Objective To compare the effectiveness and safety of transurethral plasma kinetic enucleation of the prostate (TPKEP) and transurethral resection of the plasma (TURP) in patients with benign prostate hyperplasia (BPH) on the basis of bipolar plasma kinetic technology. Methods Eighty BPH patients who met the included criteria were assigned to two groups according to block balanced randomization, of which, 40 received TPKEP and the others received PKRP. We conducted statistical analysis after recording the clinical outcomes including international prostate symptom score (IPSS), quality of life (QOL), maximum flow (Qmax), post void residual urine volume (PVR), rates of prostate coated perforation, blood loss in the operation, duration of operation, time of bladder irrigation, duration of indwelling catheter, post-operative adverse effects, etc. Results The two groups were consistent at baseline before operation. The results of the analysis of clinical outcomes showed that, the TPKEP group was superior to the TURP group in prostate coated perforation (2 cases vs. 8 cases), hemoglobin in flushing fluid (index of blood loss, 10.95±5.02 g vs. 15.8±5.86 g), duration of operation (45.13±11.22 min vs. 53.33±8.69 min), time of bladder irrigation (12.58±2.77 h vs. 22.1±2.33 h), duration of indwelling catheter (65.13±10.67 h vs. 84.5±5.67 h), post-operative irritation sign of the bladder and urethra (5 cases vs. 12 cases), and the event of indwelling catheter after removal (0 cases vs. 4 cases), with significant differences; however, the TPKEP group was higher than the TURP group in the incidence of transient uracratia (10 cases vs. 3 cases), with a significant difference. The results of a 6-month follow-up showed that, no significant difference was found between the two groups in IPSS (2.78±1.03 vs. 2.40±1.13), QOL (1.28±0.45 vs. 1.45±0.51), Qmax (21.10±2.68 vs. 20.58±2.57), and PVR (2.82±2.90 vs. 2.18±2.27), respectively (Pgt;0.05). Long-term uracratia, urethrostenosis and secondary bleeding were not observed after operation in both groups. Conclusions TPKEP and TURP were alike in the short-term effectiveness of operation. TPKEP is safer than the TURP, which is regarded as a fairly ideal method for treating symptomatic BPH. However, the long-term effectiveness of TPKEP is yet to be further proved by large-scale randomized controlled trials with long-term follow-up.
Objective To assess the effectiveness and safety of YunNan BaiYao capsules in reducing bleeding quantity during TURP. Methods A double-blind randomized controlled trial was conducted. We randomly allocated 40 patients to the treatment group （ YunNan BaiYao 0.25 g capsule, 2 capsules, q. i. d. , n = 20 ） and the control group （starch capsule, 2 capsules, q. i. d. , n =20）. Patients in both groups were administered three days before operation. Average bleeding quantity, bleeding index of prostate, bleeding intension, length of stay, catheter retention time, and time of washing bladder were observed and compared. Results The average bleeding quantity, bleeding index of prostate and bleeding intension were better in the treatment group than that of the control group with significant difference （P 〈0. 05 ）. The length of stay, catheter retention time and time of washing bladder had no significant difference between the two groups （P 〉0.05）. No obvious adverse effect was observed in both groups. Conclusions YunNan BaiYao capsule can effectively reduce bleeding quantity during TURP without obvious adverse effects.
Objective To evaluate the effect of epristeride on gross hematuria secondary to transurethral resection of prostate (TURP). Methods A total of 50 patients with gross hematuria secondary to TURP were divided into two groups: 25 patients were treated with routine treatment plus 5 mg epristeride, twice a day for 3 months, while the other 25 only received routine treatment. Results At the 6-month follow-up visit, gross hematuria recurred in 63% of patients in the control group, but in only 30% of patients in the epristeride group. The difference was statistically significant (Plt;0.05). Moreover, the grade of gross hematuria was significantly lower in the epristeride group (Plt;0.05). Conclusion Epristeride appears to be effective in treating gross hematuria secondary to TURP.
