Objective:To study the correlation of urodynamic characteristics with insulin resistance and serum damage media in patients with diabetes and benign prostatic hyperplasia (BPH). Methods:45 patients with type 2 diabete...Objective:To study the correlation of urodynamic characteristics with insulin resistance and serum damage media in patients with diabetes and benign prostatic hyperplasia (BPH). Methods:45 patients with type 2 diabetes mellitus and BPH treated in our hospital between May 2014 and August 2016 were selected as DM+BPH group, 58 patients with BPH alone were selected as BPH group, and 50 healthy volunteers were selected as control group. Urodynamic tester was used to measure the maximum flow rate (MFR), postvoid residual (PVR) and detrusor pressure at maximum flow rate (Pdet), and serum was collected to determine insulin resistance indexes and oxidative stress indexes. Results:MFR and Pdet of DM+BPH group were significantly lower than those of control group (P<0.05) while PVR was significantly higher than that of control group (P<0.05);MFR of BPH group was significantly lower than that of control group (P<0.05) while PVR and Pdet were significantly higher than those of control group (P<0.05);MFR and Pdet of DM+BPH group were significantly lower than those of BPH group (P<0.05) while PVR was significantly higher than that of BPH group (P<0.05);insulin secretion index (HOMA-β), insulin sensitive index (ISI) as well as serum manganese superoxide dismutase (MnSOD), copper-zinc superoxide dismutase (CuZnSOD) and glutathione peroxidase (GPx) levels of DM+BPH group and BPH group were significantly lower than those of control group (P<0.05) while insulin resistance index (HOMA-IR) as well as serum thioredoxin (Trx) and thioredoxin-interacting protein (TXNIP) levels was significantly higher than those of control group (P<0.05);HOMA-β, ISI as well as serum MnSOD, CuZnSOD and GPx levels of DM+BPH group were significantly lower than those of BPH group (P<0.05), positively correlated with MFR and Pdet, and negatively correlated with MFR, and HOMA-IR as well as serum Trx and TXNIP levels was significantly higher than those of BPH group (P<0.05), negatively correlated with MFR and Pdet, and positively correlated with MFR. Conclusions: Insulin resistance and oxidative stress injury are the mechanisms that cause the urodynamic changes in patients with diabetes and BPH.展开更多
BACKGROUND Thermo-expandable urethral stent(Memokath 028)implantation is an alternative treatment for older patients with lower urinary tract symptoms and benign prostatic obstruction.Following prostatic urethral sten...BACKGROUND Thermo-expandable urethral stent(Memokath 028)implantation is an alternative treatment for older patients with lower urinary tract symptoms and benign prostatic obstruction.Following prostatic urethral stent implantation,minor complications such as urinary tract infection,irritative symptoms,gross hematuria,and urethral pain have been observed;however,there are no reports of life-threatening events.Herein,we report a critical case of Fournier’s gangrene that occurred 7 years after prostatic stenting.CASE SUMMARY An 81-years-old man with benign prostatic hyperplasia(volume,126 ccs;as measured by transrectal ultrasound)had undergone insertion of a thermoexpandable urethral stent(Memokath 028)as he was unfit for surgery under general anesthesia.However,the patient had undergone a suprapubic cystostomy for recurrent acute urinary retention 4 years after the insertion of prostatic stent(Memokath 028).We had planned to remove the Memokath 028;however,the patient was lost to follow-up.The patient presented to the emergency department 3 years after the suprapubic cystostomy with necrotic changes from the right scrotum to the right inguinal area.In digital rectal examination,tenderness and heat of prostate was identified.Also,the black skin color change with foulsmelling from right scrotum to right inguinal area was identified.In computed tomography finding,subcutaneous emphysema was identified to same area.He was diagnosed with Fournier’s gangrene based on the physical examination and computed tomography findings.In emergency room,Fournier’s gangrene severity index value is seven points.Therefore,he underwent emergent extended surgical debridement and removal of the Memokath 028.Broad-spectrum intravenous antibiotics were administered and additional necrotic tissue debridement was performed.However,the patient died 14 days after surgery due to multiorgan failure.CONCLUSION If Memokath 028 for benign prostatic hyperplasia is not working in older patients,its rapid removal may help prevent severe complications.展开更多
