To evaluate the efficacy of nephrostomy balloon dilation （NBD） for patients who developed vesicourethral anastomotic stricture （VAS） following radical prostatectomy. NBD was performed in patients who developed VAS...To evaluate the efficacy of nephrostomy balloon dilation （NBD） for patients who developed vesicourethral anastomotic stricture （VAS） following radical prostatectomy. NBD was performed in patients who developed VAS following radical prostatectomy. Quality of life （QoL）, International Prostate Symptom Score （IPSS） and maximal urinary flow rate （Qmax） were evaluated. Four hundred and sixty-three prostate cancer patients underwent radical retropubic prostatectomy （RRP）, and 86 underwent laparoscopic radical prostatectomy （LRP）. Most patients （90.3%） had T2 or T3 prostate cancer and a pathological Gleason score of ; 7. Forty-five （8.2%） and four （4.7%） patients developed VAS due to radical or LRP, respectively. Forty （89%） patients underwent NBD, including three cases of repeat dilation. The median Qmax was 4 ml s- （interquartile range （IQR）, 2.3-5.6） before dilation and improved to 16 ml s- （IQR, 15-19） and 19 ml s-1 （IQR, 18-21） at the 1- and 12-month follow-up, respectively （P〈 0.01）. Fifteen （37.5%） patients had urinary incontinence prior to dilation, whereas only three （7.5%） patients had incontinence 12 months following dilation （P 〈 0.01）. The median IPSS score improved from 19 （IQR, 17-24） before dilation to 7 （IQR, 6-8） at 12 months following dilation, and the QoL score improved from 5 （IQR, 4-6） before dilation to 2 （IQR, 2-3） at 12 months following dilation （P 〈 0.01 in both）. VAS occurs in a small but significant proportion of patients following radical prostatectomy. NBD offers an effective remedy for VAS.展开更多
Objective:Toimprove the diagnosis and treatment of prostate abscess by summing up experience of 6 cases of prostatic abscess.Methods:From May 2014 to October 2019,6 cases of prostatic abscess were diagnosed by means o...Objective:Toimprove the diagnosis and treatment of prostate abscess by summing up experience of 6 cases of prostatic abscess.Methods:From May 2014 to October 2019,6 cases of prostatic abscess were diagnosed by means of clinical manifestations combined with digital rectal examination(DRE),ultrasound and computed tomography(CT).Five cases were performed transurethral incision and drainage for prostatic abscess,and 1 case underwent ultrasound-guided perineal drainage.Results:The symptoms of the 6 patients disappeared after drainage and recovered well without recurrence.Conclusions:The clinical manifestations combined with DRE,ultrasonography and CT are beneficial to the diagnosis of prostatic abscess.Both transurethral incision and drainage and ultrasound-guided perineal drainage are effective way to treat prostate abscess.展开更多
Objective:To investigate the causes of bladder explosion during transurethral plasmakinetic resection of prostate and to explore effective measures to reduce the risk of bladder explosion.Methods:The treatment process...Objective:To investigate the causes of bladder explosion during transurethral plasmakinetic resection of prostate and to explore effective measures to reduce the risk of bladder explosion.Methods:The treatment process of bladder rupture(2cases)and bladder muscle layer laceration(1case)during transurethral plasmakinetic resection of prostate were retrospectively analyzed.Results:Two cases with intra-peritoneal rupture were cured by open surgery,and 1case with bladder muscle layer laceration was cured by conservative treatment.The main cause of bladder explosion is that:the flammable gas produced during the resection of prostate tissue mixed with the gas from the outside into the bladder to a certain proportion,in the action of electric spark,causing gas explosion.Conclusions:Using dorsal elevated position,shortening operative time,and reducing gas entering the bladder are three key points to prevent bladder explosion.展开更多
Objective: To study the postoperative trauma of the retroperitoneal laparoscopic intrasinusal pyelolithotomy (RLIP) and percutaneous nephrolithotomy (PCNL). Methods: A total of 118 patients who were diagnosed with sin...Objective: To study the postoperative trauma of the retroperitoneal laparoscopic intrasinusal pyelolithotomy (RLIP) and percutaneous nephrolithotomy (PCNL). Methods: A total of 118 patients who were diagnosed with single pelvis calculus in Shanghai Punan Hospital of Pudong New District between September 2013 and February 2017 were selected and randomly divided into RLIP group and PCNL group who received retroperitoneal laparoscopic intrasinusal pyelolithotomy and percutaneous nephrolithotomy respectively. The removal of the stones was observed 1 week and 4 weeks after surgery, and 3mL of cubital venous blood was collected 3 d and 7 d after operation to detect the renal function indicators, inflammatory markers and stress indicators. Results: The stone removal success rate of RLIP group 1 week and 4 weeks after operation were significantly higher than those of PCNL group, serum BUN, Scr and Cys-C contents as well as eGFR levels were not significantly different between RLIP group and PCNL group 3 d and 7 d after operation, and serum Cor, NE, HSP70, NO, IL-6, hs-CRP, TNF-α and PGE2 contents of RLIP group 3 d and 7 d after operation were significantly lower than those of PCNL group. Conclusion: RLIP is significantly better than PCNL in stone removal and causes significantly less postoperative trauma than PCNL.展开更多
