Objective To investigate the therapeutic effect of post-traumatic complex posterior urethral stricture in the male patients.Methods Clinical data of 479 male patients with post-traumatic complex posterior urethral stricture were reviewed.One-stage resection of the stenosis and end-to-end anastomosis was performed in 422 patients and scrotal flap with blood pedicle posterior urethroplasty in 57.Results The mean operation time was 115 minutes(range,90-140 minutes).The mean blood loss was 225 ml(range,100-300 ml).No intraoperative blood transfusion was needed.The mean follow-up time was 15 months(range,12-24 months).Among the 422 patients performed end-to-end anastomosis,386 patients had good voiding and 36 had dysuria because of the formation of anastomotic stoma valve(21 patients)or stricture ring(15 patients).The problem was resolved by transurethral valve/stricture ring resection.Among 57 patients undergone posterior urethroplasty,45 patients had good voiding nine patients were found with anterior urethra-skin tube anastomotic stoma stricture,of which four patients were treated by urethral dilatation and five by endourethrotomy; three patients were found with posterior urethra-skin tube anastomotic stoma stricture,of which one patient was treated by urethral dilation and two by endourethrotomy.Conclusions One-stage resection of the stenosis and end-to-end anastomosis is the main treatment for post-traumatic complex posterior urethral stricture.If the condition of the patients does not allow the end-to-end anastomosis,posterior urethroplasty can be an alternative.

BACKGROUND: Muscarine receptor plays a key role in adjusting contraction of detrusor muscle cell, and M3R, isoforms of its receptor, can mediate contraction of detrusor muscle cell directly. Ca2+ is the direct factor in stimulating contraction of detrusor muscle cell. Of several 10 kinds of Ca2+conjugable receptors protein, Ca2+ conjugated with different receptor proteins can adjust various reactions.OBJECTIVE: To investigate the effect of Ca2+-calmodulin (Ca2+-CaM) on contraction of M3R-mediated detrusor muscle cell.DESIGN: Compared observation .on the basis of detrusor muscle cell.SETTING: Ourological Center of Southwest Hospital of the Third Military Medical University of Chinese PLA.MATERIALS: The experiment was completed at Central Laboratory of Southwest Hospital of the Third Military Medical University of Chinese PLA. Healthy Wistar rats were selected in this study.METHODS: The primary cultured detrusor muscle cells were divided into experimental group and control group. Cells were inoculated in 6-well plate, and 10-4 mmol/L carbachol and M2R antagonist were added to cells of the experimental group during 70% confluence to block M3R and M2R respectively. Ca2+ concentration and CaM activity were detected by Ca2+ test kit and CaM test kit respectively.MAIN OUTCOME MEASURES: Changes of [Ca2+]I concentration and CaM activity of cells in both groups.RESULTS: The mean channel fluorescence values (log) of [Ca2+]I and CaM were higher in the experimental group than those in the control group(3.26±0.38, 2.06±0.12; 2.87±0.34, 2.14±0.24, P ＜ 0.05).CONCLUSION: Results in this study suggest that Ca2+-CaM participates in adjusting contraction of M3R-mediated detrusor muscle cells through signal transduction.

BACKGROUND: Urinary incontinence can be divided into stress, urgent and mixed types, they can not be easily distinguished only basing on clinical experience, which often result in misdiagnose or improper treatment OBJECTIVE: To discuss the value of urodynamical inspection, especially stress leak point pressure (SLPP) determination in the diagnose of female stress urinary incontinence.DESIGN: Retrospective paralleled comparison observation.SETTING: Center of General Urology Department, Southern Hospital,Third Military Medical University of Chinese PLA PARTICIPANTS: Totally 120 female patients who received medical treatment in the uropoiesis surgical department of the Southwest hospital due to urinary incontinence between January 1996 and May 2002 were enrolled in this experiment.gle was determined and considered as normal if it was ＜100° and abnormal if ＞ 100°. Urethral tilt angle is judged as normal if ＜ 45° and abnormal if ＞45°; Urethrovesical junction (when static state) was judged as normal if not tion: including fulling urinary bladder pressure measurement, static urethral Cystourethrography classification standard: type Ⅰ refers to posterior urethrovesical angle vanished with urethral tilt angle＜45° and the biggest urethra closure pressure＞20 cmH2O; type Ⅱ: refers to posterior urethrovesical angle vanished with urethral tilt angle＞45° and the biggest urethra closure pressure＜20 cmH2O; type Ⅲ refers to normal posterior urethrovesical angle with urethral tilt angle＜45° and the biggest urethra closure pressure ＞20 cmH2O. SLPP classification standard: typeⅠ: SLPP ＞120 cmH2O; type Ⅱ: SLPP of 90- 120 cmH2O; type Ⅲ: SLPP ＜ 60 cmH2O;type Ⅱ/Ⅲ: SLPP of 60 - 90 cmH2O.compared with that of cystourethrographic classification.RESETS: Totally120 patients all remained in the final result analysis.stress urinary incontinence, 64 cases as symptomatic stress urinary incontinence including 28 cases of unstable bladder and 36 cases of low compliclassification: of the 56 genuine stress urinary incontinence, 20 cases were diagnosed as type Ⅰ; 16 cases as type Ⅱ and 10 cases as type Ⅱ/Ⅲ; 10cases as type Ⅲ. Two classification was proved of 100% consistency in type Ⅰ and Ⅲ, and 94.1% and 90.1% in type Ⅱ and type Ⅱ/Ⅲ respectively, difference was not remarkable (P＞0.05).CONCLUSION: SLPP determination can be used to make accurate classification of female genuine stress urinary incontinence, possessing important instructive significance for the treatment.

