To the Editor: Ureteral calculus is a common urological disease. In recent years, one of the main treatment methods is ureteroscopy with holmium laser lithotripsy. However, with the extensive application of holmium la...To the Editor: Ureteral calculus is a common urological disease. In recent years, one of the main treatment methods is ureteroscopy with holmium laser lithotripsy. However, with the extensive application of holmium laser lithotripsy, the increasing incidence of postoperative ureteral stricture or even occlusion has attracted the attention of clinicians to its etiology. The issue of the intraoperative holmium laser thermal effect has also gradually gained attention. The holmium laser is a long-wavelength pulsed laser, which crushes calculi by an optomechanical/photoacoustic mechanism as well as a photothermal mechanism, and it is mainly based on the photothermal mechanism.[1] Currently, multiple in vitro studies worldwide have confirmed that the holmium laser did increase the water temperature in the working area. However, these studies only simulated the lithotripsy process of the holmium laser in vitro, which did not completely reflect the thermal effect of the holmium laser during an actual operation. Accordingly, this study monitored the temperature changes of the lavage fluid in the operative field during the actual holmium laser lithotripsy process under an ureteroscope, with the aim of providing more information for the etiology study of ureteral stricture after ureteroscopy with holmium laser lithotripsy.展开更多
Postfinasteride syndrome(PFS)is a term coined to characterize a constellation of reported undesirable sexual,physical,and neuropsychiatric side effects.In the present study,we conducted the meta-analysis to demonstrat...Postfinasteride syndrome(PFS)is a term coined to characterize a constellation of reported undesirable sexual,physical,and neuropsychiatric side effects.In the present study,we conducted the meta-analysis to demonstrate whether the use of 5α-reductase inhibitors(5ARIs)increases the risk of PFS-like adverse effects.A search of studies published until May 10,2020,was performed using PubMed,EMBASE,and the Cochrane Library.We included randomized controlled trials with at least one comparison between male patients receiving 5ARIs versus placebo for the treatment of benign prostatic hyperplasia(BPH)or androgenetic alopecia(AGA),and identified 34 studies from 28 articles that met our eligibility criteria.In the random-effects model,the overall use of 5ARIs exhibited a 1.87-fold risk of PFS-like adverse effects during the trial(95%confidence interval[CI]:1.64-2.14).Regarding specific types of adverse effects,the use of 5ARIs had a 1.89-fold risk of sexual adverse effects(95%CI:1.74-2.05)and was associated with an increased risk of physical adverse effects(relative risk[RR]:1.31,95%CI:0.80-2.15),albeit without statistical significance.This meta-analysis helped to better define the adverse effects caused by 5ARIs.We concluded that the overall use of 5ARIs significantly increased the risk of PFS-like adverse effects in men with AGA or BPH during treatment.Enhanced awareness of and education on the PFS-like adverse effects are necessary for clinicians.展开更多
文摘To the Editor: Ureteral calculus is a common urological disease. In recent years, one of the main treatment methods is ureteroscopy with holmium laser lithotripsy. However, with the extensive application of holmium laser lithotripsy, the increasing incidence of postoperative ureteral stricture or even occlusion has attracted the attention of clinicians to its etiology. The issue of the intraoperative holmium laser thermal effect has also gradually gained attention. The holmium laser is a long-wavelength pulsed laser, which crushes calculi by an optomechanical/photoacoustic mechanism as well as a photothermal mechanism, and it is mainly based on the photothermal mechanism.[1] Currently, multiple in vitro studies worldwide have confirmed that the holmium laser did increase the water temperature in the working area. However, these studies only simulated the lithotripsy process of the holmium laser in vitro, which did not completely reflect the thermal effect of the holmium laser during an actual operation. Accordingly, this study monitored the temperature changes of the lavage fluid in the operative field during the actual holmium laser lithotripsy process under an ureteroscope, with the aim of providing more information for the etiology study of ureteral stricture after ureteroscopy with holmium laser lithotripsy.
基金the National Natural Science Foundation of China for their support in generating this manuscript(No.81770758 to LW).
文摘Postfinasteride syndrome(PFS)is a term coined to characterize a constellation of reported undesirable sexual,physical,and neuropsychiatric side effects.In the present study,we conducted the meta-analysis to demonstrate whether the use of 5α-reductase inhibitors(5ARIs)increases the risk of PFS-like adverse effects.A search of studies published until May 10,2020,was performed using PubMed,EMBASE,and the Cochrane Library.We included randomized controlled trials with at least one comparison between male patients receiving 5ARIs versus placebo for the treatment of benign prostatic hyperplasia(BPH)or androgenetic alopecia(AGA),and identified 34 studies from 28 articles that met our eligibility criteria.In the random-effects model,the overall use of 5ARIs exhibited a 1.87-fold risk of PFS-like adverse effects during the trial(95%confidence interval[CI]:1.64-2.14).Regarding specific types of adverse effects,the use of 5ARIs had a 1.89-fold risk of sexual adverse effects(95%CI:1.74-2.05)and was associated with an increased risk of physical adverse effects(relative risk[RR]:1.31,95%CI:0.80-2.15),albeit without statistical significance.This meta-analysis helped to better define the adverse effects caused by 5ARIs.We concluded that the overall use of 5ARIs significantly increased the risk of PFS-like adverse effects in men with AGA or BPH during treatment.Enhanced awareness of and education on the PFS-like adverse effects are necessary for clinicians.
