中华泌尿外科杂志最新文献

{"title":"External physical vibration lithecbole in treatment of ureteral calculi with renal colic used different positions: a prospective multicenter randomized controlled clinical study","authors":"Jiacheng Zhang, T. Yu, Zedong Liao, Xiangjun Li, Yanli Sun, Jun Chen, Jun Fu, B. Lyu, Yue Duan","doi":"10.3760/CMA.J.ISSN.1000-6702.2020.01.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6702.2020.01.009","url":null,"abstract":"Objective \u0000To evaluate the efficacy and safety of different positions external physical vibration lithecbole (EPVL) therapy for ureteral calculi related renal colic. \u0000 \u0000 \u0000Methods \u0000This study was a prospective multicenter randomized controlled trial. The inclusion criteria was that patients volunteered to participate in the trial and signed informed consent, patients’age ranged from 18-65 years old, ureteral calculi related with renal colic, stone diameter was less than 7 mm, patients were not treated with analgesia, antispasmodic drugs. The exclusion criteria was that combination of severe urinary tract infection, severe hydronephrosis, urinary malformation, severe hypertension, history of cerebrovascular disease, vital organ dysfunction, obesity (BMI>35 kg/m2), history of ureteral calculi exceeded 2 months, abnormal blood coagulation. Patients were randomized into observation group and control group using random number table method. The observation group and the control group were placed on the physical vibration stone arranging machine with head low foot high position and head high foot low position respectively. The inclination angle was 24°. The secondary vibrator vibrated for 6 minutes, then the patient took the prone position and opened the main, the secondary vibrator. The treatment is completed after 6 minutes of vibration. The analgesic effect, stone removal, follow-up effects and adverse reactions in the two groups was compared. We defined the pain relief rate as(VAS score before treatment-VAS score after treatment)/VAS score before treatment×100%. \u0000 \u0000 \u0000Results \u0000A total of 100 patients were included in the study, 50 in the observation group and 50 in the control group. There were no statistical difference in the age of the two groups [(41.8±11.7)years and (46.6±13.9 years)], gender distribution [37(male)/13(female) and 42(male)/ 8(female)], location of stones (in the observation group, 19 cases in upper ureter, 7 cases in the middle ureter and 24 cases in the lower ureter; in the control group, 12 cases in the upper ureter, 3 cases in the middle ureter, and 35 in the lower ureter), left and right distribution of stones [21(right)/ 29 (left) and 22 (right)/ 28(left)], long diameter of stones [(5.2±0.9)mm and(5.1±1.1)mm], VAS scores before treatment (7.5±1.4 and 7.6±1.5), and readmission rate [22%(11/50)With 18%(9/50)], 1 week stone removal rate [70%(35/50) and 64%(32/50)]. The incidence of adverse reactions was 8%(4/50) in the observation group including 3 cases of nausea, 1 case of vomiting. The incidence of adverse reactions was 4% in the control group (2/50), which 2 cases showed nausea. The number of patients who chose EPVL, ESWL or surgery for the subsequent treatment in observation group was 35 cases, 9 cases, and 6 cases respectively. The number of patients who chose EPVL, ESWL or surgery for the subsequent treatment in the control group was 35 cases, 10 cases and 5 cases respectively. There was no significant difference between t","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":"41 1","pages":"46-50"},"PeriodicalIF":0.0,"publicationDate":"2020-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42249449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The necessity of presetting ureteral stents before ureteroscopic lithotripsy: a Meta-analysis","authors":"Yi Zhang, Xiulan Wang, Ji Zhang","doi":"10.3760/CMA.J.ISSN.1000-6702.2020.01.