前列腺结石与血清前列腺特异抗原关系的研究

血清前列腺特异抗原(PSA)是诊断和鉴别诊断前列腺癌(PCa)的一项重要指标,但许多良性前列腺疾病如前列腺增生、前列腺炎也可导致血清PSA升高.前列腺结石在前列腺疾病中发病率较高,有关前列腺结石对血清PSA有无影响的临床研究较少.本文就前列腺结石对血清PSA有无影响进行了临床研究,现分析报告如下.     

前列腺巨大结石1例

患者，男，60岁。因进行性排尿困难、尿线变细2年，肉眼血尿1d就诊。3年前曾因尿道外口黏液腺囊肿行囊肿切除术。体检：尿道外口狭窄，直径约1mm；前列腺Ⅲ度大，质韧，表面光滑，无明显触痛，中央沟消失，未及硬结。尿常规检查白细胞＋＋，红细胞＋＋＋。     

前列腺结石与前列腺炎的相关性

前列腺炎病人前列腺液 (ＥＰＳ)的各种成分随疾病发生而改变。本文通过对 5 77例前列腺炎病人实验室检查发现 ,ＥＰＳ中结石阳性率明显高于非前列腺炎病人。现总结报告如下。1　资料及方法1.1　研究对象　 1997年 6月～ 1999年 9月 ,我院泌尿生殖科门诊病人 ,共 5 77例。其中前列腺炎组2 96例 ,年龄 2 1～ 75岁 ,平均 (4 0 .7± 13.8)岁 ;非前列腺炎组 2 81例 ,年龄 16～ 71岁 ,平均 (36.3±12 .3)岁。1.2　取材及检验方法　以指肚按压前列腺 ,用载玻片在尿道口接取挤压出的ＥＰＳ。观察其颜色、透明度、有无絮状物 ,测定 ｐＨ值 ,然后高倍…     

前列腺结石与良性前列腺增生患者前列腺体积的相关性研究

目的探讨前列腺结石与前列腺增生症患者前列腺体积的相关性。方法回顾性分析本院2012年1月至2013年12月出院诊断为良性前列腺增生的患者392例,根据经直肠前列腺彩超结果将患者分为前列腺结石阴性组与阳性组,比较两组的年龄、前列腺特异性抗原(PSA)、前列腺总体积、内腺体积以及各经线之间有无差别。结果结石阴性组与结石阳性组前列腺总体积(TPV)、总体积宽径(TPV-b)、内腺体积宽径(TZV-b)差别有统计学意义(P0.05);结石阴性组与结石阳性组的年龄、内腺体积(TZV)、血清总PSA(TPSA)密度以及其他各经线差别无统计学意义(P0.05)。结论前列腺结石与前列腺增生程度存在一定的内在关系,结石有可能促进前列腺组织的增生。     

尿道下裂与扩大的前列腺囊

目的　探讨尿道下裂患者扩大的前列腺囊发生率及对尿道成形术的影响与处理方法。　方法　通过体检、尿道造影、尿道膀胱镜检查对 52例尿道下裂患者扩大的前列腺囊的发病率及程度 ,单纯尿道下裂与同时合并扩大的前列腺囊患者尿道成形术后尿瘘发生率进行分析。　结果　 52例中合并扩大的前列腺囊 1 6例 ,占 31 %。阴茎头型 5例、阴茎型 8例、阴茎阴囊型 2 0例、会阴型 1 9例 ,合并扩大的前列腺囊分别为 0、1、6、9例 ,且随尿道下裂严重程度的增加级别增高。术后尿瘘发生率单纯尿道下裂为 1 8.2 % ,合并扩大的前列腺囊者为 4 6 .7%。　结论　随尿道下裂程度增加 ,扩大的前列腺囊发生率及程度增加 ,术后尿瘘发生率亦逐渐增加。     

慢性前列腺炎与前列腺结石的相关性

目的:探讨慢性前列腺炎(CP)与前列腺结石(PC)的相关性。方法:对500例健康志愿者和491例CP患者经会阴B超检测PC,将其分成无PC组与有PC组,并进行NIH-CPSI评分、症状持续时间及前列腺按摩液(EPS)中白细胞计数的统计分析。结果:健康组和CP组PC的检出率分别为19.8%、42.2%,差异有显著性(P<0.01);健康组各年龄段(20～30,31～40,41～50,51～60和61～70岁组)PC的检出率分别为5%(5/100)、12%(12/100)、19%(19/100)、27%(27/100)、36%(36/100),CP组各年龄段PC的检出率分别为15.8%(12/76)、32.1%(69/215)、55.7%(59/109)、66.2%(43/65)、82.8%(24/29),两组各年龄段间PC的检出率差异有显著性(P<0.01);无PC组与有PC组NIH-CPSI评分差异无显著性(P>0.05),症状持续时间及EPS中白细胞计数差异有显著性(P<0.01)。结论:CP中PC的检出率明显增多,PC与感染、年龄及症状持续时间有关,与NIH-CPSI评分无关。     

