Further evidence of endogenous hydrogen sulphide as a mediator of relaxation in human and rat bladder

We investigated the expression of hydrogen sulphide （H2S） in human and rat lower urinary tract （including bladder, prostate and urethra） tissues, and we sought to determine whether H2S induces relaxation of human and Sprague-Dawley （SD） rat bladder strips. Human normal lower urinary tract tissue was obtained for the evaluation of endogenous H2S productivity using a sulphide-sensitive electrode and for the analysis of the expression levels of all three synthases of endogenous H2S, cystathionine β-synthase （CBS）, cystathionine y lyase （CSE） and 3-mercaptopyruvate sulphur transferase （MPST, as known as 3-MST） by Western blot assay. CBS, CSE and MPST were located in human sample slides by immunohistochemistry. Human and male adult SD rat bladder strips were tested for H2S function with a transducer and recorded. All experiments were repeated six times. The endogenous H2S productivity and the H2S synthases had various distributions in the human and rat lower urinary tract tissues and were located in both epithelial and stromal sections. L-cysteine （L-Cys, a substrate of CBS, CSE and MPST） elicited relaxation in a dose-dependent manner on human bladder strips ere-contracted by acetylcholine chloride. This effect could be diminished by the ATe-sensitive potassium ion （KATe） channel blocker glibenclamide （GLB）, the CSE inhibitor DL-propargylglycine （PEG） and the CBS inhibitor hydroxylamine （HA）. H2S and its three synthases were present in the human and rat lower urinary tract tissues and relaxed human and rat bladder strips, which implied that endogenous H2S might play a role in physiological function and pathological disorders of the lower urinary tract symptoms （LUTS） or overactive bladder （OAB）.

Suprapubic cystostomy versus nonsuprapubic cystostomy during monopolar transurethral resection of prostate： a propensity score-matched analysis

We aim to reassess the safety of the monopolar transurethral resection of the prostate （M-TURP） without suprapubic cystostomy at our institution over the past decade. This retrospective study was conducted in patients who underwent M-TURP at Peking University First Hospital between 2003 and 2013. A total of 1680 patients who had undergone M-TURP were identified, including 539 patients in the noncystostomy group and 1141 patients in the cystostomy group. After propensity score matching, the number of patients in each group was 456. Smaller reductions in hemoglobin and hematocrit （10.9 g vs 17.6 g and 3.6% vs 4.7%, respectively） were found in the noncystostomy group. In addition, patients undergoing surgery without cystostomy had their catheters removed earlier （4.6 days vs 5.2 days）, required shorter postoperative stays in the hospital （5.1 days vs 6.0 days）, and were at lower risk of operative complications （5.7% vs 9.2%）, especially bleeding requiring blood transfusion （2.9% vs 6.1%）. Similar findings were observed in cohorts of prostates of 30-80 ml and prostates 〉80 ml. Furthermore, among patients with a resection weight 〉42.5 g or surgical time 〉90 min, or even propensity-matched patients based on surgical time, those with cystostomy seemed to be at a higher risk of operative complications. These results suggest that M-TURP without suprapubic cystostomy is a safe and effective method, even among patients with larger prostates, heavier estimated resection weights, and longer surgical times.