ABSTRACT
Objective:To investigate the effects of finasteride combined with tamsulosin hydrochloride administered during the perioperative period on glandular microvessel density in patients with benign prostatic hyperplasia.Methods:Ninety patients with benign prostatic hyperplasia who received treatment in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from August 2017 to August 2019 were included in this study. They were randomly assigned to receive either oral tamsulosin hydrochloride alone (control group, n = 45) or oral finasteride combined with tamsulosin hydrochloride (observation group, n = 45) during the perioperative period of transurethral resection of the prostate. All patients received 6 weeks of medication. Clinical efficacy, adverse reactions, and urodynamic indexes, glandular microvessel density, International Prostatism Symptom Score, bother score, and urine color/degree of haematuria score pre- and post-treatment were compared between the two groups. Results:The maximum urinary flow rate in each group significantly increased 6 weeks after treatment compared with before treatment. The detrusor pressure and residual urine volume in each group decreased 6 weeks after treatment compared with before treatment. After 6 weeks of treatment, the maximum urinary flow rate was significantly higher in the observation group than in the control group [(15.63 ± 2.26) mL/s vs. (13.14 ± 2.23) mL/s], and residual urine volume was significantly lower in the observation group than in the control group [(29.19 ± 4.81) mL vs. (32.25 ± 5.52) mL, t = 5.26, 2.80, both P < 0.05). International Prostatism Symptom Score measured 6 weeks after treatment and urine color/degree of haematuria score measured 1 week after treatment were (12.09 ± 2.17) points and (1.51 ± 0.27) points, respectively in the observation group, which were significantly lower than those in the control group [(14.28 ± 2.22) points, (2.03 ± 0.38) points, t = 4.73, 7.48, both P < 0.05]. Factor VIII related antigen- and CD34-positive glandular microvessel density values in the observation group were (14.74 ± 3.05) counts/visual field and (19.41 ± 3.07) counts/visual field, respectively, which were significantly lower than those in the control group [(18.08 ± 3.16) counts/visual field, (22.27 ± 3.16) counts/visual field, t = 5.10, 4.35, both P < 0.05]. The incidence of postoperative hematuria was significantly lower in the observation group than in the control group [15.56% (7/45) vs. 35.56% (16/45), χ2 = 4.73, P < 0.05]. Conclusion:Compared with tamsulosin hydrochloride alone, finasteride combined with tamsulosin hydrochloride administered during the perioperative stage can greatly improve the urodynamic indexes of patients with benign prostatic hyperplasia, reduce microvessel density value, International Prostatism Symptom Score, bother score, and decrease the incidence of hematuria. The combined therapy provides a novel idea for preventing perioperative bleeding in patients with benign prostatic hyperplasia.
ABSTRACT
Objective To evaluate the morbidity of the post-prostatectomy incontinence of supra-pubic transvesical prostatectomy(SPP) and transurethral resection of prostate(TURP). Methods One hundred and thirtyfive patients were divided into two groups. 82 patients underwent SPP and 53 patients underwent TURP. We ob-served the morbidity and the time lasting of post-prostatectomy incontinence, the severity of post-prostatectomy in-continence as evaluated by Stamey incontinence grading system,patients who had more than one week postoperativeincontinence were received urodynamic tests,then we got the information of their incontinence types. Results We found that patients who underwent SPP had higher morbidity, severity and time lasting than those who underwent TURP. SPP group had much more morbidity of stress incontinence than TURP group, but the same morbidity of ur-gent incontinence after operation as the later. Conclusion TURP may be better than SPP in consideration of the post-prostateetomy incontinence. SPP group has more stress incontinence and it may be caused by complete resection of prostate and damnifieation of the mucous membrane of membranous urethra.
ABSTRACT
Objective To discuss the causes leading to dissatisfying result after operation therapy for BPH.Methods 42 patients who had not acquired satisfying result after operation therapy for BPH were underwent the urodynamic examination.Results 42 patients were classified into two groups according to their different symptoms:difficuhy to void,32 case8,including 8 cases with low contractifity of detrusor,and 24 cases with Madder outflow obstruction(BOO);incontinence,10 eases,including 6 cases of urgency incontinence and 4 cases of stress incontinence.Condusion We can see that the causes leading to dissatisfying resuh after operation for BPH are mainly the dysfunction of detmsor and BOO,and the result of urodynamic examine can guide us the causes and the next therapy.