前列腺结石的经直肠超声观察

前列腺结石的经直肠超声观察刘跃新焦志友陈山张岐山刘效慈刘淑敏我院自１９９２年１１月～１９９６年１０月，应用经直肠腔内二维和三维超声检查，共发现前列腺结石３１２例，其中２３４例为前列腺增生患者。报告如下。资料和方法门诊诊断或怀疑前列腺疾病病人共１１４０...     

前列腺结石对血清PSA水平的影响

目的 探讨前列腺结石对血清PSA的影响.方法 对120例健康人群、60例CP、80例BPH经会阴超声检查前列腺结石的发生率,同时进行血清PSA的检测.结果 三组间前列腺结石的发生率分别为9.17%、41.67%、58.75%,差异有显著性;且三组间结石组与非结石组年龄比较有显著差异;而血清PSA在三组间结石组与非结石组差异无显著性.结论 前列腺结石在BPH、CP中检出率较高,其发病率与年龄有很大关系;前列腺结石对血清PSA无影响.     

TVP术中前列腺结石的临床意义

我院于2000年至2005年开展经尿道前列腺汽化电切术(TVP)共935例，其中合并前列腺结石654例，约占总数的70％。我们结合术中观察探讨，报告如下。     

慢性前列腺炎合并前列腺结石的临床研究

目的 探讨慢性前列腺炎(CP)与前列腺结石(PC)的关系.方法 对500例健康人群和491例CP患者经直肠B超检测PC,将其分成CP与CP+Pc组,进行CPSI评分.结果 ①对照组PC的检出率随年龄增大而增高(χ2=68,P<0.001);②CP与对照组各年龄段PC的检出率差异有显著性(P<0.001);CP组各年龄段PC的检出率分别为15.79%、30.09%、55.66%、66.15%、82.76%,各年龄段间差异有显著性(P<0.001);③CP与CP+PC组CPSI评分差异无显著性(P>0.05).结论 CP中PC的检出率明显增多,且随年龄增大而增高;年龄与CP是形成PC的重要因素.     

The composition and structure of stones in enlarged prostatic utricles (EPU)

Our objective was to comprehensively test the composition, morphology, and structure of enlarged prostatic utricle (EPU) stones, which, as a kind of biolite in abnormal anatomical structures of the genitourinary system, have not yet been reported. Thirty-one EPU stones coming from 8 patients, who had been treated in our center from 1985 to 2009, were taken out by transurethral fenestration of EPU and were analyzed by scanning electron microscopy, x-ray diffraction (XRD) analysis, and Fourier transformation infrared spectral (FTIS) analysis. Under scanning electron microscope, all these EPU calculi were seen to be constituted of many intensive minicrystals and amorphous matrix. By XRD and FTIS analysis, we determined that the 31 EPU stones in our research were all hydroxyapatite crystal. We consider that EPU calculi should belong to the category of prostatic pseudocalculi and that the formation of EPU calculi is not caused by the abnormal change of urine composition, but should be ascribed to continuously concentrated EPU liquid by absorption of capsule walls and calculous matrix mainly coming from deciduous epithelial cells of EPUs. The role of the amorphous matrix is to link microcrystals, which promotes the growth of EPU stones.     

