Journal Detail Information

1

Cite

Share

Management of renal calculi: retrograde ureteroscopic holminum laser versus percutaneous nephrolithotripsy

Sixing YANG ; Chao SONG ; Lingqi LIU ; Fan CHENG ; Tianpeng WU ; Huijun QIAN ; Xiaobin ZHANG

Chinese Journal of Urology.2013;34(9):666-669. doi:10.3760/cma.j.issn.1000-6702.2013.09.007

Objective To compare the therapeutic effect of retrograde ureteroscopic Ho:YAG laser lithotripsy (UHL) and percutaneous nephrolithotripsy (PCNL) in treating patients with renal calculi of ≤3 cm.Methods From Feb.2008 to Apr.2011,a total of 109 cases (117 renal calculi in total) treated by either PCNL (50) or UHL (67) were retrospectively analyzed.Operative time,stone free rate,postoperative hospital stay,hospitalization expenses and complications were compared in the 2 groups.Results The mean stone burden of the UHL group and PCNL group was 2.5 cm (1.5-3.0) cm and 2.4 cm (1.3-3.0) cm,respectively.There was no significant difference in two groups.In UHL group,operations were performed successfully in all 67 calculi,of whom,43 patients needed combination of flexible ureteroscopy to break the stone fragments falling into the renal calices.No serious complication was recorded except postoperative fever in 3 cases.In PCNL group,all patients had been successful operated.Postoperative fever occurred in 2 cases.Obvious intraoperative and postoperative haemorrhage appeared in 1 case,and cured by selective renal artery embolization.The operation time of the UHL group and PCNL group was (117.0±36.5) min and (90.0±18.3) min respectively,and had no significant difference in two groups (P＞0.05).The stone free rate of the UHL group and PCNL group was 94％ (63/67) and 92％ (46/50) respectively,and had no significant difference in two groups (P＞0.05).Hemoglobin decline of the UHL group and PCNL group was (0.3±0.1) g/L and (20.6±8.1) g/L,and had significant difference in two groups (P＜0.05).Postoperative hospital stay of the UHL group and PCNL group was (5.0±2.4) day and (7.0±3.7) day,and had statistical difference in two groups (P＜ 0.05).Hospitalization expenses of the UHL group and PCNL group was (15 477.0±754.3) RMB and (27 453.0± 1763.5) RMB,and had statistical difference in two groups (P＜0.05).Conclusions Although UHL and PCNL have similar curative effect in treating renal stones of less than 3 cm,UHL have the advantages of lcss trauma and complication,lower expenses and fewer hospital stay.In treating renal stones of smaller than 3 cm,especially in the contraindication of PCNL,UHL may be a better choice.

2

Cite

Share

Application of psychological evaluation in patients with interstitial cystitis/bladder pain syndrome

Fei YANG ; Hailun ZHAN ; Yangbai LU ; Jiefu HUANG ; Xiangfu ZHOU

Chinese Journal of Urology.2013;34(9):670-673. doi:10.3760/cma.j.issn.1000-6702.2013.09.008

Objective To explore the correlation between anxiety,depression and the symptoms of interstitial cystitis/bladder pain syndrome (IC/PBS) patients,improving the psychological knowledge of IC/PBS patients,providing theoretical basis for psychological intervention.Methods During November 2009 to October 2011,54 IC/PBS patients including 42 women and 12 men patients were treated,with mean age of (41.0±12.4) years and mean course of the disease of (63.0±59.2) months.O'Leary-Sant questionnaire was used for IC/PBS symptoms assessment,and Visual Analogue Scale (VAS) was used to evaluate pain associated with bladder,Self-rating Anxiety Scale (SAS) was used for anxiety assessment,and Beck Depression Inventory Ⅱ (BDI-Ⅱ) was used for depression assessment.The relationship between depression,anxiety and the symptoms of IC/PBS patients was evaluated.Results Of the 54 IC/PBS patients,mean ICSI score was (15.0±1.84) points,mean ICPI score was (8.0±2.6) points,mean O'Leary-Sant questionnaire score was (24.0±3.9) points,mean VAS score was (7.0± 1.0) points,mean anxiety score was (52.0± 7.2) points,with 35 cases (64.8％) suffering from anxiety symptoms.Mean depression symptoms score was (16.0±4.5) points,with 41 cases (75.9％) suffering from depressive symptoms.The degree of anxiety and depression were associated with education level,the sleep quality and monthly income of IC/PBS patients.Anxiety and depression had no definite correlation with marital status and working conditions.Anxiety and depression were closely related (proportion) with the symptoms (frequency,urgency,pain or discomfortrelated to bladder) of IC/PBS patients.Conclusions Anxiety and depression are common in patients with IC/PBS,and they are related to symptom severity.In order to improve the quality of life,much attention must be paid to psychological condition assessment and treatment of IC/PBS patients.

