ObjectiveTo compare the clinical efficacy of transurethral plasmakinetic resection of bladder tumors (PKRBT) and holmium laser resection of bladder tumors (HOLBT), and discuss the effcacy, safety, indication, and complications of PKRBT for the treatment of bladder tumors compared with HOLBT. MethodsA hundred patients with bladder tumors were divided into two groups randomly, who were selected from patients in the Department of Urology of West China Hospital from March 2011 to March 2013. Among all the 100 cases, half of them were treated with PKRBT, and all others treated with HOBLT. The significant markers in both groups were recorded and evaluated, including the situation of before operation, during operation and after operation. The data recorded consisted of the general records of patients' medical background, concomitant disease, laboratory examination, and the position, amount, pathology of the tumor, total operative duration, the time of gross hematuria, the time of postoperative bladder irrigation and catheterization, the length of stay, postoperative complications and patients' conditions at month 3, 6, and 12 during the follow-up. ResultsAll operations were successfully performed, and there was no significant diTherences between the two groups in preoperative indexes (P>0.05). No abnormalities were detected in the postoperative laboratory examinations. The diTherences in operatative duration, time of bladder irrigation, duration of indwelling catheter, and postoperative length of stay between the two groups were not significant (P>0.05). But the mean time of gross hematuria was significantly shorter after operation in the HOLBT patients [(6.1±7.6) hours] than in those treated with PKRBT [(15.3±17.2) hours] (P<0.05). There was no significant diTherence between the two groups in the recurrence rate 3, 6, and 12 months after operation (P>0.05). ConclusionHOLBT can be used safely and effectively in treating bladder tumors, and it is easy for clinical manipulation. HOLBT is as effective and safe as PKRBT with similar adverse side-effect rate within and after operation.
ObjectiveTo systematically review the safety and efficacy of greenlight laser photoselective vaporization (PV) for nonmuscle-invasive bladder tumors (NMIBTs). MethodsSuch databases as PubMed, EMbase, The Cochrane Library (Issue 2, 2016), CNKI, CBM, VIP and WanFang Data were systemically searched from inception to February 2016, to collect randomized controlled trials (RCTs) investigating the efficacy and safety of greenlight PV for NMIBTs. Two reviewers independently screened literature, extracted data, assessed the risk of bias of included studies. Then RevMan 5.3 software was used for meta-analysis. ResultsA total of 11 RCTs involving 921 patients met the predefined criteria. The results of meta-analysis showed that: Compared with electrocautery transurethral resection and plasmakinetic resection in treating NMIBTs, greenlight PV could significantly shorten indwelling catheter time and hospital stay, decrease bladder perforation, obturator nerve reflex, blood loss rate and tumor recurrence rate; but the operative time between the greenlight PV group and the routine surgery group was not statistically different. ConclusionCurrent evidence shows that greenlight PV is safe and effective in treating NMIBTs. Due to the limited quality and quantity of the included studies, more large-scale high-quality studies are warranted to further assess these results.
Objective To systematically review the effect of bariatric surgery for male’s erectile function. Methods We electronically searched databases including PubMed, EMbase, The Cochrane Library (Issue 5, 2016), CNKI, VIP and WanFang Data from inception to May 30th 2016, to collect randomized controlled trials and before-after studies about bariatric surgery therapies for erectile function in obese male. Two reviewers independently screened literature, extracted data, and assessed the methodological quality of included studies. Then RevMan 5.3 software was used for meta-analysis. Results A total of 7 before-after studies involving 270 patients were included. The results of meta-analysis showed that: compared with before treatment, bariatric surgery could significantly improve 1-year erectile function score (MD=5.05, 95%CI 3.52 to 6.59, P < 0.000 01), 1-year sexual desire score (MD=0.99, 95%CI 0.47 to 1.51, P=0.000 2), 1-year contact satisfaction score (MD=2.70, 95%CI 0.21 to 5.19, P=0.004) and 1-year total satisfaction score (MD=1.68, 95%CI 0.27 to 3.09, P=0.002), but there was no significant difference in orgasm function score (MD= –0.21, 95%CI –0.74 to 0.33, P=0.45) between before and after treatment. Conclusion Bariatric surgery is effective in improving the erectile function, sexual desire and sexual satisfaction in morbidly obese male. Due to the limited quality and quantity of the included studies, the above conclusion needs to be verified by more large-scale high-quality studies.