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6702.2020.01.011","url":null,"abstract":"Objective \u0000To systematically evaluate the necessity of presetting double-J stent before flexible ureteroscope lithotripsy. \u0000 \u0000 \u0000Methods \u0000Computer retrieved clinical studies on the effect of preoperative presetting double-J-catheter on flexible ureteroscope lithotripsy in PubMed, Cochrane Library, Embase, Scopus, Wan fang, CNKI and VIP databases were reviewed. The retrieval time was from the database construction to November 2018. All of the possible combinations of the following terms were used for the search: flexible ureteroscopic, preoperative, double J stent, and calculus. Two researchers independently conducted literature screening, quality evaluation and data extraction, and completed Meta analysis by using statistical software RevMan5.3. \u0000 \u0000 \u0000Results \u0000Thirty-two case-control trials and 14 randomized controlled trials were screened, with a total of 17 480 patients, including 6 211 patients in the experimental group and 11 269 patients in the control group. The results of meta-analysis showed that the experimental group was superior to the control group in term of the overall postoperative stone clearance rate (OR=1.69, 95%CI 1.37-2.08, P<0.05). In terms of postoperative kidney stone removal rate, the experimental group was superior to the control group (OR=1.67, 95%CI 1.41-1.99, P<0.05). In terms of the removal rate of ureteral calculi after surgery, there was no significant difference between the two groups (OR=1.71, 95%CI 0.91-3.20, P=0.10). The success rate of flexible ureteroscope access sheath implantation was higher in the experimental group (OR=5.77, 95%CI 3.32-10.31, P<0.05). The rate of passive usage balloon dilation in the control group was higher(OR=0.23, 95%CI 0.15-0.35, P<0.05). For the incidence of intraoperative complications, the experimental group was lower (OR=0.56, 95%CI 0.38-0.84, P=0.004). For the incidence of postoperative complications, the experimental group was also lower(OR=0.64, 95%CI 0.45-0.90, P=0.01). The operation time of the control group was longer(MD=-4.95, 95%CI -8.90--1.01, P=0.01). \u0000 \u0000 \u0000Conclusions \u0000Presetting double-J-catheter can improve the stone removal rate after flexible ureteroscope lithotripsy for the treatment of kidney stone, improve the success rate of flexible ureteroscope access sheath implantation, reduce the utilization rate of ureteral balloon dilator, reduce the incidence of intraoperative and postoperative complications, and shorten the operation time. \u0000 \u0000 \u0000Key words: \u0000Urinary calculus; Flexible ureteroscopic; Double J stent; Meta-analysis","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":"41 1","pages":"138-146"},"PeriodicalIF":0.0,"publicationDate":"2020-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42708541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prognostic value of concomitant carcinoma in situ in patients with upper tract urinary carcinoma after radical nephroureterectomy: an systematic review and Meta-analysis","authors":"Lijin Zhang, Z. Zha, Hu Zhao, Jun Yuan, P. Guo, Yejun Feng","doi":"10.3760/CMA.J.ISSN.1000-6702.2020.01.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6702.2020.01.010","url":null,"abstract":"Objective \u0000The aim of this study was to evaluate the influence of concomitant carcinoma in situ (CCIS) on tumor survival for the upper tract urinary carcinoma (UTUC) through systematic review and meta-analysis. \u0000 \u0000 \u0000Methods \u0000In the light of Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, a systematic search of Web of Science, PubMed and EMBASE China National Knowledge Infrastructure (CNKI) and Wanfang database by key words \"upper urinary tract urothelial carcinoma\" \"renal sputum cancer\" \"concomitant carcinoma in situ\" , and \"radical ureterectomy\" were performed for all reports that included detailed results on the predictors of CCIS. The search deadline is June 2019, and the search terms are English and Chinese. Methodological quality evaluation was performed using the QUIPS tool, and statistical analysis of the relevant data was performed using Stata 12.0 and RevMan 5.3 software. \u0000 \u0000 \u0000Results \u0000Sixteen articles were included in this study and all published between 2012 and 2019. A total of 11 131 patients with UTUC, including 1 774 (15.9%) patients with CCIS. According to our final results, there was a significant correlation of CCIS with worse cancer-specific survival (CSS) (HR=1.10, 95%CI 1.05-1.16, P<0.001), recurrence-free survival (RFS) (HR=1.15, 95%CI 