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The learning curve for transurethral enucleation with bipolar energy for benign prostate hyperplasia:a single-surgeon experience of 494 patients

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Asian Journal of Andrology 2024年第3期26卷 288-294页

作者： Byeongdo Song Sang Hun Song Seong Jin Jeong Department of Urology Seoul National University Bundang HospitalSeongnam 13620Korea Department of Urology Seoul National University College of MedicineSeoul 03080Korea

This study was performed to investigate the learning curve of transurethral enucleation with bipolar energy(TUEB)for benignprostatic *** study involved 494 consecutive patients who underwent TUEB for benign prostatic hyperplasia fromAugust 2018 to March 2022 by one surgeon(SJJ,Seoul National University Bundang Hospital,Seongnam,Korea).The patientswere followed up at 1 week,1 month,3 months,and 6 months *** evaluate the learning curve of TUEB,perioperativeparameters including the enucleation ratio(enucleated tissue weight/transitional zone volume),TUEB efficiency(enucleatedtissue weight/operation time),and enucleation efficiency(enucleated tissue weight/enucleation time)were *** and postoperative complications were also assessed,including the International prostate Symptom Score(IPSS),IPSSquality-of-life(QoL)score,and uroflowmetry *** patients’median age was 72(interquartile range[IQR]:66–78)years,and the estimated prostate volume and transitional zone volume were 63.0(IQR:46.0–90.6)ml and 37.1(IQR:24.0–60.0)ml,*** enucleation ratio,TUEB efficiency,and enucleation efficiency were 0.60(IQR:0.46–0.54)g ml−1,0.33(IQR:0.22–0.46)g min−1,and 0.50(IQR:0.35–0.72)g min−1,respectively,plateauing after 70 *** functional outcomes,including total IPSS,IPSS QoL score,and uroflowmetry outcomes,significantly improved at 6 months after TUEB(all P<0.05),but without significant differences over the learning ***-five(13.2%)patients developed complications after TUEB,21.5%of whom experienced major complications(Clavien–Dindo grade≥3).The rate of major complications declined as the number ofTUEB cases increased(P=0.013).Our results suggest that the efficiency of TUEB stabilized within 70 procedures.

关键词： benign prostate hyperplasia learning curve perioperative efficiency prostate transurethral enucleation with bipolar energy

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Transurethral plasmakinetic resection of the prostate is a reliable minimal invasive technique for benign prostate hyperplasia： a meta-analysis of randomized controlled trials

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Asian Journal of Andrology 2015年第1期17卷 135-142,I0011页

作者： Kai Wang Yao Li Jing-Fei Teng Hai-Yong Zhou Dan-Feng Xu Yi Fan Department of Urology Zhejiang Xiaoshan Hospital Hangzhou 311202 China Department of Urology Shanghai Changzheng Hospital Second Military Medical University Shanghai 200003 China Department of Urology General Hospital of Beijing Military Command Beijing 100700 China.

To evaluate the efficacy and safety of plasmakinetic resection of the prostate （PKRP） versus transurethral resection of the prostate （TURP） for the treatment of patients with benign prostate hyperplasia （BPH）, a meta-analysis of randomized controlled trials was carried out. We searched PubMed, Embase, Web of Science and the Cochrane Library. The pooled estimates of maximum flow rate, International prostate Symptom Score, operation time, catheterization time, irrigated volume, hospital stay, transurethral resection syndrome, transfusion, clot retention, urinary retention and urinary stricture were assessed. There was no notable difference in International prostate Symptom Score between TURP and PKRP groups during the 1-month, 3 months, 6 months and 12 months follow-up period, while the pooled Qmax at 1-month favored PKRP group. PKRP group was related to a lower risk rate of transurethral resection syndrome, transfusion and clot retention, and the catheterization time and operation time were also shorter than that of TURP. The irrigated volume, length of hospital stay, urinary retention and urinary stricture rate were similar between groups. In conclusion, our study suggests that the PKRP is a reliable minimal invasive technique and may anticipatoriiy prove to be an alternative electrosurgical procedure for the treatment of BPH.

