经尿道等离子体双极汽化电切治疗高原地区高危前列腺增生

目的:探讨经尿道等离子体双极汽化电切术(PKRP)治疗高原高危前列腺增生(BPH)患者的安全性和疗效.方法:采用采用PKRP治疗高原高危BPH患者25例,随访3～22个月.结果:手术时间20～90min,平均(45±22)min,术中出血少,均未输血,无前列腺电切综合征(TuRs)及真性尿失禁发生,国际前列腺症状评分(IPSS)术前为(24.3±4.5)分,术后3个月降至(8.6±2.5)分(P＜0.01).结论:应用经尿道等离子体双极电切术治疗高原高危BPH安全性高、并发症少、疗效确切,明显拓宽了BPH的手术适应证.     

经尿道超脉冲等离子体双极电切术联合腔内剜除法治疗BPH 126例

目的:探讨经尿道超脉冲等离子体双极电切术(PKSP TURP)联合腔内剜除法治疗BPH的临床疗效.方法:采用英国Gyrus公司的经尿道超脉冲等离子体双极电切系统行PKSP TURP联合腔内剜除法治疗BPH 126例,按ROUS标准:前列腺增生Ⅱ度43例、Ⅲ度53例、Ⅳ度30例;前列腺质量37～126 g.观察手术时间、术中出血量、术后留置导尿管时间、手术并发症以及住院时间、术前、术后IPSS评分、QOL评分、RU、Qmax的差异.结果:手术时间25～120 min,平均51.8 min;术中出血量20～130 ml,平均65.4 ml.未发生电切综合征和膀胱穿孔等并发症.术后留置导尿管2～8天,平均住院时间6.9天.全部患者随访3～21个月,IPSS由(23.6±4.9)分下降至(7.0±2.4)分,QOL由(4.2±0.9)分下降至(2.4±0.6)分,RU由(78.64±32.3)ml减少至(28.1±19.4)ml,Qmax由(7.5±3.0)ml/s上升至(24.0±3.0)ml/s,术前后各参数比较,P<0.05.结论:PKSP TURP联合腔内剜除法治疗BPH,具有安全、并发症少、疗效确切等优点.     

经尿道等离子体双极电切术治疗BPH同期行腹股沟疝修补术

目的 探讨经尿道等离子体双极电切术治疗良性前列腺增生(BPH)同期行腹股沟疝修补术的安全性和疗效.方法 回顾性分析经尿道等离子体双极电切术治疗前列腺增生236例患者临床资料,其中26例合并腹股沟疝患者同期行腹股沟疝修补术.结果 26例术后随访3月～2年,国际前列腺症状评分由术前(26.4±5.3)分降到(7.8±2.6)分,剩余尿量由(80±60)mL减至(34±15)mL,无经尿道电切综合征(TURS)、尿失禁,无疝复发及手术切口感染,无其他手术并发症.结论 经尿道等离子体双极电切术治疗良性前列腺增生同期行腹股沟疝修补术可取得满意的临床效果.     

经尿道前列腺气化电切术治疗前列腺增生临床体会

目的 探讨经尿道前列腺气化切割及电切术,治疗前列腺增生(BPH)的疗效及临床体会.方法 采用经尿道前列腺气化切割电切术治疗BPH患者150例,对临床资料进行回顾性总结.结果 手术顺利、出血少、疗效满意,未出现严重并发症.结论 经尿道前列腺气化加电切术治疗BPH安全性高、并发症少、恢复快,具有出血少、手术时间短等优点.     

经尿道等离子体双极汽化电切术治疗高龄高危前列腺增生症患者的临床探讨(附248例报告)

目的 探讨经尿道等离子体双极汽化电切术(PKRP)治疗高龄高危前列腺增生症(BPH)患者的安全性及策略.方法 自2003年9月至2011年12月共248例高龄高危良性前列腺增生症患者行经尿道等离子体双极汽化电切术(PKRP),术前进行风险评估及充分准备,改进手术操作技巧,提高围手术期安全.结果 手术时间30～ 100min,平均70min;切除前列腺组织重45 ～ 110g,平均55g.术中出血少,无输血.248例患者均安全渡过围手术期,无电切综合征(TURS)和真性尿失禁等严重并发症.早期暂时性尿失禁18例,经口服“酒石酸托特罗定片”和提肛训练1～3周恢复.所有患者随访6个月以上,排尿症状消失或明显改善.结论 经尿道等离子体双极汽化电切术(PKRP)仍是治疗高龄高危前列腺增生症患者安全、有效的方法.     

