Endoscopic inguinal lymphadenectomy is feasible for patients with penile cancer and genital malignancy. The technique reduces the risk of complication rate, and the oncologic outcome is highly promising. Larger studies, longer term follow-up are needed to assess the oncologic control and possible morbidity.
Background: The aim of this study was to explore the safety and efficacy of prostatic arterial embolization (PAE) with Bletilla striata particles as embolic agent in treatment of lower urinary tract symptoms (LUTS) resulted from benign prostatic hyperplasia (BPH). Methods: Superselective angiogram of prostatic artery was performed with Seldinger's technique, and the artery was occluded with Bletilla striata particles 150-200 mm. PAE was successful in 68 of 75 patients (90.7%). Results: The total effective rate in international prostate symptoms score (IPSS), quality of life (QOL), peak urinary flow (Qmax), postvoid residual volume (PVR) at 1, 3, 6, 12 months was 100% (68/68), 100% (68/68), 95.6% (65/68), and 95.6% (65/68), respectively. At 12-month follow-up, the mean IPSS, QOL, and PVR decreased from 25.86 ± 3.53 to 6.52 ± 1.51 points (P < 0.01), from 4.56 ± 0.61 to 1.26 ± 0.43 points (P < 0.01), and from 131.52 ± 19.13 to 10.89 ± 2.34 ml (P < 0.01), respectively, while Qmax increased from 9.83 ± 2.14 to 18.15 ± 2.33 ml/s (P < 0.01). The mean prostate volume (PV) decreased from 82.61 ± 23.71 ml to 32.78 ± 3.54 ml (with a mean reduction of 60.31%, P < 0.01). There was no significant difference in prostatic specific antigen (PSA) and international index of erectile function (IIEF) between pre-PAE and post-PAE. One patient had major event of skin necrosis of scrotal and perineal area (1.5%). Recurrence of LUTS was noted in two patients (2.9%). Conclusions: PAE with Bletilla striata will provide evidence on the effectiveness and safety in treatment of LUTS of BPH. However, more studies are needed to assess the long-term outcomes and potential complications.
Objective: The objective of the study was to highlight the epidemiology, aetiology, presentation, diagnosis and outcomes of penile fracture in China. Methods: Except reporting eight cases, we also retrieved literatures from Chinese publications between January 1984 and July 2017. Data extracted included authors, regions and year of publication, aetiology, clinical features, diagnosis, treatment and outcome. Results: In 113 publications 984 cases (including our eight cases) were retrieved. An annual incidence in China has been estimated between 0.002/million and 0.2/million male populations. The commonest causes were coitus and masturbation. Clinical features were the classical triad of "cracking" sound, immediate detumescence and pain. Swelling, ecchymosis and deformity were present in the majority of patients. Diagnosis was made mainly on clinical grounds; ultrasonography can be very helpful in equivocal cases. Concomitant urethral injury accounted for 6.3% of all cases. Treatment options were surgery and conservative in 92.2% and 7.8% patients, respectively. Early surgical repair was advocated because a higher incidence of complications was found in conservatively treated patients. Complications of the injury included penile curvature, nodules, infection, painful coitus, urethral fistula, and erectile dysfunction. Conclusions: Penile fracture may be underreporting which can usually be diagnosed based solely on history and physical examination findings. Early surgical repair is obviously preferable option because of excellent results even in the presence of urethral injury.
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