摘要:目的:探讨良性前列腺增生经尿道前列腺电切术围手术期的护理经验。方法:回顾性分析96例良性前列腺增生患者临床资料。结果:96例患者手术顺利,围手术期经周密的护理,疗效满意,无明显并发症。结论:周密的手术期护理对经尿道前列腺电切术治疗老年良性前列腺增生十分重要。Abstract: Objective: To investigate the perioperative nursing care of transurethral prostatic resection (TURP). Methods: The data of 96 TURP cases were analyzed retrospectively. Results: All the operations were performed successfully, and there were no obvious complications among the patients with precise nursing care. Conclusion: It is very important for precise nursing care to the patients who underwent TURP.
摘要:目的:探讨口腔颊黏膜尿道背侧镶嵌补片法治疗长段前尿道狭窄围术期的护理措施。 〖方法:术前做好口腔、会阴部及肠道准备,重视患者心理护理;术后重视尿管护理,维持吻合口低压状态,做好口腔及饮食护理,适当限制活动,注重并发症的观察与及时处理。结果:术后2～3月手术成功率达到92.4%,仅7.5%患者复发。结论:保证围手术期护理措施的质量对尿道成形手术的效果起到了重要的作用。 Abstract: Objective: To explore the perioperative nursing measures for the patients who underwent urethroplasty with dorsal onlay autogenetic oral ducal mucosa. Methods: Preoperative preparation includes oral cavity, perinea region,bowel cleansing and psychological nursing. Postoperatively, urinary catheter nursing is crucial to keep the anastomosis tension acceptablely low. Other postoperative care includes oral cleansing, activity restricting, discovering and dealing promptly with the complications. Results: Success rate was 92.4% 23 months after operation .Only 7.5% patients relapsed. Conclusions: Intensive perioperative nursing care was obviously helpful in improving the outcome of urethroplasty.
摘要:目的:探讨经尿道前列腺等离子切除术(PKRP)治疗前列腺增生症(BPH)的疗效及安全性。方法:回顾分析采用PKRP治疗的BPH患者,收集患者临床资料,随访12个月,并对手术前后患者国际前列腺症状评分、最大尿流率、生活质量评分进行比较。结果:2006年8月至2008年8月PKRP手术治疗BPH患者共238例,手术时间30～159 min,平均70 min,切除腺体25～127 g,平均54 g。无电切综合征。术后及1年后最大尿流率、国际前列腺症状评分、生活质量评分三项指标较术前明显改善(Plt;0.05)。结论:PKRP是治疗BPH安全有效的治疗方式。Abstract: Objective: To assess the clinical efficacy and safety of plasmakinetic energy transurethral resection of the prostate (PKRP) for benign prostatic hypertrophy (BPH). Methods: The data of patients with BPH treated with PKRP were retrospectively analyzed and the International Prostate Symptoms Scales (IPSS), maximum flow rate (Qmax) and Quality of Life (QOL) of patients with 12month followup were compared before and afteroperation and postoperation. Results: A total of 238 patients with BPH were enrolled from June 2006 to June 2008. The duration of the procedure was 70. 3 min (ranged from 30 min to 159 min) and the weight of dissected tissue was 54 g (ranged from 25 g to 127 g). No transurethral resection syndrome occurred. IPSS, Qmax and QOL were improved obviously after operation (Plt;0.05). Conclusion: PKRP is effective and safe.
