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The impact of minimally invasive surgeries for the treatment of symptomatic benign prostatic hyperplasia on male sexual function： a systematic review

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Asian Journal of Andrology 2010年第4期12卷 500-508页

作者： Ryan W. Frieben Hao-Cheng Lin Peter E Hinh francesco berardinelli Steven E. Canfield Run Wang Division of Urology University of Texas Medical School at Houston Houston TX 77030 USA Department of Urology Affiliated Drum Tower Hospital Nanjing University School of Medicine Nanjing 210008 China Division of Urology Department of Medicine and Aging Sciences ＂G.d＇Annunzio＂ University Chieti Italy Department of Urology University of Texas MD Anderson Caneer Center Houston TX 77030 USA

A systematic review of randomized controlled trials and cohort studies was conducted to evaluate data for the effects of minimally invasive procedures for treatment of symptomatic benign prostatic hyperplasia （BPH） on male sexual function. The studies searched were trials that enrolled men with symptomatic BPH who were treated with laser surgeries, transurethral microwave therapy （TUMT）, transurethral needle ablation of the prostate （TUNA）, transurethral ethanol ablation of the prostate （TEAP） and high-intensity frequency ultrasound （HIFU）, in comparison with traditional transurethral resection of the prostate （TURP） or sham operations. A total of 72 studies were identified, of which 33 met the inclusion criteria. Of the 33 studies, 21 were concerned with laser surgeries, six with TUMT, four with TUNA and two with TEAP containing information regarding male sexual function. No study is available regarding the effect of HIFU for BPH on male sexual function. Our analysis shows that minimally invasive surgeries for BPH have comparable effects to those of TURP on male erectile function. Collectively, less than 15.4% or 15.2% of patients will have either decrease or increase, respectively, of erectile function after laser procedures, TUMT and TUNA. As observed with TURP, a high incidence of ejaculatory dysfunction （EjD） is common after treatment of BPH with holmium, potassium-titanyl-phosphate and thulium laser therapies （〉 33.6%）. TUMT, TUNA and neodymium：yttrium aluminum garnet visual laser ablation or interstitial laser coagulation for BPH has less incidence of EjD, but these procedures are considered less effective for BPH treatment when compared with TURP.

关键词： benign prostatic hyperplasia ejaculatory dysfunction erectile dysfunction minimally invasive surgery sexual function,transurethral resection of the prostate

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Evidence that chronic hypoxia causes reversible impairment on male fertility

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Asian Journal of Andrology 2008年第4期10卷 602-606页

作者： Vittore Verratti francesco berardinelli Camillo Di Giulio Gerardo Bosco Marisa Cacchio Mario Pellicciotta Michele Nicolai Stefano Martinotti Raffaele Tenaglia Department of Medicine and Aging Science University of Chieti Chieti 66013 Italy Department of Basic and Applied Medical Sciences University of Chieti Chieti 66013 Italy Biostatistical Office Regina Elena Institute Rome 00144 Italy Laboratorio di Patologia Clinica H University of Chieti Chieti 66013 Italy

Aim： To evaluate the effect of chronic hypoxia on human spermatogenic parameters and their recovery time. Methods： Seminological parameters of six male healthy mountain trekkers were evaluated in normoxia at sea level. After 26 days exposure to altitude （ranging from 2 000 m to 5 600 m, Karakorum Expedition） the same parameters were again evaluated after returning to sea level. These parameters were once again evaluated after 1 month and then again after 6 months. Results： Sperm count was found to be lower immediately after returning to sea level （P = 0.0004） and again after a month （P = 0.0008）. Normal levels were reached after 6 months. Spermatic motility （%） shows no reduction immediately after returning to sea level （P = 0.0583）, whereas after 1 month this reduction was significant （P = 0.0066）. After 6 months there was a recovery to pre-hypoxic exposure values. Abnormal or immature spermatozoa （%） increased immediately after returning to sea level （P = 0.0067） and then again after 1 month （P = 0.0004）. After 6 months there was a complete recovery to initial values. The total number of motile sperm in the ejaculate was found to be lower immediately after returning to sea level （P = 0.0024） and then again after 1 month （P = 0.0021）. After 6 months there was a recovery to pre-hypoxic exposure values. Conclusion： Chronic hypoxia induces a state of oligospermia and the normalization of such seminological parameters at the restoration of previous normoxic conditions after 6 months indicate the influence of oxygen supply in physiological mechanisms of spermatogenesis and male fertility.

关键词： male fertility hypoxia seminological parameters high altitude

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Single-site laparoscopic partial nephrectomy: Where are we going?

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World Journal of Clinical Urology 2014年第3期3卷 358-363页

作者： Roberto Castellucci Luca Cindolo Mario Alvaréz-Maestro Guido Giusti francesco berardinelli Fabio Pellegrini Luigi Schips Urology Department Hospital "Infanta Sofia"65129 Madrid Spain Urology Department Hospital "S.Pio da Pieterelcina"66054 Vasto Italy Stone Center Urology Department Humanitas Clinical and Research Center20089 Rozzano Italy

AIM:To review an evolution of laparoscopic surgery,there has been a growing interest in laparoendoscopic single-site surgery(LESS).METHODS:A comprehensive electronic literature search was conducted using PubM ed database to identify all publications relating to LESS-partial nephrectomy(PN).The research includes articles published from April 2008 to January *** focused our attention only on articles in which were cited the single-site surgical technique(laparoscopic and robotic),tumour stage and grade,mean tumour size,intraoperative variables,blood loss and transfusion rate,length of postoperative stay and complication rates,Clavien classification,positive of surgical margins,pain assessment at ***:A total of 9 studies were collected with 221patients *** mean patients age was 62 *** mean tumor size was 2.35 cm with a mean operative time of 181 min(range 111-270 min)and 58.3%were done by *** mean ischemia time was *** 25.8%of patients underwent an unclamp *** estimated blood loss was 296 mL and median length of hospital stay was 4 *** rate of severe post-operative complications(≥Clavien gradeⅢ)was 5.4%.Not all surgical series of LESS-PN or Robotic-LESS-PN shows conversion in Multiport Laparoscopic or Open *** oncologic outcomes,surgical margins were positive 4%of patients(9/221),no distant or port-site metastases were ***:LESS-PN and RLESS-PN are feasible and associated with reduced postoperative pain,shorter median hospital stay,shorter recovery time,and better cosmetic satisfaction without compromising surgical and oncological safety.

关键词： Nephron sparing surgery Partial nephrectomy Laparoendoscopic single-site surgery Single-port access surgery Single-incision laparoscopic surgery Robotic single-port partial nephrectomy

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