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Endoscopic Internal Urethrotomy in the Treatment of Male Urethral Stenosis in the urology-andrology department of KARA Teaching Hospital (Togo)

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Open Journal of urology 2024年第1期14卷 20-26页

作者： Musapudi Éric Mbuya Komi Hola Sikpa Edoe Viyome Sewa Messan Semefa Agbedey Gnimdou Botcho Kodjo Tengue Tchilabalo Matchonna Kpatcha urology and andrology department Kara Teaching Hospital Kara Togo urology and andrology department Hubert Koutoukou Maga National Teaching Hospital Cotonou Benin Surgery department University Clinics of Lubumbashi Lubumbashi DRC Aneho Prefectural Hospital Center Aneho Togo urology and andrology department Kpalime Prefectural Hospital Center Kpalime Togo urology and andrology department Sokodé Regional Hospital Center Sokodé Togo urology and andrology department Sylvanus Olympio Teaching Hospital Lomé Togo

Introduction: Endoscopic internal urethrotomy (EIU) is a method for stricture opening using transurethral incision by direct visualisation of the urethral channel, resulting in a widening of the urinary canal with the aim of improving the quality of bladder emptying. The aim of the study was to evaluate the indication and results of EIU in the treatment of stenosis of the male urethra in the urology-andrology department of Kara Teaching Hospital. Methodology: This was a cross-sectional descriptive study with retrospective data collection in the urology-andrology department of Kara Teaching Hospital. It involved 21 records of patients with urethral stenosis treated by endoscopic internal urethrotomy (EIU) in the said department during the period from January 2021 to September 2023. The following variables were evaluated: age, circumstance of discovery, site, length, number, etiology of the urethral stenosis and evolution of the patients. Results: The mean age of the patients was 59.2 ± 11.7 years. Infectious etiology of stenosis was predominant with 10 patients (47.6%) followed by trauma with 5 cases (23.8%). The bulbar urethra was the most frequently observed site, with 11 cases (52.4%). The length was mostly less than 2 cm in 12 patients (57.1%). Stenosis was unique in 14 patients (66.7%). The mean postoperative follow-up time was 3.2 months. The result was immediately better in 11 patients (52.4%) and it was poor in 8 patients (38.1%) who required maintenance dilation sessions.

关键词： Internal Urethrotomy Urethral Stenosis Kara Togo

A method for reducing thermal injury during the ureteroscopic holmium laser lithotripsy

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Asian Journal of urology 2023年第1期10卷 89-95页

作者： Xiaoliang Zhu Feiping Li Xixi Hu Haiping Li Songjiang Wu Haihong Jiang Department of Urology and Andrology Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityTaizhouChina Department of Urology and Andrology The First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina

Objective:Many studies have demonstrated the heat effect from the holmium laser lithotripsy can cause persistent thermal injury to the ureter.The purpose of this study was to elucidate the use of a modified ureteral catheter with appropriate firing and irrigation to reduce the thermal injury to the“ureter”during the ureteroscopic holmium laser lithotripsy in vitro.Methods:An in vitro lithotripsy was performed using a modified catheter(5 Fr)as the entrance for the irrigation and the holmium laser fiber while using the remaining space in the ureteroscopic channel as an outlet.Different laser power settings(10 W,20 W,and 30 W)with various firing times(3 s,5 s,and 10 s)and rates of irrigation(15 mL/min,20 mL/min,and 30 mL/min)were applied in the experiment.Temperature changes in the“ureter”were recorded with a thermometer during and after the lithotripsy.Results:During the lithotripsy,the local highest mean temperature was 60.3℃ and the lowest mean temperature was 26.7℃.When the power was set to 10 w,the temperature was maintained below 43℃ regardless of laser firing time or irrigation flow.Regardless of the power or firing time selected,the temperature was below 43℃ at the rate of 30 mL/min.There was a significant difference in temperature decrease when continuous 3 s drainage after continuous firing(3 s,5 s,or 10 s)compared to with not drainage(p<0.05)except for two conditions of 0.5 J×20 Hz,30 mL/min,firing 5 s,and 1.0 J×10 Hz,30 mL/min,firing 5 s.Conclusion:Our modified catheter with timely drainage reducing hot irrigation may significantly reduce the local thermal injury effect,especially along with the special interrupted-time firing setting during the simulated holmium laser procedure.

