Transurethral assistant transumbilical laparoendoscopic single-site radical prostatectomy.

The laparoendoscopic single-site (LESS) technique is the latest technical innovation in laparoscopic surgery to undergo exponential development in urology. This study undertaken to illustrate our initial experience LESS radical prostatectomy (RP) and analyze early outcomes. Nineteen patients diagnosed with prostate cancer underwent LESS-RP in our institute. The patients were divided into two groups: conventional LESS and transurethral assistant LESS. Preoperative, perioperative, postoperative, pathologic, and functional outcomes data were assessed. With the help of a transurethral assistant, the mean operation and anastomosis time were decreased markedly. No focal positive margins were encountered. No prostate-specific antigen recurrence was detected 1 month postoperatively. Complete continence recovery (no pad) was observed in 32% of the patients at 1 month after the operation. No intraoperative and postoperative complications were reported. LESS-RP is a feasible and effective surgical procedure for treatment of prostate cancer. Moreover, transurethral assistant LESS could reduce the difficulty of LESS-RP and shorten the operation time.

[Chinese medicinal compound CFF-1 induces the apoptosis and cycle-arrest of prostate cancer cells via the PI3K/AKT/FOXO1 signaling pathway].

OBJECTIVE: To explore the apoptosis-inducing effect of the Chinese medicinal compound CFF-1 on prostate cancer cells and its related molecular mechanisms. METHODS: Normal prostate WPMY-1 cells and prostate cancer LNCaP, CWR22Rv1, PC3 and DU145 cells were treated in dehydrated alcohol with CFF-1 at 0, 2, 5, or 10 mg/ml for 24 hours. Then the viability of the prostate cells was detected by morphological observation, MTT and CCK-8 assay, nuclear condensation and disruption measured by DAPI staining, the cell cycle and apoptosis calculated by flow cytometry, the activity of the PI3K/AKT/FOXO1 signaling pathway and the expressions of its downstream apoptosis- and cycle-related proteins determined by Western blot. RESULTS: CFF-1 significantly arrested the cell cycle in the G1 phase, decreased the cell viability and increased the nuclear condensation and disruption in a dose-dependent manner, and elevated the apoptosis rate of prostate cancer cells. At the molecular level, CFF-1 dose-dependently reduced the activity of the PI3K/AKT signaling pathway and phosphorylation of the FOXO1 protein, increased the transcription activity of FOXO1, and eventually regulated the expressions of cell apoptosis- and cycle-related genes. CONCLUSIONS: The Chinese medicinal compound CFF-1 can significantly inhibit the growth, arrest the cycle, and induce the apoptosis of prostate cancer cells by decreasing the activity of the PI3K/AKT/FOXO1 signaling pathway, which suggests its potential clinical application value in the treatment of prostate cancer.

[Clinical efficacy of integrated traditional Chinese and Western medicine for castration-resistant prostate cancer].

OBJECTIVE: To investigate the clinical effects of integrated traditional Chinese and Western medicine in the treatment of castration-resistant prostate cancer (CRPC). METHODS: A total of 54 CRPC patients were randomly divided into a control and a trial group, all treated by endocrine therapy (oral Bicalutamide at 50 mg per d plus subcutaneous injection of Goserelin at 3.6 mg once every 4 wk) and chemotherapy (intravenous injection of Docetaxel at 75 mg/m2 once every 3 wk plus oral Prednisone at 5 mg bid), while the latter group by Fuyang Huayu Prescription (a Traditional Chinese Medicine ï¼»TCMï¼½ prescription for tonifying yang and dispersing blood stasis) in addition, for a course of 24 weeks. Comparisons were made between the two groups of patients in the level of serum prostate-specific antigen (PSA), Karnofsky physical condition scores, function assessment of cancer therapy-prostate (FACT-P) scores, and TCM symptoms scores before and after 12 or 24 weeks of treatment. RESULTS: Compared with the baseline, the serum PSA level was significantly decreased after 12 weeks of treatment both in the control (ï¼»25.9 ± 39.3ï¼½ vs ï¼»20.0 ± 21.1ï¼½ µg/L, P <0.05) and in the trial group (ï¼»22.1 ± 33.9ï¼½ vs ï¼»17.9 ± 19.1ï¼½ µg/L, P <0.05), with no statistically significant differences between the two groups (P >0.05). At 24 weeks, however, the PSA levels in the control and trial groups were slightly increased to (23.1 ± 28.4) and (19.6 ± 23.5) µg/L, respectively, with no statistically significant differences in between (P >0.05). Karnofsky, FACT-P and TCM symptoms scores were all markedly improved in the trial group after 12 weeks of treatment (P <0.05) and remained stable at 24 weeks, but not in the control group either at 12 or at 24 weeks (P >0.05). CONCLUSIONS: TCM Fuyang Huayu Prescription combined with endocrine therapy and chemotherapy is effective for CRPC.

[Integrated therapy of traditional Chinese and Western medicine for BPH with diabetes mellitus: clinical observation of 52 cases].

OBJECTIVE: To investigate the effect of the integrated therapy of traditional Chinese and Western medicine in the treatment of BPH complicated by diabetes mellitus. METHODS: Fifty-two cases of BPH complicated by diabetes mellitus were equally randomized to a treatment group and a control group, and both underwent transurethral plasmakentic vaporization when fasting glucose was kept at 6.0 - 8.0 mmol/L, followed by anti-infection, rehydration and semeiologically supportive therapies. And both of the two groups received Chinese medicinal herbal treatment before and after surgery. RESULTS: Neither of the two groups showed postoperative electrolyte disturbance, ketone acidosis, or hypoglycemia. The incidences of postoperative constipation, bladder convulsion and urinary tract infection were significantly lower in the treatment group than in the control group (P < 0.05). CONCLUSION: The integrated therapy of traditional Chinese and Western medicine for BPH with diabetes mellitus can not only smoothly tide the patients over the perioperative period, but also improve their quality of life by reducing postoperative constipation, bladder convulsion and urinary tract infection.

[TUBVP and HOLEP: desirable surgical options for large benign prostatic hyperplasia ( >80 ml)].

OBJECTIVE: To compare the safety and efficacy of the two surgical alternatives, transurethral bipolar vaporization resection of the prostate (TUBVP) and holmium laser enucleation of the prostate (HOLEP), in the treatment of large benign prostatic hyperplasia (BPH). METHODS: Retrospective analyses were made of 56 cases of large BPH ( >80 ml), 34 treated by TUBVP with the Bipolar Vaporization System (ACMI Medical Ltd, U.K.) at 160 W in cutting and 80 W in coagulation mode, and 22 by HOLEP with the Holmium Laser System (LUMNIS Ltd, US) at 100W. The safety and efficacy of the two approaches were assessed based on the operative and follow-up data. RESULTS: Blood loss was significantly less in the HOLEP than in the TUBVP group ( P < 0.01), but the time of postoperative bladder irrigation and catheter indwelling was obviously shorter in the latter. IPSS, Qmax and Residual unine were markedly improved at 1 and 3 months after the surgery, with no statistically significant differences between the two groups. CONCLUSION: Both TUBVP and HOLEP are safe and effective surgical options for the treatment of large BPH. Particularly the former, easier to be popularly applied, is promising to be a new "gold standard" in the surgical treatment of BPH.