经尿道等离子体双极电切术治疗前列腺增生

目的探讨经尿道等离子体双极电切治疗前列腺增生(BPH)的安全性与有效性。方法用经尿道等离子体双极电切法行前列腺切除术(PKVP)81例。结果81例术中出血少,无前列腺电切综合征(TURS)和前列腺包膜穿孔发生。术后随访1-6个月,最大尿流率(Qmax)由术前的(6．2±4．1)ml／S上升至术后的(21．2±4．6)ml／S;国际前列腺症状评分(IPSS)由术前的(25．6±4.8)分下降至术后的(6．8±2．6)分;生活质量评分(QOL)由术前的(5．1±0．5)分降低至术后的(1．8±0．5)分;残余尿由术前的(67±70)ml减少至术后的(15±20)ml。结论经尿道等离子体双极电切治疗前列腺增生疗效确切,安全性好,并发症少。     

经尿道等离子体双极电切术治疗前列腺增生

目的：探讨经尿道等离子体双极电切术治疗良性前列腺增生的安全性和疗效。方法：回顾性分析经尿道等离子体双极电切治疗前列腺增生100例患者临床资料。结果：术中出血少．无前列腺电切综合征,术后随访3～6个月,最大尿流率由术前8．2ml／s升到术后19．5ml／s,国际前列腺症状评分由术前25分降到9分,剩余尿由56ml减至10.8ml,无尿失禁。结论：经尿道等离子体前列腺切除术具有安全性高、并发症少、疗效好的优点。     

经尿道等离子双极电切治疗前列腺增生176例

目的探讨经尿道等离子双极电切术治疗前列腺增生（BPH）的疗效和安全性。方法分析采用等离子双极电切治疗的176例BPH患者的临床资料。结果手术平均时间73min,切除前列腺组织平均51．4g,无需要输血病例,无电切综合症（TURs）和永久性尿失禁发生,术后所有患者排尿顺畅。结论经尿道等离子双极电切术是治疗BPH安全、有效的方法。     

经尿道电汽化联合电切术治疗前列腺增生症

目的 :探讨良性前列腺增生症 (BPH)的有效治疗方法。方法 :联合应用经尿道前列腺电汽化术 (TUVP)和经尿道前列腺电切术 (TURP)治疗BPH患者 96例。结果 :手术操作时间 3 0～ 90min ,手术过程顺利 ,视野清晰 ,出血量少 ,疗效满意 ,未出现严重并发症。结论 :TUVP与TURP联合应用治疗BPH具有二者特点 ,出血少 ,安全性高 ,并发症少 ,疗效显著。     

等离子双极汽化电切除术治疗高危前列腺增生症

目的 探讨经尿道等离子双极汽化电切术治疗高危前列腺增生症(BPH)患者的疗效和安全性.方法 采用等离子双极电切术(PKRP)治疗高危BPH 64例,同期采用传统尿道电切术(TURP)24例,对两种术式的临床效果及安全性进行评估.结果 两组患者术后国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)均得到显著改善(P<0.01);但PKRP组病人术中出血更少,单位时间内组织切除率更高,无低钠血症及水中毒(TURS)等并发症.结论 两种经尿道(TUR)手术都是治疗BPH的有效方法;但PKRP具有止血效果好、安全性高、对机体生理功能影响小,并发症少等优点,对高危BPH患者是一极具优势的TUR手术方法.     

Determination of canine prostatic size in situ: comparison of direct caliper measurement with radiologic and transrectal ultrasonographic measurements

The use of transrectal ultrasonography to estimate canine prostatic size in situ was evaluated and compared to that of direct measurement via calipers and an in situ radiologic procedure. The length, width, and depth of prostates were measured by transrectal ultrasound in both the transverse and sagittal planes from which prostatic volume was calculated. Prostatic volumes were subsequently transformed into prostatic weights using the following nomogram: prostatic Weight (g) = 0.602 x prostatic Volume (cm3) + 1.16. Prostatic weights estimated by ultrasound as well as by direct measurement with caliper were similar (P greater than 0.10) to the true gravimetric weight; however, prostate weights estimated by the radiological X-ray procedure were significantly (P less than 0.01) lower. The relationship between true gravimetric prostate weight and that estimated by ultrasound was described by the following regression equation: estimated weight (g) = 1.127 gravimetric weight (g) - 1.665; r = 0.900; P less than 0.001; n = 23. In summary, the results of this study demonstrate that transrectal ultrasonography can be used to accurately predict canine prostatic weight.     

