A Comparative Study on the Efficacy of Four Types of Circumcision for Elderly Males with Redundant Prepuce.

PURPOSE: Circumcision is a common human urologic surgery performed in males with redundant prepuce to prevent the transmission and reduce the risk of urologic diseases. However, the optimal circumcision method for elderly men remains to be determined. Herein, the current study was conducted to characterize the efficacy of four different kinds of circumcision for elderly males with redundant prepuce. METHODS: This retrospective study included 132 elderly males diagnosed with redundant prepuce who underwent circumcision at the outpatient department. Among them, 38 cases were subjected to traditional surgery (Group A), 23 cases to sleeve circumcision (Group B), and 42 cases to Shang Ring circumcision (Group C) and 29 cases to suturing device circumcision (Group D). Subsequently, the operation time, loss of blood, postoperative pain, complications, wound healing, and the satisfaction were respectively compared and analyzed. RESULTS: The operation time of these 4 groups was calculated to be 27.3 ± 2.39 min, 30.4 ± 2.23 min, 6.3 ± 1.33 min, 7.6 ± 1.29 min, in Group A, Group B, Group C, Group D, respectively (P < 0.05). Besides, the loss of blood was 15.6 ± 2.84 mL, 11.8 ± 1.73 mL, 1.3 ± 0.44 mL, 3.7 ± 1.41 mL, respectively (P < 0.05). The elderly males who underwent Shang Ring circumcision exhibited the highest postoperative pain score, the longest pain duration, the longest healing time, the lowest recovery satisfaction rate and the highest operation experience satisfaction rate (P < 0.05). CONCLUSION: Taken together, all four types of male circumcision present with advantages and drawbacks. The traditional male circumcision and sleeve circumcision led to longer operation time and more bleeding, but no additional medical equipment was needed. Meanwhile, the Shang Ring circumcision caused the shortest operation time and the least bleeding, accompanied by the longest pain duration and recovery time. Therefore, the application of sleeve circumcision or a suturing device was recommended for elderly males suffering from redundant prepuce.

Overexpression of shugoshin1 predicts a poor prognosis for prostate cancer and promotes metastasis by affecting epithelial-mesenchymal transition.

OBJECTIVE: The aim of the study was to investigate the role of shugoshinl (SGO1) in human prostate cancer (PCa). MATERIALS AND METHODS: Quantitative real-time PCR (qRT-PCR) was used to determine the expression of SGO1 in PCa tissues and cell lines. The correlation between SGO1 expression and clinicopathological characteristics of PCa patients was analyzed using Kaplan-Meier analysis. SGO1 siRNA was successfully constructed and transfected into PCa cell lines (LNCaP and PC3). The knockdown efficacy was assessed by qRT-PCR. MTT assay and Transwell assay were conducted to observe the effect of SGO1 on the proliferation and invasion of PCa cell lines. RESULTS: SGO1-expression levels were found to be higher in the PCa tissues and cell lines. Correlation was identified between the expression of SGO1 and preoperative prostate-specific antigen (P=0.017), lymph-node metastasis (P=0.044), and Gleason score (P=0.041). Patients with higher SGO1 expression displayed more advanced clinicopathological characteristics in addition to a shorter biochemical recurrence-free survival time. Additionally, SGO1 knockdown resulted in the inhibition of PCa cell proliferation, migration, and invasion. CONCLUSION: Taken together, the findings of the current study present evidence suggesting that SGO1 could inhibit the growth and invasion of PCa cells, highlighting its potential as a novel therapeutic target for the treatment of PCa.

Prevascularized bladder acellular matrix hydrogel/silk fibroin composite scaffolds promote the regeneration of urethra in a rabbit model.

OBJECTIVE: To evaluate the effects of urethral regeneration with prevascularized bladder acellular matrix hydrogel (BAMH)/silk fibroin (SF) composite scaffolds in a rabbit model. MATERIALS AND METHODS: BAMH/SF and collagen Type I hydrogel/SF (CH/SF) scaffolds were prepared and the structure of the scaffolds was assessed using scanning electron microscopy. BAMH/SF, CH/SF and SF scaffolds were incubated in the omentum of male rabbits for two weeks and then harvested for repairing autologous urethral defects. Histological analysis of the incubated scaffolds was performed to evaluate the neovascularization capacity, and the outcomes of urethroplasty were evaluated at one and three months post-operatively. RESULTS: The composited scaffolds were composed of a highly porous BAMH or CH buttressed by compact SF outer layer. The histological analysis of the incubated BAMH/SF revealed a signifcant increase of the neovascularization among three groups after a two-week incubation. At three months, the urethra maintained wide caliber in the BAMH/SF group. Strictures were found in the CH/SF and SF groups. Histologically, at one month, intact and multilayer epithelium occurred in the BAMH/SF group, and one layer epithelium was found in the CH/SF and SF groups. However, there was similar epithelial regeneration in BAMH/SF and CH/SF groups at three months (p > 0.05). Comparisons of smooth muscle content and vessel density among the SF, CH/SF and BAMH/SF revealed a significant increase at each time point (p < 0.05). CONCLUSION: Our results demonstrate that incubated BAMH/SF promote neovascularization, and prevascularized BAMH/SF promote the regeneration of the urethral epithelium and smooth muscle, which indicates its potential for urethral reconstruction.

