Objective To search for new tumor markers from urine of bladder transitional cell carcinomas. Methods Urine samples from 61 bladder cancer patients who were histologically diagnosed and 53 healthy volunteers and 42 cases with other urogenital diseases were analyzed using surface-enhanced laser desorption/ionization time of flight mass spectrometry (SELDI-TOF-MS) IMAC-Cu-3 ProteinChip technology,which can specifically bind the metal-combining-proteins.Proteomic spectra were generated by mass spectrometry.A blinded test set was used to determine the sensitivity and specificity of the differentially expressed markers. Results Four differentialy expressed potential markers were identified.Their corresponding molecular weights were 3445,3703,3896 and 5932, respectively.The 3445 protein was identified as ?-defensin,with its sensitivity for diagnosing bladder cancer being 80% and specificity being 75%.The sensitivity of 3703 protein was 32%,while its specificity was 94%.97% of the patients who were positive for 3703 protein were with high grade and invasive bladder cancer.The sensitivity for 3896 and 5932 proteins were 78% and 55%;the specificity for them were 40% and 35%,respectively. Conclusions SELDI-TOF-MS ProteinChip technology is a quick,easy and practical,high throughput analytic method.It can screen out several relatively specific,potential markers from urine of bladder cancer patients,so it has better clinical feasibility.

Objective To discuss the pathological and clinical features, diagnosis and treatment of prostatic duct adenocareinoma. Methods The clinical data of nine cases of prostatic duct adeno-carcinoma were retrospectively analyzed, with the average age of 76 (59-106) years. Six cases were presented with dysuresia and/or nocturia, and two of them had the painless gross hematuria. Two pa-tients presented painless gross hematuria as the first symptom. One case was detected the elevated ser-um PSA in a routine healthy examination. Radical prostatectomy (RP) was performed in 1 case;RP and bilateral orchidectomy and external beam radiotherapy (EBRT) were performed in 1 case;5 cases underwent transurethral resection of the prostate (TURP) combined with photoselective vaporization of the prostate (PVP) by green laser and bilateral orchidectomy;1 case underwent TURP combined with PVP;1 case underwent bilateral orchidectomy combined with EBRT. Eight cases took flutamide for 3-45 months. All patients were followed-up according to the scheduled time. Results The op-erations were successfully performed in all 9 patients. The papillary or cauliflower-like tumors infiltra-ted colli culus seminalis and prostate duct nearby. The glands were coated with tall pseudostratified columnar cells. The nuclei were large, dark stained with more frequent mitoses. The positive rates of immunolabelling antibody PSA, AR, PAP were found to be 89%(8/9), 100%(5/5), 100%(5/5) re-spectively. The distribution of Gleason score was 6-7(3 cases), and≥8(6 cases), and a coexisting acinar carcinoma component was identified in 5 cases of the group. Nine cases had a mean follow up for 20(3-48) months. Five cases have developed biochemical recurrence, of whom 3 died of bone metas-tasis and multiple organ failure, and 1 developed lung and bone metastasis. Three cases remained alive without recurrence. The remaining 1 case survives during the follow-up survey for 6 months until now, without examinations due to the old age. Conclusions Duct adenocarcinoma of the prostate presents the low incidence and lacks of typical symptoms in the early stage. Diagnosis was confirmed mainly on the basis of pathology. The tumors tend to have a more advanced stage and a very short term survival rate. The treatment options and management are similar to that of high-grade adenocar-cinoma of the prostate;meanwhile, close follow-up survey should be performed.

tionale and effective surgical approach, and technique.

