目的分析光纤铥激光前列腺剜除术(thulium fiber laser enucleation of the prostate,ThuFLEP)在不同体积良性前列腺增生(benign prostatic hyperplasia,BPH)患者中的应用效果。方法回顾性分析2022年1月至2025年1月在武义县第一人民医...目的分析光纤铥激光前列腺剜除术(thulium fiber laser enucleation of the prostate,ThuFLEP)在不同体积良性前列腺增生(benign prostatic hyperplasia,BPH)患者中的应用效果。方法回顾性分析2022年1月至2025年1月在武义县第一人民医院接受ThuFLEP治疗的BPH患者96例,按术前前列腺体积大小分为小体积组(<40 mL,n=26)、中体积组(40~80 mL,n=40)、大体积组(>80 mL,n=30),对比3组围术期指标、国际前列腺症状评分量表(international prostate symptom score,IPSS)、国际勃起功能指数评分表-5(five-item international index of erectile function,IIEF-5)、生活质量评分(quality of life,QoL)、排尿功能[最大尿流率(Qmax)、残余尿量(PVR)、膀胱顺应性(BC)]、并发症。结果3组粉碎时间、术后尿管留置时间、术后并发症发生率相比,差异无统计学意义(P>0.05);大体积组手术时间、剜除时间、术后住院时间均长于中体积组、小体积组,手术出血量、血红蛋白下降值、剜除前列腺质量均高于中体积组、小体积组(P<0.05),中体积组上述指标分别长于或高于小体积组(P<0.05);3组术前、术后6个月的IPSS、IIEF-5、QoL评分及Qmax相比,差异无统计学意义(P>0.05);3组术后6个月的IPSS、QoL评分及PVR均显著降低,IIEF-5评分及Qmax、BC均显著升高(P<0.05);大体积组术前、术后6个月的PVR均高于中体积组、小体积组,BC均低于中体积组、小体积组(P<0.05),中体积组前、术后6个月的PVR高于小体积组,BC低于小体积组(P<0.05)。结论ThuFLEP在不同体积BPH中均有利于改善患者排尿功能、减轻临床症状、提升性生活质量及生活质量,大体积虽会延长手术时间、增加出血量,但未显著增加并发症发生率。展开更多
Background:Penile augmentation through injectable substances is becoming increasingly common.A growing number of aesthetic clinics are developing penile enlargement procedures using various injectable materials.Althou...Background:Penile augmentation through injectable substances is becoming increasingly common.A growing number of aesthetic clinics are developing penile enlargement procedures using various injectable materials.Although these procedures are now performed in more controlled and medically supervised environments,their long-term outcomes remain poorly understood.The promotion of such medical treatments contributes to an increasing interest among adult males in self-injection as a method to alleviate psychological distress associated with penile size concerns.At the same time,access to injectable substances through unofficial or unregulated sources has become increasingly easy.Tor our knowledge,we report the first documented case of self-injection with Garamycin®(gentamicin)cream,contributing to the literature on the often multidisciplinary management of penile enlargement injections,a field still lacking well-established guidelines.Case Description:This case report describes a young patient who self-injected Garamycin®into the penis for the purpose of enlargement.He presented to our urology department with worsening symptoms,including severe and poorly tolerated pain.His primary request was prompt relief of pain while preserving,as much as possible,the aesthetic appearance and functional integrity of his penis.This case required a multi-stage surgical approach to salvage the penis and preserve both its structural integrity and functional outcome.Conclusions:To our knowledge,this case report documents the first reported instance of Garamycin®injection performed for the purpose of penile enlargement.It provides insight into the clinical course of such penile cream injections,demonstrates that a two-stage scrotal flap can achieve both functional and aesthetic outcomes,and highlights the importance of comprehensive management particularly addressing the traumatic impact of penile deformity secondary to inflammation and/or infection,as well as the body dysmorphic concerns often associated with these cases.展开更多
