Objective To improve the management of the complications in patients with advanced prostate cancer. Methods Bone pain, anemia, urinary tract obstruction, hematuria and edema in the lower extremities and scrotum of patients with prostate cancer were managed with analgesics(24 cases), bisphosphonates(14 cases), isotope strontium-89(6 cases), external beam irradiation(9 cases), blood transfusion(9 cases), TURP(7 cases), superpubic cystostomy(8 case), percutaneous nephrostomy(4 case) and cysto-irrigation(6 case). Results 16 patients were alived and 10 were died of respiratory or circulation failure . The patients were relieved from pain and the other complications for several months after the palliative measures had been taken. Conclusions Bone pain, anemia, urinary tract obstruction and hematuria are common complications of advanced prostate cancer. They may have great impact on the life quality of patients. Diverse therapeutic modalities should be employed to palliate these disabling symptoms.

Objective To explore the causes of readmission after prostatectomy for BPH and to discuss the treatment approaches. Methods A total of 106 cases who were eligible for the study were reviewed.47 cases had residual and recurrent adenoma;of these cases,42 underwent TURP and 5 open prostatectomy again.32 cases developed urethral stricture;of these cases 27 underwent transurethral cold knife incision plus electric resection of scar and 3 urethral orifice reconstruction and 2 suprapubic cystostomy.11 cases who had experienced bleeding after TURP underwent transurethral bladder washing and coagulating.7 cases had neuropathic bladder dysfunction;of these cases 2 underwent transurethral bladder neck circle muscle resection,3 intermittent self-catheterization and 2 suprapubic cystostomy.6 cases had prostatic cancer;of these cases 1 underwent radical prostatectomy,3 palliative TURP plus orchiectomy and 2 orchiectomy.2 cases had incontinence after TURP;of the 2 cases 1 used external collecting device and 1 was transfered to other hospital for surgery.1 case had abdominal incision hernia and then underwent hernia repair. Results Among 106 cases, 97 cases underwent operations and of them 84 (86.6%) cases achieved successful results.The follow-up time was 6 months to 15 years with a mean of 5 years and 8 months.9 cases with urethral stricture required regular urethral dilation after surgery.4 cases who had had unsuccessful surgery underwent suprapubic cystostomy.Other 9 cases did not undergo operations due to poor health and other reasons. Conclusions Correct preoperative diagnosis, rational surgical type and adequate intraoperative and postoperative management are key to preventing readmission. Transurethral surgery is most favorable treatment choice for readmitted patients after prostatectomy for BPH.

Objective To investigate the regulatory effect of transforming growth factor-? 1 (TGF-? 1)on the proliferation and apoptosis of human prostatic epithelial cells in vitro. Methods The primary culture was prepared by collagenase dissociation of minced prostatic tissue obtained from 8 BPH patients (53 to 70 of age) on open prostatectomy and from 5 organ donors (23 to 36).Cells were cultured in serum free prostate epithelial cell growth media and identified by immunocytochemical studies.The cells were passaged and cultured in media free of bovine pituitary extract and EGF and TGF-? 1 and EGF in different doses were then added either alone or in combination according to experimental requirement.The rate of cell proliferation was assessed by counting the cell number and by 5-bromo-2'-deoxyuridine (ELISA).Apoptosis induced by TGF-? 1 was examined by in situ transferase-mediated dUTP nick and labeling. Results The cultured cells had the typical morphological features of epithelium and stained positive for PSA and Pan-Keratin.The cells from normal prostates of young donors showed more mitogenic activity than those from BPH prostates.EGF enhanced cell proliferation whereas TGF-? 1 inhibited cell proliferation which could be reversed by increasing concentration of EGF.TGF-? 1 induced apoptosis of human prostatic epithelial cells.The effect of TGF-? 1 and EGF was concentration dependent. Conclusions TGF-? 1 is a direct physiological regulator of cell proliferation and cell apoptosis of human prostatic epithelial cells.

