中华男科学杂志最新文献

Prostatitis is one of the three most common prostate diseases in men, the other two being prostatic hyperplasia and prostate cancer, and about 50% of men worldwide have been attacked by prostatitis during their lives. The incidence of infertility is significantly higher in patients with chronic prostatitis / chronic pelvic pain syndrome (CP/CPPS) than in those without it, which is mainly attributed to the changed semen composition of the CP/CPPS patients. Using the key words chronic prostatitis, chronic pelvic pain syndrome, sperm, semen, and seminal plasma, we searched PubMed and Medical Lines online for originals, review articles, clinical trials, case reports and associated citations on humans and animals published up to 2024. We comprehensively reviewed the previous studies and investigations relating chronic prostatitis, seminal plasma change and sperm quality, and discussed the impact of the change of semen composition on sperm quality.

Objective: To explore the perioperative nursing methods of autologous dermal transplantation for penile girth enhancement combined with penile lengthening surgery.

Methods: Summarize the perioperative nursing data of 5 patients with small penis who underwent autologous groin dermal transplantation for penile girth enhancement combined with penile lengthening surgery.

Results: After comprehensive perioperative nursing, all 5 patients recovered well after the surgery. The preoperative APPSSI scores of the patients were 4.60±0.48, which were all less than 6 points. The postoperative APPSSI scores at 2 months, 6 months, and 12 months were 9－12 (10.6±1.02), 10－12 (11.2±0.98), and 10－12 (11.2±0.98) respectively, showing satisfaction with the surgical outcomes. There was a statistically significant difference compared to the preoperative APPSSI scores (Ｐ<0.05). The preoperative SAS scores were 45－58 (52.2±4.35), and the SAS scores at 2 months, 6 months, and 12 months postoperatively were 31－40 (34.2±3.31), 30-41 (35.8±3.65), and 33－40 (35.6±2.33) respectively, indicating a reduction in anxiety levels after the surgery, with a statistically significant difference compared to the preoperative SAS scores (P<0.05). The preoperative IIEF-5 scores were 7－15 (10.4±2.87), and the IIEF-5 scores at 2 months, 6 months, and 1 year postoperatively were 16－24 (19.8±2.71), 18－25 (21.2±2.48), and 18－24 (20.8±2.39) respectively, showing a significant improvement postoperatively, with statistical significance (P<0.05). The preoperative NPTR examination showed a sustained erection time of 18－25 (21.2±2.59) minutes, and the NPTR examination at 2 months, 6 months, and 1 year postoperatively showed sustained erection times of 18－24 (21.8±2.28), 20-25 (23.4±2.30), and 24－27 (25.4±1.14) minutes respectively. There was no statistically significant difference in the sustained erection time at 2 months and 6 months postoperatively compared to preoperative NPTR examination, but there was a statistically significant difference at 12 months postoperatively (P<0.01).

Conclusion: Comprehensive perioperative nursing is an important factor in achieving high satisfaction with the surgery, promoting postoperative recovery, and improving the quality of sexual life for patients undergoing autologous groin dermal transplantation for penile girth enhancement combined with penile lengthening surgery.

Objective： To explore the effect of psychological nursing on the prognosis of male patients with urethral riding injury treated by ureteroscopic urethral catheter implantation (UCI).

Methods: This study included 63 male patients with urethral straddle injury treated in the General Hospital of Southern Theater Command from February 2020 to March 2023. We divided the patients into a control (n = 29) and an experimental group (n = 34) according to the odd- or even-numbered days of admission and treated them by ureteroscopic UCI. Meanwhile those of the former group received routine nursing care and the latter underwent psychological nursing intervention in addition. We obtained the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores of the patients, recorded their postoperative pain scores, catheter-removal time, hospitalization days, postoperative complications and overall recovery status, and compared the data collected between the two groups.

Results: At 3 days after surgery, both the SAS and SDS scores were significantly lower in the experimental group than in the control (SAS: 45.2 ± 2.9 vs 50.4 ± 3.6, P< 0.05; SDS: 41.9 ± 2.5 vs 48.3 ± 4.0, P< 0.05), and so were the pain scores at 24 hours (6.2 ± 0.6 vs 6.8 ± 0.9, P< 0.05), 48 hours (4.9 ± 0.7 vs 6.1 ± 0.8, P< 0.05) and 72 hours after surgery (2.5 ± 0.6 vs 3.9 ± 0.9, P< 0.05). The hospitalization time was remarkably shorter in the experimental than in the control group (［14.1 ± 2.9］ vs ［16.1 ± 3.4］ d, P< 0.05), but there was no statistically significant difference in the time of postoperative catheterization between the two groups of patients (［19.3 ± 3.7］ vs ［19.6 ± 4.4］ d, P > 0.05). A 30-day postoperative follow-up found 2 cases of difficult urination in the control group but no complications in the experimental group.

