Thirty six patients aged 50-70 years with benign prostatic hyperplasia (BPH) received doxazosin and desmopressin treatment for 4 weeks.After treatment the International Prostate Symptom Scores (IPSS) and Quality of Life (QoL) scores of patients were significantly improved (17.4 ± 2.5 vs.11.8 ± 1.1 and 3.9 ±0.6 vs.1.8 ± 1.3,respectively;both P ＜ 0.01).The nocturia frequency was decreased from 4.6±1.5 to 2.1±1.6 (P＜0.01);nocturnal urine output from (564±73) to (348±45) ml (P＜0.05);the hours of undisturbed sleep increased from (88.6 ± 17.5) min to (146.2 ± 12.8) min (P ＜0.05).There were no significant differences in serum levels of sodium,potassium and chlorine,and osmoticpressure before and after treatment.The results indicate that doxazosin combined with desmopressin is safe and effective for treatment of nocturia in patients with BPH.

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 investigate the relationship between prostate histologic inflammation classification and prostate cancer (PCa) in needle biopsy specimens with serum prostatic specific antigen (PSA) under 20 μg/L.Methods The clinical records of patients who underwent prostate biopsy were retrospectively analyzed in Beijing Hospital Urological Department from January 2011 to December 2013.The patients underwent prostate biopsy because of PSA raised and without pelvic radiotherapy.The needle biopsy specimen was evaluated by the pathohistologic criteria of location,extent and grade classification of prostate inflammation.Results PCa was detected in 84 (37.2％) biopsies and benign prostatic disease (BPD) in 142 (62.8％) biopsies.There were significant differences between PCa and BPD in inflammation classification (location:P＜0.001,extent:P＜0.001,grade:P＜0.001).On multivariable Logistic regression analysis,both location and extent classification of chronic histologic prostatitis were found tobe significantly associated with a lower risk of PCa in biopsy (location:P =0.001,OR =0.114,95％ CI 0.032-0.405 ; extent:P =0.021,OR =0.232,95％ CI 0.067-0.804).There was no relationship between grade classification and PCa (P=0.223,OR=1.805,95％CI 0.698-4.667).Under the evaluation of location and extent classification,it could differentiate PCa with BPD in biopsy with a sensitivity,specificity,positive predictive value and negative predictive value of 91.7％,50.7％,52.4％,91.1％,respectively.Conclusion The location and extent classification of chronic prostatitis is found to be associated with a lower risk of PCa independently.

Objective To investigate the status of geriatric doctors' acknowledge and treatment of outpatients with lower urinary tract symptoms in 15 Chinese cities.Methods The investigation was conducted in 15 Chinese cities and involved 1056 geriatric doctors from December 2013 to February 2014.The questionnaire survey was made in behavior,attitude,skill and knowledge(BASK)of LUTS.The geriatric doctors participated in the investigation by answering the questionnaires about acknowledge for definition,etiology,diagnosis and treatment of the LUTS,and in results discussion,which was aimed at improving participants' cognition for diagnosis and treatment of elderly LUTS and at strengthening the practice.The final objective was to promote diagnosis standardization and to improve the level of clinical diagnosis and treatment for the elderly 1UTS.Results 95.9％ of geriatric doctors considered that they knew well the main clinical manifestations of LUTS.However,34.3 ％ of geriatric doctors were able to classify the symptoms of LUTS correctly.More than 90.0 ％ of geriatric doctors considered that the causes of LUTS were variable and they mastered the common cause of LUTS.But,38.0％ of them were able to completely master the causes of LUTS and 35.5％ would actively ask outpatients about the symptoms.70.0％ of the doctors thought they were familiar with the initial manifestations of LUTS and benign prostatic hypertrophy(BPH).However,many Chinese geriatric doctors didn't follow up the guidelines and 30.0％ of them failed to evaluate the severity of LUTS via IPSS(International Prostatic Symptom Score).75.8％ of geriatric doctors considered that they would give the patients the best treatment options by comprehensive assessment.However,60.0％ of them didn't know that α1 receptor blocker was the first line of treatment option of patients with moderate severe LUST.More than half of them were unclear that the patients with prostate volume under 40 ml could be treated by α1 receptor blocker.82.3％ of geriatric doctors considered that LUTS and hypertension should be treated respectively.But,55.0％ of them didn't know that ALLHAT trial has proved that Doxazosin would increase the risk of cardiovascular event.Conclusions The geriatric doctors are now able to pay attention to outpatients with LUTS,but still should further strengthen their acknowledge on the definition,cause,diagnosis and treatment of LUTS.

Objective To evaluate the efficiency and safety of extraperitoneal laparoscopic radi-cal prostatectomy for the treatment of localized prostate cancer. Methods Fifteen localized prostate cancer patients were treated with extraperitoneal laparoscopic radical prostatectomy. The mean pre-op-erative PSA was 8.1 ng/ml and prostate biopsy pathological Gleason score was 5.7±1.3. The Beijing Hospital Technique characterized by cutting directly into linea alba abdominis was used to establish the extraperitoneal space. Harmonic scrapple was used in dissection and haemostasis during the proce-dure. This technique was evaluated in respects of operating time, estimated blood loss, complications during surgery, postoperative complications, post-operative pain score (NRS), catheterization time, length of hospital stay, pathological results and post-operative PSA. Results All the surgeries had been completed successfully except 1 case converted to open surgery. The average operation time was (316±74)min, the average estimated blood loss was (4084±362)m1. There were 5 cases accepted blood transfusion. No rectal or ureteral injury happened during operation. The NRS at post-operative day 1 and day 2 were 2.3 and 1.4. The average length of hospital stay was (19.5±4.9)d. The cathe-terization time was (14.1±2.9)d. There were 2 cases (13%) with positive surgical margins. No case was found having lymph node metastasis. During the 1-12 month follow up, 10 cases (67%) were continence. PSA in 12 cases was lower than 0.2 ng/ml. Conclusion Extraperitoneal laparoscopic radical prostatectomy is feasible and safe in the treatment of localized prostate cancer.