关键词： benign prostate hyperplasia lower urinary tract symptoms plasmakinetic resection of prostate transurethral resectionof prostate

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Periodontal disease and risk of benign prostate hyperplasia: a cross-sectional study

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Military Medical Research 2020年第2期7卷 157-165页

作者： Lan Wu Bing-Hui Li Yun-Yun Wang Chao-Yang Wang Hao Zi Hong Weng Qiao Huang You-Jia Zhu Xian-Tao Zeng Center for Evidence-Based and Translational Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071China department of Stomatology Zhongnan Hospital of Wuhan UniversityWuhan 430071China Center for Evidence-Based Medicine Institute of Evidence-Based Medicine and Knowledge TranslationHenan UniversityKaifeng 475000China Department of Urology Zhongnan Hospital of Wuhan UniversityWuhan 430071China

Background:Both periodontal disease and benign prostatic hyperplasia are age-related diseases that affect millions of people ***,this study aimed to investigate the association between periodontal disease and the risk of benign prostatic ***:A total of 4930 participants were selected from an available health examination that was carried out in 2017,only males were considered for further *** eligible males were divided into benign prostatic hyperplasia and normal groups,the benign prostatic hyperplasia group was then divided into prostate volume≤60 g and>60 g subgroups;all their periodontal status was extracted and then into normal(CPI score of 0),periodontal disease(CPI score between 1 and 4),and periodontitis(CPI score between 3 and 4)*** correlation between periodontal disease and benign prostatic hyperplasia was investigated using logistic regression analyses and greedy matching case-control *** analysis based on prostate volume was also *** analyses were conducted with SAS 9.4 ***:A total of 2171 males were selected for this *** presence of periodontal disease significantly increased the risk of benign prostatic hyperplasia by 1.68 times(OR=1.68,95%CI:1.26–2.24),and individuals with periodontitis showed a higher risk(OR=4.18,95%CI:2.75–6.35).In addition,among matched cases and controls,this association remained robust(periodontal disease:OR=1.85,95%CI:1.30–2.64;periodontitis:OR=4.83,95%CI:2.57–9.07).Subgroup analysis revealed that periodontal disease significantly increased benign prostate hyperplasia risk as well(for prostate volume≤60 g:OR=1.64,95%CI:1.22–2.20;for volume>60 g:OR=2.17,95%CI:1.04–4.53),and there was a higher risk in the group with a prostate volume greater than 60 ***:Periodontal disease is significantly and positively associated with an increased risk of benign prostatic *** validation studies should be performed to explore the re

关键词： benign prostate hyperplasia Periodontal disease Periodontitis Risk factor Inflammatory disease

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Effect of β Radiation on Bcl-2 and Bax Expressions in benign prostate hyperplasia Tissues

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Chemical Research in Chinese Universities 2008年第4期24卷 501-504页

作者： MA Qing-jie GAO Shi ZHAO Jie GU Xin-quan CAI Shan-yu ZHAO Guo-qing Department of Nuclear Medicine China-Japan Union Hospital Jilin University Changchun 130033 P. R. China Isotope Division China Institute of Atomic Energy Beijing 102413 P. R. China

The authors chose specimens from nine normal prostate tissues（NP group）, 15 benign prostate hyperplasia（BPH） prostates（BPH group）, and 35 BPH prostates that had been treated＇with ^90Sr/^90Y Prostatic hyperplasia Applicator（exposure group）. The expressions of bcl-2 and bax in stroma and epithelia of prostate tissues were demonstrated by means of immunohistochemical staining, and the staining positive rate was semiquantatively determined, so as to observe the expression of bcl-2 and bax genes in the prostate tissues of normal individuals and BPH patients, before and after fl radiation, and to evaluate the influence of fl radiation on bcl-2 and bax expressions. The expressions of gene bcl-2 in the prostate epithelia of NP and BPH are significantly higher than those in the prostate stroma（P〈0.01）. However, the expressions of bcl-2 in the prostate epithelia and stroma of the BPH group are obviously higher than those in the NP group（P〈0.01）. The expression of gene bax in the prostate epithelia of the NP group is higher than that in the BPH group（P〈0.05）. However, bcl-2 expressions in the prostate epithelia and stroma of the BPH group are significantly higher than the bax expressions（P〈0.01）. Compared with those of the NP group, the expressions of bcl-2 in the prostate epithelia and stroma of the exposure group decrease remarkably, even as the expressions of the bax notably increase（P〈0.01）. Thus, the administration of β radiation can remarkably affect bcl-2 and bax gene expressions, to regulate cell apoptosis, in the prostate tissues of BPH.

