Low-intensity extracorporeal shock wave therapy for traumatic erectile dysfunction: results of a controlled trial / 中华泌尿外科杂志

Objective:To evaluate the efficacy of low-intensity extracorporeal shock wave therapy (LI-ESWT) in patients with traumatic erectile dysfunction.Methods:The present study included 62 patients with traumatic erectile dysfunction, including 30 patients treated with low intensity shock waves and 32 controlled patients. The treatment groups were performed six times (twice per week), each by 3 000 impulses. The follow-up was performed 4, 8 and 12 weeks after LI-ESWT. The International Index of Erectile Function-5 (IIEF-5), nocturnal penile tumescence (NPT) and the Erection Hardness Score (EHS) were used to evaluate the therapeutic efficacy of LI-ESWT.Results:LI-ESWT could significantly improve IIEF-5 (15.67±3.89 vs. 9.41±4.66, P<0.01). 67% of patients in the LI-ESWT group and none of the control group answering 'yes’ to the SEP-Q2 elevated. In the low intensity shock wave treatment group and the control group 67% and 0 of patients, respectively, achieved erection hard enough for vaginal penetration, that is an EHS (Erection Hardness Score) of 3 ( P<0.01). According to changes in the IIEF-5 score treatment was effective in 70% of men who received low intensity shock wave treatment but in none in the control group ( P<0.01). Therapeutic efficacy could last 12 weeks ( P<0.05). No adverse events were reported during and following treatment. Conclusions:These studies suggest that LI-ESWT could improve the IIEF and EHS of traumatic ED patients.

The value of definitive perineal urethrostomy for the treatment of complex adult anterior urethral strictures / 中华泌尿外科杂志

Objective To analyze the clinical outcome of definitive perineal urethrostomy for the treatment of complex adult anterior urethral strictures.Methods From June 2012 to February 2018,28 patients who underwent the definitive perineal urethrostomy for a complex anterior urethral stricture were retrospectively reviewed.The mean age of the patients was 62.3 (range 34 to 77) years and stricture etiology was lichen sclerosus in 46.4％ (13/28) of the cases,iatrogenic stricture after transurethral resection of the prostate in 35.7％ (10/28),failed hypospadias repair in 10.7％ (3/28),infection 3.6％ (1/28)and idiopathic etiology 3.6％ (1/28).The mean stricture length was 9.6 (range 4.5 to 16.0) cm and the stricture length ＜5 cm in 7.1％ (2/28) of the cases,5-10 cm in 35.7％ (10/28) and ＞ 10 cm in 57.1％ (16/28).0f28 patients 21 (75％) underwent prior urethral dilation,4 (14.3％) underwent direct vision internal urethrotomy (DVIU) and 17 (60.7％) underwent urethroplasty.Among the medical history of interest,hypertension was observed in 17 patients (60.7％),chronic ischemic heart disease in 11 patients (39.3％),diabetes mellitus in 9 patients (32.1％) and chronic obstructive pulmonary disease (COPD) in 9 patients (32.1％).All patients completed the perineal urethrostomy with inverted U-shaped perineal skin flap.The patient was placed in a normal lithotomy position and an inverted U-shaped perineal incision was made.We can get an inverted U-shaped perineal skin flap after dissecting along the bulbospongiosus muscle.The bulbar urethra was opened along the ventral surface and the margins of the spongiosum tissue were closed with perineal skin flap.We analyzed the clinical characteristics of the patients,the outcome of the technique and investigated the satisfaction rates of the patients by outpatient follow-up or telephone interview.Surgical success was defined as functional voiding without the need for further procedures.Results The perioperative complications included 3 cases of urinary tract infection,1 case of bleeding and 1 case of wound dehiscence.Mean follow-up length was 27.2 (range 6.0 to 64.0)months.Of 28 cases 26 (92.9％) were successful and the mean maximum urinary flow rate was 26.5 (range 17.0 to 40.0) ml/s.Postoperatively,2 cases of urethrostomy strictures were found in 2 months and 4 months,respectively.They required periodic outpatient dilation and the younger one was in the waiting list for revision of the perineostomy and the older one refused the revision.Of 28 patients 24 (85.7％) were satisfied with the results obtained with surgery,15 were very satisfied,9 cases satisfied and 4 cases dissatisfied.Conclusions The successful rate of the definitive perineal urethrostomy for the complex adult anterior urethral strictures was high and patients were satisfied with the outcome of the surgery.The definitive perineal urthrostomy is a well-tolerated treatment option for patients with complex anterior urethral strictures,especially for those aged and with extensive comorbidities.

