1.Effects of retropubic and obturator urethral suspension on postoperative maximum flow rate and residual urine volume
Qi WANG ; Hanwei KE ; Zehua DING ; Weiyu ZHANG ; Xiaopeng ZHANG ; Tao XU ; Kexin XU
Journal of Peking University(Health Sciences) 2025;57(4):717-720
Objective:To compare the changes of maximun flow rate and residual urine volume after tension-free vaginal tape(TVT)and trans-obturator tape(TOT)in the treatment of stress urinary incon-tinence in women.Methods:The clinical data of female patients with stress urinary incontinence who underwent transvaginal midsection tension-free urethral suspension in Peking University People's Hospital from January 2022 to January 2024 were retrospectively analyzed.All the patients were followed up 1 month,6 months and 12 months after surgery.Urodynamics were performed to evaluate urethral sphincter function before surgery.At the same time,B-ultrasonography was improved to determine the residual uri-nary volume of the bladder,and urgent incontinence,detrusor weakness and bladder outlet obstruction were excluded,and the diagnosis was clearly stress incontinence.Maximum flow rate and residual urinary volume were measured during follow-up,and combined with the urinary incontinence questionnaire of the International Urinary Incontinence Advisory Committee,the surgical effect was judged to be cured,im-proved or ineffective according to the degree of improvement of urinary leakage symptoms after surgery.Results:A total of 150 female patients with stress urinary incontinence were included in the study,the average age of the patients was(55.12±10.23)years old,and the follow-up time was 12 months.All patients completed postoperative follow-up,of whom 60 underwent TVT and 90 underwent TOT.The overall effective rates(cure+improvement)1,6,and 12 months after surgery in the TVT group were 93.3%(56/60),91.7%(55/60),and 91.7%(55/60),and those in the TOT group were 92.2%(83/90),90.0%(81/90),90.0%(81/90),respectively,and there was no statistical difference be-tween the two groups.The average maximum urinary flow rates 1,6,and 12 months after surgery in the TVT group were(17.21±4.22)mL/s,(18.05±5.33)mL/s,and(18.37±4.92)mL/s,and those in the TOT group were(18.21±5.32)mL/s,(19.05±4.33)mL/s,and(19.27±4.92)mL/s,re-spectively,and there was no statistical difference between the two groups.The mean residual urine volume 1,6,and 12 months after surgery in the TVT group was(13.21±5.22)mL,(18.25±5.33)mL,and(16.37±7.92)mL,and those in the TOT group was(11.21±6.32)mL,(13.05±5.33)mL,and(11.27±5.92)mL,respectively,and there was no statistical difference between the two groups.Compared with preoperative levels,there were no significant differences in the average maximum flow rate and the residual urine volume in both group at 1,6,and 12 months after surgery.Conclusion:Both TVT and TOT are effective in the treatment of stress incontinence,and have no effect on postopera-tive maximum flow rate and residual urine volume.
2.Effects of retropubic and obturator urethral suspension on postoperative maximum flow rate and residual urine volume
Qi WANG ; Hanwei KE ; Zehua DING ; Weiyu ZHANG ; Xiaopeng ZHANG ; Tao XU ; Kexin XU
Journal of Peking University(Health Sciences) 2025;57(4):717-720
Objective:To compare the changes of maximun flow rate and residual urine volume after tension-free vaginal tape(TVT)and trans-obturator tape(TOT)in the treatment of stress urinary incon-tinence in women.Methods:The clinical data of female patients with stress urinary incontinence who underwent transvaginal midsection tension-free urethral suspension in Peking University People's Hospital from January 2022 to January 2024 were retrospectively analyzed.All the patients were followed up 1 month,6 months and 12 months after surgery.Urodynamics were performed to evaluate urethral sphincter function before surgery.At the same time,B-ultrasonography was improved to determine the residual uri-nary volume of the bladder,and urgent incontinence,detrusor weakness and bladder outlet obstruction were excluded,and the diagnosis was clearly stress incontinence.Maximum flow rate and residual urinary volume were measured during follow-up,and combined with the urinary incontinence questionnaire of the International Urinary Incontinence Advisory Committee,the surgical effect was judged to be cured,im-proved or ineffective according to the degree of improvement of urinary leakage symptoms after surgery.Results:A total of 150 female patients with stress urinary incontinence were included in the study,the average age of the patients was(55.12±10.23)years old,and the follow-up time was 12 months.All patients completed postoperative follow-up,of whom 60 underwent TVT and 90 underwent TOT.The overall effective rates(cure+improvement)1,6,and 12 months after surgery in the TVT group were 93.3%(56/60),91.7%(55/60),and 91.7%(55/60),and those in the TOT group were 92.2%(83/90),90.0%(81/90),90.0%(81/90),respectively,and there was no statistical difference be-tween the two groups.The average maximum urinary flow rates 1,6,and 12 months after surgery in the TVT group were(17.21±4.22)mL/s,(18.05±5.33)mL/s,and(18.37±4.92)mL/s,and those in the TOT group were(18.21±5.32)mL/s,(19.05±4.33)mL/s,and(19.27±4.92)mL/s,re-spectively,and there was no statistical difference between the two groups.The mean residual urine volume 1,6,and 12 months after surgery in the TVT group was(13.21±5.22)mL,(18.25±5.33)mL,and(16.37±7.92)mL,and those in the TOT group was(11.21±6.32)mL,(13.05±5.33)mL,and(11.27±5.92)mL,respectively,and there was no statistical difference between the two groups.Compared with preoperative levels,there were no significant differences in the average maximum flow rate and the residual urine volume in both group at 1,6,and 12 months after surgery.Conclusion:Both TVT and TOT are effective in the treatment of stress incontinence,and have no effect on postopera-tive maximum flow rate and residual urine volume.