Background:Inflatable Penile Prosthesis(IPP)is the treatment for erectile dysfunction(ED)refractory to pharmacological therapies.Long-term data on factors associated with prosthesis survival remain unclear.This study ...Background:Inflatable Penile Prosthesis(IPP)is the treatment for erectile dysfunction(ED)refractory to pharmacological therapies.Long-term data on factors associated with prosthesis survival remain unclear.This study aimed to analyze the long-term survival of penile prostheses and identify risk factors associated with survival without reintervention.Methods:This is a retrospective,single-center study of patients who underwent IPP implantation between January 2014 and December 2022.Preoperative data related to the patient and the etiology of ED,as well as perioperative data,were collected.The primary outcome was survival without reintervention,defined as prosthesis revision or explantation due to mechanical dysfunction or infection.We conducted survival analyses without reintervention and searched for risk factors using a multivariate Cox model.Results:In total,33 out of 137 patients underwent reintervention(24.1%),including 24(17.5%)prosthesis revisions and 9(6.6%)had explantations.Median follow-up was 39 months with an interquartile range(IQR)of 9.00 to 62.00.Median survival without reintervention was 7 years.In univariate analysis,downsizing(p=0.046)was associated with reintervention.Smoking(p=0.003)and age(p=0.034)were associated with prosthesis explantation.The number of implantations(p=0.009)was associated with prosthesis revision.Multivariate analysis by the Cox model did not identify any independent predictive factors for reintervention.Conclusion:Smoking may play a role in infection post-IPP implantation.Primary implantations seem to be associated with better survival.Adjusting cylinder size,known as downsizing,is likely to be a proxy for the complexity of the procedure and thus linked to earlier reintervention.展开更多
Overview:Surgical management of benign prostatic hyperplasia(BPH)has evolved significantly,incorporating various minimally invasive procedures aimed at reducing morbidity and optimizing patient outcomes.Despite advanc...Overview:Surgical management of benign prostatic hyperplasia(BPH)has evolved significantly,incorporating various minimally invasive procedures aimed at reducing morbidity and optimizing patient outcomes.Despite advancements,transurethral approaches continue to pose risks such as urethral strictures and urinary incontinence due to mechanical and thermal stress.To address these limitations,the Suprapubic Transvesical Adenoma Resection of the Prostate(STARP)was developed,offering a direct suprapubic route that bypasses the urethra entirely.Recent studies have validated STAR-P as both feasible and safe,emphasizing advantages such as enhanced visualization of the urinary sphincter,minimized urethral trauma,effective hemostasis,and reduced operative stress.The procedure utilizes specially designed instrumentation,including a large-caliber bipolar resectoscope(42 Fr),allowing the efficient removal of substantial adenoma tissue in fewer resection passes compared to traditional methods.Objectives:This article provides a comprehensive,step-by-step description of the STAR-P technique.The primary objective is to detail patient selection criteria,preoperative assessments,procedural steps including mini-open suprapubic access,specialized instrumentation usage,resection techniques,and postoperative management protocols.Highlighting technical considerations and procedural innovations aims to inform urologists about the potential benefits of STAR-P,particularly in patients at higher risk for urethral complications or those with large prostate volumes.By documenting the procedural intricacies and outcomes clearly and thoroughly,we seek to encourage informed adoption of STAR-P as an alternative,effective surgical approach for managing benign prostatic hyperplasia,thus contributing to the evolving landscape ofminimally invasive urological surgery.展开更多