Animals ; Animals, Newborn ; Bifidobacterium ; growth & development ; metabolism ; Gastrointestinal Tract ; microbiology ; Liver Function Tests ; Parenteral Nutrition ; methods ; Rabbits

ObjectiveTo study the association between the prognosis of Ta transitional cell carcinoma (TCC) of the bladder and risk-related factors.MethodsA total of 88 cases (62 males and 26 females;mean age,61 years;age range,41-81 years)of initial T_a TCC of the bladder treated with transurethral resection of bladder tumor (TURBt) plus intravesical chemotherapy or immunotherapy were enrolled.Among them,there were 26 cases of G_1,61 cases of G_2 and 1 case of G_3.For tumor site,62 cases (16 cases of G_1,45 of G_2,1 of G_3) had single tumor and 26 cases (10 cases of G_1,16 of G_2) had multi-site tumors.The mean follow-up was 113 months (range,56-168 months).The tumor grade,original tumor number and their association with the recurrence and progression of this type of TCC were retrospectively analyzed. Results The overall recurrence rate (RR) was 60%(53/88).In single tumor group,RR of G_1 cases was 25%(4/16);RR of G_2 cases was 62%(28/45) and the total RR was 52%(32/62).In multi-site tumor group,RR of G_1 cases was 80%(8/10),RR of G_2 cases was 75%(12/16) and the total RR was 77%(20/26).The RR of multi-site tumor group was significantly higher than that of single tumor group ( P

The clinical efficacy and safety of RevoLix 2 μm continuous wave laser vaporesection in treatment of senile patients with benign prostatic hyperplasia (BPH) were retrospective evaluated.In 291 senile patients with BPH,213 received 2 μm continuous wave laser vaporesection (group A) and other 78 patients received transurethral resection of prostate (TURP, group B).Compared with group B the intraoperative blood loss was less, the bladder irrigation time, catheter time and hospitalization time were shorter in group A.The subjective or objective indexes were all significantly improved at 3 and 12 months after laser treatment.The improvements of international prostate symptom score (IPSS), IPSS-S, overactive bladder symptom score (OABSS) in patients of 70-79 were more marked than those of 80 or older.Patients with mild overactive bladder (OAB) had less improvement in IPSS and IPSS-S than those with moderate-severe OAB which suggest that the storage symptoms could be improved significantly by removing obstruction.

Objective To explore the significance of clinical staging methods for prostate cancer before radical prostatectomy in the prediction of pathological stage, the selection of therapy, judgement of efficacy and the evaluation of prognosis. Methods Thirty-four patients with organ confined prostatic cancer were reviewed to compare the serum prostate specific antigen(PSA), Gleason score staging by biopsies, percentage of positive prostate biopsies staging, digital rectal examination(DRE) staging and magnetic resonance imaging(MRI) staging with the pathological staging results after radical prostatectomy. Results Pathological diagnosis by radical prostatectomy showed that 20 of 34(58.8%) patients with prostate cancer were in stage B, and 12 (35.3%) in stage C and 2 (5.9%) in stage D. All methods for cancer staging were significantly correlated with the pathological staging results ( P

Objective　To evaluate the real-life clinical characteristics of benign prostatic hyperplasia (BPH) patients with moderate and severe enlarged prostate.　Methods　From February 2009 to January 2011,a prospective,non-interventional,multi-center study was conducted on 2 758 BPH patients recruited from 32 hospitals in 10 cities nationwide with the following criteria:prostate volume (PV) larger ≥30 ml and international prostate symptom score (IPSS) ≥ 8. Patient age,PV,IPSS,Qmax medical treatment patterns and physician prescription practice were recorded. The demographic information and clinic characteristics were evaluated as well.　Results　The mean patient age,PV,IPSS score and Qmax of 2 786eligible patients were 69.2 ±8.5 years (50 to 97 years),47.8 ±16.6 ml (30 to 165 ml),17.5 ±5.4 (8to 35 ) and 11.6 ± 3.6 ml/s (2 to 36 ml/s),respectively.Age subgroup analysis pointed that the mean PV and Qmax in 50 -55 years group were 42.8 ml and 13.3 ml/s compared to 49.0 ml and 11.1 ml/s in the group beyond 71 years.Both parameters had statistical significances (P ＜ 0.05 ). For 56.1％ of the patients,it was their first time coming to clinic seeking for medical advice. Of whom,22.8％ patients had taken BPH prescription medication regularly beyond two weeks.Only 31.3％ of the patients had a history of BPH shorter than one year.22.9％ and 18.3％ of the patients had a history of BPH for 1 -2 and 3 -4 years.And 27.5％　of the patients had a history of BPH related symptoms longer than five years. Only 52.6％ patients were treated with α adrenoceptor antagonists + 5-α reductase inhibitor by urologists according to the recommendation in Chinese guideline of BPH.　Conclusions　The symptoms and key parameters of moderate and severe benign prostatic hyperplasia (BPH) patients become worse and more with increased age in China.It is quite late for most patients coming to clinic seeking for their first medical advice.Furthermore,there is a huge gap between urologist prescription and the recommendation of the Chinese guideline on BPH.