3

Cite

Share

Analysis of therapeutic methods of surgical treatment for urethrocutaneous fistulas after urethroplasty

Qiang FU ; Yuemin XU ; Sanbao JIN ; Yinglong SA ; Jiong ZHANG ; Hong XIE ; Renjie CUI

Chinese Journal of Urology.2013;34(9):691-693. doi:10.3760/cma.j.issn.1000-6702.2013.09.016

Objective To discuss the curative effect of different operative methods for the treatment of urethrocutaneous fistula (UCF) after urethroplasty.Methods Clinical data of 54 cases of UCF from January 2003 to July 2011 were collected.Simple suture,advancement skin flap,pedicle penile skin flap urethroplasty,tongue/buccal mucosa urethroplasty were performed according to the size,location,number and whether there was urethral stricture of UCF.The treatment effect was recored and analyzed.Results The success rate of UCF repair was 85％ (46/54).There were 4 patients cured after second surgery.The success rates of repair of UCF with simple suture,advancement skin flap,pedicle penile skin flap urethroplasty,tongue/buccal mucosa urethroplasty were 95％,76％,82％,and 83％,respectively.Postoperative recurrence was observed in 5 patients in 6 months after the surgery and 4 of them received the re-operation.Conclusion According to the principle and the individual circumstance,taking personalized operative methods may improve the success rate of the repair of all kinds of UCF.

4

Cite

Share

Association of sperm-nucleoprotein transition with sperm parameters and embryo development

Jiujia ZHENG ; Shiquan XIAO ; Xu YANG ; Na ZHOU ; Liya ZHANG ; Xuefeng HUANG

Chinese Journal of Urology.2013;34(9):694-698. doi:10.3760/cma.j.issn.1000-6702.2013.09.017

Objective To investigate the correlation between sperm-nucleporotein transition and sperm parameters and embryo development,also to evaluate the influence of pregnancy out comes of assisted reproductive technology (ART).Methods Sperm-nucleoprotein transition assay of a total of 676 patients underwent ART treatment were detected by aniline blue staining,and the correlation analysis between spermnucleoprotein transition and sperm parameters,DNA damage,acrosin activity,fertilization rate,cleavage rate,quality of early embryo development as well as blastocyst formation rate was performed.Results The sperm concentration,(a+b) ％ sperm,sperm count and acrosin activity was (66.5±4.6) × 109/L,(149.2±9.9)×109/L,(51.2±1.3)％ and (72.2±3.3) mU/106 sperm in abnormal group,and (91.9±2.7) ×109/L,(240.0±8.0) ×109/L,(57.3±0.8)％ and (85.7±1.9) mU/106 sperm in normal group,which reached significant difference (P＜0.01).DNA fragmentation index (DFI) was (17.3± 1.0)％ in abnormal group,which was significantly higher than (14.6±0.5)％ in normal group.The cleavage rate of 95.0％,D3/D5 high quality embryo rates of 34.2％ and 1.28％,D5 blastocyst formation rate and the total rate of blastocyst formation rate of 22.4％ and 38.6％ in abnormal group,which were significantly lower than that in normal group (96.9％,38.2％,2.70％,27.9％ and 46.4％) (P＜0.01).The rate of spontaneous abortion was 12.3％ in abnormal group,which was significantly higher than that in normal group (4.7％) (P＜0.01).However,there was no significant difference in biochemical pregnancy rate and ectopic pregnancy rate between the 2 groups (P＞0.05).Conclusions Sperm-nucleoprotein transition was positively related with sperm parameters,DNA damage,acrosin activity,and also has an adverse effect on embryo development and the outcomes of ART.It is suggested that the sperm-nucleoprotein transition should be detected before ART.

