Application of syringe needle guided transabdominal double-J tube placement in total laparoscopic ileal neobladder surgery / 现代泌尿外科杂志

【Objective】 To explore the application of 1.2 mm×35 mm thin walled, long oblique angle syringe needle guided double-J tube insertion through abdominal wall in total laparoscopic ileal neobladder surgery. 【Methods】 Clinical data of 5 patients undergoing total laparoscopic ileal neobladder surgery in our hospital during Dec.2020 and Jan.2022 were retrospectively analyzed. Under laparoscopy and direct vision, 3 cm above pubic symphysis was taken as the puncture point, and an syringe needle was inserted to establish a channel. After that, a double-J tube was inserted under the guidance of the guide wire through the needle. 【Results】 The double-J tube was successfully implanted in all 5 patients. The time needed was 2-4 min, with an average of 3 min. 【Conclusion】 Under the guidance of a 1.2 mm×35 mm syringe needle, the placement of a double-J tube through the abdominal wall in total laparoscopic ileal neobladder surgery is safe, effective, simple and accurate. It can not only preserve the original operation channel without destroying the pneumoperitoneum, but also shorten the operation time. It is a new auxiliary means in total laparoscopic ileal neobladder surgery.

Acupuncture for chronic prostatitis/chronic pelvic pain syndrome: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the short-term efficacy, long-term efficacy and safety of acupuncture for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).@*METHODS@#Forty-two patients with CP/CPPS were randomly divided into an acupuncture group (21 cases, 1 case dropped off) and a sham acupuncture group (21 cases). The patients in the acupuncture group were treated with acupuncture at bilateral Zhongliao (BL 33), Huiyang (BL 35), Shenshu (BL 23) and Sanyinjiao (SP 6); the needling depth of Zhongliao (BL 33) and Huiyang (BL 35) was 60 to 80 mm, while Shenshu (BL 23) and Sanyinjiao (SP 6) was directly punctured of 30 mm. The patients in the sham acupuncture group were treated with acupuncture at non-acupoints, including points 2 cm next to Shenshu (BL 23), Zhongliao (BL 33) and Huiyang (BL 35), and the midpoint of the connecting line between the spleen meridian and the kidney meridian. All the non-acupoints were treated with directly puncture of 2 to 3 mm. The needles were left for 30 min in both groups, once every other day in the first four weeks, three times a week, and twice a week in the next four weeks, totally 20 treatments. Before treatment, after treatment and in follow-up of 24 weeks after treatment completion, the National Institutes of Health-chronic prostatitis symptom index (NIH-CPSI) score and urinary flow rate were observed in both groups; the clinical efficacy and safety were evaluated.@*RESULTS@#Compared with those before treatment, the pain and discomfort scores, urination symptoms scores, quality of life scores and total scores of NIH-CPSI in both groups were reduced after treatment in the two groups (P<0.01), while each item score and total score of NIH-CPSI in the acupuncture group were reduced in follow-up (P<0.01, P<0.05). After treatment and in follow-up, each item score and total score of NIH-CPSI in the acupuncture group were lower than those in the sham acupuncture group (P<0.05, P<0.01). After treatment, the maximum and average urinary flow rates in the acupuncture group were higher than those before treatment (P<0.05), and the average urinary flow rate in the acupuncture group was higher than that in the sham acupuncture group (P<0.05). The total effective rate was 75.0% (15/20) in the acupuncture group, which was higher than 42.9% (9/21) in the sham acupuncture group (P<0.05). No significant adverse reactions were observed in the two groups, and there was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).@*CONCLUSION@#Acupuncture could effectively alleviate the clinical symptoms, improve quality of life, and has a sustained, safe and reliable therapeutic effect in patients with CP/CPPS.