Long-term efficacy of oral mucosa urethroplasty (report of 324 cases) / 中华泌尿外科杂志

Objective To summarize the long-term efficacy of oral mucosal urethroplasty.Methods The clinical data of 324 patients with anterior urethral stricture who underwent oral mucosal urethroplasty from January 2013 to May 2018 were retrospectively analyzed.The patients were 27-65 years old with an average age of 47 years.Among them,51 patients had urethral meatal stenosis,174 patients had penile urethral stricture and 99 patients had bulbar urethral stricture.The length of urethral stricture was 2.8-14.0 cm,with an average of 6.4 cm.The preoperative maximal urinary flow rate Qmax was 3.2-8.4 ml/s,with an average of 4.8 ml/s.In the urethral meatal stenosis group (51 patients),15 underwent urethrotomy and 36 underwent meatal urethroplasty.In the penile urethral stricture group (174 patients),ventral sagittal incision was done in 21 patients,subcoronal circumferential incision in 49 patients and midline perineal incision in 104 patients.The perineal incision or verted Y incision were done in all the bulbar urethral strictures.Results The patients were followed-up for 3-75 months,with an average of 35.0 months.The results were satisfied in 290 (89.5％) patients.The post-operative maximal urinary flow rate Qmax was 15.8-32.2ml/s,with an average of 21.5 ml/s.Thirty-four patients (10.5％) developed recurrent urethral stricture,including 7 patients in the urethral meatus,17 patients in the penile urethra and 12 patients in the bulbar urethra.Among the recurrent urethral stricture patients,18 treated with the dilatation and 16 treated with the urethroplasty.Five patients (1.5％) developed fistula,including 2 patients in the ventral sagittal incision,1 patient in the circumferential incision and 2 patient in the perineal incision.Conclusions The long-term effect of oral mucosal urethroplasty is realistic.The rate of urethral stricture recurrence and fistula is low.The recurrence can be treated again by urethroplasty.The surgical approach for oral mucosa urethroplasty depends on the location and length of the anterior urethral stricture.

Mucinous Adenocarcinoma of the Suprapubic Cystostomy Tract without Bladder Involvement.

We present a case of adenocarcinoma developing at the vesicocutaneous edge of a vesicostomy, 8 years after it was created, in a patient who had neurogenic bladder secondary to medullitis. The patient died 6 months after the start of surgery therapy. Although transitional and squamous cell carcinoma of a vesicostomy have been reported, to our knowledge, the presence of adenocarcinoma at the vesicostomy edge without bladder involvement has not been reported previously.

The value of procalcitonin compared to C-reactive protein and blood white cell count in early detection of sepsis following percutaneous nephrolithotomy / 中华泌尿外科杂志

