[Clinical characteristics and prognostic factors of distant metastatic penile cancer].

OBJECTIVE: To investigate the clinical features of distant metastatic penile cancer (DMPC) and the factors influencing its prognosis. METHODS: We searched the Surveillance, Epidemiology and End Results Database for cases of DMPC diagnosed between 2004 and 2019, analyzed their clinical characteristics and the cancer-specific survival (CSS) rates relating to different factors using the Kaplan-Meier method and the differences among the variables by log-rank test. We determined the variables independently associated with CSS by Cox regression analysis. RESULTS: According to the inclusion criteria, 108 cases of DMPC were identified. The patients were mainly married White people, with a median CSS of 9 months, and 1-, 2- and 3-year CSS rates of 36.4%, 17.8% and 13.5%, respectively. Pairwise comparison showed no statistically significant differences in the median overall CSS among the patients in the surgery, chemotherapy and surgery + chemotherapy groups (8 mo vs 9 mo vs 13 mo, P > 0.05). Race was an independent factor affecting the prognosis of CSS. CONCLUSION: Distant metastatic penile cancer is a rare malignancy with poor prognosis, for which there have been no existing ideal treatment options.

[Spiral thermo-expandable prostatic stent implantation for benign prostatic hyperplasia: Clinical analysis of 26 cases].

OBJECTIVE: To investigate the surgical techniques and clinical effect of Memokath transurethral spiral thermo-expandable prostatic stent (STEPS) implantation in the treatment of BPH. METHODS: From January 2017 to January 2018, 26 BPH patients underwent Memokath transurethral STEPS implantation, 9 under the flexible cystoscope and the other 17 under the rigid cystoscope. The patients were aged 62－91 years old, with a prostate volume of 32－78 ml, postvoid residual urine volume (PVR) of (67.3 ± 11.2) ml, maximum urinary flow rate (Qmax) of (6.3 ± 1.8) ml/s, and IPSS score of 26.7 ± 5.7. Eight of the patients had preoperative urinary retention, of whom, 6 received catheterization and 2 had undergone cystostomy for bladder fistula before STEPS implantation. RESULTS: The operations lasted 15－30 minutes and were successfully completed in 24 cases while stent-shedding occurred in the other 2. Twenty-two of the patients achieved spontaneous urination immediately after surgery and 2 experienced bladder clot embolism. At 3 month after surgery, 24 of the patients showed significant improvement in PVR (ï¼»21.4 ± 7.7ï¼½ ml), Qmax (ï¼»18.3 ± 4.7ï¼½ ml/s) and IPSS (8.3 ± 2.1), and 13 exhibited no statistically significant difference from the baseline in the IIEF-5 score (14.1 ± 1.1 vs 14.3 ± 1.0, P > 0.05). At 12 months, all the patients were found with markedly improved urination but no adverse events except recurrent urinary tract infection in 2 cases. CONCLUSIONS: Memokath STEPS implantation, with its advantages of simple operation, high safety, definite effectiveness, non-influence on sexual function, is a new effective surgical option for the treatment of BPH.

Comparing efficacy of α1D-receptor antagonist naftopidil and α1A/D-receptor antagonist tamsulosin in management of distal ureteral stones.

PURPOSE: To compare the efficacy of α(1)D-receptor antagonist Naftopidil and α(1)A/D-receptor antagonist Tamsulosin in management of distal ureteral stones. MATERIALS AND METHODS: A total of 131 patients with distal ureteral stones were included in the study from December 2008 to September 2010. The patients were randomized to 3 groups: group 1 (43 patients), those receiving 10 mg naftopidil once daily; group 2 (45 patients), those receiving 0.4 mg tamsulosin once daily; and group 3 (43 patients) were given a watchful waiting and served as control group. All patients were followed up for 2 weeks. Ultrasonography and kidney-ureters-bladder (KUB) were performed on day 7 and 14. At the end of the follow-up period, patients who failed to expel the stone were scheduled to undergo ESWL or ureteroscopy. RESULTS: Stone expulsion was observed in 31 patients in group 1 (72.1%), 37 patients in group 2 (82.2%), and 13 patients in group 3 (30.2%). A statistically significant difference was noted with Chi-square testing between groups 1 and 3, and groups 2 and 3 (P = 0.000 and P = 0.000, respectively). Average time to expulsion was 7.6 ± 2.26 days (range 1-12 days) in group 1, 7.7 ± 1.94 days (range 2-11 days) in group 2, and 9.4 ± 2.48 days (range 6-14 days) in group 3. A statistically significant difference was observed in time to expulsion between groups 1 and 3, and groups 2 and 3 (P = 0.000, P = 0.001, respectively) by ANOVA testing. The side effects encountered in the study groups were generally mild and did not require cessation of therapy in any patient. CONCLUSIONS: Naftopidil could significantly increase spontaneous passage of distal ureteral stones with low side effects. The stone expulsion rate is similar for the tamsulosin.