Point electro-cauterization versus holmium laser cauterization in the treatment of post-ejaculation hematuria / 中华男科学杂志

Objective@#To investigate the advantages and disadvantages of point electro-cauterization (PEC) and holmium laser cauterization (HLC) in the treatment of post-ejaculation hematuria.@*METHODS@#From January 2015 to December 2018, 73 patients with post-ejaculation hematuria, aged 24－63 (36.8 ± 4.2) years, underwent PEC (n = 35) or HLC (n = 38) after failure to respond to 3 months of conservative treatment. We compared the hospital days, total hospitalization expenses, maximum urinary flow rate (Qmax), average urinary flow rate (Qavg), Hamilton Anxiety Rating Scale (HAMA) score, postoperative duration of hematuria, and recurrence rate at 3 and 6 months after surgery.@*RESULTS@#All the patients experienced first ejaculation but no post-ejaculation hematuria at 1 month after operation. The recurrence rates were lower in the PEC than in the HLC group at 3 months (5.71% vs 2.63%, P > 0.05) and 6 months postoperatively (8.57% vs 5.26%, P > 0.05). Compared with the baseline, the Qmax was decreased from (18.56 ± 2.53) ml/s to (13.68 ± 3.31) ml/s (P < 0.05) and the Qavg from (14.35 ± 2.26) ml/s to (9.69±1.84) ml/s in the PEC group at 1 month after surgery (P < 0.01), but neither showed any statistically significant difference in the HLC group. Mild to moderate anxiety was prevalent in the patients preoperatively, particularly in those without job or regular income and those with a long disease course or frequent onset, the severity of which was not correlated with age, education or marital status. The HAMA score was decreased from18.65 ± 4.33 before to 12.35 ± 3.63 after surgery in the PEC group (P < 0.01), and from 16.88 ± 2.11 to 6.87 ± 4.36 in the HLC group (P < 0.01). The mean hospital stay was significantly longer in the former than in the latter group (［5.2 + 1.3］ vs ［3.4 ± 0.5］ d, P < 0.01), while the total cost markedly lower (［6.35 ± 1.20］ vs ［12.72 ± 2.15］ thousand RMB ¥, P < 0.05).@*CONCLUSIONS@#Both PEC and HLC are safe and effective for the treatment of post-ejaculation hematuria, with no significant difference in the recurrence rate at 3 and 6 months after operation, but their long-term effect needs further follow-up studies. PEC may increase the risk of negative outcomes of the postoperative urinary flow rate, while HLC has the advantages of better relieving the patient's anxiety, sooner discharge from hospital and earlier recovery from postoperative hematuria, though with a higher total cost than the former.

Transurethral holmium laser enucleation of the prostate combined with Jisheng Shenqi Decoction for benign prostatic hyperplasia / 中华男科学杂志

Objective@#To assess the clinical effects of transurethral holmium laser enucleation of the prostate (HoLEP) combined with Jisheng Shenqi Decoction (HoLEP + JSSD) on BPH.@*METHODS@#This study included 110 BPH patients treated in our hospital from August 2017 to April 2018, who were randomly assigned to receive HoLEP (n = 55) or HoLEP + JSSD (n = 55). We compared the pre- and post-operative IPSS, quality of life (QOL) score, prostate volume, postvoid residual urine volume (PVR), maximum urinary flow rate (Qmax), average urinary flow rate (Qavg) and levels of serum T, E2 and T/E2 as well as postoperative complications between the two groups of patients.@*RESULTS@#After treatment, both IPSS and QOL score were significantly lower in the HoLEP + JSSD than in the HoLEP group (P 0.05) or the total incidence rate of complications postoperatively (21.82% vs 29.09%, P > 0.05).@*CONCLUSIONS@#HoLEP + JSSD can significantly alleviate the lower urinary tract symptoms as well as improve the QOL and bladder and urinary tract functions of BPH patients.