Objective To assess the value of procalcitonin (PCT) levels compared to C-reactive protein (CRP) levels and blood white cell count in early detection of sepsis following percutaneous nephrolithotomy.Methods This prospective observational study included 91 patients,including 59 male patients and 32 female patients,undergoing percutaneous nephrolithotomy between April 2014 and October 2015.Their mean age was (54 ± 15)years old,ranging 15 to 88 years old.The average size of stone was (20.9 7.0) am.Those patients were classified into two groups,based on whether the postoperative sepsis existed.In this group,51 cases were concluded in the sepsis group and 40 in the non-sepsis group.A statistically significant difference between patients with and without sepsis was found in the hydronephrosis (44 vs.25,P =0.009),urine white cell count [(402 ± 970) / μ1 vs.(70 ± 171) / μ1,P ＜ 0.01],positive urine culture(36 vs.20,P ＜ 0.05),positive pelvic urine culture (22 vs.5,P =0.001).There was not any significant difference in sex,age,size of calculi and blood culture between patients with and without sepsis (P ＞ 0.05).Blood white blood cell count,CRP,and PCT were measured in patients with an acute onset of sepsis.Diagnostic accuracy of PCT values was analyzed by the receiver operating characteristics (ROC) curve.Results A statistically significant difference between patients with and without sepsis was found in the PCT [(7.43 ± 10.15)μg/L vs.(0.14 ± 0.10)μg/L,P ＜ 0.01] and blood white cell count [(14.18 ± 6.47) × 109/L vs.(11.22±4.22) × 109/L,P ＜0.05].There was not any significant difference in CRP [(64.93 ± 68.60) mg/ml vs.(70.76 ± 53.36) mg/ml,P ＞ 0.05] between patients with and without sepsis.ROC curve analysis showed that blood white cell count and PCT concentrations had similar predictive values for the development of sepsis (area under the curve,0.78 and 0.90,respectively) with the best cut-off values of blood white cell count for 12 × 109/L (sensitivity 50％,specify 88％) and 0.5 μg/L (sensitivity 64％,specify 100％)for PCT.54 cases were performed blood culture,which showed positive in 12 cases and negative in 42 cases.The significant difference of PCT level could be noticed in two groups [(16.99 ± 11.64) μg/ L vs.(3.77 ± 7.23) μg/ L,P ＜ 0.05)].No significant difference was found in CRP,Blood white cells count among those groups (P ＜ 0.05).ROC curve analysis showed that PCT concentrations had predictive values for the positive blood culture (area under the curve,0.80) with the best cut-off values of 8 μg/L (sensitivity 71％,specify 88％) for PCT.Conclusions PCT was a useful marker for the diagnosis of the sepsis after percutaneous nephrolithotomy as compared with WBC and CRP.

The clinical application of thorough rectal disinfection with povidone-iodine in preventing infectious com-plications after transrectal ultrasound guided prostate biopsy / 实用医学杂志

Objective To investigate the efficacy of thorough rectal disinfection with povidone-iodine in prevention of postoperative infection of transrectal ultrasound-guided prostate biopsy. Methods A retrospective analysis was carried out on 520 patients who received transrectal ultrasound-guided prostate biopsy in our department from April 2014 to January 2017.To ensure the faeces were watery,all patients took polyethylene glycol electrolyte powder orally for bowel preparation the day before surgery.And all patients were asked to fast from 10 pm the day before biopsy. From April 2014 to June 2015,a total of 206 patients(Group A)were admitted to our department for transrectal ultrasound -guided prostate biopsy,who received routine rectal disinfection before biopsy,and the rectum was disinfected with povidone-iodine for 3 times. While from July 2015 to January 2017,a total of 314 patients(Group B)were admitted to our department for transrectal ultrasound-guided prostate biopsy,who received thorough rectal disinfection before biopsy,and the rectum was disinfected with the mixture of povidone-iodine solution and 5 milliliters of 2 % lidocaine solution for 20 times. There was no significant difference in patients′mean age,PSA or prostate volume between the two groups. All patients received 13 cores transrectal ultrasound-guided prostate biopsy using 18 gauge biopsy needles,and they all received infusion of 300 mg etimicin sulfate once daily for 2 days post operation to prevent infections.We analyzed the differences of infection rate between the two groups.Results Infectious complications were observed in 7(3.4%)patients in group A,while none(0%)in group B(P=0.004),indicating a significantly lower infection rate in group B than that in group A. Conclusions Thorough rectal disinfection with povidone-iodine is a safe,effective and low-cost way in preventing infectious com-plications after transrectal ultrasound-guided prostate biopsy,which is worthy of promotion in clinic.