前列腺增大与性功能障碍的临床相关性

前列腺直肠指检可以为了解前列腺的生长状态和发现可疑的外周结节提供有用的信息。本实验的目的在于研究经直肠指检发现前列腺增大与性功能障碍（SD）的临床和生化相关性。对一组2379例患者进行回顾性分析。样本（n=1823;平均年龄为54．7±11．4岁）选自无明显前列腺疾病的人群。对几个指标进行了研究。经过校正后,经直肠指检发现的前列腺增大与代谢终合症（HR=1．346[1．129．1．759];P=0．030）、二型糖尿病（HR=I．489[1．120．1．980];P=0．006）、低密度脂蛋白胆固醇增高（〉100mgdl^-1;HR=1．354[1．018—1．801];P=0．037）及平均血压增高（HR=1．017n．007．1．027]每增加1mmHg;P=0．001）的高发病存在相关性。因此,前列腺增大也与动脉性勃起功能障碍及其他的男科疾病的高发病相关,如精索静脉曲张和早泄。在前列腺增大的人群中PSA水平显著高于非前列腺增大的人群（HR=3-318[2．304;4．799]每增加1单位PSA;P〈0．0001）。根据不同标准,动脉性ED也与PSA水平升高相关。结论：我们的研究结果表明对于ED患者,进行前列腺大小的检查,包括临床（DRE）和生化（PSA）检查是必要的,以此能对患者的性功能障碍和代谢及心血管背景有全面的了解。     

Laparoscopic excision of a large prostatic utricle revealed by haematuria: 1-year follow-up

Prostatic utricles revealed by the presentation of haematuria are very rare. Only limited experience with laparoscopic surgery of prostatic utricle has been reported to date. Herein we report a 20-year-old male with frequently terminal haematuria and oligozoospermia who underwent successful laparoscopic excision of a large prostatic utricle. Haematuria disappeared and semen quality improved during 1-year follow-up.     

Laparoscopic excision of prostatic utricles in children

OBJECTIVE: To report our experience of laparoscopic excision of symptomatic prostatic utricles in children. PATIENTS AND METHODS: Prostatic utricles were excised laparoscopically in four boys (mean age 6.3 years, range 1.5-17). Cysto-urethroscopy and cannulation of the prostatic utricle was initially undertaken with a cystoscope that was left in situ inside the prostatic utricle to facilitate subsequent identification and mobilization during the laparoscopic procedure. Laparoscopy was conducted via a 5-mm port inserted through a supra-umbilical incision. Two more 5 mm working ports were inserted at the right and left mid-abdomen. The prostatic utricle was easily identified with the guidance of cystoscopic transillumination. Dissection was further facilitated by lifting and counter-traction of the prostatic utricle using the indwelling cystoscope. The prostatic utricle was completely mobilized and divided at its confluence with the urethra using an ultrasonic scalpel. RESULTS: Laparoscopic excision of the prostatic utricle was successful in all four patients. The urethral defect was closed by intracorporeal suturing in three patients while the defect was small enough to be adequately closed by ultrasonic coagulation in one. One patient also had a nonfunctioning dysplastic kidney associated with an ectopic ureter joining into the prostatic utricle, and underwent nephroureterectomy at the same setting. The mean (range) operative duration was 148 (105-225) min. All four patients recovered uneventfully with no complications. CONCLUSIONS: Laparoscopic excision under cystoscopic guidance is effective for symptomatic prostatic utricles, offering a good surgical view and allowing easy dissection in a deep and narrow pelvic cavity.     

The long-term influence of vasectomy on prostatic volume and morphology in man

During the past two decades several papers have described the changes in prostatic secretory capacity following vasectomy. Based upon results indicating a reduction of secretory function, it was suggested that even prostatic size and the incidence of benign prostatic hyperplasia (BPH) might be altered after the operation. In this study, which included 56 males who had been vasectomized 8 years previously and 56 age-matched control persons, transrectal ultrasonic scanning of the prostate was used for exact measurements of the prostatic volume and for the investigation of intraprostatic echo pattern. The total prostatic volume, the volume of the periurethral gland, and the volume of the peripheral zone were not influenced by the vasectomy; nor was the growth rate of these zones affected. In the vasectomy group, the frequency of adenomatous prostates was 19.6%, whereas 30.3% of prostates in the control group had ultrasonic signs of BPH. However, this is not a statistically significant difference. Subdividing the material according to age did not reveal altered BPH frequency in any age group when vasectomized and controls were compared.     