1.09-1.21, P<0.001) and overall survival (OS) (HR=1.10, 95%CI 1.03-1.17, P=0.003). Begg′s bias analysis showed no significant publication bias in CSS (P=0.822), RFS (P=0.348), and OS (P=0.452). \u0000 \u0000 \u0000Conclusions \u0000This study demonstrated that CCIS was associated with poor oncological outcome and could serve as a independent prognostic factor for patient with UTUC after radical nephroureterectomy. \u0000 \u0000 \u0000Key words: \u0000Urologic diseases; Upper tract urinary carcinoma; Radical nephroureterectomy; Concomitant carcinoma in situ; Prognosis; Meta-analysis","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":"41 1","pages":"51-56"},"PeriodicalIF":0.0,"publicationDate":"2020-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46110037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical analysis of female urethral diverticulum resection and reconstruction under Jacknife position","authors":"Weidong Chen, J. Xing, Ya-Huei Zeng, Fei Liu, Yuxin Chen","doi":"10.3760/CMA.J.ISSN.1000-6702.2019.12.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6702.2019.12.009","url":null,"abstract":"Objective \u0000To explore the clinical efficacy of female urethral diverticulum resection and reconstruction under the folding position. \u0000 \u0000 \u0000Methods \u0000Retrospective analysis of 22 female patients with urethral diverticulum was performed from September 2010 to December 2018. There were 12 cases of simple diverticulum, 6 cases of horseshoe diverticulum, 4 cases of circumferential diverticulum, aged from 26 to 72 years, with an average of 46.2 years, whose BMI ranged from 24.2 to 34.8 kg/m2, with an average of 30.4 kg/m2. Eleven cases (50%) presented with dysuria, 10 cases (45.5%) with repeated urinary tract infections, 7 cases (31.2%) with difficulty of voiding, 10 cases (45.5%) with urethral secretion, 9 cases (40.1%) with difficulty of sexual intercourse, and 4 cases (18.2%) without symptoms. Unlike the traditional surgical procedure under the lithotomy position, the folding position was used to expose the vagina and separate the vaginal mucosa by longitudinal incision, and the diverticulum was completely removed to the neck. The peri-operative complications and efficacy were recorded. \u0000 \u0000 \u0000Results \u0000All 22 cases underwent successful procedures, and were followed up for 25.2 months on average (ranged 8 to 42 months). One of them suffered from weak stream 2 months after operation, with residual urine volume of 100ml by ultrasonography. Her symptoms improved after dilatation of the urethra. Two cases suffered from different degrees of lower urinary tract storage symptoms 1 month after the operation (1 case of mild dysuria and 1 case of urinary tract infection), who improved after oral administration of levofloxacin tablets for 3-5 days. All patients had no urethral diverticulum recurrence 3 months later by ultrasonography, half a year by cystoscopy, and every six months by ultrasonography. \u0000 \u0000 \u0000Conclusions \u0000Surgical treatment is still the best choice for patients with urethral diverticulum. The success rate of transvaginal urethral diverticulum reconstruction with a Jackknife position is high, postoperative recurrence rate is low, and postoperative complications are few. \u0000 \u0000 \u0000Key words: \u0000Diverticulum; Urethra; Female; Jacknife position; Surgery","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":"40 1","pages":"920-922"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42795757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of super-mini-percutaneous nephrolithotomy(SMP) for upper urinary stone of adults and children","authors":"A. Simayi, Talaiti Tayier, Lei Peng, Aihemaiti Aimaier, Zhang Xiaoan, Yalikun Alimu","doi":"10.3760/CMA.J.ISSN.1000-6702.2019.12.