Objective To discuss the clinicopathologic features, diagnosis and treatment of pri-mary prostatic signet ring cell carcinoma (PPSRCC). Methods Clinical data of 23 PPSRCC cases were retrospectively reviewed. The mean age was 74 years and majority of them had aggravated dysu-ria. The mean serum PSA was 45.3 ng/ml (7.4-126.8 ng/ml). To exclude the metastasis from stomach and colon SRCC, upper gastric tract endoscopy and barium enema were carried out. Seven pa-tients received radical prostatectomies and 2 patients who had positive margins received hormonal and radiation therapy. The rest of patients received maximal androgen blockade therapy. Photoselective vaporization of the prostate was performed on 11 patients who had lower urinary tract symptoms. All cases were investigated by routine pathological, immunohistochemical studies. Results Seventeen cases of PPSRCC were associated with concurrent high-grade prostatic carcinoma, only 6 cases were pure SRCC. Immunohistochemical stains were positive in all cases for PSA and PAP. Stains were ne-gative for AB/PAS (23/23) and CEA (21/23). The clinical TNM stages were 7 of Ⅱ , 10 of Ⅲ and 6 of Ⅳ. Follow-up was available on 20 cases with a mean 24 months and 3 cases were lost during follow up. Eight cases died of metastasis. Five cases had evidence of recurrence 12-21 months from presen-tation. Conclusions The diagnosis of PPSRCC depends on pathological and immunohistochemical studys after metastasis from stomach and colon SRCC is excluded. Early diagnosis and combination treatment for PPSRCC might improve its prognosis.

Objective To examine the feasibility of using the serous-lined tunnel technique for orthotopic neobladder, continent cutaneous diversion and ureteral replacement by the intestinal segment. Methods In 31 patients of orthotopic ileal neobladder, the serous-lined tunnel techniques were used for antirefluxing ureteral implantation: In 13 patients of continent ileal pouch, the techniques were adopted for continent-valve construction and for uretersl implantation: In 3 patients (with lower ureteric cancer), the same techniques were applied for constructing the ileal ureters with a proximal antirefluxing mechanism. Results With a mean follow-up of 27 mon( 12-132 mon), 88 ureters implanted into ileal neobladders or continent pouches functioned well with neither obstruction nor reflux: 12 in 13 continent valves functioned well with no incontinence. 3 patients with ileal ureters showed no ileo-ureteric reflux and had reduced hydronephrosis comparing to that of before surgery.Conclusions Ureteral reimplantation and continent valve formation achieved by adopting the serouslined tunnel technique provide satisfactory results. The versatility of the technique is obvious in the present experience and the creative application of the serous-lined tunnel technique should be possible in urinary reconstruction.

This study aims to investigate the effect of non-transecting anastomotic urethroplasty for treatment of posterior urethral stricture.A total of 23 patients with traumatic posterior urethral stricture were enrolled and then divided into two groups.In one group,12 patients underwent non-transecting anastomotic urethroplasty.In the other group,11 patients underwent conventional posterior urethra end-to-end anastomosis.The effect of operation was evaluated using the following parameters:the bleeding amount during operation,operation time,IIEF-5 scores after operation,maximum flow rate (Qmax),and rating scale of quality of life (QoL).The comparison between the conventional posterior urethra end-to-end anastomosis group and the non-transecting anastomotic urethroplasty group showed no significant difference with regard to average operation time.However,a significant difference was observed between the groups with regard to the bleeding amount during operation.The patients in the group of non-transecting anastomotic urethroplasty urinated smoothly after the removal of catheter.Meanwhile,one patient from the group of conventional posterior urethra end-to-end anastomosis had difficulty urinating after the removal of catheter.Furthermore,significant differences in the operation time,bleeding amount during operation,IIEF-5 scores after operation,and rating scale of QoL were observed,whereas no significant difference was observed between urine flow rates of the two groups after operation.Overall,nontransecting anastomotic urethroplasty is effective for posterior urethra reconstruction,and it can reduce the occurrence rate of erectile dysfunction after operation.

Objective:To investigate the effect of modified transanal approach in the repair of vesicorectal fistula after radical prostatectomy.Methods:From September 2011 to December 2019, 32 cases of vesicorectal fistula after radical prostatectomy were retrospectively analyzed. All patients underwent cystostomy before repair operation. The average diameter of the fistulas was 19 (3-40) mm. There was only one fistula in 24 cases and 8 cases with more than 2 fistulas. The operation was performed in the jack knife position, and the fistula was prepared by resection of the fistula through the anus with bipolar resectoscope. Then bladder wall and rectum wall were separated by the loop and sutured respectively. After operation, the patients were treated with antispasmodic and anti-infective treatment, and the catheter was retained. Cystography and cystoscopy were reexamined 3 months after operation. Catheter was removed in the successful cases, and the failure was repaired again.Results:All operations were completed successfully. The mean operation time was 67(55-125) min, and the median follow-up was 22 (6-30) months. Thirty-one cases (96.8%) were successfully repaired, of which 25 cases were successfully repaired at the first operation, and 6 cases were successfully repaired again (all by transanal route). One case failed to be repaired. He had received external pelvic radiotherapy before operation. After the failure of repair, cystoscopy showed large fistula and stiff surrounding tissue. Then bilateral ureteral skin stoma and cystectomy were performed.Conclusions:Modified transanal approach in the repair of vesicorectal fistula after radical prostatectomy is an effective method. This kind of operation has less trauma, fewer complications and can be operated repeatedly. It is suitable for patients with low position, small fistula and without radiotherapy.

