Sertraline in the treatment of premature ejaculation: A double-blind placebo controlled study

This study investigated the efficacy and the adverse effects of sertraline in the treatment of premature ejaculation (PE). Thirty-seven patients with PE were randomly assigned to receive either sertraline or a placebo. Of them 22 were given 50 mg of sertraline per day and the other 15 patients were given an identical placebo one per day. After 4 weeks, the latency to ejaculation in the sertraline group was found to be significantly longer than that of the placebo group (p<0.01). None of the patients discontinued therapy due to adverse effects. These results indicate that sertraline is an effective therapy for PE.     

Urethrocystography during and after transurethral prostatic resection.

Ten men were subjected to transurethral electroresection because of prostatic adenoma. All were examined with urethrocystography on 3 occasions, viz. at the end of operation, 4-7 days later and after a further 2-3 months. Peroperative examination for residual adenoma appeared to be of little value, while examination a few days after the operation revealed residual adenomas in 2 cases and possibly also in a third. The cavity left after the operation had the same size at the peroperative and the first postoperative examination, though its outline was sometimes smoother at the latter. During urination the cavity invariably increased in size. At the second postoperative examination the operation cavity was clearly smaller and its outline smoother in 9 of 10 cases. The cavity still expanded during micturition. No passage of contrast medium to the veins was ever demonstrable. At the peroperative examination the contrast medium was not injected under any substantial pressure and the cavity was not exposed to pressure by micturition. Even at the first postoperative examination, when the operation cavity was exposed to pressure by urination, the veins that had been opened at operation had closed so effectively that no contrast medium passed outside the prostatic capsule. Urethrocystography in association with TUR of prostatic adenoma is of interest to the urological surgeon. It provides him with a possibility to check his work very carefully.     

Symptomatic treatment of benign prostatic obstruction with Nicergoline: A placebo controlled clinical study and urodynamic evaluation

Summary A double-blind crossover study of the alphablocker Nicergoline was carried out in sixteen patients affected by benign prostatic bladder outflow obstruction. The irritative symptoms of prostatic hypertrophy, including nocturnal frequency and dysuria, were improved after Nicergoline significantly more than after placebo. In 10 further patients with prostatic hypertrophy, peak and mean flow rates increased by 50% and 77% respectively after the acute administration of Nicergoline. No side effects were detected. In conclusion Nicergoline seems to be active and well tolerated in the treatment of benign prostatic obstruction.     

Cefotaxime for prevention of infectious complications in bacteriuric men undergoing transurethral prostatic resection. A controlled comparison with methenamine

Forty-two men with urinary tract infection and benign prostatic hyperplasia were randomized into two groups before transurethral resection. One group (22 patients) received Claforan (cefotaxime) peroperatively and thereafter daily for five days. In the other group (20 patients), Hiprex (methenamine hippurate) was given daily from the day before the operation, for a total of six days. All the bacterial isolates were sensitive to cefotaxime. The efficacy of the medication was clinically and bacteriologically evaluated. Postoperative temperature elevation (greater than 38 degrees C) occurred in one of the 22 patients in the cefotaxime group, and in nine of the 20 in the methenamine hippurate group (p less than 0.05). None of the former group, but two patients in the latter, had septicemia. The difference was not statistically significant. The response to treatment was satisfactory in 13 of the 22 patients in the cefotaxime group, but in only one of the 20 treated with methenamine hippurate (p less than 0.005). Antibiotic treatment is recommended for bacteriuric patients undergoing transurethral prostatic resection.     

A comparison of bladder neck incision and transurethral prostatic resection.

