[Diagnosis and treatment of prostatic abscess: Report of 11 cases and review of the literature].

OBJECTIVE: To analyze the clinical features, imaging characteristics, treatment options and prognosis of prostatic abscess (PA), and provide some new ideas for the diagnosis and treatment of the disease. METHODS: This retrospective study included 11 cases of confirmed PA treated in the Fifth Medical Center of PLA General Hospital. We analyzed the clinical data obtained from the electronic medical records, including basic demographic statistics, risk factors, clinical symptoms, laboratory results, imaging findings, treatment methods, treatment-related complications and outcomes. RESULTS: The 11 patients diagnosed with PA between May 2016 and August 2022 were aged (64.18 ± 7.19) years and all had at least 1 comorbidity, including 5 cases of diabetes mellitus (45.5%) and 8 cases of dysuria (72.8%). PA was confirmed in 3 cases by CT and in 8 cases by MRI, 6 (54.5%) multifocal and 10 (90.9%) >2 cm in diameter, with a median size of 3.84 cm. After admission, positive urine culture was found in 3 cases, positive blood culture in 1, Klebsiella pneumoniae in 2 and Enterococcus Faecalis in 1. Three of the patients were treated by intravenous administration of antibiotics alone, and the other 8 by transurethral PA unroofing in addition. Antibiotics medication lasted for a median of (12.9 ± 3.88) d and hospital stay averaged (19.18 ± 8.20) d. The patients were followed up for 3 months, which revealed the presence of PA in 2 of the cases treated with antibiotics alone, but not in any of the cases treated by surgery. CONCLUSION: PA is relatively rare and has no specific symptoms clinically. Imaging examination is very important for accurate diagnosis, and transurethral PA unroofing plus antibiotics administration could be considered as an optimal management of the disease.

An early experience of the robot-assisted laparoscopic nephroureterectomy without re-docking in a single position.

OBJECTIVE: This study aims to evaluate the execution of robot-assisted laparoscopic nephroureterectomy without repositioning the patient. METHODS: The clinical data of 9 patients who underwent robot-assisted laparoscopic nephroureterectomy between May 2017 and November 2018 were analyzed, proceeding in a single position, without repositioning the patient. This involved 5 men and 4 women, with an average age of 61.67 ± 10.37 years and an average body mass index (BMI) of 24.78 ± 3.84. We considered the duration of the intervention, the blood loss, the duration of the hospital stay, the duration of maintenance of the drainage and the follow-up on all patients, with or without complications and recurrence of the tumor. RESULTS: The intervention was completed in all 9 cases. The average duration of the intervention was 242.89 ± 13.37 minutes, the average blood loss was 166.67 ± 70.71 ml, the average hospitalization time was 2 ± 0.71 days, the average time drainage maintenance was 5.11 ± 1.05 days and the average follow-up times without complications and tumor recurrence were 12.56 ± 6.19 months. CONCLUSION: Robot-assisted laparoscopic nephroureterectomy without repositioning the patient during the procedure simplifies the procedure and shortens the duration of the procedure. It is also a safe, effective and feasible minimally invasive treatment method. KEY WORDS: Nephroureterectomy, Robot-assisted laparoscopic, Tumor recurrence, Single position, Upper tract urothelial carcinoma.

Comparison of the short-term efficacy of sequential treatment with intravesical single-port laparoscopic partial cystectomy with bladder preservation or open partial cystectomy in combination with cisplatin plus gemcitabine chemotherapy.

This study aimed to assess the short-term efficacy of sequential therapy for T2/T3a bladder cancer with intravesical single-port laparoscopic partial cystectomy or open partial cystectomy combined with cisplatin plus gemcitabine (GC) chemotherapy in a prospective randomized controlled study. Thirty patients with bladder cancer who underwent open partial cystectomy (group A) or single-port laparoscopic partial cystectomy (group B) and received standard GC chemotherapy were analyzed. Perioperative functional indicators and tumor recurrence during a 1-year postoperative follow-up were compared between the two groups. The baseline characteristics were comparable between the two groups. The mean operative time, amount of blood loss and duration of hospital stay were 90.3 min, 182.0 ml and 7.3 days, respectively, for group A, and 105.3 min, 49.3 ml and 5.8 days, respectively, for group B. No secondary postoperative bleeding, urine leakage, wound infection or other complications were observed in the two groups. Postoperative scarring was not evident in group B. The overall incidence of surgical complications, tumor recurrence rate and complications during chemotherapy in the postoperative follow-up period of 12 months were similar between the two groups. Single-port laparoscopic partial cystectomy surgery is an idea surgical method for the treatment of invasive bladder cancer, with good surgical effect, minimal invasiveness, rapid recovery and short hospital stay. The data from 1-year postoperative follow-up showed that laparoscopic surgery was superior with regard to perioperative bleeding, postoperative recovery and duration of indwelling urinary catheter use. However, regarding the tumor recurrence rate, long-term comparative details are required to determine the effect of laparoscopic surgery.

