In vitro dynamic bladder models for studying urinary tract infections: a narrative review.

Experimental models of the bladder are key to studying the pathogenic mechanism of catheter-related bacterial biofilm infection. Although numerous studies have reported multiple models, these model designs were heterogeneous. This study aimed to review the status quo and explore the problems associated with in vitro dynamic bladder models for studying urinary tract infections (UTIs). The PubMed and SinoMed databases were searched from their inception to February 2020. Studies regarding in vitro bladder models related to UTIs were reviewed based on a bibliometric evaluation of their basic characteristics and model analysis. A total of 74 papers and 44 bladder models were included in this study. The results were as follows: (I) urine transmission devices: 10 studies applied the gravity effect of culture media, while the others used peristaltic pumps, and 11 of them combined stirring or rotating forces. The flow rates in all studies ranged from 15 µL/min to 50 mL/min. (II) Bladder model: two studies reported on simulating the bladder using plastic bags, while the others reported on glass cylinders or fermenters with a capacity of 200 to 700 mL. E. coli and P. mirabilis were the main bacterial strains. (III) Infection carrier: six studies reported planktonic bacteria as their infection carrier, while 45 studies reported silica gel, rubber, polyurethane, silicone, polytetrafluoroethylene, or perfusion bag. (IV) Infection medium: 25 studies reported the culture medium. Thirty-two studies reported artificial urine, while 17 studies reported human urine. (V) Research analysis: 45 studies investigated the bacterial biofilm formation in the bladder model. Thirty-six studies compared the effects of various drug coatings, diverse material surfaces, or different materials. Only five studies compared distinct bladder models. The included studies' main defects were the single simulation of bladder urodynamics, divers parameter settings, and non-standard experimental modeling. Our analysis showed for the first time that in vitro dynamic bladder models could provide new ideas for exploring the mechanism and prevention of bacterial biofilm infection in urinary implanted biomaterials. Due to the limitations of the included studies, more high-quality studies are needed to verify the conclusions above further.

[Dissection of prostate coalesce in treatment of benign prostate hypertrophy with relatively small volume].

OBJECTIVE: To evaluate the curative effect of dissection for coalesce of prostate in treatment of bladder outlet obstruction (BOO) caused by benign prostate hypertrophy (BPH) with relatively small volume (less than 30 g). METHODS: Thirty-six patients of BOO caused by BPH with relatively small volume underwent dissection of prostate coalesce. Follow-up was conducted for 32 months (9 - 52 months). The values of international prostate symptom score (IPSS), maximum flow rate (Qmax), and postvoid residual volume (PRV) before and after treatment were measured and compared. RESULTS: The post-operative IPSS was 5.03 +/- 2.66, significantly lower than that before operation (14.19 +/- 5.35), the post-operative Qmax was (17.71 +/- 4.1) ml/s, significantly higher than that before operation [(6.19 +/- 2.14) ml/s], and the post-operative PRV was (8.53 +/- 4.78) ml, significantly lower than that before operation [(50.58 +/- 14.84) ml] (all P < 0.001). CONCLUSION: Dissection of prostate coalesce is an ideal method in treatment of BOO caused by BPH with relatively small volume (less than 30 g).

[Qingrelishi-category Chinese medicine for chronic prostatitis: a systematic review].

OBJECTIVE: To evaluate the efficacy and safety of the Qingrelishi-category Chinese medicine (for dispelling heat and resolving dampness) in the treatment of chronic prostatitis. METHODS: Randomized clinical trials or controlled clinical trials comparing Qingrelishi with plant america, other herbal medicine and Western medicine in the treatment of chronic prostatitis were identified by electronic and manual retrieval and analysis. The methodological quality of the included trials was assessed and Meta-analysis was performed with Revman 4. 2 software. RESULTS: Forty-four randomized clinical trials or controlled clinical trials (n=5746) were identified. The methodological quality ranked high in three double-blind trials and the others ranked low. Meta-analysis indicated that Qingrelishi was more effective than Nankangpian( RR 1.22, 95% CI 1.10-1.35) and Prostate( RR 1.26, 95% CI 1.13-1.41) in the treatment of chronic prostatitis. Subgroup analysis revealed that Qingrelishi was more effective than Qianliekang (RR 1.32, 95% CI 1.19-1.45) and quinolones antibiotic (RR 1.34, 95% CI 1.15-1.57). There were no significant differences in efficacy either between Qingrelishi and a-receptor blocker and Puleanpian or between Qingrelishi plus quinolone antibiotics and quinolone antibiotics alone. Eighteen articles reported side effects and no serious adverse events were reported. CONCLUSION: Qingrelishi may be effective in the treatment of chronic prostatitis. However, the evidence is not strong due to the generally low methodological quality and the variations of the herbs. More randomized clinical trials are required.