Objective To investigate the effect of TGF ? 1 and EGF on the proliferation of cultured human prostatic epithelial cells. Methods The primary culture was prepared by collagenase digestion of minced prostatic tissue obtained from prostatectomies of 8 benign prostatic hyperplasia(BPH) patients (aged 53 to 70) and 5 organ donors (aged 23 to 36). Cells were cultured in serum free prostatic epithelial cell growth media and identified by immunocytochemical method. The cells were passaged and cultured in media without bovine pituitary extract (BPE) and then, EGF and TGF ? 1 with different concentration were added into the culture either alone or in combination according to the experimental protocol. The cell proliferation was assessed by counting the cell number (BrdU) and ELISA. Results Cultured cells showed typical morphological features of epithelium and stained positive for PSA and Pan Keratin. After 5 7 passages cells went senescence. BPE and EGF enhanced whereas TGF ? 1 inhibited the cell proliferation and the inhibition was reversed by increasing the concentrations of EGF. The effect of both TGF ? 1 and EGF displayed concentration dependent manner. Conclusions Cell proliferation of the cultured human prostatic epithelial cells could be modulated by TGF ? 1 and EGF. These results indicated that TGF ? 1 and EGF, as the negative and positive growth factors might play an important role in the pathogenesis of BPH.

Objective To observe the efficacy of finasteride and M-receptor antagonist (tolterodine tartrate release tablet) in patients with benign prostatic hyperplasia (BPH) with overactive bladder (OAB).Methods 40 patients with BPH and OAB were treated with finasteride (5 mg,Qd) and tolterodine tartrate release tablet (4 mg,Qd) for 6 months.The clinical effects were evaluated by the International Prostate Symptom Score (IPSS),Overactive Bladder Symptom Score (OABSS),urgency rating scale,maximum flow rate,voiding volume,prostate volume before and after treatment.Results Compared with before treatment,the IPSS,OABSS,urgency rating scale,maximum flow rate,voiding volume,prostate volume were improved [(11.8±1.4) vs.(19.2±2.1),(4.6±2.6) vs.(9.3±1.8),(1.2±1.9) times/week vs.(4.7±1.0) times/week,(14.5±2.7) ml/s vs.(10.2±2.2) ml/s,(25.2±2.6) ml vs.(34.6±3.2) m1,(46.2±2.2) ml vs.(57.6±1.3) ml,all P＜0.05] after treatment.No urinary retention and other adverse reactions were found.Conclusions Finasteride combined with M-receptor antagonist (tolterodine tartrate release tablet) is an effective and safe therapeutic method for patients with BPH and OAB.

Objective To evaluate the diagnostic and therapeutic status of lower urinary tract symptoms (LUTS) of benign prostatic hyperplasia (BPH) in urological outpatients.Methods The survey was conducted at 57 urological clinics in 14 cities during the period of October-December 2011.All surveyed male outpatients were inquired about whether there was a history of LUTS/BPH or not.Then eligible patients received a more detailed questionnaire for LUTS.Results Among a total of 6 200 male outpatients,47.4％ (n =2 940) had a history of LUTS/BPH.The rate for LUTS was 30.0％ (n =882) in patients aged under 40 years and 60.0％ (n =1 764) in those aged over 60 years.The major complains included frequency (72.0％),urgency (53.0％) and nocturia (48.0％).At a rate of 63.0％,the patients aged 71-80 years came more to a hospital for nocturia than 61-70 years (52.0％) and 51-60 years (49.0％).The average International Prostate Symptom Score (IPSS) was 14.98 (6-35) and 59.0％ patients had moderate symptoms and 26.0％ severe symptoms.The average score of quality-of-life was 4.12 (1-6) points.And the average overactive bladder symptom score (OABSS) was 5.78 (3-15) points and 56.0％ patients had moderate overactive bladder (OAB) and 3.0％ severe OAB.Urinalysis was largely normal.The main causes for LUTS included OAB (25.2％),BPH and OAB (20.4％),BPH (20.2％),prostatis (20.2％) and urinary infection (11.8％).Conclusions LUTS and BPH are common in urological outpatients.And the incidence is rising yearly.Clinical examinations and drug regimens should be timely adjusted according to the etiology.And patient education should be strengthened at the same time.

Objective To evaluate the effect of hydrodistension on interstitial cystitis and the psychological changes after hydrodistension.Methods Thirty two patients with interstitial cystitis underwent hydrodistension from May 2011 to Jun 2012 in Department of Urology,Beijing Hospital.Interstitial cystitis symptom index(ICSI),Visual onalogue Scale (VAS) pain score,quality of life questionnaire(QOL) score,self-rating anxiety scale(SAS) score,self-rating depression scale(SDS) score were recorded and analyzed before and at 1-3 month after hydrodistension surgery.The voiding diary and postoperative complications were cared.Results Symptoms were improved in twenty nine patients,the efficiency rate was 90.6％ (29/32).There were significant differences in ICSI score,VAS pain score,QOL score,SAS score,SDS score between pre and 3 month post-surgery [(26.7± 2.3) vs.(15.2±1.9),(4.6±2.5) vs.(1.8±1.1),(4.3±2.2) vs.(2.2±1.6),(53.8±3.7) vs.(40.8±2.3),(54.8±2.3) vs.(42.4±1.5),t=8.33,7.94,6.54,7.20,8.52,respectively,all P ＜0.05].No complication was found after surgery.Both the clinical symptoms and the anxiety and depression symptoms in patients were relieved,and QOL was improved.Conclusions For the patients with interstitial cystitis,the undergoing of hydrodistension surgery can relieve the anxiety and depression symptoms and improve quality of life.