Effect of bladder overdistention on uroflowmetry and post-void residual urine in children with enuresis / 中华实用儿科临床杂志

Objective@#To explore the effect of bladder overdistention on uroflowmetry and post-void residual urine(PVR)in children with primary nocturnal enuresis (PNE).@*Methods@#A total of 136 children with PNE from March 2015 to June 2018 at Department of Pediatric Urodynamic Center, the First Affiliated Hospital of Zhengzhou University were enrolled, aged 5-14 years, with mean age of (7.96±2.48) years old.Uroflowmetry and PVR measurement were performed in the condition of over and no urinary distention, respectively.According to the initial urinary voided volume (VV), the children were divided into 3 groups, 25 mL≤ VV<50 mL(group 1), 50 mL≤VV<100 mL(group 2), and VV≥100 mL(group 3). The VV, maximum flow rate (Qmax), average flow rate (Qave), urine flow time, and PVR were compared interms of condition between the groups.Different types of flow curve were analyzed simultaneously.@*Results@#In the condition of bladder over distention, the VV, Qmax, Qave, urinary flow time and PVR of children were higher than those with no overdistention[group 1: (168.25±103.23) mL vs.(34.04±7.03) mL, (17.76±11.13)mL/s vs.(8.23±2.72) mL/s, (9.56±4.13) mL/s vs.(4.30±1.55) mL/s, (20.24±15.13) s vs.(8.64±4.27) s, (3.90±3.55) mL vs.(1.50±2.55) mL; group 2: (168.65±80.66) mL vs.(68.04±15.13) mL, (16.41±5.18) mL/s vs.(14.61±5.29) mL/s, (9.86±3.56) mL/s vs.(8.14±2.29) mL/s, (18.75±10.73) s vs.(9.41±3.47) s, (5.98±8.59) mL vs.(2.77±6.41) mL; group 3: (280.24±102.00) mL vs.(181.50±66.22) mL, (22.73±8.21) mL/s vs.(20.42±6.25) mL/s, (12.57±3.68) mL/s vs.(11.00±3.22) mL/s, (23.46±10.65) s vs.(17.01±6.90) s, (3.78±6.26) mL vs.(2.09±3.21) mL], and the differences were all significant(all P<0.05). Excluding physiological pseudomorphism, urinary flow curves of 114 children with initial urinary intention and excessive voiding were obtained.The incidence of Staccato urinary flow curve was significantly higher than that with no distention [6.14%(7/114 cases) vs.21.93%(25/114 cases), χ2=14.45, P<0.05].@*Conclusions@#Bladder overdistention induced significant influence on the uroflowmetry and PVR.

Clinical Observation of Acupuncture plus Moxibustion for Prostatic Hyperplasia / 上海针灸杂志

Objective To observe the clinical efficacy of acupuncture plus moxibustion in the treatment of benign prostatic hyperplasia.Method Sixty cases of benign prostatic hyperplasia were randomly divided into two groups, 30 cases in the treatment group, 30 cases in the control group. The treatment group was intervened by Acupuncture and moxibustion, while the control group was by orally takingJingzhu Qianlie Longbitong capsules. The International Prostate Symptom Score (IPSS), Quality of Life score (QOL), maximal urinary flow rate (Qmax), residual urine volume (RUV) were compared before and after 3 courses of treatment. Result The total effective rate was 93.3% in the treatment group, versus 66.7% in the control group, and the difference was statistically significant (P<0.05); the IPSS score, QOL score, Qmax, and RUV were significantly changed in both groups after intervention (P<0.05).Conclusion The treatment group and the control group both show improvements in IPSS, QOL score and Qmax and reduction of RUV, which proves that acupuncture plus moxibustion can produce a content efficacy in treating benign prostatic hyperplasia.

Efeito do extrato aquoso de cabelo de milho (Zea mays L. ) sobre a excreção renal de água e eletrólitos e pressão arterial em ratos Wistar anestesiados / Effect of aqueous extract of corn silks (Zea mays L. ) on the renal excretion of water and electrolytes and arterial pressure in anesthetized Wistar rats