前列腺癌组织中前列腺跨膜上皮抗原表达的临床意义

目的 :探讨前列腺跨膜上皮抗原 (STEAP)在前列腺癌 (PCa)组织中的表达及与肿瘤病理分级之间的关系。方法 :采用免疫组化SP法 ,用STEAP单克隆抗体对前列腺不同病变组织及非前列腺肿瘤组织石蜡包埋切片进行免疫组化染色 ,其中PCa组织 131例 ,良性前列腺增生 (BPH)组织 16 4例 ,非前列腺肿瘤组织标本 5 6例。引入阳性面积单位概念判定STEAP染色强度。　结果 :2 95例前列腺病变组织中 ,仅 3例PCa和 5例BPH组织STEAP呈阴性表达 ,STEAP在PCa组织中明显高表达 ,非前列腺肿瘤组织染色均呈阴性。STEAP表达与PCa的Gleason分级之间存在显著负相关性。　结论 :STEAP能够用来判断PCa的预后 ,在PCa的免疫治疗方面具有良好的应用前景。     

Diffusion of Piperacillin, Cefotiam, Minocycline, Amikacin and Ofloxacin into the Prostate

Background: The successful treatment of bacterial prostatitis depends on an effective antimicrobial concentration in prostatic tissue against the infecting organism. In this study we compared the diffusion of 5 types of antimicrobials into the prostate.
Methods: The concentrations of piperacillin, cefotiam, minocycline, amikacin, and ofloxacin were determined in prostatic fluid, prostatic tissue, and serum 2.5 to 3 hours after a single administration from 55 patients with benign prostatic hypertrophy.
Results: Although amikacin showed the highest mean concentration both in prostatic tissueand prostatic fluid, the prostatic tissue/serum ratio was significantly higher (P < 0.01) for ofloxacin (1.49 ± 0.80) and minocycline(0.94 ± 0.39)compared with those for amikacin (0.49 ± 0.2l)and piperacillin (0.21 ± 0.15). Also, the prostatic fluid/serum ratio was lower than the prostatic tissue/serum ratio for each drug, however, the prostatic fluid/serum ratio of ofloxacin was significantly higher than that of other antimicrobials tested (P < 0.01).
Conclusion: These results support earlier studies demonstrating that fluoroquinolones are a useful class of antimicrobials for the treatment of chronic bacterial prostatitis. They also suggest that in view of the pharmacokinetic properties and antimicrobial activities, amikacin and minocycline may be alternate antimicrobial options for selected patients with bacterial infections of the prostate.     

Phosphotyrosine phosphatase activity of human and canine acid phosphatases of prostatic origin

Human and canine prostatic specimens containing high levels of acid phosphatase (AP) activity were tested, at acid pH, for their ability to hydrolyze the major phosphoaminoacids present in phosphorylated proteins, phosphoserine (p-ser), phosphothreonine (p-thr), and phosphotyrosine (p-tyr). The cleavage of a synthetic substrate, para-nitrophenyl-phosphate (p-npp), was also measured as an indicator of AP activity; its inhibition by sodium-L-tartrate (T) was used as a criterion to identify prostatic acid phosphatase (PAP). It was found that: 1) the Km of p-tyr and p-npp were 2.0 mM and 0.41 mM, respectively, with similar Vmax values (0.078 and 0.087 mumoles of phosphate (Pi) liberated per minute per milligram of protein); 2) the ID50 were 0.25 mM and 0.50 mM with sodium orthovanadate (VO4) and T, respectively, using p-npp as substrate-with p-tyr as substrate, the values obtained were 0.016 mM and 0.11 mM, respectively; 3) activity toward p-ser and p-thr was minimal; 4) native PAP from dog seminal plasma, with a molecular weight of 90-100 kD, as determined by gel filtration on HPLC, hydrolyzed p-tyr preferentially, and this phosphatase (Pase) activity was also strongly inhibited by both T and VO4; and 5) the AP present in human and canine prostatic tissue and cells, as well as in their secretions, also preferentially hydrolyzed phosphotyrosine, and it was inhibited by T and VO4. It is proposed that these p-tyr Pases may be involved in the local regulation of prostatic growth.     