关键词： benign prostate hyperplasia β Radiation Apoptosis

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Clinical significance of distally located periurethral calcification in patients with lower urinary tract symptoms of benign prostate hyperplasia

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Asian Journal of Andrology 2023年第3期25卷 361-365页

作者： Seong Hyeon Yu Do Gyeong Lim Sun-Ouck Kim Department of Urology Chonnam National University Medical SchoolGwang-ju 61469Korea

This study evaluated the association of periurethral calcification(PUC)with uroflowmetric parameters and symptom severity in male patients with lower urinary tract symptoms(LUTS)of benign prostatic hyperplasia(BPH).The data were collected from a prospectively maintained database of 1321 men with LUTS of BPH who visited Chonnam National University Hospital(Gwang-ju,Korea)from January 2015 to December *** severity and location were evaluated on the midsagittal plane during transrectal *** among age,prostate-related parameters,International prostate Symptom Score(IPSS),and uroflowmetric parameters were *** the 1321 patients in this study,530(40.1%)had *** with PUC had significantly higher IPSS(mean±standard deviation[s.d.]:15.1±8.7 vs 13.1±7.9;Pprostate-specific antigen(PSA)level(P=0.009),higher total IPSS(Pprostate volume(P<0.001),compared with patients who had non-severe(mild or moderate)*** analysis showed that distal PUC was independently associated with high total IPSS(P=0.02),voiding symptom score(P=0.04),and storage symptom score(P=0.023),and low Qmax(P=0.015).In conclusion,PUC was significantly associated with worse LUTS parameters in terms of IPSS and ***,distally located PUC was independently associated with worse LUTS of BPH in men.

关键词： benign prostate hyperplasia calcification location

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The effect of α-blocker therapy on erectile functions in patients with lower urinary tract symptoms due to benign prostate hyperplasia

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Asian Journal of Andrology 2009年第6期11卷 716-722页

作者： Omer Demir Ismail Ozdemir Ozan Bozkurt Guven Asian Ahmet Adil Esen Dokuz Eylul University Medical School Department of Urology Inciralti Izmir 35340 Turkey

In this study we aimed to evaluate the impact of doxazosin treatment on erectile functions in patients with lower urinary tract symptoms （LUTS） and having erectile dysfunction （ED） at baseline. Fifty-three patients with LUTS （IPSS score 〉 7） whose maximum flow rate （Qmax）〈 15 mL s-1 and PSA 〈 4 ng dL^-1 were enrolled in the study. Patients received doxazosin 4 nag once daily for 6 weeks. Subjective efficacy was assessed by IPSS, IPSS- Quality of Life （IPSS-QoL） for LUTS and efficacy was assessed by International Index of Erectile Function （IIEF） for erectile functions at baseline and sixth weeks. The objective efficacy was assessed by Q The patients were classified according to their self reported erectile status： group I had ED and group II did not have ED. At the endpoint, doxazosin significantly improved the total IPSS score （-7.7 ±6.1, P = 0.006）, IPSS-QoL score （-1.5 ± 1.5, P = 0.024） and Qmax （3.2 ± 4.6 mL s^-1, P = 0.002） over baseline. Mean decrease in IPSS and IPSS-QoL scores after the treatment period were 6.9 ＋ 6.4 （P 〈 0.001） and 0.95 4- 1.80 （P 〈 0.05） in group I, whereas 8.2 4- 5.8 （P 〈 0.001） and 1.9 4- 1.1 in group IX （P 〈 0.001）, respectively. Mean changes of Qmax values were 2.3 4- 3.3 mL s^-1 in group I （P 〈 0.05） and 3.7 4- 5.3 mL s-1 in group II （P 〈 0.001）. The improvement of IIEF-EF scores after the treatment period was only significant for group I. The efficacy of a-blocker therapy for LUTS was better by means of symptomatic relief for patients who did not have ED when compared with patients who had ED at baseline. However, slight improvement in erectile functions with a-blocker therapy was only seen in LUTS patients with ED.