[Transurethral diode laser enucleation versus transurethral electrovaporization resection of the prostate for benign prostatic hyperplasia with different prostate volumes].

OBJECTIVE: To compare the clinical effect of diode laser enucleation of the prostate (DIOD) with that of transurethral resection of the prostate (TURP) on benign prostate hyperplasia (BPH) with different prostate volumes. METHODS: This retrospective study included 256 BPH patients treated by DIOD (n = 141) or TURP (n = 115) from March 2012 to August 2015. According to the prostate volume, we divided the patients into three groups: <60 ml (42 for DIOD and 31 for TURP), 60－80 ml (51 for DIOD and 45 for TURP), and >80 ml (48 for DIOD and 39 for TURP). We obtained the relevant data from the patients before, during and at 6 months after surgery, and compared the two surgical strategies in operation time, perioperative levels of hemoglobin and sodium ion, post-operative urethral catheterization time and bladder irrigation time, pre- and post-operative serum PSA levels, International Prostate Symptoms Score (IPSS), post-void residual urine (PVR) volume and maximum urinary flow rate (Qmax), and incidence of post-operative complications among different groups. RESULTS: In the <60 ml group, there were no remarkable differences in the peri- and post-operative parameters between the two surgical strategies. In the 60－80 ml group, DIOD exhibited a significant superiority over TURP in the perioperative levels of hemoglobin (ï¼»3.25 ± 1.53ï¼½ g/L vs ï¼»4.77 ± 1.67ï¼½ g/L, P <0.05) and Na+ (ï¼»3.58 ± 1.27ï¼½mmol/L vs ï¼»9.67 ± 2.67ï¼½ mmol/L, P <0.01), bladder irrigation time (ï¼»30.06 ± 6.22ï¼½h vs ï¼»58.32 ± 10.25ï¼½ h, P <0.01), and urethral catheterization time (ï¼»47.61 ± 13.55ï¼½ h vs ï¼»68.01 ± 9.69ï¼½ h, P <0.01), but a more significant decline than the latter in the postoperative PSA level (ï¼»2.34 ± 1.29ï¼½ ng/ml vs ï¼»1.09 ± 0.72ï¼½ ng/ml, P <0.05), and similar decline was also seen in the >80 ml group (ï¼»3.35 ± 1.39ï¼½ ng/ml vs ï¼»1.76 ± 0.91ï¼½ ng/ml, P <0.05). No blood transfusion was necessitated and nor postoperative transurethral resection syndrome or urethral stricture observed in DIOD. However, the incidence rate of postoperative pseudo-urinary incontinence was significantly higher in the DIOD (22.7%, 32/141) than in the TURP group (7.83%, 9/115) (P <0.05). CONCLUSIONS: DIOD, with its obvious advantages of less blood loss, higher safety, faster recovery, and more definite short-term effectiveness, is better than TURP in the treatment of BPH with medium or large prostate volume and similar to the latter with small prostate volume.

[Shang Ring circumcision by transverse incision in the distal penis foreskin and pull-up of the interior board for short frenulum praeputii].

OBJECTIVE: To investigate the effectiveness of surgical strategies for Shang Ring circumcision in the treatment of short frenulum praeputii in patients with redundant prepuce or phimosis. METHODS: Totally, 130 cases of short frenulum praeputii with redundant prepuce or phimosis were randomly assigned to an experimental group and a control group of equal number to receive Shang Ring circumcision, the former by transverse incision in the distal penis foreskin and pull-up of the interior board, and the latter by conventional transverse incision and longitudinal suture of the frenulum praeputii. Comparisons were made between the two groups in the surgical duration, intraoperative blood loss, 24 h postoperative pain visual analog score (VAS), postoperative complications, satisfaction with the penile appearance, and the quality of sexual life. RESULTS: The surgical duration, intraoperative blood loss, 24 h postoperative VAS, postoperative sexual satisfaction, and satisfaction with penile appearance were (4.60 +/- 1.20) min, (2.61 +/- 1.81) ml, 1.73 +/- 0.76, 98.5%, and 98.5%, respectively, in the experimental group, as compared with (21.60 +/- 6.30) min, (11.10 +/- 3.40) ml, 5.37 +/- 1.84, 70.3% and 69.8% in the control, with statistically significant differences between the two groups (P < 0.05). The incidence rates of such major complications as wound dehiscence, infection, and moderate to severe edema were 1.5% (1/65), 3.1% (2/65), and 4.6% (3/65), respectively, in the experimental group in comparison with 12.3% (8/65), 15.3% (10/65), and 30.7% (20/65) in the control, with statistically significant differences between the two groups (P < 0.05). None of patients had any serious complications. CONCLUSION: Shang Ring circumcision by transverse incision in the distal penis foreskin and pull-up of the interior board, with its advantages of shorter operation time, less blood loss, mild pain, fewer complications, and higher satisfaction and acceptance of the patients, can be used as an safe and effective approach to the treatment of short frenulum praeputii.