5

Cite

Share

Heterogenous acellular dermal matrix seeded with adipose derived stem cells for urethral reconstruction in a rabbit model

Bingwei HUANG ; Sen LI ; Xi YU ; Peng GE ; Jian LIN

Chinese Journal of Urology.2013;34(10):787-792. doi:10.3760/cma.j.issn.1000-6702.2013.10.017

Objective To assess the feasibility of heterogeneous acellular dermal matrix(ADM)seeded with adipose derived stem cells(ADSC)for urethroplasty in a rabbit model.Methods ADSC were isolated from a rabbit and expanded in vitro,then identified by flow cytometry.We seeded ADSC onto the ADM and made it into tissue-engineered urethra.12 male rabbits were removed 1 cm urethra and divided into experiment group and control group.There were 6 rabbits in each group.Reconstructed urethra with tissueengineered urethra was used in experiment group,while unseeded ADM were used in control group.Urethrography was performed at 6 months after surgery.The animals were scarified at 3 and 6 months after surgery and the repaired urethra were harvested.H&E staining and immunohistochemical staining were performed with cytokeratin AE1/AE3 and smooth muscle desmin makers.Results The morphology of isolated ADSC was with long spindle cross-links,and had multicentral growth.Flow cytometry showed that the ADSC expressed CD166,CD105,CD90 and CD44,but not expressed CD45 and CD13.The cells could growth well on the ADM and showed good biocompatibility with it.All animals could void normally,urethrography showed there was no significant stenosis.3 months after surgery,the experiment group appeared regenerated smooth muscle but not in the control group,both groups did not regenerate urothelium.At 6 months urothelium and smooth muscle cells could be observed in the experiment group,but only the smooth muscle was evident in the control group.Conclusions By applying tissue engineering methods,we can seed the ADSC onto the heterogeneous ADM and make it into tissue-engineered urethra,which can help improve the reconstructive effect of urethra.

6

Cite

Share

Experience in management of high-risk patients of benign prostatic hyperplasia treated with transurethral resection of prostate

Jingchao HAN ; Ming XIA ; Yan BAI ; Jiwei ZHANG ; Haitao WANG ; Qun HE

Chinese Journal of Urology.2013;34(11):843-846. doi:10.3760/cma.j.issn.1000-6702.2013.11.011

Objective To investigate the experience in management of the high risk benign prostatic hyperplasia (BPH) patients in order to improve the safety of the operation.Methods The high-risk factors of 115 patients with BPH who had been treated with transurethral resection of prostate (TURP) were analyzed.The blood pressure of hypertensive patients should be controlled below 140/90 mm Hg.The patients with myocardial infarction should be in stable condition for more than 6 months.Smoking cessation,oxygen inhalation,and pulmonary function training should be carried out during the perioperative period in patients with chronic obstructive pulmonary disease,correct expectoration methods and rational use of antibiotics were also needed to improve the maximum amount of pulmonary ventilation to more than 70％.The blood-glucose of diabetic patients should be controlled below 8 mmol/L by insulin.Catheter was indwelled in patients with chronic obstructive renal insufficiency for more than 2 weeks so that the blood Cr could be below 130 μmol/L.Anticoagulant therapy should stop at least 5 days before surgery.Patients were encouraged to have physical training early after surgery and to have ankle stretch movement when they recovered form anesthesia,and pressure cycle drive therapeutic apparatus were also used to prevent deep venous thrombosis.Results All the patients tolerated TURP safely.Operation time was 30 to 60 min,the weight of the resection prostate tissue was 12 to 37 g,blood loss was 80 to 150 ml,and catheterization time was 3 to 7 days.The overall incidence of complications was 1.7％.There were 2 cases with deep venous thrombosis,who recovered after anticoagulant therapy.There were no pulmonary infection,bleeding,TUR syndrome,and other complications.Conclusion Correct analysis and effective management of the perioperative risk factors in high-risk BPH patients treated with TURP can improve the safety of the operation and reduce the complications.