关键词： benign prostate hyperplasia doxazosinlerectile dysfunction lower urinary tract symptoms treatment outcome

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Natural history of benign prostate hyperplasia

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Chinese Medical Journal 2006年第24期119卷 2085-2089页

作者： WU Shi-liang LI Ning-chen XIAO Yun-xiang JIN Jie QIU Shao-peng YE Zhang-qun KONG Chui-ze SUN Guang NA Yan-qun Department of Urology Peking University First Hospital Beijing 100034 China Department of Urology First Affiliate Hospital of Zhongshan Medical University Guangzhou 510080 China Department of Urology Tongji Hospital Tongji-Medical CollegeHuazhong University of Science and Technology Wuhan 430030China Department of Urology First Clinical Hospital China Medical University Shenyang 110001 China Institute of Urology Tianjin Medical University Tianjin 300211China

Background benign prostate hyperplasia is one of the most common diseases affecting the health of the aging males. Watchful waiting is an acceptable management strategy for benign prostate hyperplasia in which the patient is monitored by the physician but receives no active intervention. The epidemiological data on this are lacking in China. Our study was designed to evaluate the changes of signs and symptoms of patients with benign prostate hyperplasia during management by watchful waiting in China. Methods One hundred and forty-five patients with benign prostate hyperplasia aged 〉 50 years were enrolled in management by watchful waiting. All the patients were visited every 6 months and were given an International prostate Symptom Score and Quality of Life questionnaire to complete. They also had uroflowmetry and were assessed using ultrasonography to get the volume of prostate, transition zone and amount of residual urine. The Student＇s t test, the Chi-square test, and variance analysis were used in the statistical analysis. Results All patients were visited after 6 months, the mean volume of transitional zone was found to have increased by 1.6 ml （P〈0.01）, International prostate Symptom Score was increased by 0.8 （P〈0.01） and Quality of Life was increased by 0.2 （P〈0.01）, and there was no statistical change in other data. Among these patients, 17.9% （26/145） visited again after 12 months when the data failed to show a statistically significant difference among the three groups （0, 6, and 12 months）. Conclusions After one year＇s follow-up, the progression of benign prostate hyperplasia was slow and the clinical data did not undergo much change.

关键词： benign prostate hyperplasia natural history epidemiology

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Open prostatectomy in the Management of benign prostate hyperplasia in a Developing Economy

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Open Journal of Urology 2016年第12期6卷 179-189页

作者： Abdulkadir A. Salako Tajudeen A. Badmus Afolabi M. Owojuyigbe Rotimi A. David Chinedu U. Ndegbu Chigozie I. Onyeze Department of Surgery Faculty of Clinical Sciences Obafemi Awolowo University Ile-Ife Nigeria Urology Unit Department of Surgery Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Nigeria Department of Anaesthesia and Intensive Care Faculty of Clinical Sciences Obafemi Awolowo University Ile-Ife Nigeria

Background: Open prostatectomy (OP) is still relatively common in developing countries and remains a useful benchmark against which the minimal access surgical techniques are compared. This study aims to document the indications and outcomes of OP in a typical developing economy. Method: The records of patients with benign prostate hyperplasia (BPH) who had OP in our university teaching hospital between July 2004 and June 2014 were retrospectively reviewed. Some analyzed parameters include the demographic characteristics, indications, pre-operative work-up, anaesthetic techniques, OP type, complications, histopathology results and follow-up duration. Results: A total of 247 cases were studied. Mean age was 67 years while the commonest surgery indication was recurrent acute urinary retention. Average prostate specific antigen (PSA) was 8.4 ng/ml while hypertension was the most common comorbidity (44.1%). Regional anaesthesia was mainly used (79.4%) while retropubic prostatectomy was the commonest OP type done (58.7%). The enucleated specimen weighed above 60 g in 91.9% of cases. All our patients were able to micturate spontaneously with urine stream above 20 mls/second on follow-up one week after discharge. Mean duration of hospital admission and follow-up were 7 days and 9 months respectively. Complications occurred in 90 patients (36.4%), of which surgical site infections were the commonest (9.8%). There was 0.4% mortality. Histopathology results showed BPH (95.5%), (incidental) prostate adenocarcinoma (2.4%) or prostatic intra-epithelial neoplasia (2.1%). Conclusion: OP remains an important therapeutic option for management of BPH in developing countries partly due to relatively large prostate size and presence of BPH complications from late presentationin many patients. The surgery is efficient and has relatively low morbidity and minimal mortality.

