Objective:To evaluate the effect of transurethral resection of the prostate on nocturia and sleep quality in men with benign prostatic hyperplasia.Methods:This retrospective study included 122 patients who underwent TURP(transurethral resection of the prostate) for BPH(benign prostatic hyperplasia)from December 2016 to December 2018.The age was(69.7±7.9)years old. There was 20 cases with diabetes and 40 cases with hypertension. The preoperative mean prostate volume was (64.4±41.2)ml and mean BMI was (24.3±2.7)kg/m 2. The preoperative IPSS score was (20.5±5.5) points, the number of nocturia events(assessed by the seventh question of IPSS) was (4.4±1.9) times, hours of undisturbed sleep (HUS) was (1.7±1.0) h, 110 cases with HUS <3 h; nocturia quality-of-life questionnaire (N-QOL) was (24.9±6.3) points, quality of life (QOL) was (4.4±0.9) points. 111 patients had the urodynamic examination done. The maximum urine flow rate was (6.4±3.1) ml/s, the maximum bladder volume was (318.5±83.6) ml, the residual urine volume was (153.9±158.9) ml, and the maximum detrusor pressure was (78.4±35.5)cmH 2O.Detrusor muscle strength decreased in 27 cases, 18 cases had OAB, 9 cases of effective bladder capacity declined and 60 cases had bladder outlet obstruction. 42 cases had an effective bladder volume <200 ml, of which 33 had a maximum bladder capacity >200 ml with nocturia (4.5±1.9) times, 9 cases had a maximum bladder capacity ≤200 ml with nocturia (4.7±1.7) times. All 122 patients were treated with TURP. Result:122 patients were followed up for 3-20 months. After operation the number of nocturia significantly decreased to (1.9±1.23) times ( P<0.05), HUS significantly improved to(3.4±1.3) h ( P<0.05), and 91 cases had HUS ≥3 with 82.7% remission rate; N-QOL significantly improved to (37.3±6.7) points ( P<0.05), IPSS significantly decreased to (4.9±4.2) points ( P<0.05), and QOL significantly decreased (0.8±0.9) points ( P<0.05). 121 patients had nocturia ≥2 voids before surgery, and 96 patients had improved (≥50% reduction of nocturnal frequency). There were 68 patients with nocturia ≥2 voids after operation with total score of preoperative IPSS (21.8±5.3), and 54 patients with nocturia <2 voids with total score of preoperative IPSS (19.2±5.5)( P<0.05). Patients with a effective bladder capacity less than 200 ml were divided into a group with a maximum bladder volume ≤200 ml and a group with a maximum bladder capacity>200 ml. The nocturia did not improve significantly after surgery ( P>0.05) in the group with a maximum bladder volume ≤200 ml, and the nocturia in the group with a maximum bladder capacity >200 ml had significantly improvement ( P<0.05). The group with a maximum bladder capacity ≤200 ml had nocturia (3.4±1.5) times after surgery, which was no significant different from that before surgery ( P=0.12); nocturia (1.9±1.1) times after operation in the group with maximum bladder volume>200 ml, and there was significant difference compared with before surgery ( P<0.05). Conclusion:TURP can significantly prolong the HUS of BPH patients with nocturia, and improve the life and sleep quality of patients. TURP partly reduces the number of nocturia, but some patients still suffer from nocturia after operation. The high total score of IPSS before operation and the maximum bladder volume ≤200 ml are the risk factors for nocturia after operation.

Objective:To evaluate the efficacy and safety of disitamab vedotin combined with tislelizumab in the neoadjuvant treatment of bladder cancer.Methods:The clinical data of 16 bladder cancer patients who received neoadjuvant therapy with disitamab vedotin combined with tislelizumab from April 2022 to January 2023 at the First Hospital of Chongqing Medical University were retrospectively analyzed. There were 15 males and 1 female, aged (66.12±14.37) years old. The immunohistochemical staining of biopsy pathology showed that HER-2 (0), (+ ), (+ + ), and (+ + + ) were in 1, 6, 6, and 3 cases, respectively. Before neoadjuvant therapy, 5 cases were in T 2N 0M 0 stage, and 11 cases were in T 3N 0M 0 stage. Biopsy pathology showed 3 cases were low-grade uroepithelial carcinoma, and 13 cases were high-grade uroepithelial carcinoma. Neoadjuvant therapy regimens: Disitamab vedotin 120 mg, every 2 weeks for 1 cycle, a total of 4 cycles. Tislelizumab 200 mg, every 3 weeks for 1 cycle, a total of 3 cycles. Surgery was performed at 2-3 weeks after neoadjuvant therapy. The efficacy and adverse effects of neoadjuvant therapy were analyzed. Results:All 16 cases completed neoadjuvant therapy.Five cases achieved complete remission, 7 cases achieved partial remission, 3 cases had stable disease, and 1 case had disease progression.Twelve cases(75.0%) achieved objective remission, 15 cases (93.8%) had disease control, and 14 cases(87.5%) had a reduction in the target lesion from baseline. Complete remission was achieved in 2 (22.2%)of 9 HER-2-positive patients and and 3 (42.9%) of 7 HER-2-negative patients, respectively, and objective remission was achieved in 8 (88.9%) and 4 (57.1%). After neoadjuvant treatments, surgical treatments were refused in 6 cases, and bladder-preserving combination therapy was performed in 2 cases. Radical cystectomy were performed in 8 cases, with negative margins for surgical incision, of which 5 cases (62.5%) had postoperative pathologic stage