关键词： Modified catheter Holmium laser Lithotripsy Thermal injury

A prospective randomized controlled study on scheduled PDE5i and vacuum erectile devices in the treatment of erectile dysfunction after nerve sparing prostatectomy

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Asian Journal of andrology 2022年第5期24卷 473-477页

作者： Ming Zhang Ji-Zhong Che Yi-Dong Liu Hong-Xiang Wang Yan-Ping Huang Xiang-Guo Lv Wei Liu Mu-Jun Lu Department of Urology and Andrology Shanghai Institute of AndrologyRenji HospitalShanghai Jiao Tong University School of MedicineShanghai 200001China department of urology Yantai Affiliated Hospital of Binzhou Medical UniversityYantai 264100China

Cavernous nerve injury is an important cause of erectile dysfunction(ED).Although protective nerve technology has been widely used in nerve-sparing radical prostatectomy(nsRP),the incidence of ED is still very high after surgery.The purpose of our study was to evaluate erectile function(EF)and penile length in the non-erectile state(PLNES)following scheduled phosphodiesterase 5 inhibitor(PDE5i),vacuum erectile device(VED)treatment,and combination therapy after nsRP.One hundred patients with localized prostate cancer and normal EF were randomized to scheduled PDE5i group,VED treatment group,a combined treatment group,and the control group without any intervention.The International Index of Erectile Function-5(IIEF-5)scores and PLNES were evaluated after 6 months and 12 months of treatment.Sexual Encounter Profile(SEP-Question 2 and SEP-Question 3)were evaluated after 12 months of treatment.Ninety-one of the 100 randomized patients completed the study.We found that the 5 mg tadalafil once a day(OaD)combined with VED can help improve IIEF-5 scores in nsRP patients after both 6 months and 12 months.VED alone or combined with tadalafil OaD can help patients maintain PLNES.VED combined with tadalafil OaD can improve the rate of successful penetration(SEP-Question 2)after 12 months.There were no significant differences in the return to target EF after 12 months among the groups.No significant correlation was noted between the variables and return to target EF(IIEF≥17),and between the variables and effective shortening of the patient’s penis(shortening≥1 cm)after 12 months of intervention.

关键词： erectile dysfunction nerve-sparing radical prostatectomy penile length tadalafil vacuum erectile devices

Effects of plication procedures in special cases of Peyronie’s disease:a single-center retrospective study of 72 patients

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Asian Journal of andrology 2022年第3期24卷 294-298页

作者： Wen Ji Li Jie-Wen Bao Jian-Hua Guo Da-Chao Zheng Min-Kai Xie Zhong Wang Department of Urology and Andrology Ninth People’s HospitalSchool of MedicineShanghai Jiaotong UniversityShanghai 200011China

General recommendations regarding surgical techniques are not always appropriate for all Peyronie’s disease(PD)patients.Therefore,the purpose of this study was to investigate the effects of plication procedures in PD patients with severe penile curvature and the effects of early surgical correction in patients who no longer have progressive deformities.The clinical data from 72 patients who underwent plication procedures were analyzed in this study.Patients were divided into Groups A and B according to the curvature severity(≤60°or>60°)and Groups 1 and 2 according to the duration of disease stabilization(≥3 months or<3 months).At the 1-year follow-up,90.0%(36/40)and 90.6%(29/32)patients reported complete penile straightening,and 60.0%(24/40)and 100.0%(32/32)patients reported penile shortening in Groups A and B,respectively.No curvature recurrence occurred in any patient,and no significant differences were observed in postoperative International Index of Erectile Function–Erectile Function domain(IIEF-EF),erectile pain,sensitivity,or suture knots on the penis whether such outcomes were grouped according to the curvature severity or the duration of stabilization.However,the duration from symptom onset to surgical management in Group 1 was significantly longer than that in Group 2(mean±standard deviation[s.d.]:20.9±2.0 months and 14.3±1.2 months,respectively,P<0.001).The present study showed that the plication procedures seemed to be an effective choice for the surgical treatment of PD patients with severe penile curvature.In addition,the early surgical treatment seemed to benefit those patients who already had no erectile pain and no longer exhibited progressive deformity.