7

Cite

Share

Analysis of different bulbourethral sling procedurnges for treatment of male acquired urinary incontinence

Yuemin XU ; Baojun GU ; Hong XIE ; Zhangshun LIU ; Chao FENG ; Xiaofang FEI

Chinese Journal of Urology.2013;34(11):847-850. doi:10.3760/cma.j.issn.1000-6702.2013.11.013

Objective To explore the efficacy of different bulbourethral sling procedures in the treatment of male acquired urinary incontinence.Methods A retrospective study of 105 patients with acquired urinary incontinence was performed.The patients underwent 3 different bulbourethral sling procedures under urodynamic monitoring between October 2000 and June 2013.Mean age was 54 years (range 15-81).Urinary incontinence was secondary to post-prostatectomy in 70 patients and posterior urethroplasty in 35.Preoperatively,10 patients were completely urinary incontinence and 95 patients were stress urinary incontinence.Mean duration of urinary incontinence was 3 years (1-12).The surgical techniques were composite device suspension in 54 patients,pedicled rectus abdominalis muscle and fascial flaps suspension in 10 and transobturator sling in 41.Results The patients were followed up for 3-128 months (mean 54 months).The urethral catheter was left in situ for 5-7 days in 103 patients.Of the 103 patients,5 patients were difficulty in voiding but corrected by indwelling of urethral tube for another 1 week in 4 patients and transurethral bladder neck resecting in 1.In the remainder 2 patients,the maximum urethral pressure was 110 and 158 cm H2O (1 cm H2O=0.098 kPa) at the end of surgery and both patients were able to void on day 14 and 21 respectively and achieved complete continence.In this study,complete continence was achieved with good voiding in 74 patients (70.5％),completed control of urination rate was 81,4％ (57/70) in group of prostate and 48.6％ (17/35) in group of posterior urethroplasty.Twenty-six patients were improved and 5 patients were failed.Conclusion Bulbourethral sling procedure under urodynamic monitoring is an effective option in the treatment of male acquired urinary incontinence,especially for patients of incontinence of post-prostatectomy.

8

Cite

Share

Association between substance P and chronic prostatitis in rat model

Yang SU ; Chaozhao LIANG ; Song FAN ; Xiang FANG

Chinese Journal of Urology.2013;34(11):855-858. doi:10.3760/cma.j.issn.1000-6702.2013.11.015

Objective To explore the correlation between prostate neuroendocrine cells and chronic prostatitis via substance P (SP) detection.Methods Forty SPF-level SD male rats in two months old were randomized into two groups:the chronic prostatitis model group and the control group,20 in each.The model was induced by castration surgery under aseptic condition and post-castration injection of 17-β estrogen for 1 month duration.The control group was done by injection of 0.9％ NS without castration surgery.Making sure that the chronic prostatitis model was made successfully,then SP quantification in the 2 groups was analyzed via ELISA and immunohistochemical staining.Results The difference of SP in the 2 groups was significant (P =0.009) and SP was expressed highly in the model rats compared with controls.Conclusion The relationship between prostate neuroendocrine cells and chronic prostatitis is notable,maybe they participate in progress of chronic prostatitis.

9

Cite

Share

Analysis of the characteristics of minimal fat renal angiomyolipoma and clear cell renal carcinoma in high resolution multi-slice spiral CT

Qinqin KANG ; Chao MA ; Huojun ZHANG ; Chunshu PANG ; Tao SONG ; Le CHANG ; Jianping LU

Chinese Journal of Urology.2013;34(10):732-737. doi:10.3760/cma.j.issn.1000-6702.2013.10.003