Change in the ratio of free-to-total prostate-specific antigen during progression of advanced prostate cancer.

BACKGROUND: The ratio of free-to-total prostate-specific antigen (PSA) is different in benign prostatic hyperplasia and in the early stage of prostate cancer. The present study was undertaken to examine the ratio of free-to-total PSA in the advanced stage of this cancer and its subsequent change during course of the disease. METHODS: Free and total PSA were measured in sera collected from the following patients with benign and cancerous prostatic diseases: 47 cases of benign prostatic hypertrophy, nine in TIC with less than 10 ng/mL of total PSA, 11 in stage C, 16 in D2, 22 in remission under endocrine therapy, and 12 in relapse. In addition, PSA was measured sequentially in four other patients who were also in relapse. RESULTS: The ratio of free-to-total PSA was similar in early and advanced stages of untreated prostate cancer and was lower than that in benign prostatic hyperplasia. The ratio increased to the level of benign prostatic hyperplasia during remission from stages C and D2 under endocrine therapy. There was no correlation with the intervals from the start of the therapy to examination. Following relapse, the ratio came down gradually to the level obtained in untreated prostate cancer. CONCLUSION: The ratio of free-to-total PSA was similar in all stages of untreated prostate cancer. Response and relapse to endocrine therapy were associated with increase and decrease in ratio, respectively.     

Androgen receptor isoforms in human and rat prostate

Aim: To investigate the androgen receptor (AR) isoforms and its variability of expression in human and rat prostatic tissues. Methods: Human benign prostatic hyperplasia (BPH) and prostatic cancer tissues were obtained from patients undergoing prostatectomy, and rat ventral prostate was incised 3 days after castration. Forty-one AR-positive BPH specimens, 3 prostatic cancer specimens, and 6 rat prostates were used. After processing at 4℃, the tissues were examined by means of high resolution isoelectric focusing (IEF) technique to determine their AR isoforms. Results:From the prostatic specimens, 3 types of AR isoforms were detected with pI values at 6.5, 6.0, and 5.3. In human BPH tissues, 15/41 (36.6%) specimens showed all the three types of isoforms, while 19/41 (46.3%) showed 2 isoforms at various combinations and 7/41(17.1%), 1 isoform. For the 3 prostatic cancer specimens, one showed 3 isoforms, one, 2 isoforms, and the other failed to show any isoform. All rat prostatic tissues showed 2 isoforms at different combinations. Binding of ^3H-dihydrotestosterone (DHT) to the isoforms was inhibited by the addition of 100-fold excess of DHT or testosterone, but not progesterone, oestradiol or diethylstilboestrol. Conclusion: AR isoforms are different in different patients. Although their genesis is not clear, the therapeutic implication of the present observation appears to be interesting, that may help clarifying the individual differences in the response to hormonal therapy.(Asian J Androl 2000 Dec;2:307-310)     

Accuracy of prostate volume measurements using transrectal multiplanar three-dimensional sonography

The aim of this study is to evaluate the accuracy of three-dimensional (3D) ultrasound in comparison with conventional bidimensional (2D) sonography in prostatic calculations. The study was performed using a Kretztechnik Voluson 530D machine with a 7.5 MHz endocavitary transducer. From March 1998 to March 2000, we examined 80 patients (63-74 years, mean 68 years). There were 59 patients with benign prostate hypertrophy (BPH) and 21 with prostate cancer awaiting a radical prostatectomy. The mean absolute error in 3D ultrasound measurement was +/-0.2-3 mL. (range of error was 6.5%). Volume measurement using 2D ultrasound methods was much less accurate than 3D ultrasound methods: +/-0.4-5 mL. (range of error was 35%). Both 2D and 3D measurements show that the margin of error depends on the frequent presence of a third prostatic lobe, on the morphology, and on the size of the prostatic gland. The precise estimation of prostate volumes may provide information on the real effectiveness of some therapies that act on the reduction in volume of benign alteration, such as in prostatic hypertrophy, and may eliminate the current limits of 2D sonography with a significant clinical contribution for virtually no extra cost.     