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6702.2019.12.011","url":null,"abstract":"Objective \u0000To compare the safety and efficiency of totally ultrasonography-guided super-mini-percutaneous nephrolithotomy(SMP) in the treatment of upper urinary stone in adults and children(<14years). \u0000 \u0000 \u0000Methods \u0000From May 2015 to July 2018, 81 cases of children(53%) and 71(47%) cases of adults with upper tract stones underwent the SMP by total ultrasound guidance. In the group of children, it’s including 53 male and 28 female with 85 channels in total, the patients age ranged from 10 months to 14 years, [mean (56.0±39.7) months], The stone size ranged from 0.8-3.5 cm, [mean (1.7±0.7)cm]. About stone distribution, 42 cases of pelvic stones, 25 cases of calyceal and pelvic stones, 5 cases of calyceal stones, 7 cases of upper uretaral stones, 1 case of upper ureteral and calyceal stones, 1 case of malformation with double renal pelvis and ureter. Urinary infection rate was 86.4%(70/81), positive rate of urinary culture was 39.5%(32/81). In the group of adults, it’s including 43 male and 28 female, the patients aged from 18 to 81 years, [mean (44.1±15.4)years], The stone size ranged from 1.0-3.0 cm, [mean (1.7±0.6)cm]. About Stone distribution, 19 cases of pelvic stones, 13 cases of calyceal and pelvic stones, 7 cases of calyceal stones, 24 cases of upper uretaral stones, 3 cases of upper ureteral and calyceal stones, 1 case of malformation with double renal pelvis and ureter. Urinary infection rate was 87.3%(62/71), positive rate of urinary culture was 26.8%(19/71). The patient was placed in the lithotomy position under general anesthesia. A 5F ureteric catheter was retrogradely inserted into the collecting system and urethral catheter was placed in the bladder. The patient was then turned prone. The selected calix was punctured under ultrasound guidance by 18G puncture needle and a 0.032 inch guidewire was inserted into the collecting system. Nephrostomy tract was established using Dilators(it was done in one step for 12F and in two steps for 14F). After the corresponding size of suction-evacuation sheath was placed, the sheath was connected to the specimen collection bottle via the oblique branch of a metal connector. The miniature endoscope was inserted into the sheath to observe the collecting system and stone fragmentation was completed by using YAG laser or pneumatic lithotripter. Stone free rate after surgery at 1day(SFR) and 1 month(1 month SFR), stone size, operative time(from starting fragmentation to the end of the surgery), hemoglobin drop and hematocrit drop in the first day after surgery, rate of surgecal complications, tubeless rate(totally tubless: no ureteric stent and nephrostomy tube; tubeless: no nephrostomy tube but ureteric stent), average length of hospital stay and urinary infection were recorded and compared. \u0000 \u0000 \u0000Results \u0000In children group, mean operative time was (27.7±13.0)min(range 5-60 min), SFR and SFR at 1 month were 96.3%(78/81)and 98.8%(80/81), mean hemoglobin drop was (8.0±9.1)g/L(range 0-41 g/L), mean hematocrit","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":"40 1","pages":"927-931"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45019623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified extraperitoneal laparoscopic VIP (Vattikuti institute prostatectomy) for prostate cancer: initial experience","authors":"Cheng Sida, Hong-Yun Peng, Zhang Lei, Tang Qi, H. Han, Li Xuesong, Z. Liqun","doi":"10.3760/CMA.J.ISSN.1000-6702.2019.12.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6702.2019.12.005","url":null,"abstract":"Objective \u0000To investigate the operating key steps and the initial experience of IUPU (Institute of Urology, Peking University) modified extraperitoneal laparoscopic VIP (Vattikuti institute prostatectomy) technique and the initial follow-up outcomes. \u0000 \u0000 \u0000Methods \u000046 patients of prostate cancer underwent the modified extraperitoneal laparoscopic VIP and were reviewed from November 2017 to September 2018. Patients aged 54 to 77 years, with mean age of 65.5 years old. Their preoperative PSA was 0.15 to 69.76 ng/ml with an average of 13.4 ng/ml. All patients were diagnosed by prostate biopsy and Gleason score was 6 to 10 with an average of 7.5. MRI was used to assess their clinical stage before operation. All the modified laparoscopic VIP were done through the extraperitoneal approach by a single surgeon and the follow-up by telephone for the PSA level and continence recovery (urine pad test). The major differences between modified laparoscopic VIP and the routine steps of radical prostatectomy are as follows: use of extraperitoneal approach and traditional laparoscopic