Clinical study of solanine combined with tamsulosin in the treatment of typeⅢprostatitis / 中国生化药物杂志

Objective To investigate the clinical study of sarcoside combined with tamsulosin in the treatment of type Ⅲ prostatitis. Methods 84 patients with type Ⅲ prostatitis who were treated and diagnosed in Jishuitan Hospital from November 2015 to December 2016 were randomly divided into experimental group and control group according to the time of hospitalization, 42 cases in each group. The control group was treated with tamsulosin hydrochloride sustained-release capsules, and the experimental group was treated with the addition of the new drug. The maximum urinary flow rate and mean urinary flow before and after treatment were recorded, compared and analyzed before and after treatment. Results The maximum urinary flow rate and mean urinary flow rate were increased in both groups after treatment, and there was significant difference between the two groups (P<0.05). The data of the maximum urinary flow rate and the mean urinary flow rate in the experimental group were significantly better than those in the control group. The data of the two groups were statistically significant (P<0.05). In addition, the experimental group after treatment of prostate symptom score was significantly better than the control group score, the two groups of data were significantly different, the data were statistically significant (P<0.05). In addition, the total effective rate of the experimental group was significantly higher than the control group(80.95%vs. 73.81%). The data were statistically significant (P<0.05). Conclusion The clinical efficacy of sorbenaside combined with tamsulosin in the treatment of type Ⅲ prostatitis is better than that of the original treatment. The treatment can improve the patient's urination and prostate symptoms and improve the patient's comfort.

Clinical application of antidepressant combined with α-blocker in the treatment of chronic prostatitis / 中国生化药物杂志

Objective To investigate the clinical effect of antidepressants combined with α-blockers in the treatment of chronic prostatitis.Methods A retrospective analysis of 90 cases of chronic prostatitis treated in our hospital from January 2016 to December 2016 was divided into two groups according to the random number table.The control group was treated with α-blocker Combined with vitamin C treatment, the study group using antidepressants combined with α-blockers treatment.The NIH-CPSI score and SDS score were recorded before and after treatment, and the therapeutic effects were compared between the two groups.Results There were no significant differences in NIH-CPSI scores and SDS scores between the two groups.After treatment, the scores of NIH-CPSI and SDS were significantly better than those before treatment, and the study group was superior to the control(91.1%) was higher than that of the control group(71.1%), the total effective rate of depression(93.3%) was higher than that of the control group(73.3%), and the total effective rate was 91.1%, The difference was statistically significant(P<0.05),comparable.Conclusion Antidepressants combined with α-blockers are effective in the treatment of chronic prostatitis, which is beneficial to the alleviation of clinical symptoms and the improvement of their symptoms.Therefore, it has a good clinical value and worthy of further popularization.

Flexible ureterorenoscope holmium laser lithotripsy for treatment of different sizes lower pole caliceal stones / 中国内镜杂志

Objective To compare the effects of flexible ureterorenoscope holmium laser for treatment of different sizes lower pole caliceal stones. Methods 140 patients with lower pole caliceal stones from August 2011 to April 2015 were enrolled, 40 patients were divided into observation group which the largest stone diameter > 2.0 cm, 100 patients were divided into control group which the largest stone diameter ≤ 2.0 cm. All these patients received flexible ureterorenoscope holmium laser treatment. Then we observe and compare the prognosis. Results The postop﹣erative 3 d and 1 month of gravel success rates were 97.5 % and 80.0 % in observation group, while the control group were 98.0% and 95.0%. The postoperative 1 month of gravel success rates in observation group was signifi﹣cantly lower than that in control group (P 0.05). Conclusion Compared with small lower pole caliceal stones, the success rate of flexible ureterorenoscope holmium laser treatment of large lower pole caliceal stones is declined, the patients also have some trauma, and the renal function is also fluctuate, postop﹣erative disease is relatively higher that clinically to be carefully chosen.

