AIM: To investigate the relationship between prostatespecific antigen(PSA) levels and(1) bladder outlet obstruction(BOO) and(2) the severity of prostate inflammation.METHODS: Two hundred and twenty-two consecutive pat...AIM: To investigate the relationship between prostatespecific antigen(PSA) levels and(1) bladder outlet obstruction(BOO) and(2) the severity of prostate inflammation.METHODS: Two hundred and twenty-two consecutive patients undergoing transurethral resection of the prostate(TURP) were prospectively included. Patients with proven urinary tract infection and/or known prostate cancer were excluded. PSA levels, International Prostate Symptoms Score(IPSS), prostate weight, post residual volume and pressure flow parameters were determined. A histopathological assessment of the presence and severity of inflammation was also performed.RESULTS: Patients had a mean age of 69.1 ± 8.6 years(45-90 years), with mean preoperative PSA levels of 4.7 ± 5.4 ng/m L(0.2-32.5 ng/m L) and IPSS of 15.7 ± 6.9(0-32). Mean Pdet Q max was 96.3 ± 34.4 cm H2O(10-220 cm H2O). The mean resected prostate weight was 39.4 ± 27.3 g(3-189 g). Correlations were observed between PSA(logarithmic) and resected prostate weight(r = 0.54; P < 0.001), PSA(logarithmic) and Pdet Q max(r = 0.17; P = 0.032), and resected prostate weight and Pdet Q max(r = 0.39; P < 0.001). Furthermore, low correlations were observed between PSA(logarithmic) and active(r = 0.21; P < 0.0001) and chronic(r = 0.19; P = 0.005) inflammation. CONCLUSION: In this study we showed a correlation between BOO(Pdet Q max) and PSA(logarithmic). Furthermore, we demonstrated a weak correlation between PSA(logarithmic) and active as well as chronic prostatic inflammation.展开更多
目的:探讨经尿道前列腺切除术后泌尿系感染的危险因素及防治措施。方法:回顾性分析70例行经尿道前列腺切除术的患者,术后泌尿系感染的发生情况,并采用单因素分析和多因素Logistic回归分析,分析术后泌尿系感染的相关因素。结果:单因素分...目的:探讨经尿道前列腺切除术后泌尿系感染的危险因素及防治措施。方法:回顾性分析70例行经尿道前列腺切除术的患者,术后泌尿系感染的发生情况,并采用单因素分析和多因素Logistic回归分析,分析术后泌尿系感染的相关因素。结果:单因素分析结果表明术前合并糖尿病、术前行导尿术、前列腺体积较大、手术时间较长、术后保留导尿时间较长等使术后泌尿系感染的几率增大(P<0.05),术前预防性应用抗生素可降低术后感染的发生率(P<0.05)。多因素Logistic回归分析结果显示:合并糖尿病、术前导尿、前列腺体积>50 m L、手术时间>60 min、术后保留导尿>7 d、术前未预防性应用抗生素是术后并发泌尿系感染的危险因素(P<0.05)。结论:术前合并糖尿病、术前导尿、前列腺体积>50 m L、手术时间>60 min、术后保留导尿>7 d、术前未预防性应用抗生素是经尿道前列腺切除术后泌尿系感染的危险因素。展开更多
目的探讨经尿道膀胱肿瘤电切术(transurethral resection of bladder tumor,TURBT)治疗复发性非肌层浸润性膀胱尿路上皮癌的疗效。方法本组复发性非肌层浸润性膀胱尿路上皮癌63例,肿瘤单发36例,多发27例。肿瘤直径0.2~3.0cm,术前均经...目的探讨经尿道膀胱肿瘤电切术(transurethral resection of bladder tumor,TURBT)治疗复发性非肌层浸润性膀胱尿路上皮癌的疗效。方法本组复发性非肌层浸润性膀胱尿路上皮癌63例,肿瘤单发36例,多发27例。肿瘤直径0.2~3.0cm,术前均经膀胱镜检查,活检病理检查确诊为低级别尿路上皮癌。所有患者均行TURBT,术后常规卡介苗或化疗药物膀胱灌注,定期复查膀胱镜。结果 63例均顺利完成手术,无严重手术并发症。术后61例获得随访,随访时间8~62个月,平均36个月,38例长期稳定,未见复发;23例复发,复发率37.7%(23/61)。其中17例再次行TURBT,手术后9例病情稳定,8例术后再次复发,再行TURBT1~4次(其中5例临床分期增至T2,鉴于患者高龄或全身情况较差,仍采用TURBT治疗);6例术后复发,因临床分期增加至T2~T3,行开放手术,其中2例行膀胱部分切除术,4例行根治性膀胱切除术。随访期间死亡2例。结论对于复发性非肌层浸润性膀胱尿路上皮癌,TURBT安全性高,并发症少,疗效确切。对于进展为T2期的老年体弱膀胱癌患者,多次TURBT可改善生活质量,延缓患者生命,可有选择性地应用。展开更多