3.Optimization study of an animal model for interstitial cystitis/bladder pain syndrome based on the dose effect of cyclophosphamide
Hanwei KE ; Qi WANG ; Kexin XU
Journal of Peking University(Health Sciences) 2024;56(5):908-912
Objective:To evaluate the efficacy of cyclophosphamide(CYP)at different doses in repli-cating the symptoms of interstitial cystitis/bladder pain syndrome(IC/BPS)in an animal model,thereby providing an experimental basis for understanding the pathophysiology of IC/BPS and assessing treatment strategies.Methods:Twenty-eight female Sprague-Dawley rats aged seven weeks were divided into four groups:Group a(25 mg/kg CYP),group b(75 mg/kg CYP),group c(125 mg/kg CYP),and group d(a control group).The rats were injected intraperitoneally with either CYP or saline solution.Evalua-tions included urine spot tests,von Frey filament pain threshold tests,urodynamic examinations,and his-tological assessments.Results:The study found that the 25 mg/kg CYP dosage significantly outperformed higher doses in simulating bladder dysfunction and inflammatory responses while minimizing the impact on the rats'physiological functions.Specifically,urine spot area,group a showed a significant reduction in urine spot area compared with the control group(P<0.05),while groups b and c did not show signifi-cant differences.Pain threshold:The von Frey filament test indicated increased visceral pain in group a,aligning closely with IC/BPS patient symptoms,without a significant increase in urination frequency.Urodynamic assessments:Group a exhibited decreased bladder compliance and reduced maximum bladder capacity(P<0.05),with no significant differences in baseline bladder pressure and maximum detrusor pressure across all groups.Histological analysis:Hematoxylin-eosin(HE)staining revealed that bladder tissue in group a had moderate inflammatory reactions,whereas groups b and c showed severe inflamma-tion and tissue damage,correlating with the higher doses of CYP.Furthermore,the urine spot tests and von frey filament tests provided quantitative data supporting the model's reliability,urine spot count,group a had an average urine spot count of(15±3)spots,significantly higher than the control group's(5±2)spots(P<0.01).Nociceptive score:Group a nociceptive score increased to 0.5±0.1,indica-ting heightened pain sensitivity compared with the control group 0.10±0.05(P<0.01).Conclusion:The 25 mg/kg CYP demonstrated significant advantages in simulating the key features of non-ulcerative IC/BPS,summarizing the main aspects of the human condition,including persistent visceral pain and mild inflammatory reactions in bladder tissue.These findings offer substantial experimental support for drug development and treatment research in IC/BPS and provide new insights into the complex patho-physiology of the disease.
4.Achievement of satisfactory outcomes of benign prostatic hyperplasia surgery based on avoiding complications
Journal of Modern Urology 2023;28(1):10-14
The outcomes of surgical treatment of benign prostatic hyperplasia (BPH) has been verified as it causes few complications. However, if complications develop, they will have significant impacts on patients’ quality of life. Therefore, in order to provide individualized treatments, patients’ general condition, expectations of treatment, clinical symptoms, prostate volume, advantages and disadvantages of different operative methods and operators’ mastery of operative methods should be considered to reduce the incidence of postoperative complications such as stress incontinence, urethral stricture and bladder neck contracture. This article discusses the choices of surgical interventions of BPH from the perspective of surgical safety and reduction of complications so as to improve the satisfaction of patients.
5.Clinical features and optimal treatment of primary urethral carcinoma
Hanwei KE ; Lin ZHU ; Qi WANG ; Xiaopeng ZHANG ; Kexin XU
Journal of Modern Urology 2023;28(12):1013-1017
【Objective】 To explore the clinical features and treatment outcomes of female urethral carcinoma so as to improve the awareness and prognosis of this rare malignant disease. 【Methods】 Clinical data of 8 cases of female urethral carcinoma treated during Jan. 2012 to Dec.2022 at the Department of Urology of Peking University People’s Hospital were retrospectively analyzed. The patients underwent urodynamic tests, cystourethroscopy and pathological biopsy to confirm the diagnosis. Traditional radical surgery was performed in 5 cases, and radical surgery for lower urethral cancer with bladder preservation was performed in 3 cases. 【Results】 The patients aged 36 to 68 years, with a mean of 53.75 years. Urinary obstruction, lower urinary tract symptoms and urethral masses were common manifestations. Urodynamic tests indicated bladder outlet obstruction. After surgical treatment, radical surgery for lower urethral cancer with bladder preservation showed advantages over traditional radical surgery in terms of intraoperative bleeding, operation time and postoperative hospital stay. 【Conclusion】 Female primary urethral carcinoma is rare but invasive. Early diagnosis and radical surgery are crucial for improving the prognosis. Radical surgery for lower urethral cancer with bladder preservation has better treatment outcomes and postoperative quality of life compared to traditional radical surgery. For such patients, symptoms should be closely monitored and timely diagnosis and treatment should be performed.
6.Evaluating bladder function is important in prostatic hyperplasia surgery
Journal of Modern Urology 2023;28(3):183-185
Benign prostatic hyperplasia (BPH) may lead to benign prostatic obstruction (BPO), which may result in bladder dysfunction. Based on the urodynamic analysis of bladder function of 793 BPO patients, bladder function could be classified into 3 stages and 6 types. Detrusor overactivity with impaired contractility (DHIC) is the transitional period of bladder function from compensation to decompensation. The indications of surgical therapy of bladder outlet obstruction (BOO) in different guidelines do not consider the bladder function. This paper emphasizes the importance of bladder function in the surgical choices for BOO, in order to select targeted and individualized surgical methods, and discusses the choice of surgical treatment for BPO from the perspective of bladder function.

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