RESUMEN
OBJECTIVE: To observe the clinical effects of pre-suture ligation and suture knot positioning in single-operator circumcision with the stapler. METHODS: Totally 120 six to fourteen years old children with phimosis or redundant prepuce were equally and randomly assigned to receive traditional single-operator circumcision with the stapler (group 1), single-operator circumcision with double suture knots for positioning the cutting plane with the stapler (group 2), or pre-suture ligation plus single-operator suture knot positioning circumcision with the stapler (group 3). We recorded and comparatively analyzed the operation time, intraoperative blood loss and hematoma, the number of residual suture knots, the patients' satisfaction with foreskin reservation, sutured frenulum and incision aesthetics, and the rates of surgical conversion, severe postoperative dysuria, severe wound exudation and perioperative anxiety of the parents and surgeon. RESULTS: Statistically significant differences were observed among the three groups in the operation time, intraoperative blood loss, incidence of intraoperative hematoma, number of residual suture knots, the patients' satisfaction with foreskin reservation, sutured frenulum and incision aesthetics, and the rates of surgical conversion, severe postoperative dysuria, severe wound exudation and perioperative anxiety of the parents and surgeon (P < 0.05). Compared with group 1, group 3 showed obviously less operation time and intraoperative blood loss and lower incidence of intraoperative hematoma, number of residual suture knots and rates of surgical conversion and perioperative anxiety of the parents and surgeons, and higher rates of patients' satisfaction with foreskin reservation, sutured frenulum and incision aesthetics. The intraoperative blood loss, incidence of intraoperative hematoma, and the rates of severe postoperative dysuria, severe wound exudation and perioperative anxiety of the parents and surgeon were lower in group 3 than in group 2. CONCLUSION: Pre-suture ligation plus single-operator suture knot positioning circumcision with the stapler helps reduce the operation time, intraoperative blood loss, incidence of intraoperative hematoma, number of residual suture knots and rates of surgical conversion and perioperative anxiety of the parents and surgeon, and increase the patients' satisfaction with foreskin reservation, sutured frenulum and incision aesthetics.
RESUMEN
OBJECTIVE: To observe the clinical effect of single-suture versus that of double-suture knot in positioning the cutting plane in circumcision with a stapler. METHODS: We randomly assigned 120 patients with redundant prepuce or phimosis into three groups of an equal number to receive traditional circumcision without suture knot (group 1), circumcision with single-suture knot (group 2), and circumcision with double-suture knot (group 3) for positioning of the cutting plane. We recorded and compared the operation time, intraoperative blood loss, the rates of frenulum sewing, non-frenulum sewing, poor frenulum sewing and surgical conversion, intraoperative anxiety of the doctors, postoperative ecchymosis, and satisfaction with the retained ventral and dorsal prepuce and postoperative penile appearance among the three groups. RESULTS: There were statistically significant differences among the three groups in the surgery time, intraoperative blood loss, the rates of frenulum sewing, non-frenulum sewing, poor frenulum sewing and surgical conversion, intraoperative anxiety of the doctors, and satisfaction with the retained ventral and dorsal prepuce and postoperative penile appearance, (P < 0.05), but not in postoperative ecchymosis (P = 0.849). The rate of satisfaction with the retained dorsal prepuce was remarkably higher in group 3 than in group 2 (P = 0.003), and the intraoperative anxiety rate of the doctors was lower in the former than in the latter group (P = 0.003). CONCLUSIONS: Both single- and double-suture knots for positioning the cutting plane in circumcision with a stapler can help reduce the operation time, intraoperative blood loss, the rates of frenulum sewing, non-frenulum sewing, poor frenulum sewing and surgical conversion, intraoperative anxiety of the doctors, and satisfaction with the retained ventral and dorsal prepuce and postoperative penile appearance, and double-suture knot positioning has an even higher application value in decreasing the intraoperative anxiety of the doctors and increasing the satisfaction with the retained dorsal prepuce.