Experience of treating high risk prostate hyperplasia patients with a HPS120 laser.

BACKGROUND: The aim of this study was to investigate the effects and safety of 120 watt PVP surgery for the high risk prostate hyperplasia patients. METHODS: 120 watt PVP surgery was performed on 120 cases of high risk prostate hyperplasia patients. The assessment included the operation time, energy consumed, hemoglobin changes, and serum salt concentration, whether to keep urinary catheter, hospitalization time, and complications after the operation. International Prostate Symptom Scoring (IPSS), the maximum urine flow rate (Qmax) and residual urine volume (RUV) were conducted preoperatively and postoperatively for the patients. RESULTS: There were 30% of patients taking oral anti-coagulant drug (n = 36), 88 cases with abnormal ECGs. All the patient's internal diseases, include the cardiovascular disease (42/120), the hypertension (56/120), the respiratory system diseases (51/120), the cerebrovascular diseases (39/120), anemia (24/120), liver or kidney dysfunction (16/120), diabetes (18/120), hypoproteinemia (15/120) were under controlled. The average age, prostate volume and energy consumed was 82.8 ± 8.6 (70-96) years, 66.1 ± 25.3 (30-160) ml, and 224 ± 85 (31-596) kJ respectively. The average follow-up time was 20.8 ± 3.2 (18-24) months. The incidence of bladder neck contracture and urethral stricture were 1.7% and 0.8% respectively, no prostate cancer occurred during the subsequent follow-up period. CONCLUSIONS: 120 watt PVP surgery can safely and effectively alleviate the urination parameters of high risk prostate hyperplasia patients. The surgical process is safe and effective, and is not affected by the various internal diseases or the use of oral anti-coagulant drugs.

[Construction of a replicative anti-tumor DNA vaccine PSCK-2PFcGB and its expression in vivo and in vitro].

OBJECTIVE: To construct a replicative anti-tumor DNA vaccine PSCK-2PFcGB based on Semliki Forest Virus (SFV) replicon vector and observe its expression in vivo and in vitro. METHODS: The plasmid pVAX1-2PFcGB was digested with Nhe I, and the digestion product was blunted prior to further digestion with BssH II to obtain the fragment 2PFcGB, a fusion gene containing the multitarget complex antigen 2PAG encoding both the most cytotoxic T lymphocyte epitopes of human survivin and chorionic gonadotropin ß chain-CTP37 of human and monkey. The 2PFcGB fragment was inserted into the PSCK vector digested by Sma I. The products with the expected size were extracted and ligated, and the positive clones were screened by kanamycin and amplified. The recombinant PSCK-2PFcGB, following identification by colony PCR and restriction endonuclease Nde I, was transfected into 293T cells via lipofectamine 2000 and its expression was detected. The recombinant plasmid was also transfected into mouse quadriceps femoris muscle to observe its expression in vivo by immunohistochemistry. RESULTS: Nde I digestion resulted in a fragment of the expected size. Transfection with the recombinant plasmid PSCK-2PFcGB resulted in successful expression of the antigen and adjuvant molecular protein in 293T cells, with the positivity rates of 5.70% and 19.75%, respectively. The fusion tumor antigen survivin and hCGß-CTP37 were also detected in the muscular tissues of the mice. CONCLUSION: A novel replicative anti-tumor DNA vaccine PSCK-2PFcGB has been successfully constructed and can be expressed in 293T cells and in the muscular tissues of immunized mice, which provide a basis for further studies of the antitumor activity and immunological mechanism of the DNA vaccine.