文摘To evaluate the efficacy of nephrostomy balloon dilation （NBD） for patients who developed vesicourethral anastomotic stricture （VAS） following radical prostatectomy. NBD was performed in patients who developed VAS following radical prostatectomy. Quality of life （QoL）, International Prostate Symptom Score （IPSS） and maximal urinary flow rate （Qmax） were evaluated. Four hundred and sixty-three prostate cancer patients underwent radical retropubic prostatectomy （RRP）, and 86 underwent laparoscopic radical prostatectomy （LRP）. Most patients （90.3%） had T2 or T3 prostate cancer and a pathological Gleason score of ; 7. Forty-five （8.2%） and four （4.7%） patients developed VAS due to radical or LRP, respectively. Forty （89%） patients underwent NBD, including three cases of repeat dilation. The median Qmax was 4 ml s- （interquartile range （IQR）, 2.3-5.6） before dilation and improved to 16 ml s- （IQR, 15-19） and 19 ml s-1 （IQR, 18-21） at the 1- and 12-month follow-up, respectively （P〈 0.01）. Fifteen （37.5%） patients had urinary incontinence prior to dilation, whereas only three （7.5%） patients had incontinence 12 months following dilation （P 〈 0.01）. The median IPSS score improved from 19 （IQR, 17-24） before dilation to 7 （IQR, 6-8） at 12 months following dilation, and the QoL score improved from 5 （IQR, 4-6） before dilation to 2 （IQR, 2-3） at 12 months following dilation （P 〈 0.01 in both）. VAS occurs in a small but significant proportion of patients following radical prostatectomy. NBD offers an effective remedy for VAS.
基金Shanghai key specialty medical construction plan(No.ZK2019C07)。
文摘Objective:Toimprove the diagnosis and treatment of prostate abscess by summing up experience of 6 cases of prostatic abscess.Methods:From May 2014 to October 2019,6 cases of prostatic abscess were diagnosed by means of clinical manifestations combined with digital rectal examination(DRE),ultrasound and computed tomography(CT).Five cases were performed transurethral incision and drainage for prostatic abscess,and 1 case underwent ultrasound-guided perineal drainage.Results:The symptoms of the 6 patients disappeared after drainage and recovered well without recurrence.Conclusions:The clinical manifestations combined with DRE,ultrasonography and CT are beneficial to the diagnosis of prostatic abscess.Both transurethral incision and drainage and ultrasound-guided perineal drainage are effective way to treat prostate abscess.
基金Shanghai medical specialty construction plan(No.ZK2019C07)。
文摘Objective:To investigate the causes of bladder explosion during transurethral plasmakinetic resection of prostate and to explore effective measures to reduce the risk of bladder explosion.Methods:The treatment process of bladder rupture(2cases)and bladder muscle layer laceration(1case)during transurethral plasmakinetic resection of prostate were retrospectively analyzed.Results:Two cases with intra-peritoneal rupture were cured by open surgery,and 1case with bladder muscle layer laceration was cured by conservative treatment.The main cause of bladder explosion is that:the flammable gas produced during the resection of prostate tissue mixed with the gas from the outside into the bladder to a certain proportion,in the action of electric spark,causing gas explosion.Conclusions:Using dorsal elevated position,shortening operative time,and reducing gas entering the bladder are three key points to prevent bladder explosion.
文摘Objective: To study the postoperative trauma of the retroperitoneal laparoscopic intrasinusal pyelolithotomy (RLIP) and percutaneous nephrolithotomy (PCNL). Methods: A total of 118 patients who were diagnosed with single pelvis calculus in Shanghai Punan Hospital of Pudong New District between September 2013 and February 2017 were selected and randomly divided into RLIP group and PCNL group who received retroperitoneal laparoscopic intrasinusal pyelolithotomy and percutaneous nephrolithotomy respectively. The removal of the stones was observed 1 week and 4 weeks after surgery, and 3mL of cubital venous blood was collected 3 d and 7 d after operation to detect the renal function indicators, inflammatory markers and stress indicators. Results: The stone removal success rate of RLIP group 1 week and 4 weeks after operation were significantly higher than those of PCNL group, serum BUN, Scr and Cys-C contents as well as eGFR levels were not significantly different between RLIP group and PCNL group 3 d and 7 d after operation, and serum Cor, NE, HSP70, NO, IL-6, hs-CRP, TNF-α and PGE2 contents of RLIP group 3 d and 7 d after operation were significantly lower than those of PCNL group. Conclusion: RLIP is significantly better than PCNL in stone removal and causes significantly less postoperative trauma than PCNL.
