Objective To present 8 cases of retroperitoneal laparoscopic pyelolithotomy or ureterolithotomy for the treatment of pelvis and ureteral stone. Methods 8 cases of pelvis or ureteral stone have been treated by retroperitoneal laparoscopic pyelolithotomy or ureterolithotomy. The size of the calculi was 0.8～2.4 cm with the incarceration time of 3 months～2 years.Details of the procedure were presented. Results Success has been achieved in all the patients and no complication has been observed during the 3～6 months of follow up. Conclusions Retroperitoneal laparoscopic pyelolithotomy or ureterolithotomy for the treatment of pelvis or ureteral stone is simple ,safe,less traumatic and effective.

Objective To evaluate the preoperative diagnosis of ureteral carcinoma.Methods The clinical features and selection of imaging and endoscope in 32 ureteral carcinoma patients were analyzed.Results The common symptom was hematuria.32 cases were confirmed by pathological examination as ureteral carcinoma and the diagnostic corresponding rate was 100% by color doppler and endoscopic technique.Conclusion Imaging and endoscopic examination are very important in hematuria patients without unknown reasons.Ureteral carcinoma should be considered when B mode ultrasound and venous urography show hydronephrosis and no development.Retrograde ureteropyelography and ureteroscopy are the most important diagnostic methods among various examinations.

Objective To investigate the effect of cytokine-induced kill cells( CIK)of the cord blood on bladder transitional cell carcinoma T24 in vitro. Methods The cord blood mononuclear cells( CBMC)were induced with different cytokines such as Interleukin 2( IL-2 ),interferon γ( IFN-γ),CD3Mc-Ab into CIK cells. The proliferation ability of CIK cells was measured by calculation in different culturing time,and the phenotype of CIK cells was analyzed by the flow cytometry. Bladder transitional cell carcinoma T24 cells were mixed with CIK cells to detect the mortality of the cancer cells with CCK-8 method in vitro. Results With the cultured time of CIK cells prolong,both the number and killing activity increased. the ratio of CIK cells and T24 cells were 1:2. 5,1:5,1:10 and 1:20 when the kill rate of T24 cells by CIK cells were(18. 98 ± 2. 61)%, (35. 59 ± 4. 74)%,(45. 34 ± 5. 03)% and(69. 24 ± 5. 19)%. Conclusion The CIK cells of the cord blood is proved to be with strong anti-cancer activity against T24 cells in vitro.

Objective To evaluate the clinical and pathological characteristics and treatment of small cell carcinoma of the prostate. Methods Two patients with small cell carcinoma of the prostate were reported. Case 1 was 50 year-old. He was admitted with a history of dysuria and perineal pain for 3 months. Digital rectal examination (DRE) showed that the enlarged prostate was 5. 0 cm?6. 0 cm and palpated hard and rough. Low-echo mass was shown on ultrasonography, and heterogeneous density of the prostate on CT. His serum PSA level was 0. 31 ng/ml,and fPSA level was 0.09 ng/ml. Prostate cancer was suspected by biopsy,and radical prostatectomy was performed. Case 2 was 82 year-old. The complaints consisted of dysuria and intermittent gross hematuria for 4 months. The enlarged prostate was 4. 0 cm?5. 0 cm and palpated hard and rough with multiple nodes by DRE. Low-echo mass was shown on ultrasonography, and heterogeneous density of the prostate and involvement of seminal vesicle and bladder neck on CT. His serum PSA level was 2.61 ng/ml,and fPSA level was 0.05 ng/ml. Prostate carcinoma was indicated by biopsy, and orchiectomy plus TURP was performed. Results The diagnosis of small cell carcinoma of the 2 cases were confirmed by postoperative pathology. Microscopically, the tumor cells were arranged in solid-sheet and nest structures, showing the histologic type of diffuse infiltrative carcinoma. Coagulated necrosis could be found easily. Small round or oval cells resembling lymphocytes or oat cells were the main constituents of the tumor. The nuclei were extremely hyperchromatic and scanty. The seminal vesicle and bladder neck had tumor infiltration. The immunohistochemical staining results were negative for LCA,L-26 and 34?E12,but positive for PSA,AE1/ AE3 and AR ,and suspected positive for CgA and S-100. Case 1 died of extensive lung metastasis 1 month after operation. Case 2 had retroperitoneal metastasis of the tumor 3 months after operation, and has been followed till now. Conclusions Small cell cancer of the prostate is rare but can be diagnosed properly based on clinical and pathological features. Radical prostatectomy combined with hormone and chemotherapy is reliable treatment for early stage cancer; but for late stage cancer, there is no effective treatment and the prognosis is poor.