Application of detrusor power curve analysis in urodynaimc studies / 中华泌尿外科杂志

Objective To establish a calculation method for the voiding work parameters by using the detrusor power curve and to evaluate its clinic efficacy.Methods From January 2001 to January 2011,132 male patients with benign prostate hyperplasia who underwent urodynamic tests were retrospectively reviewed.The patients' age ranged from 45 to 84 years old (mean 57 years old).All patients had no previous history of neurological disease and no positive findings in neurological examinations.The voiding work of bladder,the voiding power of bladder and voiding energy consumption were calculated by using the detrusor power curve method and the linearized passive urethral resistance relation analysis was conducted.According to the detrusor status,all patients were divided into the decreased detrusor pressure group,the normal detrusor pressure group and the increased detrusor pressure group.Meanwhile,normal urethral resistance group and the increased urethral resistance group were classified according to the urethral resistance status.The detrusor pressure at maximal flow rate (PdetQmax),the maximal flow rate (Qmax),the projected isovolumetric pressure (PIP),the voiding work,the voiding power and the voiding energy consumption were compared among the different groups.Results There were 56 cases,58 cases,18 cases in the decreased,normal and the increased detrusor pressure group respectively.The voiding work were (1.1 ± 0.5)J,(1.7± 0.7)J,(2.1±1.2)J; the voiding power were (15.3±7.3)mW,(31.9±12.6)mW,(42.5±21.1)mW; and the voiding energy consumption were (3.9± 1.2) J/L,(5.2± 1.9) J/L,(6.2±3.2) J/L in those three groups,respectively.With the increasing of detrusor pressure,PdetQ Q PIP,the voiding work,the voiding power and the voiding energy consumption all increased among three groups with significant difference (P＜ 0.05).There were 51 cases,81 cases in the normal and the increased urethral resistance group.The voiding work were (1.5±0.7)J and (1.5±0.8)J;the voiding power were (32.3±13.2)mW and (22.6±16.3)mW and the voiding energy consumption were (3.8±0.7) J/L and (5.4±2.4) J/L in two groups.The increased urethral resistance group had higher PdetQmax and voiding energy consumption (P＜0.05) and lower Qmax and voiding power (P＜0.05) than those in the normal urethral resistance group.However,the differences of PIP (P =0.438) and the voiding work (P =0.546) between the two groups were not determined.Conclusions The detrusor power curve method can be used to calculate the work parameters of voiding.This method can be applied to evaluate the compensatory state of bladder and is conductive to urodynamic analysis in low detrusor pressure status.Both detrusor pressure and urethral resistance had significant impact on the work capacity of bladder.

Ampullary tumor caused by metastatic renal cell carcinoma and literature review.

We present a case of a 50-year-old man with a metastasis to the ampulla of vater that led to the discovery of renal cell carcinomas.The man was referred to us because of jaundice.Computed tomography (CT) scan of the abdomen showed irregular masses in the right kidney. Magnetic resonance imaging (MRI) revealed dilatation of the bile duct. The patient underwent right nephrectomy and pancreatoduodenectomy. Postoperative histopathologic examination revealed clear cell carcinoma in both the renal and ampullary lesions. After a 5-year follow-up ,the patient was alive with no evidence of recurrent disease.

Effects of Extracorporeal Shock Wave Therapy Combined with Hyperbaric Oxygen on Nonunion of Long Bone Fractures / 中国康复理论与实践

@#Objective To explore the effect of extracorporeal shock wave therapy (ESWT) combined with hyperbaric oxygen on nonunion after surgery. Methods 83 patients with nonunion were treated with ESWT combined with hyperbaric oxygen (treatment group), and 32 cases served as control group. ESWT application was conducted using a protocol totaling 3000 shocks per treatment. The treatment group received 3~5 times of treatment, at the same time hyperbaric oxygen therapy was performed. The control group received no treatment and was followed up at least 3 months after treatment. Results The overall success rate was 78.31% in the treatment group, while only 12.50% recovered in the control group (P<0.01). The complications of treatment group were less and negligible. Conclusion Treatment of nonunion by extracorporeal shock wave combined with hyperbaric oxygen is safe and effective.

Management of penile defects: a review.

Penile amputation is a rare injury. Although, in principle, penile replantation can be performed using a variety of methods, few, if any, standardized procedures exist to deal with this medical emergency. The value of the various microsurgical techniques for replantation of the penis remains uncertain. This article provides a review of the management of penile defects and complications.

