[Efficacy and tolerability of dapoxetine in the treatment of premature ejaculation].

OBJECTIVE: To investigate the efficacy and adverse effects of dapoxetine in the treatment of premature ejaculation. METHODS: We randomly assigned outpatients with premature ejaculation in the proportion of 2:1 to receive 30 mg dapoxetine on demand (n =78) or 50 mg sertraline qd for one month (n = 39). Follow-up was accomplished in 95 cases, 63 in the dapoxetine group and 32 in the sertraline group. We recorded the intravaginal ejaculatory latency time (IELT), clinical global impression of change (CGIC) score, and adverse reactions of the patients and compared them between the two groups. RESULTS: IELT was significantly increased in both the dapoxetine (from [0.87 ± 0.31] to [2.84 ± 0.68] min, P < 0.05) and the sertraline group (from [0.84 ± 0.28] to [2.71 ± 0.92] min, P < 0.05) after medication. Based on the CGIC scores in premature ejaculation, the rate of excellence or effectiveness was 36.5% in the dapoxetine and 37. 5% in the sertraline group, and the rate of improvement was 63.5% in the former and 71.9% in the latter. The incidence rates of dizziness, nausea, headache, and diarrhea were slightly higher (P > 0.05) while those of fatigue, somnolence, and dry mouth significantly higher (P < 0.05) in the sertraline than in the dapoxetine group. CONCLUSION: On-demand oral medication of dapoxetine is effective and well-tolerated for the treatment of premature ejaculation.

Metabolic Syndrome Components are Associated with Increased Prostate Cancer Risk.

BACKGROUND: Our study investigated the associations of metabolic syndrome (MS) and metabolic indicators with prostate cancer (PCa) risk in the Chinese Han ethnic population. MATERIAL AND METHODS: We studied 101 PCa patients (without/with MS) and 120 healthy controls. Clinical data, including waist circumference, BMI, TG, FINS, FBG, and PCa-related indicators, were collected. The correlations between MS and PCa were analyzed. RESULTS: Compared to PCa, PV and Gleason scores increased and PSA levels decreased in PCa with MS group (all P<0.001). PV was positively correlated with BMI, FINS, and HOMA-IR (r=0.459, P<0.001; r=0.421, P=0.001; r=0.490, P=0.003, respectively), and was negatively correlated with HDL-C (r=-0.378, P<0.001). PSA level in MS patients was negatively correlated with BMI (r=-0.125, P<0.001), TG (r=-0.256, P<0.001) and FBG (r=-0.183, P<0.001). Large PV, high TG, low HDL-C, high LDL-C, and high FBG were associated with an increased risk of PCa (P<0.001, OR=1.10, 95%CI: 1.009-3.304; P<0.001, OR=2.91, 95%CI: 1.612-5.241; P<0.001, OR=7.89, 95%CI: 3.908-15.947; P=0.015, OR=1.87, 95%CI: 1.131-3.077; P=0.004, OR=2.17, 95%CI: 1.280-3.686, respectively). MS-related indicators showed a positive relationship with PCa (P<0.001, OR=1.90, 95%CI: 1.107-10.629). CONCLUSIONS: Our study shows that MS and metabolic indicators are associated with an increased risk of PCa, pointing to a novel therapeutic approach for PCa management.

Holmium laser enucleation of the prostate: a modified enucleation technique and initial results.

PURPOSE: Although holmium laser enucleation of the prostate has been proven to be an excellent technique for the treatment of benign prostatic hyperplasia, it has not been widely applied due to technical difficulties and longer operative time. We modified the current technique of enucleation and present our initial experience. MATERIALS AND METHODS: A total of 189 patients with benign prostatic hyperplasia underwent prostatectomy with our modified technique for holmium laser enucleation of the prostate. Intraoperative and postoperative data were prospectively collected. For followup International Prostate Symptom Score, quality of life, maximal flow rate and post-void residual urine were recorded. RESULTS: Mean±SD preoperative prostate volume was 78.1±24.3 cc and 60.9±39.2 gm tissue were enucleated. Mean operative and enucleation times were 54.7±21.1 and 36.5±16.3 minutes, respectively. Mean serum hemoglobin decrease was 0.98±0.72 gm/dl. Mean catheter time was 1.2±0.5 days and mean postoperative hospital stay was 4.9±3.4 days. Serious complications were not observed. Three patients complained of transient stress incontinence which resolved within 3 months. Significant improvement occurred in International Prostate Symptom Score, quality of life, maximal flow rate and post-void residual urine volume at 3 and 6-month followup compared with the preoperative baseline. CONCLUSIONS: The modified holmium laser enucleation of the prostate technique is effective and safe when treating benign prostatic hyperplasia.

[Papillary cystadenocarcinoma in a Müllerian duct cyst: report of a case with literature review].

OBJECTIVE: To study the diagnosis and treatment of Müllerian duct cysts and their involvement with malignancy. METHODS: A 44-year-old male patient with papillary cystadenocarcinoma involving a Müllerian duct cyst was presented. The presentation treatment, and pathological and radiological appearances were retrospectively analysed and discussed with literature review. The main manifestation was intermittent episode of hemospermia accompanying terminal hematuria and infertility for 15 years. Final diagnosis was determined by the findings of transrectal ultrasound scan, CT scan, MRI imaging, cystoscopic examination and biopsy. RESULTS: Exploratory laparotomy was performed through a suprapubic retrovesical approach. The finding that a duct-like wedge of tumor tissue passed through the prostate near cyst neck to the posterior urethra without affecting the adjacent prostatic tissue during tylectomy confirmed that it arises from Müllerian duct system. Pathohistologic examination disclosed a papillary cystadenocarcinoma and it infiltrated the wall of the cyst. Both seminal vesicles and ejaculatory duct had no carcinoma invasion. CONCLUSION: Müllerian duct cyst involving with malignancy is exceedingly rare, the diagnosis is based on the findings of transrectal ultrasound scan, CT scan, MRI imaging, cystoscopic examination. The final diagnosis depends on the pathohistologic examination. Lumpectomy is effective and have a good outcome.