关键词： Open prostatectomy benign prostate hyperplasia Developing Economy Nigeria

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Transurethral plasmakinetic resection of the prostate is a reliable minimal invasive technique for benign prostate hyperplasia

Transurethral plasmakinetic resection of the prostate is a r...

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2015年浙江省泌尿外科学男科学学术年会

作者：汪凯范祎於裕福林连祥浙江萧山医院泌尿外科

To evaluate the efficacy and safety of plasmakinetic resection of the prostate versus transurethral resection of the prostate for the treatment of patients with benign prostate hyperplasia,a meta analysis of randomized controlled trials was carried *** searched PubMed,Embase,Web of Science and the Cochrane *** pooled estimates of maximum flow rate,International prostate Symptom Score,operation time,catheterization time,irrigated volume,hospital stay,transurethral resection syndrome,transfusion,clot retention,urinary retention and urinary stricture were *** was no notable difference in International prostate Symptom Score between TURP and PKRP groups during the 1 month,3 months,6 months and 12 months follow up period,while the pooled Qmax at 1 month favored PKRP *** group was related to a lower risk rate of transurethral resection syndrome,transfusion and clot retention,and the catheterization time and operation time were also shorter than that of *** irrigated volume,length of hospital stay,urinary retention and urinary stricture rate were similar between *** conclusion,our study suggests that the PKRP is a reliable minimal invasive technique and may anticipatorily prove to be an alternative electrosurgical procedure for the treatment of BPH.

关键词： benign prostate hyperplasia lower urinary tract symptoms plasmakinetic resection of prostate transurethral resectionof prostate

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Re-epithelialization resulted from prostate basal cells in canine prostatic urethra may represent the ideal healing method after two-micron laser resection of the prostate

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Asian Journal of Andrology 2015年第5期17卷 831-838,I0010-I0011页

作者： Ying Cao Guang-Heng Luo Lei Luo Xiu-Shu Yang Jian-Xin Hu Hua Shi Ping Huang Zhao-Lin Sun Shu-Jie Xia Department of Urology Shanghai First People's Hospital Shanghai Jiaotong University Shanghai 200080 China Department of Urology Guizhou Provincial People's Hospital Guiyang 550002 China Department of Pathology Guizhou Provincial People's Hospital Guiyang 550002 China

The purpose of this study is to characterize the re-epithelialization of wound healing in canine prostatic urethra and to evaluate the effect of this re-epithelialization way after two-micron laser resection of the prostate （TmLRP）. TmLRP and partial bladder neck mucosa were performed in 15 healthy adult male crossbred canines. Wound specimens were harvested at 3 days, and 1, 2, 3, and 4 weeks after operation, respectively. The histopathologic characteristics were observed by hematoxylin and eosin staining. The expression of cytokeratin 14 （CK14）, CK5, CK18, synaptophysin （Syn）, chromogranin A （CgA）, uroplakin, transforming growth factor-β1 （TGF-β1）, and TGF-β type Ⅱ receptor in prostatic urethra wound were examined by immunohistochemistry and real-time polymerase chain reaction, respectively. Van Gieson staining was performed to determine the expression of collagen fibers in prostatic urethra and bladder neck would. The results showed that the re-epithelialization of the prostatic urethra resulted from the mobilization of proliferating epithelial cells from residual prostate tissue under the wound. The proliferating cells expressed CK14, CK5, but not CK18, Syn, and CgA and re-epithelialize expressed uroplakin since 3 weeks. There were enhanced TGF-β1 and TGF-β type Ⅱ receptor expression in proliferating cells and regenerated cells, which correlated with specific phases of re-epithelialization. Compared with the re-epithelialization of the bladder neck, re-epithelialization of canine prostatic urethra was faster, and the expression of collagen fibers was relatively low. In conclusion, re-epithelialization in canine prostatic urethra resulted from prostate basal cells after TmLRP and this re-epithelialization way may represent the ideal healing method from anatomic repair to functional recovery after injury.

关键词： basal cell benign prostate hyperplasia re-epithelialization two-micron laser wound healing

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