[Effect of modified holmium laser enucleation of the prostate on postoperative urinary control and sexual function in elderly patients with benign prostatic hyperplasia].

OBJECTIVE: To investigate the impact of retaining part of the urethral mucosa on postoperative urinary control, erectile function, and ejaculatory function in patients undergoing holmium laser enucleation of the prostate (HoLEP) surgery. METHODS: A retrospective analysis was conducted on 176 benign prostatic hyperplasia (BPH) patients who underwent surgical treatment at our hospital from January 2019 to January 2022, including 80 cases of modified HoLEP surgery and 96 cases of standard HoLEP surgery. Preoperative and postoperative clinical data were collected and analyzed. RESULTS: At 3 months postoperatively, both groups showed significant improvement in maximum flow rate (Qmax), International Prostate Symptom Score (IPSS) , residual urine volume (RUV) , and quality of life (QOL) compared to pre-treatment values, with statistically significant differences (P<0.05) . There was a significant difference in QOL scores between the experimental and control groups (P<0.05) . At 3 months postoperatively, the incidence of urinary incontinence was significantly lower in the experimental group compared to the control group (P<0.05) . At 6 months postoperatively, both groups showed a significant increase in International Index of Erectile Function-5 (IIEF-5) scores compared to preoperative values (P<0.05) , with no significant difference between the two groups. The incidence of retrograde ejaculation in the experimental group was significantly lower than that in the control group (P<0.05) . CONCLUSIONS: Retaining part of the urethral mucosa in HoLEP surgery can effectively treat BPH, providing significant advantages in terms of urinary control and playing a positive role in overall postoperative sexual function recovery.

[Clinical effects of the circumcision stapler, foreskin cerclage, and traditional circumcision: A comparative study].

OBJECTIVE: To compare the clinical effects of the circumcision stapler, circumcision cerclage, and traditional circumcision in the treatment of phimosis and redundant prepuce. METHODS: Using the circumcision stapler (group A), foreskin cerclage (group B), and traditional circumcision (group C), we treated 276 patients with phimosis or redundant prepuce. We made comparisons among the three groups in the operation time, intraoperative blood loss, intraoperative and 24-hour postoperative pain scores, and incidence of postoperative complications. Results: The operation time, intraoperative blood loss, and intraoperative pain score were (6.52 ± 2.45) min, (1.93 ± 0.82) ml, and 1.37 ± 0.68 in group A and (7.24 ± 1.86) min, (1.51 ± 0.72) ml, and 1.20 ± 0.79 in group B, all significantly lower than (28. 36 ± 4.22) min, (9.52 ± 3.29) ml, and 3.06 ± 0.75 in group C (P <0.05). The 24-hour postoperative pain score was remarkably higher in group B than in A and C (3. 18 ± 0. 82 vs 1. 85 ± 0. 63 and 1. 82 ± 0. 75, P <0. 05). The incidence rate of postoperative complications was markedly lower in group A than in B (5. 43% vs 14. 13%, P < 0.05), but with no significant differences between either A and C or B and C (P >0.05). CONCLUSION: The circumcision stapler, with its advantages of simple operation, minimal invasiveness, fewer complications, and better cosmetic result, deserves a wider clinical application.

[Relationship between serum ß2-microglobulin and lower extremity atherosclerotic occlusive disease].

OBJECTIVE: To explore the relationship between fasting serum level of ß2-microglobulin (ß2-M) and the development of lower extremity atherosclerotic occlusive disease (LEAOD). METHODS: A total of 59 LEAOD patients at our hospital from March 2011 to August 2012 were recruited into the LEAOD group while another 32 non-LEAOD patients into the control group. Their clinical profiles and the parameters of ankle brachial index (ABI),ß2-M and high-sensitivity C-reactive protein (hsCRP) were recorded and analyzed. RESULTS: The patients had higher serum levels of ß2-M (5.3 ± 3.2 vs 2.6 ± 1.3) and hsCRP (15.1 ± 14.8 vs 8.0 ± 6.7) according to the severity in the LEAOD group than those in the control group (P < 0.05).ß2-M was correlated with smoking (ß 1.248, odds ratio[OR] 0.020, 95% confidence interval [CI] 1.221-9.942), diabetes (ß 1.524,OR 4.591, 95%CI 1.493-14.118) and ABI (ß-4.091,OR 0.017, 95%CI 0.002-0.136) . The receiver operating characteristic (ROC) curve showed that ß2-M level had some value of predicting the occurrence of LEAOD (ROCAUC 0.821, 95%CI 0.731-0.912, P < 0.01). CONCLUSION: Serum level of ß2-M may play a role in pathologic process of LEAOD. And further studies are needed to validate its value as a biomarker for LEAOD.