Successful treatment of seminal vesicle calculi and prostatic utricle calculi by transurethral seminal vesiculoscopy

To investigate the outcomes of transurethral seminal vesiculoscopy (TSV) for the treatment of seminal vesicle calculi (SVC), prostatic utricle calculi (PUC) and combination of them, a retrospective review on 27 patients with SVC and/or PUC who complained of intractable haematospermia was conducted. Patient demographics, disease duration, operation time, stone location and complications were recorded. The calculi in the seminal vesicle and/or prostatic utricle were removed by holmium laser lithotripsy and/or basket extraction. The stone composition was determined in 19 of 27 patients using Infrared spectroscopy. The average age and disease duration of patients were 39.4 years and 23.1 months respectively. The mean operative time was 78.5 min. We detected SVC, SVC and PUC, and PUC in 59.3% (16/27), 33.3% (9/27) and 7.4% (2/27) patients respectively. The stones were mainly composed of calcium oxalate dehydrate (COD), carbonate apatite (CA), COD and calcium oxalate monohydrate (COM), CA and magnesium ammonium phosphate, CA and COM, and COD and uric acid in 42.1% (8/19), 21.1% (4/19), 15.8% (3/19), 15.8% (3/19), 5.3% (1/19) and 5.3% (1/19) cases respectively. No intraoperative and post-operative complications were noted. These results suggested that SVC and PUC can be diagnosed and treated using TSVs.     

中国以前列腺体积增大为特点的良性前列腺增生症患者的临床特点

目的 多中心调查中国以前列腺体积增大为特点的中、重度BPH患者在现实状况下的临床诊疗特点. 方法 2009年2月至2011年1月,全国10个城市的32家医院共纳入前列腺体积≥30 ml且IPSS≥8的BPH患者2758例.在不干预医生、患者正常诊疗措施的情况下,记录患者的年龄、前列腺体积( prostate volume,PV)、IPSS评分、Qmax、服药情况和医生处方习惯,分析患者的人口学信息和临床特点. 结果 患者年龄50 ～ 97岁,平均(69.2±8.5)岁,经直肠超声检查测量PV为30 ～ 165 ml,平均(47.8±16.6) ml,IPSS为8～ 35分,平均(17.5±5.4)分,Qmax为2～ 36 ml/s,平均(11.6±3.6) ml/s.以年龄为分层指标,亚组分析结果显示:50 ～ 55岁组平均PV、Qmax分别是42.8 ml、13.3 ml/s,＞71岁组平均PV、Qmax为49.0 ml、11.1 ml/s,两组比较差异有统计学意义(P值均＜ 0.05).入组患者中56.1％为初次就诊,规律服用处方药物＞2周者仅为22.8％.入组时已有BPH症状＜1年者仅为31.3％(872例),1～2、3～4和≥5年者分别占22.9％(637例)、18.3％(311例)和27.5％(766例).医生处方采用指南推荐的5-α还原酶抑制剂和α受体阻滞剂联合治疗仅为52.6％. 结论 我国中、重度BPH患者的症状和主要客观指标随年龄增长而加重,绝大多数患者初次就诊时机偏晚.医生的处方习惯与指南推荐还有很大的差距.     

选择性绿激光汽化术治疗重度前列腺增生患者的临床分析

目的探讨应用选择性绿激光汽化术（PVP）治疗重度前列腺增生症患者的临床疗效。方法回顾性分析自2004年7月至2008年7月应用PVP治疗78例前列腺体积大于80ml的良性前列腺增生症患者的临床资料。观察患者手术时间、住院时间、保留导尿管时间、输血率、术前后国际前列腺症状评分（IPS8）、最大尿流率、前列腺体积的变化及并发症。结果所有手术均成功,无输血,未出现电切综合征。平均手术时间（81．4±7．6）min,平均留置尿管时间（3．5±1．3）d,术后早期急性尿潴留9例（11．5％）,轻度尿路刺激症状21例（26．9％）,尿路感染10例（12．8％）。术后1个月IPSS评分、最大尿流率（Qmax）及前列腺体积改变均有统计学意义（P〈0．01）,39例随访时间10-48个月,永久性尿失禁1例,6例需再次手术治疗,无尿道狭窄并发症发生。结论PVP治疗重度良性前列腺增生方法安全可行,但术后早期并发症发生率较高,可作为经尿道前列腺电切术（TURP）的一种补充手术方法应用于高危患者。     

前列腺增生并膀胱结石的腔内治疗

目的：探讨经尿道前列腺电切术（TURP）结合气压弹道碎石术治疗良性前列腺增生（BPH）并膀胱结石的疗效。方法：采用TURP结合气压弹道碎石术治疗40例BPH并膀胱结石患者,并分析其疗效。结果：所有患者均一次处理成功,除20例有膀胱粘膜散在充血外,无膀胱穿孔等并发症,术后复查最大尿流率均＞15．0ml/s。结论：TURP结合气压弹道碎石术是治疗BPH并膀胱结石的一种安全、高效的方法。