Conclusion: Ureteroscopic UCI is a safe, effective and minimally invasive treatment method for male urethral riding injury, and psychological nursing helps not only shorten the time of catheterization and hospitalization but also avoid postoperative complications.

Objective: To investigate the clinical effect of pulsed thulium laser (PTL) combined with triamcinolone acetonide injection in the treatment of failed posterior urethral anastomosis (FPUA).

Methods: This retrospective study included 35 male patients treated in Gongli Hospital for failed posterior urethral anastomosis from January 2018 to December 2023. All the patients underwent direct-vision internal urethrotomy (DVIU) with transurethral PTL (the PTL group, n = 15) or transurethral plasma (the TUP group, n = 20), and all received intralesional injection of triamcinolone acetonide. We followed up the patients for a median of 21 months, recorded the age, length of urethral stricture, operation time, pre- and post-operative maximum urinary flow rate (Qmax), postoperative complications and recurrence of urethral stricture, and compared the data obtained between the two groups.

Results: All the patients smoothly completed the treatment procedures. No statistically significant differences were observed in the age, length of urethral stricture, operation time and postoperative complications between the two groups (P > 0.05). The median follow-up time for the thulium laser group and plasma group was 21.0 months (IQR 16.0－24.0) and 21.0 months (IQR 17.0－25.0), respectively, with a statistically significant difference observed in the maximum urine flow rate before and after surgery at the 12-month mark (P < 0.01). No significant disparity was found in terms of relapse-free survival between the two groups (P = 0.398) Conclusion: Pulsed thulium laser combined with triamcinolone acetonide injection can effectively maintain a short-term cicatricial stability of the urethral stricture and satisfactory urethral patency, obviously superior to plasmotomy as a remedial treatment of urethral stricture after failed posterior urethral anastomosis.

Objective: To investigate the etiology, diagnosis and treatment of 45,X/46,XY mixed gonadal dysgenesis and the patients' clinical characteristics of conception, pregnancy and delivery, with purpose of improving the treatment and pregnancy management of the patients.

Methods: We retrospectively analyzed the clinical data on a pregnant patient with 45,X/46,XY mixed gonadal dysgenesis.

Results: Based on the findings of hypoplasia of secondary sexual characteristics, streak gonads, chromosome karyotype incompatibility with social sex, and chromosome aberration in the gonadal tissue, the patient was diagnosed with 45,X/46,XY mixed gonadal dysgenesis, received oocyte donation and intracytoplasmic sperm injection-embryo transfer (ICSI-ET), and achieved a live birth.

Conclusion: Female patients with 45,X/46,XY mixed gonadal dysgenesis are infertile, but can achieve pregnancy through oocyte donation. However, the incidence rates of pregnancy complications and abnormal delivery are higher in these patients than in normal females. The perinatal outcomes can be improved by efficient treatment and pregnancy management of the patients.

Objective: To explore the effect of the "internet + health education system" in nursing care after stapler circumcision.

Methods: A total of 260 patients underwent stapler circumcision in the Outpatient Department of our hospital from January 2022 to July 2022, of whom 130 received routine nursing after operation (the control group), and the other 130 internet + medical nursing service based on the internet + health education system (the experimental group). We followed up the patients on the 1st, 3rd, 7th and 30th day after surgery, recorded their Visual Analogue Scale (VAS) scores within 24 hours postoperatively, their satisfaction scores with surgery and nursing, the incidence of complications and falloff of the stapler nails, and compared them between the two groups.

Results: The postoperative VAS scores of the patients and the incidences of postoperative edema, bleeding, infection and other complications were significantly lower (P < 0.05), the falloff of the stapler nails markedly sooner, and the patients' satisfaction scores with surgery and nursing service remarkably higher (P < 0.05) in the experimental than in the control group (P < 0.05).

Conclusion: The application of the internet + health education system in nursing care after stapler circumcision can impart relevant knowledge to the patients, enhance their self-care ability, effectively reduce postoperative complications, and improve the patients' satisfaction with surgery and nursing service.