Neuroendocrine differentiation of human prostatic primary epithelial cells in vitro

BACKGROUND: Dispersed prostatic neuroendocrine cells are involved in growth regulation of the prostate and are considered to play a role in the pathogenesis of prostate carcinoma and benign prostatic hyperplasia (BPH). They are meant either to be derived from the neural crest during embryogenesis or by direct differentiation of the cells from locally present precursor cells. METHODS: An in vitro model was developed for human prostatic epithelial and neuroendocrine cell differentiation. Minced explants from radical prostatectomies were seeded on collagen I-coated plates. RESULTS: The majority of outgrowing cells were basal cells, positive for cytokeratin markers K 5/14 and CD 44, as determined by confocal laser scanning microscopy. A small fraction of interdispersed single cells expressing c-kit, which is found on pluripotent precursors, was identified by immunofluorescence. From these basal cells, in vitro differentiation of cells with neuroendocrine morphology could be achieved within 3 days. These were at rest, i.e., non-bromodeoxyuridine incorporating cells and characteristically coexpressed K 5/14, K 18, and the neuroendocrine marker chromogranin A. Luminal cells staining for K 8 or 18 were not observed. CONCLUSION: Neuroendocrine differentiation of adult prostatic cells was achieved in vitro, favoring the hypothesis that neuroendocrine cells are derived from peripheral precursor cells. The acceleration of this differentiation pathway may be the reason for the increased presence of neuroendocrine cells in areas of epithelial hyperplasia in BPH.     

Polarity of prostate specific membrane antigen,prostate stem cell antigen,and prostate specific antigen in prostate tissue and in a cultured epithelial cell line

BACKGROUND: Madin-Darby canine kidney (MDCK) cells are immortalized epithelial cells that have been used extensively as a model system to study intracellular molecular trafficking, polarized expression, and secretion of proteins in various epithelia. In order to determine if MDCK cells might serve as a model to study molecular events within prostate epithelial cells, we have evaluated the polarized distribution of three prostate restricted proteins, PSMA, PSCA, and PSA, in situ, and in MDCK cells. METHODS: Using immunofluorescence, confocal microscopy, cell surface biotinylation, antibody internalization, and biochemical assays we evaluated surface expression and secretion of three prostate restricted proteins expressed in MDCK cells. We compared these patterns of expression to results observed within prostatic epithelium. RESULTS: We demonstrate that PSMA is localized primarily to the apical plasma membrane in both the prostatic epithelium and transfected MDCK cells, whereas PSCA is expressed in a non-polarized fashion. We also show that PSA is secreted predominantly from the apical surface of transfected MDCK cells, consistent with in vivo observations. CONCLUSIONS: Similar patterns of localization among MDCK and prostatic epithelial cells suggest that the mechanisms of polarized sorting within these cell types are conserved. Thus, MDCK cells offer a useful model system to study mechanisms of targeting of these proteins within the prostate.     

Risk factors for prostatic inflammation extent and infection in benign prostatic hyperplasia

Aim:To investigate the risk factors for prostatic inflammation extent and infection in patients with benign prostatichyperplasia(BPH)so as to manage prostatic inflammation more efficiently.Methods:Sixty patients with BPHundergoing TURP between September 2005 and December 2005 in West China Hospital of Sichuan University werestudied.Prostate fluid(PF)was collected for the measurement of secretory IgA(SIgA)and complement 3(C3).Prostate tissue were collected for testing bacterial 16S rDNA by real-time PCR,examining SIgA in the tissue andexamining the inflammation.The possible clinical and immune risk factors for prostatic inflammation or infection wereanalyzed by using the logistic regression method.Results:Abnormal white blood cell count in urinalysis,prostaticinfection and a high concentration of C3 in PF are the risk factors for prostatic inflammation extent(P=0.025,0.034 and0.035,respectively and odds ratio[OR]=18.269,8.284 and 1.508,respectively).Risk factors for prostatic infectioninclude the C3 concentration and the concentration of SIgA in PF(P=0.003 and 0.013,respectively,and OR=1.645 and0.993,respectively).Conclusion:The present study suggests that prostatic inflammation is associated with urinarytract infection,prostatic infection and the activated complement and that prostatic infection is associated with theactivated complement and downregulated mucosal immunity in prostates of the patients with BPH.It is also sug-gested that individual immune regulation should be considered in the treatment of prostatic inflammation and infectionof patients with BPH.(Asian J Androl 2006 Sep;8:621-627)