Objective To investigate the characteristics of minimal fat renal angiomyolipoma (MFAML)and clear cell renal cell carcinoma(CCRCC)in high resolution multi-slice spiral CT(MSCT)and to improve the diagnosis accuracy for the renal tumors.Methods A retrospective analysis was performed on 24 MFAML patients(16 females,8 males)with mean age of 43(19-74)years and 24 CCRCC patients(16 females,8 males)with mean age of 44(21-76)years.All patients had undergone MSCT and proved histopathologically after surgery.The characteristics included tumor location,tumor attenuation on unenhanced CT,enhancement characteristics(degree of tumor enhancement in the early corticomedullary phase,homogeneity of enhancement,amount of enhancement,enhancement pattern over time),tumor margin,intratumoral calcification,and perinephric changes.The predictive value of each CT characteristic was determined by using multivariate logistic regression analysis.Results The tumor location in the kidney (upper pole:MFAML,6 cases,CCRCC,6 cases;middle:MFAML,7 cases,CCRCC,9 cases;lower pole:MFAML,11 cases,CCRCC,9 cases)and smooth tumor margin(MFAML,n=21;CCRCC,n=19)were not significantly different between MFAML patients and those with CCRCC,P＞0.05.Twenty-one cases of both MFAMLs and CCRCCs had the significant enhancement in the early corticomedullary phase,which were hypovascular tumors,whereas the mean amount of tumor enhancement was greater in CCRCC than in MFAML in both the early corticomedullary and the corticomedullary phases(CCRCC:175 HU,196 HU;MFAML:125 HU,145 HU;P＜0.05.MFAML usually showed homogeneous enhancement(n=15)rather than heterogeneous enhancement(n =9),whereas most CCRCC showed heterogeneous enhancement(n =17)rather than homogeneous enhancement(n =7),P＜0.05).Enhancement pattern was not a significant predictor.Within the 13 MFAML cases,8 cases had sufficient blood supply(6 cases showed obvious wash-in-and-wash-out,2 cases were with prolonged enhancement),5 cases with hypovascular showed a pattern of prolonged or gradual enhancement,while 21 CCRCC cases had sufficient blood supply and 71％ of them showed obvious wash-in-and-wash-out.High tumor attenuation on unenhanced scans(MFAML:17 patients (75％);CCRCC:2 patients(8％),P=0.002,OR=0.010)and threshold enhancement values of 129.5 HU in the corticomedullary phase(MFAML:5 patients(20％);CCRCC:20 patients(83％),P =0.004,OR =0.057)were valuable predictors for differentiating MFAML from CCRCC at multivariate logistic regression analysis.Conclusions MSCT is useful in differentiating MFAML from CCRCC,with high tumor attenuation on unenhanced scans and threshold enhancement values of 129.5 HU in the corticomedullary phase being the most valuable CT findings.75％ of MFAMLs with sufficient blood supply also show a pattern of wash-in-and-wash-out,which can easily misdiagnosed as a renal cancer.

10

Cite

Share

Preliminary study of testing circulating tumor cells in patients with renal cell carcinoma by Cell-search System

Yushi ZHANG ; Hanzhong LI ; Chun ZHOU

Chinese Journal of Urology.2013;34(10):738-741. doi:10.3760/cma.j.issn.1000-6702.2013.10.005

Objective To explore the feasibility and to improve the efficiency of testing circulating tumor cells(CTC)in patients with renal cell carcinoma by Cell-search System(CSS).Methods Eight patients with renal cell carcinoma hospitalized in the PUMC urology department for further clinical evaluation in Jan.to Jun.2012 were enrolled in this study.There were 5 males and 3 females with mean age of 64 (57-70)years.There were 2 cases in clinical stage T3N0M0 and 6 cases in T4N0M1;3 cases were treated with radical nephrectomy,5 cases were treated with targeted therapy drugs.7.5 ml peripheral blood samples from these patients were collected and saved in test tube at the temperature of 15 ℃-30 ℃.The tests had to be done within 96 hrs after the blood sample drawn.We selected fluorescent anti-CKS/18/19 antibodies as CTC makers for renal cell carcinoma.Then the number of CTC was quantitative detected by CSS.The feasibility and detection rate of testing CTC in patients with RCC by CSS was evaluated,and the improvement of method was discussed.Results Quantitative test results of CTC in 8 patients with renal cell carcinoma were negative.25 CK+CD45 + double positive cells were found in one T4N0M1 patient's peripheral blood.The detection rate of the CTC in TNM stage T3N0M0 and T4N0M1 renal cell carcinoma patients using CSS with epithelial tumor cell maker anti-CK8/18/19 was zero.Conclusions Anti-CK8/18/19 antibodies can not be used in testing circulating tumor cells in patients with renal cell carcinoma by Cell-search System.

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share