Objective To investigate the clinical effect of elastics drawing off balloon catheter for 24 hours on preventing bleeding after transurethral plasmakinetic resection of prostate (TUPKRP).Methods Seven hundred patients with benign prostatic hyperplasia (BPH) underwent TUPKRP in the Eighth People's Hospital of Shanghai from Jan.2005 to Jun.2013 were randomly divided into control group (298 cases) and experiment group (402 cases).Patients in control group after transurethral resection of the bladder were given treatment as follow:the bladder was placed with F22 cavity catheter,which were fixed on the medial femoral traction;prostate wound edge was pressed for 2-3 d and saline continuous irrigated bladder for avoiding infection.Patients in experiment group were given the same treatment with control group beside prostate wound pressed for 24 h.The days (1st,3rd,5th) of bleeding after operation,cases of hematuria turn clear,cases of postoperative blood transfusion and operation bleeding were recorded.Results Cases of hematuria disappeared postoperation at 1 st,3rd,5th days after operation were 52,42,24 cases in control group and 34,22,10 cases in experiment group.The differences were significant(x2 =6.608,9.279,7.624 ;P =0.010,0.002,0.006).Cases of blood transfusion and reoperation in experiment group were 6 and 2 cases,lower than that in control group(15,9 cases ; x2 =4.955,5.264 ; P =0.026,0.022).Conclusion The method of elastics drawing off balloon catheter for 24 hours improved the effect of preventing bleeding after TUPKRP.

Objective To study the influence of post-void residual volume on prostate specific antigen (PSA) in patients with benign prostatic hyperplasia (BPH).Methods One hundred and sixty BPH patients who diagnosed by postoperative pathologic manifestations were selected.The patients were divided into 4 groups according to post-void residual volume with 40 cases each:non post-void residual volume (post-void residual volume ＜ 60 ml) group,less post-void residual volume (60 ml≤post-void residual volume ＜ 120 ml) group,middle post-void residual volume (120 ml ≤post-void residual volume ＜ 180 ml) group,mass post-void residual volume (post-void residual volume ≥180 ml) group.The serum PSA levels of 4 groups were observed.Results The PSA level in mass post-void residual volume group [(8.52 ± 6.72) iμ g/L] was significantly higher than that in non post-void residual volume group [(5.26 ± 4.16) μ g/L] and less post-void residual volume group [(5.93 ± 5.20) μ g/L],there were statistical differences (P ＜ 0.05),there was no statistical difference between non post-void residual volume group and less post-void residual volume group (P ＞ 0.05).Conclusions The serum PSA level in BPH patients with non post-void residual volume has no change,while the serum PSA level in BPH patients with mass post-void residual volume is significantly elevated.

Objective To explore the significance of urodynamics detection in benign prostatic hyperplasia (BPH) patients with cerebral vascular accident. Methods The results of urodynamics were detected in 60 BPH patients with cerebral vascular accident (research group) and 60 simple BPH patients (control group), and the results were compared. Results The levels of bladder compliance (BC), maximum bladder capacity (MCC), maximum urinary flow rate (Qmax), detrusor pressure before voiding (Pdet), maximal urethral closure pressure (MUCP), functional urethral length (FUL) in research group were significantly lower than those in control group:(25.0 ± 4.4)ml/cmH2O (1 cmH2O=0.098 kPa) vs. (34.0 ± 5.9) ml/cmH2O, (203.0 ± 16.8) ml vs. (256.0 ± 20.3) ml, (6.70 ± 0.25) ml/s vs. (11.10 ± 0.43) ml/s, (81.0 ± 13.6) cmH2O vs. (108.0 ± 20.2) cmH2O, (60.0 ± 9.8) cmH2O vs. (88.0 ± 12.2) cmH2O, (3.0 ± 0.5) cm vs. (5.2 ± 0.8) cm, P < 0.05. The level of postvoid residual volume (PRV) in research group was significantly higher than that in control group:(83.0 ± 9.4) ml vs. (48.0 ± 8.3) ml, P<0.05. The rate of low compliance bladder and unstable bladder in research group were significantly higher than that in control group:63.3%(38/60) vs. 25.0%(15/60), 66.7%(40/60) vs. 28.3%(17/60), P<0.01. Conclusions Cerebral vascular accident can increase the bladder dysfunction of patients with BPH .