目的观察探讨作息训练结合盆底肌训练(pelvic floor muscle training,PFMT)改善前列腺增生(benign prostatic hyperplasia,BPH)患者术后尿失禁(urinary incontinence,UI)的效果方法选取2022年1月至2025年1月在永康市第一人民医院接受经...目的观察探讨作息训练结合盆底肌训练(pelvic floor muscle training,PFMT)改善前列腺增生(benign prostatic hyperplasia,BPH)患者术后尿失禁(urinary incontinence,UI)的效果方法选取2022年1月至2025年1月在永康市第一人民医院接受经尿道前列腺电切术(transurethral resection of the prostate,TURP)治疗的386例BPH患者中术后发生SUI 122例为研究对象,按随机数字表法分为对照组61例(术后进行盆底肌训练)和观察组61例(作息训练结合盆底肌训练)。观察两组患者控尿功能恢复状况、尿失禁问卷简表(International consultation on incontinent questionnaire short form,ICIQ-SF)评估尿失禁(UI)改善程度与尿失禁生活质量问卷(Incontinence quality of life questionnaires,I-QOL)评估干预后的生活质量。结果干预1个月,两组尿控功能恢复差异无统计学意义(P>0.05),干预3个月和6个月,观察组控尿功能恢复均优于对照组,差异有统计学意义(P<0.05)。随访6个月,观察组ICIQ-SF评分均优于对照组,差异有统计学意义(P<0.05)。观察组I-QOL评分显著高于对照组,差异有统计学意义(P<0.05)。结论作息训练结合PFMT能显著改善BPH患者术后SUI症状,提升患者自我训练能力,提高其生活质量。展开更多
文摘目的分析光纤铥激光前列腺剜除术(thulium fiber laser enucleation of the prostate,ThuFLEP)在不同体积良性前列腺增生(benign prostatic hyperplasia,BPH)患者中的应用效果。方法回顾性分析2022年1月至2025年1月在武义县第一人民医院接受ThuFLEP治疗的BPH患者96例,按术前前列腺体积大小分为小体积组(<40 mL,n=26)、中体积组(40~80 mL,n=40)、大体积组(>80 mL,n=30),对比3组围术期指标、国际前列腺症状评分量表(international prostate symptom score,IPSS)、国际勃起功能指数评分表-5(five-item international index of erectile function,IIEF-5)、生活质量评分(quality of life,QoL)、排尿功能[最大尿流率(Qmax)、残余尿量(PVR)、膀胱顺应性(BC)]、并发症。结果3组粉碎时间、术后尿管留置时间、术后并发症发生率相比,差异无统计学意义(P>0.05);大体积组手术时间、剜除时间、术后住院时间均长于中体积组、小体积组,手术出血量、血红蛋白下降值、剜除前列腺质量均高于中体积组、小体积组(P<0.05),中体积组上述指标分别长于或高于小体积组(P<0.05);3组术前、术后6个月的IPSS、IIEF-5、QoL评分及Qmax相比,差异无统计学意义(P>0.05);3组术后6个月的IPSS、QoL评分及PVR均显著降低,IIEF-5评分及Qmax、BC均显著升高(P<0.05);大体积组术前、术后6个月的PVR均高于中体积组、小体积组,BC均低于中体积组、小体积组(P<0.05),中体积组前、术后6个月的PVR高于小体积组,BC低于小体积组(P<0.05)。结论ThuFLEP在不同体积BPH中均有利于改善患者排尿功能、减轻临床症状、提升性生活质量及生活质量,大体积虽会延长手术时间、增加出血量,但未显著增加并发症发生率。
文摘Background:Penile augmentation through injectable substances is becoming increasingly common.A growing number of aesthetic clinics are developing penile enlargement procedures using various injectable materials.Although these procedures are now performed in more controlled and medically supervised environments,their long-term outcomes remain poorly understood.The promotion of such medical treatments contributes to an increasing interest among adult males in self-injection as a method to alleviate psychological distress associated with penile size concerns.At the same time,access to injectable substances through unofficial or unregulated sources has become increasingly easy.Tor our knowledge,we report the first documented case of self-injection with Garamycin®(gentamicin)cream,contributing to the literature on the often multidisciplinary management of penile enlargement injections,a field still lacking well-established guidelines.Case Description:This case report describes a young patient who self-injected Garamycin®into the penis for the purpose of enlargement.He presented to our urology department with worsening symptoms,including severe and poorly tolerated pain.His primary request was prompt relief of pain while preserving,as much as possible,the aesthetic appearance and functional integrity of his penis.This case required a multi-stage surgical approach to salvage the penis and preserve both its structural integrity and functional outcome.Conclusions:To our knowledge,this case report documents the first reported instance of Garamycin®injection performed for the purpose of penile enlargement.It provides insight into the clinical course of such penile cream injections,demonstrates that a two-stage scrotal flap can achieve both functional and aesthetic outcomes,and highlights the importance of comprehensive management particularly addressing the traumatic impact of penile deformity secondary to inflammation and/or infection,as well as the body dysmorphic concerns often associated with these cases.
