[Testosterone replacement therapy improves metabolic indexes of the patients with hypogonadism: A meta-analysis].

OBJECTIVE: To systematically evaluate the effect of testosterone replacement therapy (TRT) on metabolic indexes in patients with hypogonadism. METHODS: We searched the databases of CNKI, CBM, Wanfang Data, VIP, PubMed, Medline, Embase and Cochrane Library from the establishment to May 2021 for clinical randomized controlled trials (RCT) on the improvement of metabolic indexes of the patients with hypogonadism treated by TRT. According to the inclusion and excretion criteria, we screened the literature, extracted the data and evaluated the quality of the included RCTs, followed by statistical analysis with the STATA15.1 software. RESULTS: Totally 19 RCTs with 1 553 cases were included. Compared with placebo, TRT effectively reduced the levels of fasting plasma glucose (FPG) and fasting insulin (FINS), improved Homeostatic Model Assessment-insulin resistance (HOMA-IR), decreased total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), increased the body mass index (BMI), lowered the waist circumference (WC), but elevated the systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the patients. No statistically significant differences were observed in the improvement of glycosylated hemoglobin (HbA1c) and triglyceride (TG) between the TRT-treated patients and placebo controls. The results of Egger's and Begg's tests showed no significant publication bias among the studies. CONCLUSION: TRT can significantly improve metabolic indexes in patients with hypogonadism, though further studies are needed to confirm its long-term efficacy and safety in patients with metabolic disorders.

[Transurethral holmium laser enucleation of the prostate combined with Jisheng Shenqi Decoction for benign prostatic hyperplasia].

OBJECTIVE: To assess the clinical effects of transurethral holmium laser enucleation of the prostate (HoLEP) combined with Jisheng Shenqi Decoction (HoLEP + JSSD) on BPH. METHODS: This study included 110 BPH patients treated in our hospital from August 2017 to April 2018, who were randomly assigned to receive HoLEP (n = 55) or HoLEP + JSSD (n = 55). We compared the pre- and post-operative IPSS, quality of life (QOL) score, prostate volume, postvoid residual urine volume (PVR), maximum urinary flow rate (Qmax), average urinary flow rate (Qavg) and levels of serum T, E2 and T/E2 as well as postoperative complications between the two groups of patients. RESULTS: After treatment, both IPSS and QOL score were significantly lower in the HoLEP + JSSD than in the HoLEP group (P < 0.05), and so were the prostate volume and PVR (P < 0.05). The Qmax, Qavg and serum T level were significantly higher (P < 0.05) while T/E2 markedly lower in the former than in the latter group (P < 0.05). There were no statistically significant differences between the HoLEP + JSSD and HoLEP groups in the E2 level (P > 0.05) or the total incidence rate of complications postoperatively (21.82% vs 29.09%, P > 0.05). CONCLUSIONS: HoLEP + JSSD can significantly alleviate the lower urinary tract symptoms as well as improve the QOL and bladder and urinary tract functions of BPH patients.

[Combined use of TUVP and TURP for prostate cancer with bladder outlet obstruction].

OBJECTIVE: To investigate a new surgical method for the treatment of prostate cancer with bladder outlet obstruction. METHODS: Forty-seven patients with prostate cancer complicated with bladder outlet obstruction were treated by combined use of transurethral electrovaporization ablation of the prostate (TUVP) and transurethral resection of the prostate (TURP). RESULTS: The operations were successful, with satisfactory results and no serious complication. IPSS decreased from (26.5 +/- 4.8) pre-operatively to (8.5 +/- 2.2) post-operatively (P < 0.05); Qmax increased from (4.6 +/- 1.5) ml/s to (14.5 +/- 3.6) ml/s (P < 0.05); and PSA decreased from (58.1 +/- 7.2) microg/L to (3.6 +/- 1.8) microg/L (P < 0.01). CONCLUSION: The combined use of TUVP and TURP is a safe and ideal method for the treatment of prostate cancer with bladder outlet obstruction.

[Combined use of TUVP and TURP for treating BPH (report of 179 cases)].

OBJECTIVE: To investigate a new operation method for the treatment of benign prostate hyperplasia(BPH). METHODS: One hundred and seventy-nine patients with BPH were treated by the combined use of transurethral electrovaporization ablation of the prostate(TUVP) and transurethral resection of the prostate(TURP). RESULTS: The procedure was successful and the results were satisfactory, with little bleeding and no serious complication. IPSS decreased from 29.0 preoperatively to 7.6 postoperatively (P < 0.05) and Qmax increased from 5.8 ml/s preoperatively to 14.8 ml/s postoperatively(P < 0.05). CONCLUSIONS: The combined use of TUVP and TURP is a safe, effective and ideal method for the treatment of BPH.