operation; after the setup of the extraperitoneal cavity, the bladder neck is separated, isolated and cut down first; the management of DVC: Cut down the super-facial and deep layers of DVC just along the capsule of the prostate apex and it’s unnecessary to suture it. Perioperative data of these patients were collected retrospectively, including operation time, intraoperative blood loss, length of hospital stay, postoperative pathology, and continence outcome after surgery. \u0000 \u0000 \u0000Result \u0000All 46 patients underwent the IUPU modified extraperitoneal laparoscopic VIP successfully without converting to open surgery. The operation time was 69-143 min with an average of 95.7 min and the estimated blood loss was 20-200 ml with an average of 81.5 ml. It was 3-17 days for the average time to remove the retropubic drainage tube postoperatively, with an average of 4.3 days. The postoperative hospital stay was 3-17 days with an average of 5.3 days. The Foley catheter was removed 14 days postoperatively. Five patients suffered from urine leakage and were managed successfully with conservative treatment. For the postoperative pathological stage, 1 patient was pT2a, 12 patients were pT2c, 12 patients were pT3a and 21 patients were pT3b. The postoperative Gleason score was 6-9 with an average of 7.7. The postoperative follow-up time was 1-11 months with an average of 6.3 months. The PSA was 0.001-0.966 ng/ml with an average of 0.181 ng/ml 1 month postoperatively and the continence rate was 54%(25/46) and 89%(34/38) 1 month and 3 months after operation respectively. \u0000 \u0000 \u0000Conclusions \u0000The IUPU modified extraperitoneal laparoscopic VIP might be a safe and feasible for the radical prostatectomy. It’s simplified for the operative steps, unnecessary to isolate and suture DVC and doesn’t increase the blood loss. It’s almost left intact for the surrounding tissues of the prostate apex and satisfactory for the","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":"40 1","pages":"901-904"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44011904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The anatomical structure of fused renal pyramid and its imaging findings in ultrasound and computed tomography","authors":"Xian Yuqi, Cheng Fan, Rao Ting, Lin Fangyou, Wei-min Yu, R. Yuan, Ning Jinzhuo, Yang Yuanting, Song Wanwan","doi":"10.3760/CMA.J.ISSN.1000-6702.2019.12.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6702.2019.12.004","url":null,"abstract":"Objective \u0000To analyze the anatomical structure and distribution of the fused renal pyramid (FRP) in cadaveric kidney, and discuss its appearances by CT and ultrasonic examinations. \u0000 \u0000 \u0000Methods \u0000From June 2018 to September 2018, 108 cadaveric kidneys were proceeded for regional anatomy. The distribution and anatomical manifestations of FRP was recorded. The renal pyramid was sliced and HE stained to explore the vascular distribution in FRP. From October 2018 to January 2019, ultrasound imaging data of 112 patients with 224 kidneys were collected, including 60 males and 52 females, age (39.0±15.1), ranging from 16 to 73 years old. The renal imaging data of 89 patients and 178 patients with enhanced renal CT were collected, including 48 males and 41 females. Age (45.4±13.6), ranging from 23 to 69 years old. The imaging findings of FRP in ultrasound and enhanced CT was summarized. \u0000 \u0000 \u0000Results \u0000In cadaver kidneys, the proportion of FRP in upper and lower calyces was 68.6% (74/108) and 64.8% (70/108), respectively, higher than that in middle calyces 34.3% (37/108). In the middle group, the incidence of mild fusion was 39.0% (16/41) and severe fusion was 48.8% (20/41). The incidence of fusion of two renal pyramidal structures was 90.2% (37/41). HE staining showed that the boundary between the artery in FRP and the surrounding renal pyramidal was unclear, and the protection of connective tissue was lacking. In Ultrasound, the FRP presented as a large trapezoidal hypo-echoic area with red and blue color signals in doppler mode. In ultrasound, the incidence of FRP was 18.8% (42/224). In enhanced CT, the FRP presented as enhanced cord-like high density shade in large low density area in cortex phase. In enhanced CT, the