Objective To study the effect of down-rdgulation of EF-1 alpha gene in prostate cancer cell line DU-145 on cancer cell migration and invasion by using RNA interference technique. Methods The prostate cancer cell line DU-145 was divided into three groups: the control group (untransfected with siRNA), randomly control group (randomly transfected with siRNA) and experimental group (transfected with EF-1 alpha siRNA). Localization of EF-1 alpha and its relationship with F-actin in cytoplasm were analyzed by immunofluorescence technique. Cancer cell migration and invasion capability of DU145 cells were studied by transwell technique in these three groups. Results EF-1 alpha expression in DU145 cell line was down-regulated by using RNA interference technique. EF-1 alpha was localized in cytoplasm and co-located with F-actin. The down-regualtion of EF-1 alpha did not change the F-actin distribution in cytoplasm. The cell migration and invasion study showed that after seeding 20×104 DU145 cells into the upper chamber of transwall for 12 hours, the cells collected in the lower chambers were (10.6±1.0)×104 in control group, (11.2±0.8)×104 in randomly control group and (3.9±0.6)×104 in experimental group. Compared with controls, the cancer cell migration and invasion capability was significantly inhibited to only 37.1% (t= 13.9, P<0.05) after the specific down-regulation of EF-1 alpha expression in DU145 cells. Conclusions The down-regulation of EF-1 alpha expression has negative impacts on prostate cancer cell migration and invasion. EF-1 alpha plays important roles in prostate cancer local invasion.

g this model, trainees could improve their basic techniques, such as resection and vaporization technique.

Objective To evaluate the safety and clinical efficacy of finasteride in treating patients with benign prostatic hyperplasia (BPH) during a 14-year period in a hospital.Methods Forty-one patients with BPH receiving finasteride 5 mg daily for the treatment from December 1994 to Febrary 2009 were included in the study. The base line and the end of study data of nocturia, prostate volume, serum creatine, complete blood count and serum prostatic specific antigen (PSA) were recorded. The acute urinary retention, surgical treatment and drug adverse reaction (prostate cancer or breast cancer) during the observation periods were recorded as well.ResultsAll the 41 cases took finasteride regularly for long-term medical therapy of BPH. At the end of this study, the average age of patients was (87.9±5.4) years old and the average duration of treatment was (141.1±27.1) months. The numbers of nocturia were 1.8±1.5 and 3.2±1.3 pre- and post- treatment, respectively (t= -4.52,P<0. 05). Before and at the end of the study, the prostate volumes were (44.9±26.6) ml and (42.8±31.3) ml, respectively(t=0. 33,P>0.05). Stratified study showed that, compared with the baseline data, the prostate volume was increased by 17.3 ％ in patients with prostate volume <25 ml(t= -0. 88 ,P>0. 05) ; the prostate volume was decreased by 17.2％ in patients with prostate volume of 25-40 ml(t=2.59,P<0.05); the prostate volumes were (63.3±28. 9) ml and (62.6±36.5) ml pre- and post-treatment in patients with prostate volume > 40 ml, and there was no significant change(t= 0.07, P>0. 05). Before and after the treatment, the serum creatine levels were (96.8±18. 6) mol/L and (86.45±32. 3) mol/L, respectively(t= 1.79, P>0. 05) ; the white blood cell counts were (6.4±1.5) × 109 L and (6.0±1.7) ×109 L, respectively (t= 1.13,P>0. 05) ; and the PSA levels were (1.2±2.0) μg/L and (1.4±1.7) μg/L, respectively (t=-0. 49,P>0. 05). Three cases (7.3％) occurred acute urinary retention. There was no prostate cancer and breast cancer case, and no new adverse event occurred during long-time use of finasteride. Conclusions This retrospective study has demonstrated that the clinical progress of BPH can be controlled effectively by long-term administration of finasteride.