关键词： penile curvature Peyronie’s disease plication

Predictors of microsurgical varicocelectomy efficacy in male infertility treatment:critical assessment and systematization

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Asian Journal of andrology 2023年第1期25卷 21-28页

作者： Azizbek B Shomarufov Vladimir A Bozhedomov Nikolay I Sorokin Igor P Matyukhov Abdukodir A Fozilov Shukhrat A Abbosov Armais A Kamalov Department of Urology and Andrology Faculty of Fundamental MedicineLomonosov Moscow State UniversityMoscow 119991Russia department of urology Tashkent Medical AcademyTashkent 100109Uzbekistan Republican Specialized Scientific-Practical Medical Center of urology Tashkent 100109Uzbekistan

In this review,we tried to systematize all the evidence(from PubMed[MEDLINE],Scopus,Cochrane Library,EBSCO,Embase,and Google Scholar)from 1993 to 2021 on the predictors of microsurgical varicocelectomy efficacy in male infertility treatment.Regarding the outcomes of varicocele repair,we considered semen improvement and pregnancy and analyzed them separately.Based on the 2011 Oxford CEBM Levels of Evidence,we assigned a score to each trial that studied the role of the predictor.We systematized the studied predictors based on the total points,which were,in turn,calculated based on the number and quality of studies that confirmed or rejected the studied predictor as significant,into three levels of significance:predictors of high,moderate,and low clinical significance.Preoperative total motile sperm count(TMSC)coupled with sperm concentration can be a significant predictor of semen improvement and pregnancy after varicocelectomy.In addition,for semen improvement alone,scrotal Doppler ultrasound(DUS)parameters,sperm DNA fragmentation index(DFI),and bilateral varicocelectomy are reliable predictors of microsurgical varicocelectomy efficacy.

关键词： male infertility microsurgical varicocelectomy predictor pregnancy semen varicocele

Comparison of ART outcomes in men with altered mRNA protamine 1/protamine 2 ratio undergoing intracytoplasmic sperm injection with ejaculated and testicular spermatozoa

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Asian Journal of andrology 2020年第6期22卷 623-628页

作者： Jonas Sarasa Maria Enciso Laura Garcia Andrea Leza Klaus Steger Jon Aizpurua iGLS Alicante 03540SpainMolecular AndrologyJustus-Liebig-UDiversity GiessenGiessen 35385Germany IVF-Spain Alicante 03540SpainMolecular AndrologyJustus-Liebig-UDiversity GiessenGiessen 35385Germany department of urology Pediatric Urology and AndrologyMolecular AndrologyJustus-Liebig-UDiversity GiessenGiessen 35385Germany