OBJECTIVETo explore whether bulbourethral suspension procedure is effective for the treatment of male urinary incontinence of post-prostatectomy and posterior urethroplasty.

METHODSTwelve male patients with urinary incontinence undergone bulbourethral suspensive operation were reviewed and analyzed with regard to the operation method, postoperative urinary dynamics and clinical results.

RESULTSTen patients resumed complete control of urination and 1 was improved. In one patient, postoperative difficulty occurred in voiding but corrected by transurethral bladder neck revision for free passage of urine and continence. Urodynamic study showed that the maximum urethral pressure ranged from 85 to 115 cm H(2)O (mean 98 cm H(2)O, 1 cm H(2)O = 0.098 kPa). The functional urethral length ranged from 3.5 to 4.5 cm (mean 3.75 cm).

CONCLUSIONBulbourethral suspension procedure is effective in the treatment of male urinary incontinence after prostatectomy and posterior urethroplasty.

Adult ; Aged ; Humans ; Male ; Middle Aged ; Prostatectomy ; adverse effects ; Suture Techniques ; Urethra ; surgery ; Urinary Incontinence ; etiology ; surgery

OBJECTIVETo investigate the possibility of urethral reconstruction with colonic mucosa for the treatment of complex longer urethral stricture (>/= 10 cm).

METHODSFrom October 2000 to September 2001, 6 patients with complex longer urethral stricture were treated with colonic mucosal graft urethroplasty. They had under gone 3 previous unsuccessful urethral repairs on average. Urethral reconstruction with a free graft of colonic mucosa ranged from 10 to 15 cm (mean 12.17 cm). Follow-up included retrograde urethrography, urethroscopy, and uroflowmetry.

RESULTSThe patients were followed up 3 - 14 months postoperatively (mean 7.8 months). Meatal stenosis developed in one patient 3 months after operation needed reoperation. The patient voided very well with urinary peak flow 28.7 ml per second duing follow-up for 12 months postoperatively. The other patients voided well with urinary peak flow greater than 15 ml per second. At urethroscopy, colonic mucosa was macroscopically difficult to distinguish from normal original urethral mucosa in 4 patients over 6 months after the operation.

CONCLUSIONSColonic mucosa graft urethroplasty is feasible for the treatment of complex longer anterior urethral stricture. The technique is useful for urethral reconstruction when penial skin and bladder mucosa are not available.

Colon ; Humans ; Intestinal Mucosa ; Treatment Outcome ; Urethra ; Urethral Stricture ; Urologic Surgical Procedures, Male

Objective:To evaluate the effects of vitamin D supplement on the mortality and incidence rate of adverse events of prostate cancer.Methods:Date from PubMed,The Cochrane Library,CNKI,Wanfang Data and VIP database during the date of database establishment and April 2014 were searched online,while relevant journals were searched manually,for all rando-mized controlled trials (RCTs)of comparison between vitamin D and placebo in the treatment of prostate cancer.The data ex-traction and quality assessment were conducted according to inclusion and exclusion criteria by two reviewers independently with RevMan5.2.Results:A total of 3 RCTs involving 2243 cases met the inclusion criteria.Vitamin D could reduce the mor-tality of prostate cancer[OR=0.23,95%CI:0.1 8-0.29],as meta-analysis demonstrated.There was no report on adverse e-vents.Conclusions:Vitamin D could reduce the mortality of prostate cancer.However,the analysis is secondary study,of which the included literatures differ in quality,and there may be bias in analytical process.Thus,basic and clinical researches with large-scale and high-quality should be performed to confirm the above conclusion.