文摘Background:Inflatable Penile Prosthesis(IPP)is the treatment for erectile dysfunction(ED)refractory to pharmacological therapies.Long-term data on factors associated with prosthesis survival remain unclear.This study aimed to analyze the long-term survival of penile prostheses and identify risk factors associated with survival without reintervention.Methods:This is a retrospective,single-center study of patients who underwent IPP implantation between January 2014 and December 2022.Preoperative data related to the patient and the etiology of ED,as well as perioperative data,were collected.The primary outcome was survival without reintervention,defined as prosthesis revision or explantation due to mechanical dysfunction or infection.We conducted survival analyses without reintervention and searched for risk factors using a multivariate Cox model.Results:In total,33 out of 137 patients underwent reintervention(24.1%),including 24(17.5%)prosthesis revisions and 9(6.6%)had explantations.Median follow-up was 39 months with an interquartile range(IQR)of 9.00 to 62.00.Median survival without reintervention was 7 years.In univariate analysis,downsizing(p=0.046)was associated with reintervention.Smoking(p=0.003)and age(p=0.034)were associated with prosthesis explantation.The number of implantations(p=0.009)was associated with prosthesis revision.Multivariate analysis by the Cox model did not identify any independent predictive factors for reintervention.Conclusion:Smoking may play a role in infection post-IPP implantation.Primary implantations seem to be associated with better survival.Adjusting cylinder size,known as downsizing,is likely to be a proxy for the complexity of the procedure and thus linked to earlier reintervention.
文摘Overview:Surgical management of benign prostatic hyperplasia(BPH)has evolved significantly,incorporating various minimally invasive procedures aimed at reducing morbidity and optimizing patient outcomes.Despite advancements,transurethral approaches continue to pose risks such as urethral strictures and urinary incontinence due to mechanical and thermal stress.To address these limitations,the Suprapubic Transvesical Adenoma Resection of the Prostate(STARP)was developed,offering a direct suprapubic route that bypasses the urethra entirely.Recent studies have validated STAR-P as both feasible and safe,emphasizing advantages such as enhanced visualization of the urinary sphincter,minimized urethral trauma,effective hemostasis,and reduced operative stress.The procedure utilizes specially designed instrumentation,including a large-caliber bipolar resectoscope(42 Fr),allowing the efficient removal of substantial adenoma tissue in fewer resection passes compared to traditional methods.Objectives:This article provides a comprehensive,step-by-step description of the STAR-P technique.The primary objective is to detail patient selection criteria,preoperative assessments,procedural steps including mini-open suprapubic access,specialized instrumentation usage,resection techniques,and postoperative management protocols.Highlighting technical considerations and procedural innovations aims to inform urologists about the potential benefits of STAR-P,particularly in patients at higher risk for urethral complications or those with large prostate volumes.By documenting the procedural intricacies and outcomes clearly and thoroughly,we seek to encourage informed adoption of STAR-P as an alternative,effective surgical approach for managing benign prostatic hyperplasia,thus contributing to the evolving landscape ofminimally invasive urological surgery.
文摘目的观察探讨作息训练结合盆底肌训练(pelvic floor muscle training,PFMT)改善前列腺增生(benign prostatic hyperplasia,BPH)患者术后尿失禁(urinary incontinence,UI)的效果方法选取2022年1月至2025年1月在永康市第一人民医院接受经尿道前列腺电切术(transurethral resection of the prostate,TURP)治疗的386例BPH患者中术后发生SUI 122例为研究对象,按随机数字表法分为对照组61例(术后进行盆底肌训练)和观察组61例(作息训练结合盆底肌训练)。观察两组患者控尿功能恢复状况、尿失禁问卷简表(International consultation on incontinent questionnaire short form,ICIQ-SF)评估尿失禁(UI)改善程度与尿失禁生活质量问卷(Incontinence quality of life questionnaires,I-QOL)评估干预后的生活质量。结果干预1个月,两组尿控功能恢复差异无统计学意义(P>0.05),干预3个月和6个月,观察组控尿功能恢复均优于对照组,差异有统计学意义(P<0.05)。随访6个月,观察组ICIQ-SF评分均优于对照组,差异有统计学意义(P<0.05)。观察组I-QOL评分显著高于对照组,差异有统计学意义(P<0.05)。结论作息训练结合PFMT能显著改善BPH患者术后SUI症状,提升患者自我训练能力,提高其生活质量。