Objective: To analyze the changes in the disease burden of prostate, testis, kidney and bladder cancers among urinary and reproductive system tumors in Chinese men from 1990 to 2019 with a prediction of the future trend.

Methods: We retrieved the data on the incidence, mortality and disease burden of prostate, testis, kidney and bladder cancers in Chinese men between 1990 and 2019 from the database of Global Burden of Disease Study 2019. Using the Joinpoint regression model, we analyzed the trend of changes in the disease burden, and predicted the prevalence of the tumors with the ARIMA model.

Results: From 1990 to 2019, the standardized incidence and prevalence of prostate, testis, kidney and bladder cancers were on the rise in Chinese men, and those of testis cancer increased most significantly, by 326.79% and 1070.93% respectively. The disease burden of PCa was the highest, with standardized incidence, prevalence and mortality ratios of 17.34/100 000, 117.65/100 000 and 7.79/100 000 respectively in 2019. The standardized mortality and disability-adjusted life years (DALY) of kidney cancer were increased by 103.59% and 103.17% respectively. The highest incidence, mortality and DALY of prostate, kidney and bladder cancers in 2019 were found in 90－94 years old males, the highest prevalence rates of prostate, kidney and bladder cancers in the 70－89-year-olds, and the highest prevalence of testis cancer in the 25－49-year-olds. ARIMA model prediction showed that the standardized incidence rates of prostate, testis, kidney and bladder cancers in Chinese men kept rising from 2020 to 2029.

Conclusion: The disease burden of prostate, testis, kidney and bladder cancers in Chinese men is on the rise, and their standardized incidence rates will be even higher by 2029, with a significant increase in the disease burden in young men, which suggests the need of more attention to the prevention and treatment of genitourinary system tumors in young males.

Objective: To investigate the application value of ultrasound technology in transurethral enucleation and resection of the prostate (TUERP).

Methods: This study included 78 BPH patients admitted in our hospital from June 2021 to June 2023, aged 70.68±8.63 years and with the indication of surgery. We randomly divided them into two groups to receive TUERP (the control group, n = 39) and ultrasound-assisted TUERP (the US-TUERP group, n = 39). We statistically analyzed and compared the relevant parameters obtained before and after operation between the two groups.

Results: No statistically significant differences were observed in the operation time and bladder irrigation time between the two groups (P > 0.05). More glandular tissues were removed but less intraoperative bleeding and fewer perioperative complications occurred in the US-TUERP group than in the control. Compared with the baseline, IPSS, postvoid residual urine volume (PVR), quality of life score (QOL) and maximum urinary flow rate (Qmax) were significantly improved in both groups at 1 and 3 months after surgery, even more significantly in the US-TUERP than in the control group (P < 0.05).

Conclusion: US-TUERP helps achieve complete resection of the hyperplastic prostatic tissue along the surgical capsule at the anatomical level, with a higher safety, fewer perioperative complications, and better therapeutic effects.

Objective: To evaluate the efficacy of Dongbai Tonglin Mixture (DTM) in the treatment of chronic prostatitis (CP) with the damp-heat downward diffusion syndrome.

Methods: We randomly selected 76 cases of CP with the damp-heat downward diffusion syndrome, equally divided them into a DTM and a control group, and treated them by oral administration of DTM and Qianlie Tai Tablets, respectively, both for 8 weeks. We obtained the NIH-CPSI and TCM Syndrome Scores of the patients, recorded the counts of white blood cells (WBC) and small particles of lecithin (SPL) in the prostate fluid, and compared them between the two groups before and after treatment.

Results: Compared with the baseline, the total NIH-CPSI scores were significantly reduced in both groups after treatment (P<0.05), particularly the scores on urination symptoms, pain / discomfort and quality of life (P<0.05), even more significantly in the DTM than in the control group (P<0.05), and so were the TCM Syndrome Scores (P<0.05), especially the scores on urinary incontinence, abdominal pain, perineal pain, and scrotal dampness (P<0.05), even more significantly in the former than in the latter group (P<0.05). The count of WBC in the prostate fluid was remarkably decreased (P<0.05), while that of SPL markedly increased in both groups after treatment (P<0.05), with an even more significant improvement in the DTM than in the control group (P<0.05), and the overall effectiveness rate of treatment was significantly higher in the former group than in the latter (88.89% vs 70.27%, P<0.05).

Conclusion: Dongbai Tonglin Mixture is effective for the treatment of CP with the damp-heat downward diffusion syndrome.