with the replantation and free flap skin; 6 with Paget's disease of penises were treated with the lesion free skin buried in the scrotum and penis.</p><p><b>RESULTS</b>All these patients were followed up for 3 months to 4 years, with the average of 9 months. Among the 4 cases of penis partial defection, 2 patients were satisfied with the penile appearance and sexual function; 1 got some satisfactory and 1 was unsatisfied. Three cases with the loss of the penis completely were satisfied with both the postoperative appearance and urination, and 1 was not satisfied. Twenty-two cases of penile curvature deformities were corrected, and one case was recurrence. Fourteen of the 15 patients with penile fracture were followed, and all got the restoration of sexual function. Among them, 5 cases with post-operative complications, including mild bending, algopareunia, subcutaneous induration, poor hardness and poor sexual pleasure, were not further treated, and another case lost; Five cases with post-operative complications of three-pieces penile prosthesis were treated successfully, and 4 of their spouses were satisfied with their sexual function after operation, only 1 of their spouse not satisfied. Among four cases with complete amputation of penis, two cases of penis were replanted successfully while two necrosis. Three cases with avulsion were treated with skin grafting successfully. All 6 cases with penile Paget's disease were followed for 2 -4 years, and free skin grafts were all survival. One patient died of brain metastases 18 months after operation and five cases were disease-free survival.</p><p><b>CONCLUSION</b>The patients should be treated based on the procedure of andrological and urological surgery, together with microsurgical, flap or skin graft technique. The urologist should design personalized surgical procedure. Most of the patient's penis shape and erectile dysfunction can be reconstructed by our procedures, but some patients can not achieve the desired appearance or function of penis. New approaches of the treatment ought to be developed to restore both of the shape and function for those severe injury of the penis.</p>

Duckett's procedure of one-stage urethroplasty for hypospadias / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the clinical effect of Duckett's procedure of one-stage urethroplasty with the transverse preputial island flap in the treatment of hypospadias.</p><p><b>METHODS</b>We retrospectively studied 20 cases of hypospadias treated by Duckett's procedure of one-stage urethroplasty with the transverse preputial island flap (Group A) from 2003 to 2007. The patients ranged in age from 2 to 22 years (mean 11.3 years). Another 30 hypospadias patients aged 7 to 34 (mean 16.1) years underwent urethroplasty with mucous membrane of the bladder (Group B) in the same period. Of the 50 cases, 13 were the penile type, 33 the penoscrotal type, 2 the scrotal type, and 2 the perineal type. Catheters were indwelled in Group A, but both cystostomy and catheter indwelling were used in Group B.</p><p><b>RESULTS</b>For Duckett's procedure, surgery succeeded in 17 cases (85%), urethra stenosis developed in 1 (5%) and urinary fistula in 2 (10%), which were successfully repaired 6 months after the operation. The mean operation frequency was 1.1 per patient. In Group B, the operation was accomplished in 2 stages and succeeded in 26 cases (86.7%), with postoperative development of urinary fistula in 3 (10%) and urethra stenosis in 1 (3.3%). The mean operation frequency was 2.1 per patient. The 2 cases of postoperative urethra stenosis were both cured by urethral sounding.</p><p><b>CONCLUSION</b>Duckett's procedure of one-stage urethroplasty with the transverse preputial island flap is effective in hypospadias repair, with a success rate close to that of other types of operations and a low rate of postoperative complications. Compared with the use of mucous membrane of the bladder, it has the advantages of one-move accomplishment and gives a better penile appearance.</p>

Correlation of age and sex hormones to the transition zone volume of the prostate / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the correlation of age and sex hormones to the total volume (TV) and transition zone volume</p><p><b>METHODS</b>Eighty-two men were divided into two groups with the age of 60 as the dividing line. Prostatic TV (TZV and TZV were measured with transrectal ultrasound (TRUS) and the concentrations of total testosterone (T), free testosterone (fT) and estradiol (E2) were measured with radioimmunoassay. Exponential curve regression and one-factor analysis of variance (ANOVA) were used for statistical analysis.</p><p><b>RESULTS</b>Age was significantly correlated with TV, TZV and the TZV/TV ratio, P < 0.01. There was a significant positive correlation between the concentrations of fT and TZV, a negative correlation between those of E2 and TZV (P < 0.01), but no correlation between those of T and TZV (P > 0.05).</p><p><b>CONCLUSION</b>The significant acceleration of the TZV of the prostate after the age of 60 is related to sex hormones.</p>

