Medium-term Clinical Efficacy and Complications of Plasmakinetic Enucleation of the Prostate Versus Transurethral Resection of the Prostate for Benign Prostatic Hyperplasia.

OBJECTIVE: To compare surgical characteristics, clinical efficacy, and complications of plasmakinetic enucleation of the prostate (PKEP) and transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: From January 2015 to May 2018, 370 patients underwent TURP were included into the TURP group. Meanwhile, another 370 patients underwent PKEP (matched by age, prostate volume, and duration of BPH) were included into the PKEP group. Then, the differences of surgical characteristics, clinical efficacy, and complications were compared between the two groups. RESULTS: The operative time, intraoperative irrigation volume, postoperative irrigation time and irrigation volume, drop in hemoglobin, blood transfusion, postoperative catheterization time, and hospital stay of the PKEP group were significantly less than those of the TURP group (P <.05). No significant differences were observed in the resected tissue weight, visual analogue scale score, and total cost of hospitalization (P >.05); The quality of life score of the PKEP group was significantly lower than that of the TURP group (P <.05). No significant differences of maximum flow rate, postvoid residual urine, Serum prostate-specific antigen, international prostate symptom score and International Index of Erectile Function score were observed (P >.05); The incidences of urinary tract irritation, massive hemorrhage, secondary hemorrhage, bladder spasm, clot retention, and retrograde ejaculation of the PKEP group were significantly lower than those of the TURP group (P <.05). CONCLUSION: PKEP and TURP are comparable regarding cost burden and clinical efficacy in medium-term follow-up. However, PKEP should be given a priority for BPH treatment because of less complication rate and better safety profile.

Caffeine improves bladder function in streptozotocin-induced diabetic rats.

AIMS: To examine the protective effects of caffeine in rats with diabetes mellitus (DM) by using urodynamics. METHODS: Female Sprague-Dawley rats (n = 24) were divided into four groups: control group, DM group, DM + caffeine (5 mg/kg/day), and DM + caffeine (10 mg/kg/day). DM was induced by streptozotocin (STZ). Cystometric studies were conducted on all rats. After 8 weeks of treatment with caffeine, the urodynamic parameters, including bladder capacity, residual urine volume, voiding time, and peak voiding pressure, were measured. RESULTS: DM rats had a higher bladder capacity and post-void residual urine volume (PVR), an increased voiding time and peak voiding pressure, and a markedly lower voiding efficiency than the control group rats. After treatment with caffeine, bladder capacity, post-void residual urine volume, and peak voiding pressure were significant lower than those in the DM group, but voiding efficiency was markedly higher. CONCLUSION: The results suggested that caffeine (5 or 10 mg/kg/day) may improve the bladder function at 8 weeks after STZ induction. Thus, this may represent a potential strategy to increase voiding efficiency in diabetes.

Curcumin ameliorates cisplatin-induced cystopathy via activating NRF2 pathway.

OBJECTIVES: The present work evaluated preventive effect of curcumin on cisplatin-induced bladder cystopathy. METHODS: Fifteen female rats were divided into (i) Control group administered with physiological saline solution for 5 days; (ii) Cis-P group injected with cisplatin (6 mg/kg); and (iii) Cis-Cur group given cisplatin (6 mg/kg) with curcumin for 5 consecutive days. The function of bladder was measured by means of urodynamic analysis. Furthermore, hematoxylin-eosin staining and Masson trichrome staining were performed for morphological analysis. The cell apoptosis was evaluated through terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) assay and flow cytometry. The expression of nerve growth factor (NGF), NF-E2-related factor 2, and hemeoxygenase-1 (HO-1) levels were measured through Western blotting. RESULTS: Urodynamic assay and histopathological manifestations revealed that curcumin ameliorated the bladder dysfunction induced by cisplatin. The level of cisplatin-induced apoptosis in the bladder decreased following curcumin treatment. Also, the increased protein expression of NGF indicated that the curcumin could offer neuroprotection for bladder against cisplatin. Curcumin also activated NRF2, and elevated the expression of HO-1, but curcumin could not rescue cisplatin-induced apoptosis in the cell lines with knockdown of NRF2. CONCLUSIONS: Taken together, the results of this paper showed that curcumin could ameliorate cisplatin-induced cystopathy and inhibit the apoptosis of bladder cell in cisplatin-treated rats. This may be attributed to curcumin's broad biological functions, particularly antioxidant effect, and to its ability to activate the NRF2 protein.

Sulforaphane attenuates di-N-butylphthalate-induced reproductive damage in pubertal mice: Involvement of the Nrf2-antioxidant system.

di-N-butylphthalate (DBP) is a ubiquitous environmental pollutant used for plastic coating and in the cosmetics industry. It has toxic effects on body health, especially the male reproductive system. Here, we investigated the effects of DBP on the male reproductive system of pubertal mice and explored the protective role of sulforaphane (SFN). The results showed that DBP significantly reduced the anogenital distance, testicular weight, sperm count and motility, and plasma and testicular testosterone levels and significantly increased the oxidative stress, sperm abnormalities, and testicular cell apoptosis. SFN supplementation ameliorated these effects. After DBP stimulation, the transcription factor nuclear factor erythroid-related factor 2 (Nrf2) was adaptively increased together with its target genes, such as HO-1 and NQO1. Upregulation of Nrf2 by SFN reduced the DBP-mediated intracellular oxidative toxicity and also increased testosterone secretion and spermatogenesis, which were decreased by DBP. These findings indicate that SFN can attenuate DBP-induced reproductive damage in pubertal mice via Nrf2-associated pathways.

[Saw palmetto fruit extract improves LUTS in type â ¢A prostatitis patients].