O milho (Zea mays L.) possui nos estigmas (cabelo de milho) substâncias que o tornam diurético, podendo ser importante no controle da hipertensão. No presente estudo, foi investigado o efeito do extrato aquoso (EA) do cabelo de milho sobre o fluxo renal de água (V) e eletrólitos e a pressão arterial (PA) em ratos Wistar anestesiados. Foram realizados 3 grupos: I) Controle - administração intragástrica (AI) de 1mL de água destilada; II) AI de 1 mL de EA de cabelo de milho a 20 por cento e III) AI de 1 mL de solução contendo furosemida. Canulou-se a artéria carótida esquerda para mensuração da PA, de 10 em 10 minutos, e a bexiga urinária, para mensuração de V de 30 em 30 minutos e da carga excretada dos íons sódio (Qe (Na+)) e potássio (Qe (K+)). Protocolo experimental: quatro períodos de 30 minutos cada: basal (avaliação dos parâmetros basais) e experimentais (Ex) 1, 2 e 3 (30, 60 e 90 minutos após a AI, respectivamente). O Grupo I não apresentou alterações significativas entre os períodos nos parâmetros analisados (p>0,05). O Grupo II apresentou aumento significativo (p<0,05) em V, em Qe (Na+) e em Qe (K+) nos períodos Ex2 e Ex3, com redução significativa na PA (p<0,05) em Ex2 e Ex3. Conforme esperado, o Grupo III apresentou aumento significativo em V nos períodos Ex2 (p<0,05) e Ex3 (p<0,001), aumento em Qe (Na+) em Ex1 (p<0,05), Ex2 (p<0,001) e Ex3 (p<0,001) e aumento em Qe (K+) em Ex2 (p<0,05) e Ex3 (p<0,001), com redução significativa na PA (p<0,05) em Ex2 e Ex3. Os dados mostram que o EA do cabelo de milho possui efeito diurético, porém não age como um diurético "de alça", uma vez que não levou à expoliação de potássio e nem a uma excreção tão acentuada de sódio quanto à furosemida.

The corn (Z. mays) has in its stigmas (corn silks) substances that make it diuretic, which may be important in hypertension control. In this study, the effect of aqueous extract (AE) of corn silks on the renal flow of water (V) and electrolytes and arterial pressure (AP) was investigated in anesthetized Wistar rats. Three groups were tested: I) Control - intragastric administration (IA) of 1mL of distilled water, II) IA of 1 mL of AE of corn silks at 20 percent and III) IA of 1 mL of a solution containing furosemide. Cannulation was performed in the left carotid artery to measure AP, at every 10 minutes, and in the urinary bladder to measure V, at every 30 minutes, and the excreted load of ions sodium (Qe (Na+)) and potassium (Qe (K+)). Experimental protocol: four periods of 30 minutes each: basal (evaluation of basal parameters) and experimental (Ex) 1, 2 and 3 (30, 60 and 90 minutes after IA, respectively). Group I had no significant differences between periods for the analyzed parameters (p>0.05). Group II presented a significant increase (p<0.05) in V, Qe (Na+) and Qe (K+) in periods Ex2 and Ex3, with significant reduction in AP (p<0.05) in Ex2 and Ex3. As expected, Group III had a significant increase in V in periods Ex2 (p<0.05) and Ex3 (p<0.001), an increase in Qe (Na+) in Ex1 (p<0.05), Ex2 (p<0.001) and Ex3 (p<0.001) and an increase in Qe (K+) in Ex2 (p<0.05) and Ex3 (p<0.001), with an important reduction in AP (p<0.05) in Ex2 and Ex3. These data show that AE of corn silks has a diuretic effect but does not act as a loop diuretic since it did not lead to potassium loss or marked sodium loss, compared to furosemide.