Between 1978 and 1988, 108 patients underwent bladder neck incision (BNI) for bladder outflow obstruction. These patients were compared to a similar group who underwent transurethral resection of the prostate (TURP), during the same time period. Only patients with minimal prostatic enlargement (less than 10 g) with prominent bladder necks and small lateral lobes were included in the study. In addition, all patients in the resection group had a resection weight of less than 10 g on the histopathology report. Patients were followed up by means of a posted questionnaire to which 59 patients in the BNI group and 86 in the TURP group responded. Pre-operative and peri-operative data were also collected from these respondents by a retrospective case record review. This found both operations to be safe with low morbidity and mortality. BNI was better than TURP in terms of shorter operation length (P less than 0.017) and shorter duration of catheterization (P less than 0.004). No other peri-operative differences were found. Follow-up results from the questionnaire showed no significant differences in symptoms between the two groups. Similarly, there was no difference in the number of re-operations performed over the 10 year period studied. Patient assessment of their operation was initially favourable in both groups (greater than 80% patient approval) however, both treatment groups experienced a gradual drop in patient approval over the 10 year period. There were no differences in the level of approval between the BNI and TURP groups.     

经尿道前列腺等离子双极电切与TURP治疗BPH的疗效比较

目的:比较经尿道前列腺等离子双极电切术(PKRP)与经尿道前列腺电切术(TURP)治疗BPH的临床疗效及安全性。方法:将164例BPH患者随机均分成PKRP组和TURP组,比较两组术后最大尿流率(Qmax)、剩余尿量(PVR)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)等指标。结果:PKRP组72例、TURP组76例获得随访,随访时间3个月。PKRP组尿道外口狭窄2例,膀胱颈挛缩1例,TURP组尿道外口狭窄6例,膀胱颈挛缩4例;PKRP组Qmax为(22.6±4.6)ml/s,PVR为(8.6±4.4)ml,IPSS为(4.6±1.2)分,QOL为(1.2±0.6)分;TURP组分别为(24.2±4.2)ml/s、(9.6±3.6)ml、(4.4±1.0)分、(1.4±0.8)分,两组比较差异有统计学意义(P<0.05)。结论:PKRP与TURP治疗BPH疗效相近,但PKRP平均手术时间、术中出血量、围手术期及术后并发症较TURP明显减少,手术安全性高,有良好的应用前景。     

Fluphenazine/nortriptyline in the irritable bladder syndrome. A double-blind placebo controlled study

A double-blind, placebo controlled, randomised order crossover study was carried out on the effect of Motival (0.5 mg fluphenazine with 10 mg nortriptyline) 3 times daily on the bladder function and psychiatric morbidity of 13 women without evidence of infection, complaining of recurrent dysuria and frequency. Bladder function was assessed symptomatically and by ambulatory urodynamics, and patients completed the General Health Questionnaire, a validated instrument for the detection of psychiatric disturbance. Correction of the urodynamic abnormalities was associated with Motival treatment in 5 of the 8 patients with unstable bladders, compared with none of 7 patients receiving placebo (P less than 0.02). Motival was also associated with a greater frequency of symptomatic improvement. Only 2 patients were classified as psychiatrically disturbed, suggesting that the therapeutic effect of Motival is not related to its psychotropic properties.     

A comparative study of Kystosol and glycine as irrigating solutions during transurethral prostatic resection.

The author has compared Kystosol and glycine as irrigating solutions during transurethral prostatic resection. Astrum analyses during the operations revealed the development of acidosis in half of the patients in the Kystosol group, whereas in the glycine group, only 4 out of 27 developed a slight decline of base excess. Development of acidosis was directly proportional to the volume of irrigation fluid used and the duration of the operation.     

经尿道汽化结合电切术治疗良性前列腺增生症

目的　探讨经尿道汽化结合电切术治疗良性前列腺增生症 (Benignprostatehyperplasia ,BPH)的临床疗效及并发症的防治。　方法　低位硬膜外麻醉下 ,联合使用环状电极、滚筒状电极以及铲状电极对 83例BPH行经尿道汽化结合电切术。　结果　平均手术时间 5 8min ,平均失血量 80ml,均未输血 ,无经尿道电切综合征 (Transurethalresectionsyndrome ,TURS)发生。全部病例随访 2月～ 2年 ,国际前列腺症状评分 (IPSS)由术前 (2 6 4± 5 7)分下降至术后 (8 4± 3 9)分 (t =2 0 31,P <0 0 0 1) ,生活质量(QOL)评分由术前 (4 9± 0 4 )分下降至术后 (1 6± 0 3)分 (t=3 92 ,P <0 0 0 1) ,最大尿流率 (Maximumflowrate ,MFR)由术前 (5 1± 3 7)ml s上升至术后 (16 3± 4 2 )ml s(t=5 6 4 ,P <0 0 0 1)。　结论　经尿道前列腺汽化术 (Transurethalvaporizationofprostate ,TVP)结合经尿道前列腺电切术 (Transurethalresectionofprostate ,TURP)治疗BPH安全性高、并发症少、效果确切。     