Asunto(s)
Circuncisión Masculina , Fimosis , Prepucio , Humanos , Masculino , Fimosis/cirugía , Periodo Posoperatorio , SuturasRESUMEN
OBJECTIVE: To investigate the efficiency and complications of modified urethral reconstruction with lingual mucosa in the treatment of complicated anterior urethral stricture (CAUS). METHODS: We retrospectively studied the clinical data on 10 cases of CAUS treated by modified urethral reconstruction with lingual mucosa from December 2017 to June 2019 concerning the age of the patients and the causes, location and length of urethral stricture. We statistically analyzed the pre- and post-operative maximum urine flow rate (Qmax), scores on Mental Status Scale in Non-psychiatric Settings (MSSNS) and quality of life (QOL) scores and observed post-operative complications such as abnormal taste, tongue numbness, urinary tract infection, urethral diverticulum, and urethral stricture. RESULTS: Compared with the baseline, Qmax was significantly improved and the MSSNS and QOL scores dramatically decreased at 3, 6 and 12 months after surgery (P < 0.01). Paraurethral infection developed in 1 case postoperatively, which was cured after dressing change, external urethral orifice stenosis occurred in another, which was improved after regular urethral orifice expansion, and mild tongue numbness was found in 2 cases at 1 month but gradually restored to abnormal. Urethrography showed no urethral diverticulum before catheter removal. CONCLUSIONS: Lingual mucosa is an ideal alternative material for urethral reconstruction in the treatment of CAUS, and lateral lingual mucosa can be easily obtained. Modified urethral reconstruction by embedding lingual mucosa in the dorsal base of the urethra, with the advantages of definite effectiveness and few postoperative complications, is worthy of clinical application.
Asunto(s)
Estrechez Uretral , Humanos , Masculino , Membrana Mucosa , Calidad de Vida , Estudios Retrospectivos , Lengua , Uretra , Estrechez Uretral/etiología , Estrechez Uretral/cirugíaRESUMEN
OBJECTIVE: To observe the clinical effect of prostatic artery embolization (PAE) in the treatment of high-risk patients with BPH. METHODS: Nine high-risk patients with BPH underwent PAE in the Third Affiliated Hospital of Anhui Medical University from January 2016 to June 2018. We followed up the patients and obtained their IPSS, quality of life score (QOL), postvoid residual urine volume (PVR), maximum urinary flow rate (Qmax), prostate volume (PV), hours of undisturbed sleep (HUS), Self-Rating Anxiety Scale score (SAS) and incidence of postoperative complications before and at 6, 12 and 24 months or longer after surgery, followed by comparative analysis of the parameters. RESULTS: Compared with baseline, IPSS, QOL, PVR, Qmax, PV, HUS and SAS were all significantly improved in the patients at 6, 12 and ≥24 months after PAE (P < 0.05). Only 1 case complained of mild numbness in the buttocks, which was gradually relieved after acupuncture therapy. CONCLUSIONS: Prostatic artery embolization is definitely effective for the treatment of high-risk patients with BPH with the bladder volume ≥200 ml, with few postoperative complications, and can be used as an effective therapeutic supplementary for improving the urination symptoms of the patients.
Asunto(s)
Embolización Terapéutica , Hiperplasia Prostática , Arterias , Humanos , Masculino , Próstata/cirugía , Hiperplasia Prostática/terapia , Calidad de VidaRESUMEN
PURPOSE: We studied the prevalence of prostatitis-like symptoms and identified their associated risk factors in a population based Chinese sample. MATERIALS AND METHODS: A volunteer group of 15,000 eligible men residing in Beijing, Anhui, Xi'an, Guangzhou and Gansu cities or provinces were invited randomly to take part in the survey to complete a questionnaire that elicited information regarding sociodemographics, Eysenck personality questionnaire, current stress and health ratings, lifestyle, medical history, expressed prostatic secretion evaluation, score of the National Institutes of Health Chronic Prostatitis Symptom Index and International Index of Erectile Function-5. RESULTS: Information on 12,743 (84.95%) men was collected. Of these men 1,071 (8.4%) reported prostatitis-like symptoms (mean National Institutes of Health Chronic Prostatitis Symptom Index pain score 7.55 +/- 3.22). The percent of chronic prostatitis was 4.5% (571) among the symptoms group according to past urological history and expressed prostatic secretion evaluation. Subjects with prostatitis-like symptoms (mean age 34.56 +/- 13.48 years) had higher mean pain and urinary symptoms scores (7.53 +/- 3.22 and 2.84 +/- 2.72, respectively) compared with subjects without prostatitis-like symptoms (1.18 +/- 2.32 and 0.72 +/- 1.66 for pain and urinary symptoms scores, respectively, mean age 30.7 +/- 10.17) (pain and symptoms scores, p <0.05). The quality of life score was 6.03 +/- 2.88 and 3.83 +/- 2.55 in groups with symptoms or nonsymptoms, respectively (p <0.05). CONCLUSIONS: Prostatitis-like symptoms are a multifactorial problem affecting men of all ages (15 to 60 years) and demographics, and the prevalence is high in China. The syndrome is closely related to alcohol consumption, cigarette smoking, frequent intercourse, as well as fatigue, pressure and too little sleep. These findings suggest that risk factors for this condition are largely modifiable and highlight potential targets for future prevention.