Assisted reproductive technologies invoIving the use of spermatozoa and eggs for in vitro fertilization(IVF)have come as the solution for many infertile couples to become parents.However,in some cases,the use of ejaculated spermatozoa delivers poor IVF performance.Some studies have suggested the use of testicular spermatozoa in severe male in fertility cases,but no guideli nes regarding their utilization are currently available.In the present study,we found the mRNA protamine 1/protamine 2(P1/P2)ratio to be a valuable biomarker of poor sperm function that could be used as a diagnostic key for the identification of cases that would benefit from the use of testicular spermatozoa.A total of 23 couples undergoing egg donation cycles with at least one previous cycle failure were studied.All couples underwent two consecutive intracytoplasmic sperm injection(ICSI)cycles with either ejaculated or testicular spermatozoa(TESA).The sperm mRNA P1/P2 ratio,fertilization rate,blastocyst rate,and pregnancy and live birth rate were compared.Results showed improved ICSI and clinical outcomes in cycles with testicular spermatozoa in men with altered mRNA P1/P2 ratios.TESA cycles presented significantly higher rates of fertilization(mean±standard deviation:76.1%±15.1%vs 65.5%±18.8%),blastocyst formation(55.0%±20.3%vs 30.8%±23.8%),and good morphological quality blastocyst(28.9%±22.9%vs 13.5%±17.9%)and also improvements on pregnancy(60.9%vs 0%)and healthy birth rates(56.5%vs 0%)than EJACULATE cycles.The results described here suggest that in patients with previous IVF/ICSI failures and aberrant mRNA protamine ratios,the use of testicular spermatozoa may be a good alternative to improve clinical outcomes.

关键词： DNA damage male infertility mRNA protamine ratio sperm chromatin testicular spermatozoa

Low-intensity extracorporeal shock wave therapy promotes recovery of sciatic nerve injury and the role of mechanical sensitive YAP/TAZ signaling pathway for nerve regeneration

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Chinese Medical Journal 2021年第22期134卷 2710-2720页

作者： Hui-Xi Li Zhi-Chao Zhang Jing Peng andrology Center Department of UrologyPeking University First HospitalPeking UniversityBeijing 100034China.

Background:Histological and functional recovery after peripheral nerve injury(PNI)is of significant clinical value as delayed surgical repair and longer distances to innervate terminal organs may account for poor outcomes.Low-intensity extracorporeal shock wave therapy(LiESWT)has already been proven to be beneficial for injured tissue recovery on various pathological conditions.The objective of this study was to explore the potential effect and mechanism of LiESWT on PNI recovery.Methods:In this project,we explored LiESWT’s role using an animal model of sciatic nerve injury(SNI).Shockwave was delivered to the region of the SNI site with a special probe at 3 Hz,500 shocks each time,and 3 times a week for 3 weeks.Rat Schwann cells(SCs)and rat perineurial fibroblasts(PNFs)cells,the two main compositional cell types in peripheral nerve tissue,were cultured in vitro,and LiESWT was applied through the cultured dish to the adherent cells.Tissues and cell cultures were harvested at corresponding time points for a reverse transcription-polymerase chain reaction,Western blotting,and immunofluorescence staining.Multiple groups were compared by using one-way analysis of variance followed by the Tukey-Kramer test for post hoc comparisons.Results:LiESWT treatment promoted the functional recovery of lower extremities with SNI.More nerve fibers and myelin sheath were found after LiESWT treatment associated with local upregulation of mechanical sensitive yes-associated protein(YAP)/transcriptional co-activator with a PDZ-binding domain(TAZ)signaling pathway.In vitro results showed that SCs were more sensitive to LiESWT than PNFs.LiESWT promoted SCs activation with more expression of p75(a SCs dedifferentiation marker)and Ki67(a SCs proliferation marker).The SCs activation process was dependent on the intact YAP/TAZ signaling pathway as knockdown of TAZ by TAZ small interfering RNA significantly attenuated this process.Conclusion:The LiESWT mechanical signal perception and YAP/TAZ upregulation in SCs might be one of the underlying

关键词： Low-intensity extracorporeal shock wave therapy Schwann cells Sciatic nerve injury YAP/TAZ

Transurethral resection of bladder tumor: A systematic review of simulator-based training courses and curricula

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Asian Journal of urology 2024年第1期11卷 1-9页