Prophylactic analgesia for daycase termination of pregnancy A double-blind study with controlled release dihydrocodeine

The incidence and severity of pain and nausea experienced by 40 primigravid day patients who presented for vaginal termination of pregnancy were examined. Controlled-release dihydrocodeine had no effect upon the incidence or severity of these minor sequelae. The requirements for escape analgesia and antiemetic therapy were less than anticipated and possible explanations are discussed. The low incidence of significant nausea and vomiting recorded in this study confirms that vaginal termination of pregnancy may be safely performed as day cases.     

Phenoxybenzamine in prostatic hypertrophy. A double-blind study

Forty-five patients awaiting prostatectomy participated in a double-blind study of phenoxybenzamine 10 mg/day for 5 weeks. Objective measurements of peak urine flow, voided volume, residual urine and frequency of micturition and nocturia showed no significant difference between phenoxybenzamine and placebo. Patients taking phenoxybenzamine had a significantly greater improvement in hesitancy and flow symptoms than those on placebo. Side effects occurred in 47.6% of patients on phenoxybenzamine and 22.2% of those on placebo. In this study phenoxybenzamine 10 mg/day was ineffective in patients with benign prostatic hypertrophy.     

A double-blind randomized controlled trial and economic evaluation of transurethral resection vs contact laser vaporization for benign prostatic enlargement: a 3-year follow-up

OBJECTIVE: To evaluate the effect of contact laser prostate surgery in the treatment of benign prostatic hyperplasia. PATIENTS AND METHODS: A prospective double-blind randomized controlled trial of transurethral resection of the prostate (TURP) and contact laser prostatectomy was conducted, with an economic evaluation of both procedures. The primary outcome measure was the change in the American Urologic Association symptom score, with secondary outcome measures being the peak urinary flow rate, treatment-related complications, re-operation rate and health service costs. RESULTS: The perioperative blood loss and transfusion requirements were statistically significantly lower for laser prostatectomy than for TURP. There was no clinically significant difference between TURP and contact laser prostatectomy in the mean change in symptom scores and flow rates. There were distinct perioperative advantages in favour of the contact laser treatment, but some disadvantages in terms of re-catheterization and re-operation rates. CONCLUSIONS: Contact laser prostatectomy is a valid treatment for benign prostatic hypertrophy. The performance of contact laser prostatectomy as day-case surgery would have cost advantages to the National Health Service.     

Combined treatment of prostatic adenoma with the 80 Watt KTP-laser and low-pressure transurethral resection

IntroductionThe purpose of this prospective study is to determine the effectiveness of method for vaporisation and elimination of the prostate adenoma. The results are analysed that obtain when combining this Laser-method with the Resection of low pressure.Material and Method151 patients with BPH symptomatic were treated between august 2004 and january 2006 with the KTP-Laser or combined with low pressure TURP. The additional Resection was carried out in those patients with great adenomas or to have accentuated middle lobule. The ablative effect was controlled at the end of the operation with TRUS (transrectal ultrasound).Results151 patients were divided in 2 groups, group 1 (n:43) those with single laser treatment and group 2 (n:108) with combined treatment. The control of the post-miccional peak-flow demonstrates an increase of 65,6% in group 1, and of 122,4 % in group 2.ConclusionOur study puts of open, the advantages to combine both operative procedures to mainly obtain a better result in the ablation of the prostate adenoma in prostates of great size.     

Prophylactic antibiotics in the treatment of penetrating chest wounds. A prospective double-blind study.