Asunto(s)
Prostatitis/diagnóstico , Prostatitis/epidemiología , Adolescente , Adulto , China , Estudios Transversales , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Encuestas y Cuestionarios , Adulto JovenRESUMEN
The aim of this study is to assess the status of treatment of chronic prostatitis (CP) in Chinese men. A population-based cross-sectional survey was performed, in which 15 000 men aged between 15 and 60 years were randomly selected to receive a questionnaire designed to assess National Institutes of Health Chronic Prostatitis Symptoms Index (NIH-CPSI) status, therapeutic efficacy and 28 other items. A total of 12 743 men (84.95%) completed the questionnaire, of whom 1 071 (8.4%) were identified as having prostatitis-like symptoms and 517 (4.5%) were diagnosed with CP according to NIH-CPSI criteria and prostatitis-like symptomatology. Of the CP patients, 372 (65%) underwent long-term routine treatment 12 times per year. Additionally, 217 (72.8%) patients received antibiotic therapy and 215 (79.3%) men showed therapeutic effects. The treatment cost USD 1 151 (8 059 yuan) per person per year on average. Most CP patients received routine treatment, in most cases with antibiotics. Treatment was costly and most CP patients were not satisfied with its effectiveness. Antibacterial treatment might have been effective primarily in patients with bacterial disease.
Asunto(s)
Antibacterianos/uso terapéutico , Infecciones Bacterianas/tratamiento farmacológico , Medicamentos Herbarios Chinos/uso terapéutico , Prostatitis/tratamiento farmacológico , Adolescente , Adulto , Infecciones Bacterianas/complicaciones , Infecciones Bacterianas/epidemiología , China/epidemiología , Enfermedad Crónica , Estudios Transversales , Quimioterapia Combinada , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Prostatitis/epidemiología , Prostatitis/microbiología , Encuestas y Cuestionarios , Resultado del Tratamiento , Adulto JovenRESUMEN
OBJECTIVE: To investigate the potassium channel currents and response thereof to the blocker of potassium channel in epithelium of prostate of Sprague Dawley (SD) rats. METHODS: The dorsolateral lobes of prostates of 20 3-month-old (adult) male SD rats and 20 12-month-old (elderly) SD rats were removed, cut into small pieces of the size of 1 approximately 2 mm(3) in phosphate-buffered Ca(2+)-free Ringer's solution, and digested by collagenase IV for 25 min. Then the tissue chunks were put into fresh solution and gently agitated. These cells were cultured for one week. Pan-keratin immunocytochemistry was conducted. The potassium channel current of the prostate epithelium was recorded by whole-cell voltage clamp. Tetraethylammonium (TEA), a blocker of calcium-activated potassium channel of the concentration of 1 mmol/L, and 1 mol/L + 1 mmol/L 4-aminopyridine (4-AP), blocker of voltage-dependent potassium channel inhibitor, were sequentially added into the extra-cellular fluid and the current density was recorded. RESULTS: TEA specifically inhibited the K(Ca) current After the addition of TEA and TEA + 4-AP, the current density at the potential of +80 mv of the 12-month-old rats was (18.48 +/- 1.7) pA/pF, significantly higher than that of the 3-month-old rats [(10.84 +/- 1.54) pA/pF, P < 0.01]. The original peak current of the 3-month-old rats was (9.5 +/- 1.8) pA/pF and became (5.4 +/- 3.1) pA/pF after the addition of TEA, decreased by 44% (P < 0.01); and the peak current of the 12-month-old rats was (19.1 +/- 2.9) pA/pF and became (7.2 +/- 3.2) pA/pF after the addition of TEA, decreased by 63% (P < 0.01). CONCLUSION: Elderly rats have stronger potassium channel currents than adult rats, and their K(Ca) current is more sensitively to TEA. Aging is related to decreased prostate gland cell secretion.