[The molecular mechanism of PML in inducing apoptosis of bladder cancer cell line].

OBJECTIVE: Study the affection of inducing expression of PML in the apoptosis and the molecular mechanism of bladder cancer. METHODS: PMEP4/PML inducible expression vector was transfected into bladder cancer UM-UC-2 cells by lipofectamine 2000 system. The positive clone cells were selected by 300 microg/ml hygromycin B and confirmed by laser confocal imaging system. Then, using the in vitro DNA ladder apoptotic assay and Western blot, the affection of inducing expression of PML on apoptosis and its molecular mechanism of bladder cancer cell was studied. RESULTS: Comparing with the vector control group, PML specific nuclear speckle significantly increased in the PMEP4/PML bladder cells. DNA ladder assay demonstrated bladder cancer cell expressing PML occurred apoptosis while the control vector cells were not influenced. Overexpression of PML could reduce Survivin expression and upregulate caspase3 and cleaved PARP protein expression CONCLUSION: Our results demonstrated that overexpression of PML could induce bladder cancer cell apoptosis through the caspase dependent pathways.

[Etiology and treatment of bladder spasm associated with benign prostatic hyperplasia].

OBJECTIVE: To investigate the etiology and treatment of bladder spasm associated with benign prostatic hyperplasia (BPH). METHODS: Urodynamic tests were performed in 102 cases of BPH before operation. The correlation of bladder spasm with aging, international prostate symptom score (IPSS), quality of life, prostatic volume, operation methods and urodynamic indexes was studied by t and chi2 tests. RESULTS: The incidences of bladder spasm in the lower compliant bladder and unstable bladder were 32.1% (9/28) and 42.5% (13/20), and those after suprapubic prostatectomy and transurethral resection of the prostate (TURP) were 50.9% (26/51) and 23.3% (12/51). There was significant difference between operation methods (P < 0.05). CONCLUSION: Bladder spasm easily develops in the lower compliant bladder and unstable bladder, especially after suprapubic prostatectomy. TURP might decrease the incidence of bladder spasm after BPH operation.

Astragalus membranaceus reduces free radical-mediated injury to renal tubules in rabbits receiving high-energy shock waves.

BACKGROUND: Recent studies have revealed the important role of free radicals in renal damage induced by high-energy shock waves (HESW). This study aimed at investigating the effects of Astragalus membranaceus, a traditional Chinese medicinal herb, on free radical-mediated HESW-induced damage to renal tubules in a live rabbit model. METHODS: Forty-five healthy male New Zealand white rabbits were randomly divided into three groups: control group (n = 15), sham group (n = 15), and herb-treated group (n = 15). Three days prior to HESW application, the controls received verapamil (0.4 mg/kg), the shams received physiological saline (20 ml), and the herb-treated animals received Astragalus membranaceus (2.4 g/kg) intravenously. HESW (1500 shocks, 18 kV) was applied to the right kidneys of all anesthetized rabbits. We measured superoxide dismutase (SOD) and malondialdehyde (MDA) levels before and after shock treatment in blood and kidney homogenates. Histopathological changes were also observed. RESULTS: MDA levels increased and SOD activity decreased significantly in the sham group (P < 0.05 for both) after shock treatment. MDA levels showed a much less increase in the controls (P < 0.05) and did not increase to statistically significant levels in the group receiving Astragalus membranaceus (P > 0.05). SOD values were significantly higher in the controls than in the shams (P < 0.05). By contrast, SOD levels recovered rapidly in the rabbits receiving Astragalus membranaceus, reaching a nadir within 24 hours, and returning to baseline more quickly than in control and sham rabbits (P < 0.05). Histopathological examinations showed that renal tubular damage in the controls was less severe than in the shams, while damage in the Astragalus membranaceus group was even more mild, with rapid recovery in comparison with the controls. CONCLUSION: This study provides preliminary evidence indicating that Astragalus membranaceus has strong protective effects on free radical-mediated renal tubular damage induced by HESW and that these effects are superior to the effects of verapamil.

[Age-specific reference ranges for serum prostate-specific antigen in Chinese men].

OBJECTIVE: To evaluate the age-specific reference ranges for serum prostate-specific antigen in Chinese men. METHODS: Serum tPSA and fPSA were measured by enzyme-linked immunosorbent assay (ELISA) and fPSA/tPSA ratio was calculated in 1,096 health Chinese men of 23 - 85 years old. The relationship between age and PSA indexes was analyzed with simple linear regression. RESULTS: The recommended age-specific reference range (95th percentile) for serum PSA for Chinese were: 1.20 microg/L for 20-29 years; 1.21microg/L for 30-39 years; 1.23 microg/L for 40-49 years; 2.35 microg/L for 50-59 years; 3.20 microg/L for 60-69 years; 3.39 microg/L for >or= 70 years. The serum PSA concentration correlated directly with age. The age-specific reference range was lower for Chinese men than not only for white and black men, but also for Japanese and Koreans men. CONCLUSION: The age-specific reference ranges for serum PSA are lower significantly for Chinese men than for black, white men, even for Japanese and Koreans men. Study the normal upper limit of PSA and the age-specific reference ranges for serum prostate-specific antigen in Chinese men is very important.