Duplex ultrasonography and internal pudendal arteriogram in the diagnosis of trauma-associated arteriogenic erectile dysfunction (a report of 7 cases) / 中华男科学杂志

<p><b>OBJECTIVE</b>To make a comparative study of duplex ultrasonography (DU) and internal pudendal arteriogram (IPA) in the diagnosis of trauma-associated arteriogenic erectile dysfunction (ED).</p><p><b>METHODS</b>Seven patients suffering from arteriogenic erectile dysfunction caused by pelvic fracture trauma underwent comprehensive history inquiries and physical examinations by duplex ultrasonography and internal pudendal arteriogram, which ruled out neurogenic erectile dysfunction.</p><p><b>RESULTS</b>DU suggested penile artery blood flow injury, and IPA indicated artery injury in all the cases, including left internal pudendal artery injury, right or left common penile artery injury and bilateral common penile artery injury.</p><p><b>CONCLUSION</b>Trauma-associated arteriogenic erectile dysfunction may result from common penile artery injury and internal pudendal artery injury. DU is proved valuable for evaluating hemodynamic abnormalities of cavernous artery flow, and IPA useful in locating common penile artery and internal pudendal artery injury. DU can be used as the first line diagnostic means to define trauma-associated arteriogenic ED.</p>

Pre- and post-prostatectomy variation and supplement of sexual hormones in patients with benign prostatic hyperplasia / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the variation of sexual hormones (T and fT) before and after prostatectomy and their post-operative supplement in patients with benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>Sixty-four cases of BPH were randomly divided into a treatment group (Group I, n = 25) and a control group (Group II, n = 39). Plasma LH, FSH, T and fT were measured by radioimmunoassay a week before and two weeks after prostatectomy. After operation, Group I received supplement of testosterone undecanoate, while Group II received none.</p><p><b>RESULTS</b>The variations of plasma LH, FSH, T and fT were not statistically significant in the two groups before prostatectomy (P > 0.05), but obviously less in Group I than in Group II after operation (P < 0.01).</p><p><b>CONCLUSION</b>Testosterone supplement is a useful therapy for post-prostatectomy patients with androgen deficiency.</p>

Comparison of PSAD and PSAD-TZ value in prostatic hyperplasia and prostatic cancer / 中华男科学杂志

<p><b>OBJECTIVES</b>To compare PSAD, PSAD-TZ, PSA, FPSA/TPSA detection used in diagnosis of prostatic hyperplasia(BPH) and prostatic cancer(PCa).</p><p><b>METHODS</b>Fourty-three cases of BPH and twenty cases of PCa with PSA < 20 micrograms/L were chosen, then compared PSA, PSAD, FPSA/TPSA, PSAD-TZ between BPH and PCa.</p><p><b>RESULTS</b>The mean PSA in BPH and PCa is (10.47 +/- 6.25) microgram/L and (13.92 +/- 3.20) microgram/L respectively with no statistic difference (P > 0.05). The mean PSAD in BPH and PCa is (0.15 +/- 0.12) microgram/L and (0.24 +/- 0.13) microgram/L respectively with statistic difference (P < 0.05). The mean FPSA/TPSA in BPH and PCa is (0.58 +/- 0.42) microgram/L and (0.26 +/- 0.17) microgram/L respectively with statistic difference (P < 0.05). The mean PSA-TZ in BPH and PCa is (0.26 +/- 0.22) and (0.51 +/- 0.28) respectively with obviously statistic difference (P < 0.01).</p><p><b>CONCLUSIONS</b>The results suggest PSAD, FPSA/TPSA, especially PSAD-TZ could be used to distinguish BPH and PCa.</p>