incidence of FRP 27.5%(49/178). \u0000 \u0000 \u0000Conclusions \u0000The FRP is a common structure in human kidney. The arteries localize within the FRP and are absence of sufficient connective tissue protection which are different from normal arteries. Ultrasound and enhanced CT have recognition ability for FRP. \u0000 \u0000 \u0000Key words: \u0000Kidney diseases; Fused renal pyramid; Anatomical structure; Percutaneous nephrolithotomy; Ultrasound; Computed tomography","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":"40 1","pages":"895-900"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48314025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical efficacy of dorsal mosaic surgery with penis free flap for the treatment of anterior urethral stricture after TURP","authors":"Xiaofang Bi, Ping Qinrong, Wang Chunhui, Yang Yang, Libing Hu, Yiming Zhong, Jian Li, Ying Zheng","doi":"10.3760/CMA.J.ISSN.1000-6702.2019.12.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6702.2019.12.008","url":null,"abstract":"Objective \u0000To investigate the clinical efficacy of dorsal mosaic surgery with penis free flap for the treatment of anterior urethral stricture after TURP. \u0000 \u0000 \u0000Methods \u0000We analyzed the clinical data of the patients with anterior urethral stricture after TURP from January 2010 to December 2017 in Yan′an hospital affiliated to Kunming medical university retrospectively. The patients' age ranged from 58 to 75 years, with an average of 64.3 years. The time from TURP to the diagnosis of anterior urethral stricture was 1-12 month, with an average of 3.5 months. 5 cases were urethral stricture at penis segment, 11 cases were urethral stricture at the junction of penis and scrotum, and the length of the narrow urethra was 2-5 cm, with an average of 3.4cm. The average maximum uroflowmetry in preoperative was (5.3±2.7) ml/s.11 cases were treated with regular urethral dilatation and the treatment durable time was more than 6 months, 5 cases were treated with intraurethral incision combined with urethral dilatation(1 or 2 times). 16 cases were not effective after receiving the above treatment, so that all cases were treated with dorsal mosaic surgery with penis free flap. Subarachnoid anesthesia combined with epidural anesthesia, the patient took the supine position.The distal end of urethral stricture was defined by urethral dilator. Incision from the ventral side of the urethra. The length of the incision was extended 0.5 cm based on the length of urethral stricture in urethral angiography.Anatomize the left and right sides of the urethral stricture and longitudinally incision the ventral side of the urethral cavernous body. The length of the incision was extended 0.5 cm to the normal urethral mucosa. The traction line retracts the ventral urethral edge along both sides.The corresponding medial line of the dorsal urethra was incised to the tunica albuginea, and the urethral edge of the dorsal side was separated from the tunica albuginea to form an elliptical region on the tunica albuginea.According to the size of the ellipse, the full thickness of the penis flap was taken, and the size of the flap was beyond the edge of the elliptical area about 0.3 cm.The free flap was covered with the 6-0 absorbable suture on the elliptical area (the skin surface was on the inner side of the urethra), the edge of the free flap was intermittently sutured with the urethral edge of the dorsal side, Multi-needle intermittent sutured flap surface on the corpus cavernosum bed.Using a silicone catheter as the stent tube of the new urethra, the 6-0 absorbable suture closes the ventral side of the incisional urethral sponge.The multi-layered meat film was sutured to prevent leakage of urine, and the fascia and skin were sutured layer by layer. The 5-0 absorbable thread sutures the wound after the foreskin was taken. \u0000 \u0000 \u0000Results \u0000The operations were successfully completed. The operation time was 90-120 min, with an average of 102.3 min. The intraoperative blood loss was 10-30 ml.","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":"40 1","pages":"915-919"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45758736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mechanism of Annexin A1 regulating the proliferation, apoptosis and migration of bladder cancer cells","authors":"Tao Wang, Peide Bai, Shunqiang Xie, Anran Sun, J. Xing","doi":"10.3760/CMA.J.ISSN.1000-6702.2019.12.