The current research aims to evaluate the risk factors of urethrocutaneous fistula after hypospadias surgery among the youth in China. One hundred twenty hypospadias patients were enrolled in our study. All of them were defined as Tanner 4 or 5. The information collected from the participants include age, urethral operation history, urinary comorbidities before operation, urine test before operation, body temperature before and after operation, type of surgical repair, chordee degree, urethral defect length and whether received vesicostomy after surgery or not. Independent t test, chi-square test and multivariate logistic regression were performed to evaluate the risk factor of urethrocutaneous fistula. Among the enrolled patients, 39 patients (32.5%) developed urethrocutaneous fistula after hypospadias repair. Our result showed significant association between the group with urethrocutaneous fistula and the group without urethrocutaneous fistula with respect to age, pyuria before operation, urethral defect length and the urethral operation history. The following logistic regression showed that urethral defect length and the urethral operation history were the risk factors of urethrocutaneous fistula. Urethral defect length and urethral operation history should be taken into consideration before undergoing hypospadias surgery since our study discovered that the risk of developing urethrocutaneous fistula after hypospadias repair is associated with urethral defect length and urethral operation history. Age, surgical procedure, type of surgical repair, chordee degree and other factors were not obviously related to the development of urethrocutaneous fistula.
Chronic prostatitis is hard to be identified in BPH patients in clinical works. This study aimed to diagnose chronic prostatitis in BPH patients by noninvasive methods. BPH patients who received transurethral resection of prostate from January 2014 to July 2015 were enrolled in current study. Patients were received examinations of PSA, sex hormones, inflammatory cytokines, metabolic panel and transrectal ultrasonography. According to histological results, patients were divided into two group of BPH with/without prostatitis. Logistic regression was used to find risk factors of chronic prostatitis. As a result, 181 men with an average age of 72.15 ± 8.41 years were enrolled in this study, including 116 patients with prostatitis and 65 patients without prostatitis. The storage sub‐score, PSA and IL‐2R were significantly higher in patients with prostatitis than those without prostatitis. Based on logistic regression analysis, the above three parameters were also the risk factors of BPH with prostatitis. The diagnostic model was calculated as: 0.317 × storage sub‐score + 0.092 × PSA + 0.003 × IL‐2R − 4.296. The AUC was 0.725. Histological prostatitis in BPH patients can be diagnosed by the combination of serum IL‐2R, PSA and storage sub‐score. Identification of chronic prostatitis in BPH patients could more efficiently alleviate urinary symptoms and reduce the risk of disease progression.
Purpose: To explore the clinical efficacy of ureteroscopic occluder and stone retrieval basket combined with holmium laser in the treatment of upper ureteral calculi. Materials and Methods: This retrospective study included 103 patients treated with ureteroscopic holmium laser lithotripsy for upper ureteral stones. Patients were divided into two groups based on the device applied during lithotripsy: group 1 for the occluders (52 cases), and group 2 for the stone retrieval baskets (51 cases). The stone upward migration rate, stone-free rate, and complication rate during or after surgery were compared. Results: The operation time was 45 ± 7 min in the occluder group and 43 ± 5 min in the basket group (P = .111). There was no significant difference between the stone retropulsion rate (13% vs. 16%, P = .787). The successful one-time stone-free rate was 92% vs. 94% (P = .999) respectively. Furthermore, there was no significant difference in the hospitalization time (P = .581) and postoperative complication rate (P = .715) between 2 groups. Conclusion: The treatment of upper ureteral calculi with ureteroscopic occluder and stone retrieval basket combined with holmium laser lithotripsy can both effectively prevent intraoperative stone retropulsion, improve the success rate of one-time lithotrips. The occluder was more cost-effective than the stone retrieval basket, yet it was a more desired choice for over dilated ureters.
Intravesical bacillus Calmette-Guerin (BCG) instillation is recommended as an adjuvant therapy for intermediate-risk and high-risk non-muscle invasive bladder cancer (NMIBC) after transurethral resection of bladder tumor (TURBt) with nearly 70% reoccurrence. In the present study, we investigated the dynamics of peripheral purified protein derivative (PPD)-specific immune responses along the treatment. Intravesical BCG instillation caused a significant increase in peripheral PPD-specific IFN-γ release of NMIBC patients, when compared to those receiving chemo-drug instillation. Through a follow-up study, we detected rapid increase in PPD-specific IFN-γ, IL-2, and IL-17A producing CD4+and CD8+T cells in the induction phase. Interestingly, the frequencies of PPD-specific IFN-γ and IL-2 producing CD4+and CD8+T cells decreased dramatically after induction treatment and were restored after BCG re-instillation, whereas IL-17A-producing T cells remained at the maintenance phase. However, we only observed that the percentages of peripheral CD8+T cells were significantly higher in BCG responder patients than those in BCG refractory patients at the baseline with the potential of predicting the recurrence. A more dramatic increase in PPD-specific IFN-γ and IL-2 producing CD4+and CD8+T cells after one and two dose BCG instillations was observed in refractory NMIBC patients. Therefore, regional BCG instillation induced transient peripheral PPD-specific T cell responses, which could be restored through repetitive BCG instillation. Higher proportions of peripheral CD8+T cells at baseline were associated with better responses to BCG instillation for the prevention of recurrence of bladder cancer.