The Effect of a 6Fr Transurethral Catheter on the Urinary Flow in Female Pressure-Flow Studies

PURPOSE: We evaluated whether a 6Fr transurethral catheter affects urinary flow in women undergoing pressure-flow studies. MATERIALS AND METHODS: We retrospectively reviewed urodynamics database of 201 consecutive women referred for the evaluation of lower urinary tract symptoms from January 1997 to June 2000. Before the urodynamic study, all patients voided privately using a standard toilet and free uroflowmetry parameters were recorded. Then, a standard pressure-flow study was performed using 6Fr transurethral catheter. We excluded the patients with inadequate voided volume(<150ml) and volume difference more than 30% between two studies. Urinary flow parameters between the two studies were analysed by paired t-test according to voided volume, main urodynamic diagnosis and uroflowmetry pattern. RESULTS: Of 201 women, 144 were excluded and 57 were subjects of our analysis. According to voided volume, pressure-flow study parameters were significantly different from the equivalent free uroflowmetry parameters: the maximum flow rate and average flow rate were significantly lower and flow time was significantly longer in pressure-flow studies(p<0.01). According to main urodynamic diagnosis categories, the subgroups of patients with normal urodynamic study, bladder outlet obstruction, detrusor instability and others showed significantly lower maximum flow rate and average flow rate in pressure-flow studies(p<0.01). According to uroflowmetry pattern, obstructive patterns such as undulating and intermittent pattern were more common in pressure-flow studies. CONCLUSIONS: The 6Fr transurethral catheter used in pressure-flow studies significantly affects urinary flow parameters. In order to make a accurate diagnosis, we must not merely rely on the results of pressure-flow studies, but we must take into account patient's individual clinical situation and also, if available, the results of free uroflowmetry in addition to pressure flow study parameters.

Clinical effect of transurethral resection of the prostate / 대한비뇨기과학회지

A clinical study was made on 330 cases of transurethral prostatectomy that were performed at the Department of Urology. Seoul Eulji General Hospital. Seoul and Daejeon Eulji General Hospital, Daejeon during the period from August, 1984 to July, 1992. Transurethral prostatectomy was per- formed on 309 cases of benign prostatic hyperplasia and 21 cases of prostatic cancer. 1. The mean age of all patients was 67.1 years(50-85 years) and the group of seventh decade was most common (40.5% in BPH and 55% in prostatic cancer). 2. The mean weight of resected prostatic tissue was 9.7 grams(3-45 grams) and the mean length of resection time was 68.6 minutes(30-125 minutes). The mean weight of resected tissue per minute was 0.23 grams. 3. The mean duration of postoperative urethral catheter indwelling was 6.3 days(2-14 days) and the mean period of postoperative hospitalization was 8.4 days(3-19 days). 4. Total complication rate was 15.5% and complications were as follows; failure to void(4.6%) bleeding(3.9%), incontinence(2.7%), urethral stricture(1.8%), secondary resection due to in- adequate resection(1.2%), extravasation(0.9%), epididymitis(0.3%), hyponatremia(0.3%), etc. One patient was dead due to deterioration of associated disease postoperatively. 5. We undertook follow-up assessment of voiding symptom with Boyarsky symptom score system on 148 cases of BPH group. The mean obstructive and irritative symptom scores decreased 84 % and 48%, respectively. We also evaluated the urinary flow rate in 102 cases of 148 cases and the mean peak flow rate improved 98%. The observed changes in symptom score and urinary flow rate was statistically and clinically significant(p<0.01).

Effects of Ethyladrianol of Urinary Flow in Normotensive Dog / 대한비뇨기과학회지

The mongrel dogs, anesthetized with pentobarbital sodium, were used as experimental animals. The effects of a single intravenous injection of ethyl adrianol. 0.5 mg per kg of body weight, on cardiovascular response and urinary flow were compared with those of epinephrine, 0.05 mg per kg of body weight and norepinephrine, 0.05 mg per kg of body weight. 1) The pressor effect induced with 0.5 mg of ethyl adrianol per kg of body weight was similar to that with equipressor doses, 0.05 mg, kg of epinephrine or norepinephrine. 2) The duration of the pressor action of ethyladrianol lasted at least one hour but only about 15minutes with equipressor dose of epinephrine or norepinephrine. 3) Ethyladrienol was responsible for the increase of the urinary volume, which phenomenon is assumed to be related of the renal-function and the durability of the reaction. 4) Ethyladrianol is considered to be one of the ideal drugs for the treatment of hypotensive shock.