Asunto(s)
Envejecimiento/fisiología , Células Epiteliales/fisiología , Canales de Potasio/fisiología , 4-Aminopiridina/farmacología , Animales , Células Cultivadas , Células Epiteliales/citología , Células Epiteliales/efectos de los fármacos , Masculino , Potenciales de la Membrana/efectos de los fármacos , Potenciales de la Membrana/fisiología , Técnicas de Placa-Clamp , Bloqueadores de los Canales de Potasio/farmacología , Próstata/citología , Ratas , Ratas Sprague-Dawley , Tetraetilamonio/farmacologíaRESUMEN
OBJECTIVE: To investigate the regulatory effect of potassium channel blocker (tetraethylammonium [TEA], aminopyridine [4-AP], glibenclamide [Glib]) on the proliferation of SD rat prostatic epithelial cells in vitro. METHODS: The primary culture was prepared by collagenase dissociation of minced prostatic tissues. Cells were cultured in serum-free prostate epithelial cell growth media and identified by immunocytochemical studies. TEA and 4-AP at the concentration of 1, 5 and 10 mmol/L and Glib at the concentration of 10, 50 and 100 mol/L were added, and after 24, 48 and 72 hours of culturing, a cell column diagram was drawn and the cell number counted. The post-passage cell growth was observed by MTT assay and Hoechst33258 nucleus staining. RESULTS: The cultured cells showed the typical morphological features of epithelia, with positive stain. MTT assay and Hoechst33258 staining showed that TEA, 4-AP and Glib at the increasing concentration effected different degrees of proliferation of prostatic epithelial cells after 24, 48 and 72 h (P < 0.01). CONCLUSION: The potassium channel blocker is a direct physiological regulator of the proliferation of SD rat prostatic epithelial cells.
Asunto(s)
Proliferación Celular/efectos de los fármacos , Células Epiteliales/efectos de los fármacos , Bloqueadores de los Canales de Potasio/farmacología , Próstata/citología , Animales , Células Cultivadas , Masculino , Próstata/efectos de los fármacos , Ratas , Ratas Sprague-DawleyRESUMEN
OBJECTIVES: Chronic pelvic pain syndrome is a common and serious health problem affecting the quality of life of men. We evaluated the prevalence of premature ejaculation (PE) in Chinese men with chronic pelvic pain syndrome and studied its correlation to chronic prostatitis. METHODS: A total of 15,000 men (aged 15-60 years) were randomly recruited to take part in a survey to provide questionnaire-elicited information for sociodemographics, sexual function, National Institutes of Health-Chronic Prostatitis Symptom Index, and International Index of Erectile Function 5-item questionnaire. The eligible subjects of the present investigation were married with sexual activity. RESULTS: Responses were collected from 12 743 men (84.95%). Of these men, 1071 (8.4%) reported having prostatitis-like symptoms. The incidence of chronic prostatitis was 4.5% (n = 571) for the entire group. Of the 7372 eligible men, the incidence of prostatitis-like symptoms, chronic prostatitis, and PE was 10.5% (n = 771), 5.0% (n = 370), and 15.3% (n = 1127), respectively. The group with PE had worse National Institutes of Health-Chronic Prostatitis Symptom Index scores (P < .05) and lower International Index of Erectile Function 5-item questionnaire scores (P < .05) than the patients without PE. Also, the percentage of prostatitis-like symptoms in the PE group was greater than that in the non-PE group (P < .05). The prevalence of PE was 64.1% and 36.9% in the prostatitis-like symptom and chronic prostatitis group, respectively, of the 7372 eligible men. CONCLUSIONS: The results of our study showed a high prevalence of PE in patients with chronic prostatitis. An examination of the prostate, physically and microbiologically, should be considered during the assessment of patients with PE.