0.05), but changed to be significant after stimulation in the rats stimulated respectively with formalin and saline (P

Objective To explore the mechanism of the referred pains in pelvic pain due to chronic prostatitis and the relation between pain due to prostatitis and pelvic floor muscle dysfunction. Methods The retrograde fluorescent double labeling and immunohistochemistry were used. A total of 24 Wistar rats were divided two groups, 12 in each group. In the first group, Propidium Iodide(PI) was injected into the prostate, Bisbenzimide(Bb)into the external anal sphincter. In the second group, PI was injected into the prostate, Bb into genitofemoral, iliohypogastric, ilioinguinal, femoral and lateral femoral cutaneous nerves. Results The fluorescent double labeled cells were found in the L 1 L 2 and L 6～S 3 dorsal root ganglia(DRG) and some of them were confirmed to contain calcitonin gene related peptide(CGRP) and P substance (SP) by immunohistochemistry. Conclusion The findings confirm that the peripheral process of DRG cells dichotomizes into prostate, external anal sphincter and somatic parties, and some of these cells contain CGRP and SP, which indicates the referred pains in pelvic floor may be caused by axon reflex in the peripheral process of DRG cells. Meanwhile, neurogenic inflammation might play an important role in this persistent pain status. Pain due to prostatitis is correlated with pelvic floor muscle dysfunction.

Objective To establish a stable animal model of bladder outlet obstruction(BOO) and to clarify the effects of BOO on the biomechanical properties of detrusor and the mechanisms. Methods BOO animal model was established by partial ligation of the proximal urethra of male Wistar rats forming, a urethra stricture with internal diameter of 1 mm. The active contraction of detrusor muscle stripes to carbachol was recorded with transfusor and organ bath tube. The compliance and maximum volume of bladder were examined by filling cystometry. Results The bladders demonstrated tropical post obstruction alterations at week 2 after partial ligation of the proximal urethra. The maximum volume (3 3?1 9) ml and bladder wet weight (10 4?2 8) g increased significantly in BOO group as compared with those in sham operation group [(1 6?0 8)ml and (7 2?3 5)g]. The detrusor contractile force of detrusor instability(DI) group was significantly lower than that in the control group. However, the contractile force in detrusor stability (DS) group was higher at week 2 but lower at week 4 after BOO than that in the sham operation group. Conclusion BOO animal model established by partial ligation of the proximal urethra of adult rats is simple and can give high survival rate and good stability, suitable for the studies of bladder outlet obstruction. There are two types of the detrusor contraction after BOO: DI group with impaired contraction and DS group with bidirectional change which was higher at early stage(week 2) but lower at later stage(week 4). The changes of bladder compliance are related to the stability of bladder, decrease in DI but increase in DS.

Objective To provide experimental basis for further study of the mechanism of urinary storage dysfunction of diabetic cystopathy (DCP). Methods Steptozotocin(STZ) induced and sucrose induced diabetic rats were employed as DCP and diuresis models. Normal rats served as the control. The changes of calcitonin gene related peptide(CGRP) were analyzed by immunocytochemical method and computer assisted image analysis software. Compliance of the whole bladder prepared in vitro was evaluated by bladder irrigation. The messenger molecule cAMP of detrusor relaxation was determined by radioimmunological assay. Results Compared with those in other groups, the CGRP immunoreactive positive nerve fibers and content of this neurotransmitter significantly decreased in the bladder wall, especially in the submucosa. Significantly higher bladder compliance was observed( P

Objective To investigate the changes of urinary bladder structure and function of aging rats. Methods The aging group and the young adult group were composed of 24 month old rats and 6 month old rats, respectively. The urodynamic changes were studied with filling cystometry, structural changes by Masson stain and image analysis. Results Filling cystometry revealed that the maximum bladder capacity increased in the aging rats. No difference in leak point pressure was found in the two groups. The occurrence rate of the detrusor instability in aging group was higher than that in young adult group. In bladder structure, fibrous tissue increased significantly but smooth muscle decreased significantly in the detrusor of aging rats. Conclusion Aging may lead to changes of rat bladder structure and function, but its mechanism needs to be further studied.

Objective To study the neurogenic mechanism of urinary bladder dysfunction changes in the aged rats. Methods Wistar rats were divided into aged group (24 month old) and young adult group (6 month old, served as the control group). The reactivity of urinary detrusor strips in the two groups to different concentrations of carbachol, noradrenalin, isoproterenol, adenosine triphosphate (ATP) and atropin, was measured respectively using an in vitro tissue bath technique. Results Compared with the young adult rats, significantly increased relaxation response to high concentration of isoproterenol and contractile response to ATP were found in aged rats. No difference in responses to carbachol, atropin and noradrenalin was found in the aged rats. Conclusion The dysfunction in aging bladder may be related to the purinergic and ? adrenergic response modifications.

Objective To elucidate the neurological mechanism of the referred pains in pelvic floor associated with the prostate. Methods The rat prostate was electrically stimulated, then the elicited action potentials (AP) of the lumbar and sacral nerves and the compound muscle action potentials from the external sphincter muscle of anus were detected. Results Action potentials from the iliohypogastric, genitofemoral, lateral femoral cutaneous, femoral, sciatic nerves compound muscle action potentials (CMAP) from the anal external sphincter were recorded. Conclusion Electric stimulation of the prostate can induce action potentials of the lumbar and sacral efferent nerves through the spinal reflex, resulting in referred pains in the perineal and pelvic areas due to muscle contraction.