作者： Panagiotis Kallidonis Angelis Peteinaris Gernot Ortner Kostantinos Pagonis Costantinos Adamou Athanasios Vagionis Evangelos Liatsikos Bhaskar Somani Theodoros Tokas department of urology University Hospital of RionPatrasGreece Department of Urology and Andrology General Hospital Hall I.T.Hall in TirolAustria Medical University of Vienna ViennaAustria department of urology University Hospital Southampton NHS Foundation TrustSouthamptonUK

Objective:Transurethral resection of bladder tumor is one of the most common everyday urological procedures.This kind of surgery demands a set of skills that need training and experience.In this review,we aimed to investigate the current literature to find out if simulators,phantoms,and other training models could be used as a tool for teaching urologists.Methods:A systematic review was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement and the recommendations of the European Association of urology guidelines for conducting systematic reviews.Fifteen out of 932 studies met our inclusion criteria and are presented in the current review.Results:The UroTrainer(Karl Storz GmbH,Tuttlingen,Germany),a virtual reality training simulator,achieved positive feedback and an excellent face and construct validity by the participants.The inspection of bladder mucosa,blood loss,tumor resection,and procedural time was improved after the training,especially for inexperienced urologists and medical students.The construct validity of UroSim®(VirtaMed,Zurich,Switzerland)was established.SIMBLA simulator(Samed GmbH,Dresden,Germany)was found to be a realistic and useful tool by experts and urologists with intermediate experience.The test objective competency model based on SIMBLA simulator could be used for evaluating urologists.The porcine model of the Asian Urological Surgery Training and Education Group also received positive feedback by the participants that tried it.The Simulation and Technology Enhanced Learning Initiative Project had an extraordinary face and content validity,and 60%of participants would like to use the simulators in the future.The 5-day multimodal training curriculum“Boot Camp”in the United Kingdom achieved an increase of the level of confidence of the participants that lasted months after the project.Conclusion:Simulators and courses or curricula based on a simulator training could be a valuable learning tool for any surgeon,and there is no doubt that they sh

关键词： Simulator Train Curriculum Transurethral resection Vaporesection Laser Bladder

Effects of patients'understanding and choice of surgical types on postoperative outcomes of Peyronie’s disease:a single-center retrospective study of 108 patients

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Asian Journal of andrology 2021年第5期23卷 484-489页

作者： Da-Chao Zheng Jie-Wen Bao Jian-Hua Guo Min-Kai Xie Wen Ji Li Zhong Wang Department of Urology and Andrology Ninth People's HospitalSchool of MedicineShanghai Jiaotong UniversityShanghai 200011China

Surgical correction can be considered for treating patients with a chronic phase of Peyronie’s disease(PD)and persistent penile curvature.In clinical practice,some patients pay too much attention to surgical complications and refuse the recommended feasible surgical types.Meanwhile,they require operations according to their preferences.This study aimed to evaluate the effects of patients’own choice of surgical type on postoperative satisfaction.This retrospective study analyzed data from 108 patients with PD who underwent surgical correction according to doctors’recommendations or patients’own demands.The objective and subjective surgical outcomes were assessed.Patients1 understanding of the disease was analyzed using a questionnaire survey.Objective measurements of surgical outcomes,including penile straightening,penile length,and sexual function,in patients who received the recommended surgery,were similar to those in patients who did not accept the recommended surgery.However,subjective evaluations,including erectile pain,discomfort because of nodules on the penis,and decreased sensitivity in the penis,were more obvious in patients who did not follow doctors’recommendations.In addition,a questionnaire survey showed that understanding PD and the purpose of surgery of patients who did not follow doctors’advice were inappropriate,as they did not conform to the principle of treatment.The present study showed that surgical correction seemed to be an objectively effective option in the management of patients in the stable chronic phase of PD.Low patient satisfaction might be related to patients’lack of correct understanding of the disease and its treatment strategy as well as unrealistic expectations.

关键词： grafting procedure patient’s satisfaction penile curvature Peyronie’s disease plication