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 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 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.

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 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 explore the clinical effects of tension-free vaginal tape obturator system inside-out (TVT-O) for the treatment of female stress urinary incontinence.Methods A retrospective analysis of 102 patients with stress urinary incontinence who were performed TVT-O surgery in our hospital from October 2011 to June 2012.The postoperative follow-up time was 1 to 8 months.Results 102 patients with stress urinary incontinence were effectively controlled after surgery,the subjective satisfactory rate was 96.1％ (98 cases),the objective of efficiency was 93.1％(95 cases).After a mean follow-up of 1-8 months,no symptoms were in recurrence.The average surgery time was (35.0± 2.1) min and the average blood loss was (25.0± 6.4) ml.International consultation on incontinence questionnaire short form (ICIQ-SF) score was 16.2 ± 3.4 beforc operation and reduced to 8.7±2.6 after 4 weeks (P＜0.05).Incontinence quality of life questionnaire score (I-QOL) preopcratively was 40.2±19.5,and 88.7±12.3 after 4 weeks (P＜0.05).One hour urine pad test:the mean preoperative urine leakage was (27.6±8.2) g,and became (5.5± 1.3)g 4weeks after operation (P＜0.05).Two patients had dysuria 3 days after surgery and became recovery after keeping catheterization one week.Eight patients had groin thigh pain which remitted two days to one week later.One patient was diagnosed overactive bladder firstly and three patients had suffered current urinary infection after surgery.Conclusions TVT-O is an effective treatment method for female stress urinary incontinence because of its high level of standardization,small trauma,few complications and fast recovery.

Objective:To evaluate the efficacy and safety of docetaxel+ prednisone in the treatment of castrated resistant prostate cancer in patients over 75 years old.Methods:In this study, 118 metastatic castration resistant prostate cancer (mCRPC) patients over 60 years old treated in Beijing Hospital from February 2013 to December 2019 were retrospectively analyzed. The median age of the patients was 72 (65, 77)years, ECOG scores ≤2. All 118 cases had bone metastasis, 5 cases had visceral metastasis. A total of 40 patients chose docetaxel as the first-line treatment of mCRPC, and the remaining 78 patients chose docetaxel as second-line or third-line treatment. The study included 53 patients >75 years old and 65 patients aged 60-75 years. The age of patients in the two groups were 67 (63, 71) years old and 78 (76, 83) years old, the difference was statistically significant ( P<0.05). Among them, there were 24 cases with Gleason score ≤7 and 41 cases with Gleason score >7 in 60-75 years old group, and 30 cases with Gleason score ≤7 and 23 cases with Gleason score >7 in the group of >75 years old, with significant difference between the two groups ( P = 0.034). Sixty-one patients received endocrine therapy and 4 received orchiectomy in the 60-75 years old group; 43 patients received endocrine therapy and 10 received orchiectomy in the group of >75 years old, the difference was statistically significant ( P=0.035). There were 37 cases with ECOG 0 score, 25 cases with 1 scores and 3 cases with 2 scores in the group of 60-75 years old; there were 5 cases with ECOG 0 score, 38 cases with 1 score and 10 cases with 2 score in the group of >75 years old, with significant difference between the two groups ( P<0.05). There was no significant difference in PSA level[ 90 (35.5, 258) ng/ml vs. 115 (60, 296) ng/ml], G8 scale score [(14.3±2.1 vs. 13.6±1.1)], Mini-Cog score[3(2, 3) vs. 3(1, 3)], and visceral metastasis [2 cases (3.1%) vs. 3 cases (5.7%)]( P>0.05). The efficacy and safety of docetaxel in the two groups were further observed. Results:The median follow-up time was 21.5 (6, 62) months. There was no significant difference in chemotherapy cycle [(6.1±1.3) vs. (6.8±1.7)] and chemotherapy dose [(70.3±4.3) mg/m 2 vs. (66.3±5.2) mg/m 2] between the 60-75 years old group and the >75 year old group ( P> 0.05). The PSA response rate [72.3%(47/65)vs.66.0%(35/53)], pain relief rate [45.0% (9/20) vs. 54.5% (6/11)], and median progression-free survival[6.1 (1.4, 11.2) months vs. 5.9 (2.0, 12.0) months] had no statistical significance ( P>0.05). There were no deaths in the two groups during chemotherapy. The median overall survival(OS) of patients aged 60-75 years and those >75 years old who received docetaxel as first-line treatment were 26.5 (16.1, 31.3) months and 24.8 (17.5, 28.4) months, respectively ( P=0.223). The median OS of the two groups were 17.3 (13.2, 20.5) months and 15.4 (12.3, 20.0) months with docetaxel treatment as second or third line treatment ( P=0.331). There were 3 cases (4.6%) and 5 cases (9.4%) of grade 3 adverse reactions in 60-75 years group and >75 years old group, respectively. Grade 3 leukopenia occurred in 1 case time (1.5%) and 2 cases (3.8%) respectively. Grade 3 neutropenia fever occurred in 1 case time in both groups. There was no significant difference in the incidence of above complications between the two groups ( P > 0.05). Conclusions:The efficacy and safety of docetaxel + prednisone chemotherapy for mCRPC patients >75 years old were similar to those of 60-75 years old. Age should not be the absolute contraindication of docetaxel for prostate cancer chemotherapy.

Objective To study the elongation factor 1α(EF-1α) gene functions in prostate cancer cell line DU145 in the aspects of cell proliferation and clone formation by using the RNA interference technique. Methods DU145 cell lines were divided into control group, transfection control group transfected with scramble siRNA and experimental group transfected with EF-1α siRNA. After transfecting EF-1α siRNA into DU145 cell line, the down-regulation of EF-la expression in DU145 cell line was confirmed by Western blotting and immunofluorescence staining. Then, the cell proliferation and clone formation assays were carried on in these 3 groups of DU145 cells. Results Compared with controls, the specific down-regulation of EF-1α expression was achieved in experimental group only. Compared with control group, after the down-regualtion of EF-1α in DU145 cell line, the cell proliferation rate decreased from day 4 to day 7 after transfection by 45. 9%, 53. 5% , 35. 3% and 38. 1% , respectively(P<0. 05). The clone formation number in experimental group decreased by 67.0% (P<0. 01). Conclusions The down-regulation of EF-1α has a negative impact on prostate cancer cell proliferation and clone formation. EF-1α might be an appropiate targeting gene in prostate cancer targeting therapy.