Objective To evaluate retroperitoneal laparoscopic Anderson-Hynes pyeloplasty. Methods 6 patients underwent laparoscopic and 10 patients underwent open Anderson-Hynes pyeloplasty.The clinic outcome including subjective and objective findings was compared between the two groups. Results All the procedures were successfully completed.The mean operating time was 279 minutes for laparoscopic pyeloplasty being much longer than the open procedure 121 minutes(P0.05).No severe postoperative complications were found.3 months after the procedure,the pain-free rate was about the same between the two groups.However the open surgery group had much pain and prolonged convalescence due to the flank incision. Conclusions Laparoscopic pyeloplasty is a minimally invasive technique that provides similar clinical and radiographic results as open pyeloplasty.

Objective To ascertain the causes of priapism and to differentiate between the ischemic low-flow type and nonischemic high-flow type so as to improve the clinicians' ability for emergency treatment of priapism. Methods Ten cases of priapism were included.Their mean age was 41 years (range,22～64 years).The priapism lasted 8 to 212 h with a mean of 21.2 h.Of them 1 case had received prostaglandin E,papaverine and phentolamine injection into cavernous body of penis,which led to ED;1 had priapism when experiencing sexual intercourse after taking sildenafil;1 had primary sarcoma of the penis;1 had transitional cell carcinoma of bladder, which metastasized to the penis;1 had leukemia; 2 had traumatic history;and 3 had unknown causes.The types,causes,treatment and outcomes of priapism were analyzed. Results Of the 10 cases,8 were of ischemic low-flow type and 2 of nonischemic high-flow type. In the 8 cases of ischemic low-flow type priapism, 4 achieved detumescence after receiving metaraminol injection (2～8 mg) at the root of cavernous body,and perfusion of haparinized saline at glans and root of cavernous body of the penis by contrecoup if necessary (1 had ED).One case undergoing glandular-cavernosal shunting achieved detumescence with preservation of erectile function.One case with leukemia was cured after chemotherapy.One case suffered from penile sarcoma and the rest 1 from metastasis of transitional cell carcinoma; the prognoses of both were unfavorable.Of the 2 cases of high-flow type,1 achieved detumescence after selective embolization of internal pudendal artery;the other was discharged after conservative treatment,but experienced ED. Conclusions Blood gas analysis of cavernosal blood,color Doppler ultrasound,and internal pudendal arteriography are useful in differentiating the types of priapism.If conservative treatment fails to achieve detumescence of the penis,surgical treatment should be performed immediately for both types of priapism.

Objective To research the clinical manifestations of renal tuberculosis and improve the diagnosis and treatment of renal tuberculosis. Methods From 1993 to 2007,223 cases of renal tuberculosis were hospitalized. Retrospective analysis was complied for all the cases about age, clinical manifestations, imaging and treatment. Results The incidence rates of the renal tuberculosis were obviously higher in the 20-40 years old(41.7%) and in the 41-54 years old (36.3%). The course of this disease was from 1 day to 30 years(mean 38. 5 months). Only 36 patients (16.1%) were made a definite diagnosis when they went to see a doctor primary. The miediagnosis of urinary tract infec-tions( 50.3%) was most frequent. The clinical manifestations of most patients included frequency(54.7%), urgency(50.2%), odynuria(42.2%)and hematuria(58.7%). About 58. 3% patients pres-ented with over 3 kinds of above manifestations. The positive yield of the tuberculin test in urine was only 41.9%. The positive diagnostic rate of renal tuberculosis was only 35.7% in KUB+IVU,72.2%in Type-B Ultrasonic, 76.0% in CT test. One hundred and seventy-three cases were performed with nephrectomy(78.6%) and partial nephrectomy(21.4%). Two cases were treated with dialysis due to uremia. Standard medication was taken for the other 48 patiernts, and effective for 41 cases. Conclu-sions The incidence of atypical renal tuberculosis is increasing. More attention must be paid especially to those patients with urinary infection.

Objective To compare the clinical features and results between transperitoneal laparoscopic radical prostatectomy and extraperitoneal laparoscopic radical prostatectomy.Methods Thirty-three prostate cancer patients treated with laparoscopic radical prostatectomy. Among them,21 cases had been done transperitoneally and 12 cases had been done extroperitoneally. The two different approaches were evaluated and compared in respects of operating time, estimated blood loss, complications during surgery, postoperative complications, intestinal function recovery time, catheterization time and length of hospital stay.Results All the surgeries had completed successfully without conversion to open surgery. For transperitoneal approach and extraperitoneal approach, the operating time was (299±46)min and (309±64)min, blood loss was (618±448)ml and (677±469)ml. There were 3 cases with severe blood loss, 2 cases with bladder injuries and 1 case with ureteral injury in transperitoneal approach group. There were 1 case with severe blood loss, 1 case with obturator never injury, 1 case with cysto-ureteral injury and 1 case with peritoneum injury in extraperitoneal approach group. For transperitoneal approach and extraperitoneal approach,the catheterization time was(14.6±3.8)d and (12.3±2.9)d, intestinal function recovery time was (2.7±0.7)d and (2.1±0.5)d, length of hospital stay was (17.0±3.6)d and (11.2±3.5)d, respectively.Conclusions Laparoscopic radical prostatectomy is feasible and safe in clinical practice. Extraperitoneal approach has better vision, less impact on abdominal organs, faster recovery and shorter hospital stay comparing to transperitoneal approach.

OBJECTIVETo investigate the effect and mechanism of alpha1-adrenoceptor blocker combined with antibiotics in the treatment of chronic prostatitis.

METHODSEighty patients with chronic prostatitis were divided into two groups, one treated with alpha1-adrenoceptor blocker (Terazosin 2 mg qn) and Levo-ofloxacin (0.2 bid), and the other given Levo-ofloxacin (0.2 bid) alone for 6 weeks. Chronic prostatitis symptom index (CPSI), urodynamic data and prostatic secretion examination were compared before and after treatment.

RESULTSThe CPSI score of the treated group decreased from 31.8 +/- 7.4 to 15.5 +/-6.6, while that of the control group decreased from 30.9 +/- 7.1 to 21.4 +/- 6.2. There was significant difference between the two groups (P < 0.05). The maximum flow rates before and after the combined treatment were 16.5 +/- 6.3 ml/s and 20.4 +/- 4.6 ml/s, while those before and after Levo-ofloxacin administration were 16.1 +/-5.8 ml/s and 17.3 +/- 6.8 ml/s. The difference was significant (P < 0.05). The maximum urethral pressure of the combined treatment group decreased from 92.5 +/- 15.3 cm H2O to 72.5 +/- 13.4 cm H2O, while that of the control group decreased from 93.2 +/- 14.8 cm H2O to 91.7 +/- 13.6 cm H2O.

CONCLUSIONAlpha1-adrenoceptor blocker can lower the intraurethral pressure, which prevents urine from refluxing to the prostate. Alpha1-adrenoceptor blocker combined with antibiotics is effective for chronic prostatitis.

Adrenergic alpha-1 Receptor Antagonists ; Adrenergic alpha-Antagonists ; administration & dosage ; Adult ; Anti-Bacterial Agents ; administration & dosage ; Chronic Disease ; Drug Therapy, Combination ; Humans ; Male ; Middle Aged ; Prostatitis ; drug therapy ; physiopathology ; Urodynamics