Introduction: Open transvesical prostatectomy remains today one of the most effective approaches for the management of benign prostatic hyperplasia despite the fact that, this method is associated with multiple compli...Introduction: Open transvesical prostatectomy remains today one of the most effective approaches for the management of benign prostatic hyperplasia despite the fact that, this method is associated with multiple complications. The objective of this study was to evaluate the influence of prostate weight on the morbidity and mortality of transvesical prostatectomy for adenoma in the urology-andrology department of the Ignace Deen National Hospital. Materials and Methods: This was a prospective, longitudinal and analytical study lasting 6 months, from March 1, 2022 to August 31, 2022 including patients admitted and operated on by open transvesical prostatectomy by assessing the influence of prostate weight on the morbidity and mortality of transvesical adenomectomies. Results: 108 patients were included in our study, the average age of our patients was 70 ± 7.7 years, cultivators were the most represented profession with 38.89%, and hypertension was the most represented comorbidity with 75%. 33.06% of cases became complicated and surgical wound infection was the main complication with a frequency of 17.40%. Statistical analysis did not conclude that, the prostate weight does not have a statistically significant influence on the morbidity and mortality of transvesical open prostatectomy for benign prostatic hyperplasia. Conclusion: Prostate weight has no influence on the morbidity and mortality of transvesical prostate adenoma.展开更多
目的分析引发老年良性前列腺增生患者术后排尿相关并发症的危险因素,并构建其风险预测模型。方法回顾性分析2021年4月至2023年9月衡阳市第一人民医院127例行经尿道前列腺电切术(transurethral resection of prostate,TURP)治疗的老年良...目的分析引发老年良性前列腺增生患者术后排尿相关并发症的危险因素,并构建其风险预测模型。方法回顾性分析2021年4月至2023年9月衡阳市第一人民医院127例行经尿道前列腺电切术(transurethral resection of prostate,TURP)治疗的老年良性前列腺增生患者的临床资料,所有样本基于单因素基础上行logistic回归分析,以此构建风险预测模型。结果127例患者中,45例患者发生排尿相关并发症(尿失禁22例,尿潴留15例,排尿困难8例)。单因素及多因素logistic回归分析显示,术前国际前列腺症状评分(International Prostate Symptom Score,IPSS)评分、尿路感染、逼尿肌功能及术后尿管留置时间进入回归模型(P<0.05),均为影响患者术后排尿相关并发症发生的独立危险因素。根据上述多因素logisitc回归分析结果,构建其风险预测模型:P=-2.184+1.357×术前IPSS评分+1.483×尿路感染+1.512×逼尿肌功能+1.596×术后尿管留置时间。采用受试者工作特征曲线验证上述预测模型对患者术后排尿相关并发症的预测价值,结果显示,受试者工作特征曲线下面积为0.852。结论术前IPSS评分高、尿路感染、逼尿肌功能不稳定及术后尿管留置时间长均为导致老年良性前列腺增生患者术后排尿相关并发症发生的重要因素,基于上述因素构建其风险预测模型,对早期筛查术后排尿相关并发症发生高危患者具有一定的临床预测价值。展开更多
目的探讨在老年良性前列腺增生患者术后康复中应用快速康复外科理念的效果。方法选择2021年1月至2023年12月于我院行手术治疗的良性前列腺增生老年患者100例,以随机数表方法分为各50例的两组,对照组常规护理;研究组快速康复外科理念护...目的探讨在老年良性前列腺增生患者术后康复中应用快速康复外科理念的效果。方法选择2021年1月至2023年12月于我院行手术治疗的良性前列腺增生老年患者100例,以随机数表方法分为各50例的两组,对照组常规护理;研究组快速康复外科理念护理。对比两组护理效果。结果研究组术后康复进程各项指标均短于对照组,P<0.05。研究组术后1 d、3 d VAS评分均低于对照组,P<0.05。较之对照组,研究组并发症发生率更低,P<0.05。研究组护理满意度98.00%,高于对照组的84.00%,P<0.05。结论快速康复外科理念应用于老年良性前列腺增生手术患者中可加快术后康复进程,减少术后并发症,减轻术后疼痛,维持良好的护患关系。展开更多
Background: Open prostatectomy is the most commonly available surgical procedure for benign prostatic hyperplasia and this is the case in most countries in West African even with all the limitations of the procedure. ...Background: Open prostatectomy is the most commonly available surgical procedure for benign prostatic hyperplasia and this is the case in most countries in West African even with all the limitations of the procedure. Objective: The objective is to determine the pattern and outcomes of open prostatectomy in Lomé. Patients & Methods: From December 2011 to November 2012, we conducted a descriptive cross-sectional study on a series of patients treated for prostate adenoma. Dysuria was assessed using the International Prostate Symptom Score (IPSS). The history of each patient was recorded, as well as paraclinical data. All patients were surgically treated via abdominal incision procedure. The data obtained included the patients’ demographics, clinical features, the IPSS scores, investigations, type of open prostatectomy, outcome and follow-up. The data were analyzed for means and frequencies using Epi Info version 3.5.3. Results: Fifty-four consecutive patients underwent surgery consecutively, their ages ranging from 40 to 92 years, with an average of 67.27 ± 12.50 years. In all, 46 (85.2%) patients presented with obstructive symptoms and 26 (48.1%) presented with urinary retention. The average prostate volume was 114.31 ± 20.11 cm3 with a range of 31 - 485 cm3. The average blood loss at surgery was 425.92 ± 38.2 ml with an average operating time of 66.05 ± 15.75 mins and the main complications were hemorrhaging and clot retention in 7 (13%), epididymo-orchitis in 9 (16.7%), and urinary incontinence in 6 (11.1%) patients. IPSS scores were under 7 in 92% of patients three months after surgery and the mortality rate was 3.7%. Conclusion: This study has shown that open prostatectomy in our environment is still the commonest surgical option for benign prostatic hyperplasia with good outcomes though with manageable complications.展开更多