Objective To investigate the minimal invasive management of cystitis glandularis with invasion of the ureteric meatus.Methods The clinical data of 18 cases were reviewed.Among the 18 cystitis glandularis patients,12 cases were invasion of bilateral ureteric meatus and 6 of unilateral ureteric meatus.Operation or drug treatment was performed on the diseases that can cause cystitis glandularis such as bladder stone,bladder neck stegnosis,external urethral meatus stegnosis and benign prostate hyperplasia.Sensitive antibiotic was administrated in all cases.After placing ureter catheter,transurethral plasma electro-resection was carried out in five patients whose ureteric meatus could be identified.In addition,of thirteen patients with ureteral orifice unable to be identified,there were ten cases with normal renal function,mitomycin was injected under affected membrana mucosa,and then the patient with ureteral orifice identified underwent transurethral plasma electro-resection after placing ureter catheter.On the other hand,the patient whose ureteral orifice still could not be recognized undertaken transurethral electro-resection at first,during which the ureter catheter was put once ureteral orifice had been detected,otherwise,the ureter catheter should be placed through cystoscope if nephritic colic emerged and hydronephrosis aggravated after operation.In those patients with kidney dysfunction,the ureter catheter was put by ureter discission or ureter replantation at first,the transurethral electro-resection could not be executed until the renal function recovered.Following all these procedure above,bladder instillation of drugs regularly,anti-infection and symptomatic treatment were administrated.Results One patient combined with bladder adenocarcinoma received cystectomy,of the other patients,six cases recurred and underwent electrotomy again resulting in no relapse.All nephrohydrops vanished or relieved obviously,nevertheless,urinary tract infection,haematuria and bladder-ureter backstreaming as the cardinal complication developed in some cases.Conclusion In the management of cystitis glandularis encroaching ureteric meatus,total or partial cystectomy can be avoided if ureter draining freely can be ensured,motivation removal,antiinfection,injection of drug under mucosa and preoperative diuresis conduce to the achievement of ureter catheter placing,transurethral plasma electro-resection is still effective methods in treating these cystitis glandularis.

Objective To investigate the expression of adamalysin-12 (ADAM-12) and PCNA in human bladder carcinoma and to investigate their correlation with different grades and stages of bladder cancer.Methods Biopsies of 15 normal bladder and 43 bladder tumors were analyzed.Immunohistochemistry was conducted to detect the expression of ADAM12 and PCNA in the biopsies.Results Postive expression signals of ADAM12 were detected significantly higher in the bladder cancer biopsies than that in the normal ones (P = 0.010).Those with lower histological grade had a higher expression level of ADAM-12 compared to the higher histological grades (P ＜0.001 ).Positive expression signals of PCNA were detected significantly higher in the bladder cancer biopsies than that in the normal ones (P = 0.026).Those with lower histological grade had a higher expression level of PCNA (P =0.014).There was a positive correlation between the expression of ADAM-12 and PCNA in bladder cancer (r =0.997,P ＜ 0.001 ).Conclusions The overexpression of ADAM-12 and PCNA in the biopsies of bladder tumors shows that protein expression of ADAM-12 and PCNA correlated with tumor stage and grade.Furthermore,ADAM-12 may be a promising biomarker of bladder cancer in the clinical implication.

Objective To investigate the expression of a dismtegnn and metalloproteinase-12 (ADAM12) and proliferating cell nuclear antigen (PCNA) in human bladder carcinoma,and to explore their correlation with different grades and stages of bladder cancer.Methods Biopsies of 12 normal bladder and 43 bladder tumors were performed.And immunohistochemistry was conducted to detect the expression of ADAM12 and PCNA in the biopsies.Results Positive expression signals of ADAM12 were detected significantly higher inthe bladder cancer biopsies than that in the normal ones (Z =4.879,P ＜ 0.05),and the expression level of ADAM-12 in lower histological grade was significantly higher than that in the moderate and higher histological grades (x2 =22.3685,P ＜ 0.01).Positive expression signals of PCNA were detected significantly higher in the bladder cancer biopsies than that in the normal ones (Z =4.879,P ＜ 0.05)).Those with lower histological grade had a higher expression level of PCNA when compared with the moderate and higher histological grades (x2 =10.665,P =0.0137).The expression of ADAM-12 was positively correlated with PCNA in bladder cancer (r =1.000,P ＜ 0.0001).Conclusion The over expression of ADAM12 and PCNA maybe play an important role in development of the bladder tumors.And ADAM12 may be a promising biomarker of bladder cancer in the clinical behavior.