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 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 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 evaluate the clinical significance of tension-free vaginal tape(TVT) procedure in the treatment with elder female stress incontinence(SUI). Methods Six patients with proven SUI were undergone the TVT with SPRAC. Results Six patients were operated under low spinal anesthesia. Mean operation time was 31.6 minutes and the mean blood loss was 36.2 ml. Five patients were able to micturate spontaneously within 24 hours after operation. One patient with fatty and vaginal colpoptosis was in-dwelling catheter for one week. Patients were followed-up for 10-28 months. Five patients were completely cured and one patient was failed after operation three months. Two patients were de novo urgency. One patient complained of persistent suprapubic discomfort. Conclusions The tension-free vaginal tape operation is a safe and effective surgical procedure for the treatment of urinary stress incontinence with fatty vaginal colpoptosis in elderly females.

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 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 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 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.