文摘Objective:To study the correlation of urodynamic characteristics with insulin resistance and serum damage media in patients with diabetes and benign prostatic hyperplasia (BPH). Methods:45 patients with type 2 diabetes mellitus and BPH treated in our hospital between May 2014 and August 2016 were selected as DM+BPH group, 58 patients with BPH alone were selected as BPH group, and 50 healthy volunteers were selected as control group. Urodynamic tester was used to measure the maximum flow rate (MFR), postvoid residual (PVR) and detrusor pressure at maximum flow rate (Pdet), and serum was collected to determine insulin resistance indexes and oxidative stress indexes. Results:MFR and Pdet of DM+BPH group were significantly lower than those of control group (P<0.05) while PVR was significantly higher than that of control group (P<0.05);MFR of BPH group was significantly lower than that of control group (P<0.05) while PVR and Pdet were significantly higher than those of control group (P<0.05);MFR and Pdet of DM+BPH group were significantly lower than those of BPH group (P<0.05) while PVR was significantly higher than that of BPH group (P<0.05);insulin secretion index (HOMA-β), insulin sensitive index (ISI) as well as serum manganese superoxide dismutase (MnSOD), copper-zinc superoxide dismutase (CuZnSOD) and glutathione peroxidase (GPx) levels of DM+BPH group and BPH group were significantly lower than those of control group (P<0.05) while insulin resistance index (HOMA-IR) as well as serum thioredoxin (Trx) and thioredoxin-interacting protein (TXNIP) levels was significantly higher than those of control group (P<0.05);HOMA-β, ISI as well as serum MnSOD, CuZnSOD and GPx levels of DM+BPH group were significantly lower than those of BPH group (P<0.05), positively correlated with MFR and Pdet, and negatively correlated with MFR, and HOMA-IR as well as serum Trx and TXNIP levels was significantly higher than those of BPH group (P<0.05), negatively correlated with MFR and Pdet, and positively correlated with MFR. Conclusions: Insulin resistance and oxidative stress injury are the mechanisms that cause the urodynamic changes in patients with diabetes and BPH.
基金Supported by the 2021 Yeungnam University Research Grant.
文摘BACKGROUND Thermo-expandable urethral stent(Memokath 028)implantation is an alternative treatment for older patients with lower urinary tract symptoms and benign prostatic obstruction.Following prostatic urethral stent implantation,minor complications such as urinary tract infection,irritative symptoms,gross hematuria,and urethral pain have been observed;however,there are no reports of life-threatening events.Herein,we report a critical case of Fournier’s gangrene that occurred 7 years after prostatic stenting.CASE SUMMARY An 81-years-old man with benign prostatic hyperplasia(volume,126 ccs;as measured by transrectal ultrasound)had undergone insertion of a thermoexpandable urethral stent(Memokath 028)as he was unfit for surgery under general anesthesia.However,the patient had undergone a suprapubic cystostomy for recurrent acute urinary retention 4 years after the insertion of prostatic stent(Memokath 028).We had planned to remove the Memokath 028;however,the patient was lost to follow-up.The patient presented to the emergency department 3 years after the suprapubic cystostomy with necrotic changes from the right scrotum to the right inguinal area.In digital rectal examination,tenderness and heat of prostate was identified.Also,the black skin color change with foulsmelling from right scrotum to right inguinal area was identified.In computed tomography finding,subcutaneous emphysema was identified to same area.He was diagnosed with Fournier’s gangrene based on the physical examination and computed tomography findings.In emergency room,Fournier’s gangrene severity index value is seven points.Therefore,he underwent emergent extended surgical debridement and removal of the Memokath 028.Broad-spectrum intravenous antibiotics were administered and additional necrotic tissue debridement was performed.However,the patient died 14 days after surgery due to multiorgan failure.CONCLUSION If Memokath 028 for benign prostatic hyperplasia is not working in older patients,its rapid removal may help prevent severe complications.