[Penile and scrotal skin flaps: first choice for urethroplasty in the treatment of hypospadias].

OBJECTIVE: To explore the feasibility of the treatment of hypospadias with penile and scrotal skin flaps. METHODS: Twenty-three hypospadias patients aged 3.5-19 (mean 6. 8) years underwent urethroplasty with penile and scrotal skin flaps. All were followed up for 6 years and analyzed retrospectively. RESULTS: Of the total number of patients, 21 (91.3%) succeeded in one operation and the other 2 developed complications, including urethral fistula and urethral structure. CONCLUSION: Penile and scrotal skin, advantageous for its adequacy, rich blood supply and contribution to high success rate of surgery, is believed to be the first choice for urethroplasty in the treatment of hypospadias.

[Expression of VEGF in prostate cancer and its correlation with ET-1].

OBJECTIVE: To investigate the expressions of VEGF in prostate cancer (PCa) and benign prostatic hyperplasia (BPH), their clinical significance and their relationship with that of ET-1. METHODS: A total of 44 specimens of PCa and 36 of BPH tissues were examined by the immunohistochemical Elivision plus method for the expressions of VEGF and ET-1. The intensity of staining for VEGF and ET-1 was assessed by light microscopy on a scale from "-" to "+ + +". RESULTS: The rates of positive expression of VEGF were 69.4% in BPH and 80.9% in PCa, positive staining mostly in the cytoplasm of glandular epithelia and cancer cells, and strongly positive in all the stroma vascular endothelial cells. The staining intensity of VEGF was significantly higher in the PCa than in the BPH group (P < 0.05) , in the bone metastasis (BM) than in the non-BM group (P < 0.01), and in the lowly than in the highly and moderately differentiated PCa tissues (P < 0.01). The expression of VEGF was positively correlated with that of ET-1 ( r(s) = 0.780, P < 0.01). CONCLUSION: VEGF is involved in the development, progression and metastasis of PCa. VEGF and ET-1 may play a joint role in its development and progression.

[Expressions of endothelin-1 in benign prostatic hyperplasia and prostate cancer and their significance].

OBJECTIVE: To investigate the different expressions of endothelin-1 ET-1) in prostate cancer (PCa) and benign prostatic hyperplasia (BPH) tissues and their clinical significance. METHODS: A total of 36 BPH and 44 PCa specimens were examined for the expression of ET-1 by immunohistochemical technique (Elivision plus method). The staining intensity for ET-1 was assessed by light microscopy on a scale from "-" to "+ + +". RESULTS: Positive immunoreactivity was found in BPH and PCa, with a positive rate of 100%. Positive staining was located mostly in the cytoplasm of glandular epithelia and smooth muscle cells of both BPH and PCa and was noted in all stroma vascular endothelial cells. These were no significant differences in the intensity of positive staining for ET-1 between the groups of BPH and PCa (P > 0.05), bone metastasis (BM) and non-BM (P > 0.05), and highly and moderately differentiated PCa (P > 0.05), but the staining intensity for ET-1 was significantly higher in the poorly than in the highly and moderately differentiated PCa (P < 0.01). CONCLUSION: ET-1 has a high expression and the localization is the same in both BPH and PCa. It is involved in the development and progression of BPH and PCa.

[DNA methylation and prostate cancer].

DNA methylation is a common event in malignancies and implicated in tumor initiation and progression. There is a battery of genes involved in critical cell processes such as DNA damage repair, which are hypermethylated in prostate cancer. DNA methylation has also been found in premalignant lesions such as prostatic intraepithelial neoplasia, but to a less extent compared with that in prostate cancer. Intensive study on DNA methylation would provide a new opportunity for the early diagnosis, prognosis and treatment of prostate cancer.

[Evaluation of color Doppler flow imaging in the diagnosis and differential diagnosis of spermatic cord torsion].

OBJECTIVE: To distinguish spermatic cord torsion from acute orchitis by color Doppler flow imaging (CDFI). METHODS: Thirteen patients with acute orchialgia were examined by CDFI. The clinical data of diagnosis and treatment were reviewed and analyzed. RESULTS: The findings of CDFI showed lower or even no blood flow in the testes in 8 cases, which were diagnosed as spermatic cord torsion. Among them, 1 received manual detorsion and 7 were proved by operations. The other 5 showed abundant blood flow signal in the testes and were diagnosed as acute orchitis or epididymo-orchitis. After the use of antibiotics, their symptoms were relieved and the blood flow of the testes reduced upon reexamination. CONCLUSIONS: CDFI plays an important role in the diagnosis and differential diagnosis of spermatic cord torsion, and could be regarded as a detecting method of first choice for patients of acute orchialgia.