Penile replantation : two case reports and review of the literature / 中华泌尿外科杂志

Objective To present our experience of dealing with complete penile amputation.Methods Two cases of penile complete amputation were reported.The first case was a 34-year-old man,suffered amputation of the penis approximately 2.5 cm distal from the pubic area with a sharp knife.3.5hours later,the patient was transferred to our hospital.The urethra mucosa and corpus spongiosum were anastomosed.The cavernous body of the penis was reattached by suturing the tunics albuginea of each corpus cavernosum to the corresponding proximal segment.One dorssl artery,two dorsal veins,and dorsal nerve were anastomosed under a 10 × microscope with interrupted 9-0 nylon nonabsorbable sutures.The second case was a 25-year-old man,presented to the emergency room 15 hours after distal penile amputation,which had 2 wounds as a result of self-mutilation caused by psychiatric problems.The urethra mucosa and corpus spongiosum were anastomosed.The cavernous body of the penis was reattached by suturing the tunics albuginea of each corpus cavemosum to the corresponding proximal segment using 4-0 polyglactic acid sutures.Results In the first case,the tourniquet was released after replantation,and the distal penis appeared to revascularize,as noted by the gradual increase in redness and size.An arterial pulse was detected,and the superficial penile veins displayed normal turgor,and no bleeding was found.On postoperative day 3,the penile skin started to necrotize.On day 12,the necrotic skin was superficially debrided,and a fistula was observed in the corresponding urethral segment.Two weeks later,the fistula was sutured with 4-0 interrupted synthetic absorbable suture,and a transposition flap to embed the whole injured penis shaft was created from the proximal scrotal skin.The glans was exposed.Two months after the second operation,the embedded penis was released from the scrotum.After follow-up of two years,the patient had glans re-epithelialization with normal voiding,sensation,and erections.In the second case,the glans was still pink,but the penile skin started to necrotize on postoperative day 3.On day 14,serious infections were noted,the necrotic skin was superficially debrided,and the amputated penis was relieved.Conclusions Prompt diagnosis and early treatment are essential to avoid the potential complications of ischemic necrosis and autoamputation.Venous outflow is a critical factor for success of replantation.Microsurgical reanastomosing of the dorsal penile vein,penile arteries,and dorsal nerves can be identified as the standard method for penile replantation.The bipedicled scrotal flap can provide adequate skin cover for penis defects.

The correlation of extent and grade of inflammation with serum PSA levels in patients with IV prostatitis.

OBJECTIVES: The inflammation was categorized more profoundly, using the standardized histopathological classification system for chronic prostatitis of NIH, to determine the influence of prostatic inflammation on serum PSA levels. METHODS: The study included 120 patients who underwent transperineal ultrasound-guided prostate biopsy. The patients were divided into groups using 3 grades for the extent, the location and the aggressiveness of prostate inflammation. The serum tPSA levels, fPSA levels, %fPSA, and PSAD in each group were compared. RESULTS: Of 120 patients, 80 with benign prostatic tissue in their biopsy specimens met the inclusion criteria, excluding 40 cases with prostate cancer. The inflammation was present in 46(57.5%) of 80 cases. The extent of inflammation correlated positively with the total PSA level (r = 0.6, P < 0.001), fPSA (r = 0.5, P = 0.001) and PSAD (r = 0.6, P < 0.001). The grade of inflammation correlated positively with the total PSA level (r = 0.5, P < 0.001), fPSA (r = 0.4, P = 0.008) and PSAD (r = 0.7, P < 0.001). A negative correlation was found between the grade of inflammation and %fPSA (r = -0.4, P = 0.013). CONCLUSIONS: If the elevation of serum PSA is thought to be caused by asymptomatic prostatitis with high aggressiveness score in BPH patients without clinical prostatitis, it might prevent unnecessary repeated biopsies.