文摘Introduction: Open transvesical prostatectomy remains today one of the most effective approaches for the management of benign prostatic hyperplasia despite the fact that, this method is associated with multiple complications. The objective of this study was to evaluate the influence of prostate weight on the morbidity and mortality of transvesical prostatectomy for adenoma in the urology-andrology department of the Ignace Deen National Hospital. Materials and Methods: This was a prospective, longitudinal and analytical study lasting 6 months, from March 1, 2022 to August 31, 2022 including patients admitted and operated on by open transvesical prostatectomy by assessing the influence of prostate weight on the morbidity and mortality of transvesical adenomectomies. Results: 108 patients were included in our study, the average age of our patients was 70 ± 7.7 years, cultivators were the most represented profession with 38.89%, and hypertension was the most represented comorbidity with 75%. 33.06% of cases became complicated and surgical wound infection was the main complication with a frequency of 17.40%. Statistical analysis did not conclude that, the prostate weight does not have a statistically significant influence on the morbidity and mortality of transvesical open prostatectomy for benign prostatic hyperplasia. Conclusion: Prostate weight has no influence on the morbidity and mortality of transvesical prostate adenoma.
文摘目的探讨在老年良性前列腺增生患者术后康复中应用快速康复外科理念的效果。方法选择2021年1月至2023年12月于我院行手术治疗的良性前列腺增生老年患者100例,以随机数表方法分为各50例的两组,对照组常规护理;研究组快速康复外科理念护理。对比两组护理效果。结果研究组术后康复进程各项指标均短于对照组,P<0.05。研究组术后1 d、3 d VAS评分均低于对照组,P<0.05。较之对照组,研究组并发症发生率更低,P<0.05。研究组护理满意度98.00%,高于对照组的84.00%,P<0.05。结论快速康复外科理念应用于老年良性前列腺增生手术患者中可加快术后康复进程,减少术后并发症,减轻术后疼痛,维持良好的护患关系。
文摘Background: Open prostatectomy is the most commonly available surgical procedure for benign prostatic hyperplasia and this is the case in most countries in West African even with all the limitations of the procedure. Objective: The objective is to determine the pattern and outcomes of open prostatectomy in Lomé. Patients & Methods: From December 2011 to November 2012, we conducted a descriptive cross-sectional study on a series of patients treated for prostate adenoma. Dysuria was assessed using the International Prostate Symptom Score (IPSS). The history of each patient was recorded, as well as paraclinical data. All patients were surgically treated via abdominal incision procedure. The data obtained included the patients’ demographics, clinical features, the IPSS scores, investigations, type of open prostatectomy, outcome and follow-up. The data were analyzed for means and frequencies using Epi Info version 3.5.3. Results: Fifty-four consecutive patients underwent surgery consecutively, their ages ranging from 40 to 92 years, with an average of 67.27 ± 12.50 years. In all, 46 (85.2%) patients presented with obstructive symptoms and 26 (48.1%) presented with urinary retention. The average prostate volume was 114.31 ± 20.11 cm3 with a range of 31 - 485 cm3. The average blood loss at surgery was 425.92 ± 38.2 ml with an average operating time of 66.05 ± 15.75 mins and the main complications were hemorrhaging and clot retention in 7 (13%), epididymo-orchitis in 9 (16.7%), and urinary incontinence in 6 (11.1%) patients. IPSS scores were under 7 in 92% of patients three months after surgery and the mortality rate was 3.7%. Conclusion: This study has shown that open prostatectomy in our environment is still the commonest surgical option for benign prostatic hyperplasia with good outcomes though with manageable complications.