目的:探讨良性前列腺增生症（benign prostatic hyperplasia，BPH）应用单极电切（TURP）经尿道前列腺剜除术的方法及疗效。方法：应用普通单极电切设备，采用经尿道前列腺剜除术治疗良性前列腺增生症患者21例。并对患者术前、术后的国际前列腺症状评分、生活质量评分进行比较。结果：全部患者均顺利完成手术，切除前列腺重量平均45 g，平均手术时间90 min，术后平均留置导尿管5~7天，术后平均住院时间5.5天。术后前列腺症状评分（IPSS）平均减少24分，生活质量评分平均减少3分。结论：经尿道单极电切前列腺剜除术治疗BPH安全、有效、并发症少，所需设备价格较低，特别适合基层医院开展，是一种值得推广的方法。
Objective To investigate the effectiveness of longitudinal preputial pedicled flap urethroplasty for chordee of Donnahoo IV type. Methods Between June 1994 and October 2011, 30 patients with chordee (Donnahoo type IV) underwent longitudinal preputial pedicled flap urethroplasty. The patients’ age ranged from 2 to 16 years (mean, 5.8 years). The morphology of the balanus-navicular fossa-external urethral orifice ranged normal; the penis length was 2.5-6.8 cm (mean, 4.3 cm); the penis bending angle was 35-70° (mean, 40.1°). Primary and secondary operation was 27 cases and 3 cases, respectively. The size of flap ranged from 1.5 cm × 1.3 cm to 4.0 cm × 2.0 cm. Results After correction, the penis length was 3.0-8.5 cm (mean, 6.6 cm); the penis bending angle was 0-10° (mean, 1.2°). All patients were followed up 6 months to 12 years (mean, 33 months). No recurrence, stabbing pain of the balanus, or foreign body sensation occurred during follow-up. Of them, 4 patients (13.33%) had urinary fistular, they had satisfactory results after the second operation; 2 patients (6.67%) had urethral stricture 1 month after operation, they also had satisfactory results after arethral dilatation. The other patients showed no scattering urinary flow and good direction without complication. Six patients had satisfactory sexual function after puberty without erection disorder, pain, or dyspareunia. Conclusion Longitudinal preputial pedicled flap urethroplasty can achieve maximum utilization of prepuce and aesthetic and functional improvement with less complication, so it is a relatively ideal mean for treating chordee of Donnahoo type IV.
Objective To investigate the local ization and expression characteristics of androgen receptor (AR) in genital tissue of patients with congenital hypospadias and simple chordee. Methods Between August 2005 and Janury 2007, dorsal prepuce, ventral perimeatal skin, and urethral plate were harvested from 25 patients with congenital hypospadias (aged from 1 year and 11 months to 19 years with an average of 3 years and 7 months) and 4 patients with simple chordee (aged from 3 years and 6 months to 16 years with an average of 7 years and 1 month). Prepuce by circumcision from 18 patients was used as control. The expression intensity and distribution of AR were assessed with mmunohistochemistry. Results AR was expressed in prepuce tissues from congentital hypospadias, simple chordee, and control. The AR positive cell rates were 62.94% ± 5.40% and 62.87% ± 5.33% in dorsal and ventral prepuce of control patients respectively, and were 59.00% ± 3.75%, 58.46% ± 4.14%, and 52.30% ± 3.53% in dorsal prepuce, ventral perimeatal skin, and urethral plate of patients with congenital hypospadias respectively. AR positive cell rate was significantly lower in patients with congenital hypospadias than in control patients (P lt; 0.05), and in urethral plate than in dorsal prepuce and ventral perimeatal skin of patients with congenital hypospadias (P lt; 0.05), and no significant difference was detected between dorsal and ventral specimens (P gt; 0.05). Stratified analysis showed a similar expression mode in severe hypospadias group and severe chordee group (P lt; 0.05). In mild to moderate hypospadias group and mild to moderate chordee group, no significant difference was shown when dorsal and ventral skin specimens were compared to that in normal control (P gt; 0.05), with AR expression diminished in urethral plate (P lt; 0.05), and AR decrease was relative to severity of chordee (P lt; 0.05). The AR positive cell rates were 59.69% ± 2.73%, 55.71% ± 1.67%,and 51.92% ± 1.87% in dorsal, ventral skin, and urethral late of patients with chordee respectively. Reducing tendency of AR expression was observed. Conclusion AR expression decreases in penile skin of patients with congenital hypospadias and simple chordee, especially in urethral plate.