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6702.2019.12.012","url":null,"abstract":"Objective \u0000Explore the function and regulatory mechanism of Annexin A1 (ANXA1) in bladder cancer cell proliferation, apoptosis and migration. \u0000 \u0000 \u0000Methods \u0000From February 2018 to June 2019, we use T24 cells as the model and divide it into over-expression control group (ctrl), ANXA1 over-expression group (ANXA1), knockdown control group (shctrl), ANXA1 knockdown group 1 (shANXA1-1), ANXA1 knockdown group 2 (shANXA1-2) and ANXA1 knockdown group 3 (shANXA1-3). 24 hours after the culture, the cells were collected and the mRNA expression level of ANXA1 was detected by Real-Time quantitative PCR. The cell activity was detected by CCK-8; the cell apoptosis and cycle were detected by flow cytometry. The cell migration was detected by Transwell assay. \u0000 \u0000 \u0000Results \u0000The Real-Time quantitative PCR showed that the expression of ANXA1 in the over expression group was significantly higher than that in the over expression control group (15 369.00±874.20 and 1.00±0.07, P 0.05), while the number of apoptosis in the knockdown group 2 and 3 were significantly higher than that in the knockdown control group (13.04%, 14.58% and 7.76%, P<0.001). Cell function analysis showed that the number of cells passing through the membrane of the over expression group was significantly higher than that of the over expression group (525.00±9.30 and 385.70±13.40, P<0.01), while that of the knockdown group 2 and 3 were significantly lower than that of the knockdown control group (214.70±6.40, 226.00±5.30 and 398.70±10.00, P<0.001). \u0000 \u0000 \u0000Conclusions \u0000Over-expression of ANXA1 significantly promoted the proliferation, cycle and migration of T24 cells and inhibited apoptosis. On the contrary, ANXA1 knockdown inhibited the proliferation, cycle and migration of T24 cells and promoted apoptosis. \u0000 \u0000 \u0000Key words: \u0000Urinary bladder neoplasms; Annexin A1; Cell proliferation; Cell apoptosis; Tumor invasion and metastasis","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":"40 1","pages":"932-936"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46091174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing unplanned re-operation of prostatic cancer and its countermeasures","authors":"Q. Wo, X. Qi, Feng Liu, Qi Zhang, Zujie Mao","doi":"10.3760/CMA.J.ISSN.1000-6702.2019.12.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6702.2019.12.006","url":null,"abstract":"Objective \u0000To analyze the main causes for unplanned re-operation of prostatic cancer. \u0000 \u0000 \u0000Methods \u0000The clinical data of 4 patients with prostatic cancer who underwent an unplanned re-operation were analyzed retrospectively between September 2014 and July 2019 in our hospital.Preoperative data of patients was collected as follows: mean age of 65 years, ranged from 56 to 71 years.tPSA ranged from 5.17-13.20 ng/ml.Gleason score of 3+ 3 in 1 case, 3+ 4 in 2 cases, 4+ 4 in 1 case. pTNM pT2a in 2 Cases, pT2b in 2 cases. LRP(extraperitoneal approach) in 1 case, RARP(transperitoneal approach) in 3 cases. \u0000 \u0000 \u0000Results \u0000The main causes for unplanned re-operation were as follows: perioperative hemodynamic instability(75%, 3/4), post-operative fever(25%, 1/4). All 4 re-operations were performed by urologists using Laparoscopic exploration of abdomen. \u0000 \u0000 \u0000Conclusions \u0000Inadequate and inappropriate surgical hemostasis are the key to lead a second-look surgery of prostatic cancer.A complete hemostasis could help to lower the re-operation rate.Laparoscopic exploration of abdomen could be one of the choices to deal with re-operation after minimally invasive radical prostatectomy. \u0000 \u0000 \u0000Key words: \u0000Prostatic neoplasms; Prostatectomy; Minimally invasive; Unplanned re-operation; Complications","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":"40 1","pages":"905-908"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44504737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}