Effect of extracellular matrix of xenogenic femoral fascia in repair of renal trauma / 中华泌尿外科杂志

Objective To study the effect of extracellular matrix(ECM)of xenogenic femoral fascia which is a tissue-engineering material in repair of renal trauma.Methods Twenty-four experiment dogs were divided into 3 groups:group 1(n=10),the kidneys were repaired using ECM of xenogenic femoral fascia;group 2(n=10),the kidneys were repaired using self-omentum;group 3(n=4),xenogenic femoral fascia was used as repair materials.The animals were sacrificed separately at 1,2 weeks and 1,2,4 months after renal repair operations in group 1,2.In group 3,the animals were sacrificed separately at 2 weeks and 2 months after renal repair operations.The examinations of blood routine were performed before and after operations immediately,blood creatinine and serum renin were measured before operations and before death.The creatinine clearances of affected and contralateral normal kidneys were evaluated before death and the local areas of renal repair were studied by light and scan electron microscopy.Results In group 1,bleeding stopped rapidly and completely after the entire patch was sutured,only mild adhesions to surrounding tissues were found in various times after operations.As time passed,the repair patch was replaced by smooth neocapsule just like a normal one.In group 2,the bleeding volume in the operations was larger than the other 2 groups.It was diffieult tO separate the kidneys from the surrounding tissues.The wounds gradually contracted because of the scar forming.In group 3,there were severe immunological reactions in the patchs.Conclusion ECM of xenogenic femoral fascia is an ideal tissue-enginee rjng material for renal repair.

Relationship between serum prostate specific antigen and asymptomatic prostatic inflammation / 中华泌尿外科杂志

Objective To discuss the relationship between asymptomatic prostatic inflammation (NIH category Ⅳ prostatitis)and serum prostate specific antigen. Methods In a retrospective study,245 prostate biopsies with benign pathological results from January 1998 to January 2000 were reviewed and the corresponding serum PSA before biopsy were analyzed.All patients were taken 6 or 13 cores prostate biopsy. Results One hundred and twenty-seven NIH-Ⅳ prostatitis and 118 patients with benign prostatic hyperplasia(BPH)were identified.The difference in free-PSA,totalPSA,f/t-PSA levels between BPH and NIH-Ⅳ prostatitis was significant(P＜0.05).In multivariate analysis,free-PSA,total-PSA,f/t-PSA was the significant predictors of histology in NIH-Ⅳ prostatitis(P＜0.05).The best prediction factors were constructed to predict pathology type in NIH-Ⅳ prostatitis:TPSA≥4 ng/ml,fPSA≥0.85 ng/ml and f/t-PSA≤0.16(P＜0.05). Conclusions Asymptomatic inflammation of the prostate was one of the confounding factors in patients with an elevated PSA.In the diagnosis of prostate diseases,it should be taken into account prostatitis might elevate the level of PSA.

A study of histopathological factors increasing postage-specific antigen / 中华泌尿外科杂志

Objective To evaluate the cause of evaluated postage-specific antigen(PSA)in patients performed transrectal uhrasonography(TRUSG)guided prostate biopsy beeause of high PSA levels.Methods In a retrospective study 504 prostate biopsies performed between January 1998 and December 2001 were evaluated and the levels of serum PSA were determined in samples obtained immediately before sextant biopsy was performed.All patients underwent 6 or 13 cote primary prostate needle biopsies.Results 185 prostate cancer,109 NIH-Ⅳ prostatitis and 210 patients with benign prostate hyperplasia(BPH)were identified.The difference in free-PSA,total-PSA,f/t-PSA levels between prostate cancer,BPH and NIH-Ⅳ prostatitis was significant(P＜0.05).No significant difference was found in age,transrectal ultrasonography and digital rectal examination.In multivariate analysis,free-PSA,total-PSA,f/t-PSA was the significant predictors of histology in prostate cancer(P＜0.05).A significant correlation was found between the serum total and free PSA levels and the grade and stage of prostate cancer(P＜0.05).Preoperative variables predictors of histology in BPH were TPSA and FPSA(P＜0.05).In multivariate analysis,TPSA was the only significant predictors of histology in BPH(P＜0.01).The best cutoff value was constructed to differ pathology type in prostate diseases:tPSA≥4 ng/ml,fPSA≥0.85 ng/ml and f/t-PSA≤0.16(P＜0.05).Conclusions High serum PSA levels may correlate with asymptomatic inflammatory prostatitis,prostate cancer and BPH.The factors contributing to elevated serum PSA concentrations include cell proliferating,glandular epithelial disrupt.