OBJECTIVE: To assess the clinical efficacy of the saw palmetto fruit extract (SPFE) in the treatment of lower urinary tract symptoms (LUTS) in patients with type ⅢA prostatitis. METHODS: This retrospective study included 54 cases of type ⅢA prostatitis treated in the Outpatient Department of our hospital from January to December 2015. The patients were aged 35.06 ± 5.85 years, with a mean disease course of 3.8 ± 2.1 years, and all received oral medication of SPFE Capsules at the dose of 320 mg qd for 12 weeks. We assessed the therapeutic effects by comparing the NIH-chronic prostatitis symptom indexes (NIH-CPSI), voiding diary, International Prostate Symptom Scores (IPSS), and results of urodynamic examination before and after treatment. RESULTS: Compared with the baseline, both NIH-CPSI and IPSS were significantly decreased after medication (27.61 ± 3.76 vs 18.6 ± 5.34, P <0.01; 20.44 ± 4.51 vs 10.96±4.62, P <0.01), and urodynamic examination and voiding diary showed dramatic post-medication improvement in the average urinary flow rate (ï¼»8.05±1.42ï¼½ vs ï¼»12.05±2.60ï¼½ ml/s, P <0.01 ), maximum urinary flow rate (ï¼»14.22±1.74ï¼½ vs ï¼»21.32±4.51ï¼½ ml/s, P <0.01), residual urine volume (ï¼»46.15±16.57ï¼½ vs ï¼»14.55±10.21ï¼½ ml, P <0.01), maximum urethral closure pressure (ï¼»76.52±3.53ï¼½ vs ï¼»65.32±4.75ï¼½ cm H2O, P <0.01), mean urinary volume (ï¼»124.63±40.55ï¼½ vs ï¼»285.93±58.68ï¼½ ml, P <0.01), urination frequency (16.96±4.17 vs 8.96±2.50, P <0.01), and nocturia frequency (8.94±3.23 vs 3.15±1.90, P <0.01). No apparent adverse reactions were observed in any of the patients. CONCLUSIONS: SPFE Capsules can safely and effectively improve LUTS and thus the quality of life of patients with type ⅢA prostatitis.

[Proteomic analysis of the testis and differential expression of Annexin A3 in hypospadiac rats].

OBJECTIVE: To investigate the effect of in utero exposure to di-n-butyl phthalate (DBP) on the protein expression in the penile tissue of hypospadiac rats, isolate and identify differentially expressed proteins, and determine the role of the differential expression of Annexin A3 in the development of hypospadia in the rat offspring after maternal exposure to DBP. METHODS: Twenty pregnant SD rats were randomly assigned to an experimental group, intragastrically administered DBP at 800 mg/kg, and a control group, given soybean oil at 5 ml/kg, both for 5 days. Three days after birth, the penises of the newborn rats were removed, and the total protein extracted for 2D-electrophoretic separation and image analysis. Differentially expressed protein spots were screened and identified by mass spectrometry, and the changes in the expression of Annexin A3 detected by Western blotting and immunohistochemistry. RESULTS: Thirty-one differentially expressed protein spots were screened, of which 17 were identified by mass spectrometry and the SwissProt database, including pyruvate kinase M2, alpha-enolase, and Annexin A3. Western blot showed that Annexin A3 was mainly located in the urethral epithelia and had a lower expression in the hypospadiac rats (1.851 +/- 0.014, n = 10) than in the controls (2.603 +/- 0.012, n = 10) (P < 0.05). CONCLUSION: A pedigree of differentially expressed proteins in the penises of DBP-induced hypospadia and normal rats was established by the proteomic method. The differential expression of Annexin A3 may play an important role in the development of hypospadia.

[Differential expression of ubiquitin C-terminal hydrolase L-1 in the rat testis following exposure to di-n-butyl phthalate in utero].

OBJECTIVE: To identify and analyze the differential expression of ubiquitin C-terminal hydrolase L-1 (UCHL1) in the testis of rat offspring after maternal exposure to di-n-butyl phthalate (DBP). METHODS: Forty pregnant rats were randomly divided into two groups and given DBP by gastric intubation at the dose of 800 mg/(kg x d) or none from the 14-18th day of pregnancy. Testes were harvested from the fetal and neonatal rats of the normal and exposed groups respectively at GD19 and PND22. The expression of UCHL1 was detected and analyzed by Western blot and immunohistochemistry. RESULTS: The UCHL1 expression was 50% lower in the DBP-exposed group than in the normal controls on GD19 (P < 0.01), but showed no significant difference between the two groups on PND22 (P > 0.05). UCHL1 was mainly located in the cytoplasm and nuclei of spermatogonia, primary spermatocytes and sub-primary spermatocytes in the developmental phase of the testis. CONCLUSION: Exposure in utero to DBP affects the UCHL1 expression in testicular spermatogenic cells, disturbs the balance of the ubiquitin-proteasome system and consequently causes maldevelopment of the testis with thinner seminiferous tubules and reduced count of spermatogenic cells.

[Persistent Müllerian duct syndrome: a report of 2 cases and review of the literature].

OBJECTIVE: To study the etiopathogenesis, clinical manifestations, diagnosis and management of persistent Müllerian duct syndrome (PMDS). METHODS: Two cases of PMDS were reported, one accompanied by transverse testicular ectopia and the other associated with cryptorchidism. Corporeal hysterectomy and orchidopexy were given to both the patients and cryptorchidectory the latter. RESULTS: Vascular supply and texture of the testis were normal in both the 2 patients after 1.5-2 years' follow-up. CONCLUSION: PMDS is male pseudohermaphroditism, for which means should be taken to preserve the blood supply and fertility function of the testis in surgical management, and attention should be paid to possible development of testis tumor in follow-up.