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Objective To determine whether intravenously transplanted bone marrow stromal cells (BMSCs) could promote recovery of lower urinary tract function in rats with spinal cord transaction.Method The BMSCs were harvested from rats and labeled with 5-bromo-2'-deoxyuridine (BrdU) (30 g/mL) in vitro for 3 days for intravenous transplantation.The BMSCs of 5th passage were characterized by flow cytometry of CD45 and CD90.Twenty-four male Sprague-Dawley rats were divided randomly into three goups.Sixteen rats received a spinal cord transection and a transplantation of cell culture medium (OP-controls,n =8) or BMSCs (n =8).Eight rats were justly given T8-T9 laminectomy (CNS-intact group,n =8).Urodynamic tests,HE staining and immunohistochemistry of the spinal cord with anti-BrdU at 28th day after transplantation were performed.Result The cultured BMSCs of 5th passage expressed 5.94％ of CD45 and 99.4％ of CD90 on flow cytometry.BMSC rats showed significant decrease in residual urine volume (0.85 ± 0.16 mL vs.1.54 ± 0.66 mL,P＜ 0.05),leak point pressure (33.85 ± 3.73 mmHg vs.40.83 ± 3.85 mmHg,P＜0.01),episodes of non-inhibitory contraction (NVC) (2.17 ± 1.12 vs.9.71 ± 3.84,P＜0.01) and increase in voiding efficiency (26.37 ± 6.97％ vs.2.68 ± 1.47,P＜0.01) compared to OP-control rats.In OP-control rats,only tonic EUS activity was remained and busting EUS activity was abolished during bladder filling.While,the tonic EUS activity and busting EUS activity were remained in BMSCs rats.Otherwise,the silent period between EUS bursts was shorter in BMSCs rats (68.86 ± 13.78 ms,P＜ 0.05) and OP-control rats (33.4 ms) than CNS-intact rats (132.79 ± 17.11 ms).Cells derived from BMSCs,identified by 5-BrdU immunoreactivity,survived and were distributed at the damaged tissue (T10),lumbar and sacral spinal cord.Conclusion Intravenously transplanted BMSCs survived in the injured spinal cord,lumbar and sacral cord for rebuilding new voiding reflex and inhibiting afferent sprouting leading to baldder dysfunction.So they had beneficial effects on the recovery of lower urinary tract function in rats with spinal cord transection.
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Objective To compare two operative approaches for treatment of distal hypospadias. Methods One hundred and seven patients were recruited into the study. Group1(n=51) underwent OUPF and group2(n= 56) underwent TIPU repair. The results were analyzed with Chi-square and two Sided test. Results Operative times for OUPF and TIPU repair were (103±29) min and (92±21)min respectively (P>0.05). Fistula occurred rates were 7.8% (4/51)and 14.2% (8/56) (P>0.05). Satisfied rates for the appearance of the penis post-operation were 84.8% (39/46)and 87.8%(36/41) respectively (P>0.05). 87 patients were followed up. With mean follow-ups of 15 months (range 6 to 47) , the overall complication rates were 15.7% (8/51) and 32.1 % (18/56)(P<0. 05) for OUPF and TIPU repair. Only 4 of 51 patients (7.8%) undergoing OUPF underwent re-operations, compared to 15 of 56 patients (26.8%) undergoing TIPU repair (P<0.001). A plateau uroflow curve (vs normal bell curve)was observed in 33.3% (13/39)and 67.6(25/37) ,respectively(P<0. 001). The average flow rate was 9. 4 ml per second (range 3. 2 to 17. 1) in patients undergoing OUPF repair, compared to 6. 8 ml per second (3. 3 to 15, P<0. 05) for those undergoing TIPU repair. Mean peak flow rates were12.2 ml per second (range 3.9 to 22.9) and 8. 3 mi per second (range 3.7 to 18. 1, P<0.01) for OUPF and TIPU procedures. Conclusion OUPF is superior to TIPU in the surgical treatment of distal hypospadias.
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Objective To evaluate the diagnosis and micro-invasive treatment of ureteral obstruction after complete cystectomy. Methods All the 12 patients (primary diseases:10 cases of bladder tumor,1 of small bladder of tuberculosis,1 of radiocystitis;post-operative ureteral obstruction:9 cases of anastomotic stenosis,3 of supra-anastomotic obstruction) underwent MRI and experienced nephroscopic monitoring for diagnosis.Eleven patients underwent surgical treatment.Of them,6 cases received ureter nickel-titanium alloy trestle;4 cases (6 sides),ureter trestle,and 1,ureterocystostomy. Results All the 12 cases were correctly diagnosed.Of them 11 were followed up for 3 months to 5 years.IVU showed normal renal function and complete resolution of hydronephrosis of the diseased kidneys in 9 cases and relief of hydronephrosis in 2.Cr and BUN were normal in all the cases.Only one case of bladder cancer died of lung metastasis. Conclusions Pelviureteroradiography under MRI or nephroscopic monitoring is the most valuable method of examination for ureteral obstruction after complete cystectomy.Surgical ureter trestle and nickel-titanium alloy ureter trestle are simple,micro-invasive and effective for paitens with such post-operative obstruction.
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Objective To evaluate the feasibility of laparoscopically assisted dismembered pyeloplasty without the V-flap reconstruction.Methods A total of 13 cases of ureteropelvic junction obstruction(UPJO) underwent laparoscopically assisted dismembered pyelopasty via a small incision through the retroperitoneal approach without the V-flap pyeloplasty technique.After exposing the proximal ureter and renal pelvis to identify the UPJ obstruction,the UPJ area is then excised and the apex of the ureter is then anastomosed to the most inferior aspect of the renal pelvis. Results All the operations had been successfully completed.The operating time was 100~180 min(mean,121 min),and the intraoperative blood loss,30~100 ml(mean,70 ml).Follow-up for 3~20 months(mean,12.3 months) in 12 cases revealed a full recovery of renal functions and disappearance of hydronephrosis.Conclusions Laparoscopically assisted dismembered pyeloplasty without the V-flap reconstruction is feasible in the treatment of UPJO.