目的探讨经尿道电切镜下电凝+含切法切除侧壁膀胱肿瘤在应对闭孔神经反射的作用。方法对我院2010年3月至2016年6月收治的114例侧壁膀胱肿瘤行经尿道膀胱肿瘤电切术(transurethral resection of bladder tumor,TURBT)患者的资料进行回顾...目的探讨经尿道电切镜下电凝+含切法切除侧壁膀胱肿瘤在应对闭孔神经反射的作用。方法对我院2010年3月至2016年6月收治的114例侧壁膀胱肿瘤行经尿道膀胱肿瘤电切术(transurethral resection of bladder tumor,TURBT)患者的资料进行回顾性分析,按照不同的手术方式将患者分成两组:A组应用常规的TURBT方法切除膀胱肿瘤(56例),B组采用电凝+含切的方法切除肿瘤(58例)。对闭孔神经反射发生率、手术时间、留置导尿管时间、术后膀胱冲洗时间、住院时间、膀胱破裂穿孔发生率及术后半年复发等进行统计学分析。结果 A组术中发生闭孔神经反射48例(严重闭孔神经反射发生34例),其中13例出现膀胱穿孔,中转全麻14例,中转开放手术5例;B组术中发生闭孔神经反射42例(严重闭孔神经反射发生11例),其中2例出现膀胱穿孔,中转全麻1例,中转开放手术1例。A、B组间在严重闭孔神经反射发生例数、膀胱穿孔例数、中转全麻例数、中转开放手术例数方面比较,差异均有统计学意义(P<0.05);A、B组在术后膀胱冲洗时间、留置导尿管时间、住院时间、术后半年肿瘤复发等方面差异均无统计学意义(P>0.05)。结论经尿道电切镜下电凝+含切法切除侧壁膀胱肿瘤可以有效减少严重闭孔神经反射导致的膀胱破裂发生率。展开更多
基金the ‘Kwaliteitsfonds Jessa ZH’ for the financial support
文摘AIM: To investigate the relationship between prostatespecific antigen(PSA) levels and(1) bladder outlet obstruction(BOO) and(2) the severity of prostate inflammation.METHODS: Two hundred and twenty-two consecutive patients undergoing transurethral resection of the prostate(TURP) were prospectively included. Patients with proven urinary tract infection and/or known prostate cancer were excluded. PSA levels, International Prostate Symptoms Score(IPSS), prostate weight, post residual volume and pressure flow parameters were determined. A histopathological assessment of the presence and severity of inflammation was also performed.RESULTS: Patients had a mean age of 69.1 ± 8.6 years(45-90 years), with mean preoperative PSA levels of 4.7 ± 5.4 ng/m L(0.2-32.5 ng/m L) and IPSS of 15.7 ± 6.9(0-32). Mean Pdet Q max was 96.3 ± 34.4 cm H2O(10-220 cm H2O). The mean resected prostate weight was 39.4 ± 27.3 g(3-189 g). Correlations were observed between PSA(logarithmic) and resected prostate weight(r = 0.54; P < 0.001), PSA(logarithmic) and Pdet Q max(r = 0.17; P = 0.032), and resected prostate weight and Pdet Q max(r = 0.39; P < 0.001). Furthermore, low correlations were observed between PSA(logarithmic) and active(r = 0.21; P < 0.0001) and chronic(r = 0.19; P = 0.005) inflammation. CONCLUSION: In this study we showed a correlation between BOO(Pdet Q max) and PSA(logarithmic). Furthermore, we demonstrated a weak correlation between PSA(logarithmic) and active as well as chronic prostatic inflammation.
文摘目的:探讨经尿道前列腺切除术后泌尿系感染的危险因素及防治措施。方法:回顾性分析70例行经尿道前列腺切除术的患者,术后泌尿系感染的发生情况,并采用单因素分析和多因素Logistic回归分析,分析术后泌尿系感染的相关因素。结果:单因素分析结果表明术前合并糖尿病、术前行导尿术、前列腺体积较大、手术时间较长、术后保留导尿时间较长等使术后泌尿系感染的几率增大(P<0.05),术前预防性应用抗生素可降低术后感染的发生率(P<0.05)。多因素Logistic回归分析结果显示:合并糖尿病、术前导尿、前列腺体积>50 m L、手术时间>60 min、术后保留导尿>7 d、术前未预防性应用抗生素是术后并发泌尿系感染的危险因素(P<0.05)。结论:术前合并糖尿病、术前导尿、前列腺体积>50 m L、手术时间>60 min、术后保留导尿>7 d、术前未预防性应用抗生素是经尿道前列腺切除术后泌尿系感染的危险因素。