Considerable controversy exists as to whether or not antibiotics should be administered "prophylactically" to patients with penetrating chest trauma. No prospective study of this problem has been reported. Therefore, 75 patients with isolated, penetrating chest injury were randomized prospectively in a double-blind study. Group A patients (38 patients) were given 300 mg. of clindamycin phosphate every 6 hours, beginning with admission and lasting until 1 day following chest tube removal or for 5 days, whichever was shorter. Group B patients (37 patients) were given a placebo on the same schedule. The patients' hospital course, fever, white blood count, culture data, and roentgenograms were recorded serially. Clindamycin-treated patients had a significantly lower incidence of radiographic pneumonia, less fever, and a lower incidence of positive pleural and wound cultures. They acquired empyema less frequently, required fewer operations, and had a shorter period of hospitalization. Antibiotics may be useful, therefore, as adjunctive therapy in the management of penetrating chest trauma.     

经尿道前列腺汽化电切术和等离子电切术治疗良性前列腺增生症的比较研究

目的 比较经尿道前列腺汽化电切(TUVP)和经尿道前列腺等离子电切术(PKRP)两种方法治疗良性前列腺增生症(BPH)的安全性和有效性.方法 TUVP组133例,PKRP组113例,对两者的手术时间、术中出血量、术后膀胱冲洗时间、术中电切综合征(TURS)发生率、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)和剩余尿量(PVR)以及术后并发症的发生率进行比较.结果 两组患者术前一般情况比较无统计学差异(p＞0.05),术后I-PSS、QOL、Qmax、RUV与术前比较均有显著性差异(p＜0.01),但两组间比较无显著性差异(p＞0.05).手术时间PKRP组明显长于TUVP组.术中出血量、术后膀胱冲洗时间PKRP组明显小于TUVP组.术后尿路刺激症状PURP明显少于TUVP组.结论 PKRP与TUVP对治疗BPH均安全有效,但PKRP术中出血较少,术后并发症率低,但手术时间较长.     

经尿道等离子杆状电极前列腺剜除与电切治疗前列腺增生的对照研究

目的评价经尿道双极等离子杆状电极前列腺剜除术(TUERP-BPRE)治疗前列腺增生(BPH)的安全性和疗效。方法回顾性分析我科2018年5月至2019年12月收住院手术治疗的157例BPH患者临床资料,其中TUERP-BPRE组92例,TURP组65例,比较两组患者围术期资料和术后3个月随访结果。结果两组患者术前基线资料一致。TUERP-BPRE组手术时间[(60±20)min vs(68±9)min]、术后血红蛋白下降值[(6.1±2.8)g/L vs(7.7±1.5)g/L]、膀胱持续冲洗时间([8.1±1.6)h v(s 9.1±2.0)h]、留置导尿管时间([4.5±0.7)d vs(4.9±0.8)d]、住院时间([5.3±0.8)d vs(5.7±0.8)d]均显著低于TURP组。两组术后3个月IPSS、QOL、RUV及Qmax均明显优于术前,但两组间比较差异无统计学意义。TUERP-BPRE组术后血电解质紊乱(6.5%vs 21.53%)、延迟性血尿(6.5%vs 23.1%)、暂时性尿失禁(5.4%vs 18.5%)及逆行射精(2.2%vs 15.4%)发生率均明显低于TURP组。结论TUERP-BPRE治疗BPH与TURP疗效相当,且手术时间短、失血少、术后恢复快、并发症少,值得临床应用推广。     

Internal urethrotomy of the prostatic urethra or transurethral resection in benign prostatic hyperplasia.

Transurethral resection of the prostate is the most common technique for the treatment of benign prostatic enlargement. The inconveniences of prostatic resection are retrograde ejaculation and bladder neck stenosis in small prostates. A randomized prospective trial was done to compare the results of conventional transurethral resection of the prostate in 22 patients and urethrotomy of the prostatic urethra in 27 with respect to postoperative retrograde ejaculation, persistent urinary symptomatology and maximal flow rates. After a mean followup of 25 months we concluded that internal urethrotomy of the prostatic urethra is the operation of choice in patients with a prostate of up to 30 gm.