Prostate disease is one of the most common urological disease. A large number of studies have shown that prostate disease is related to changes in the local microenvironment. Periodontitis is a chronic inflammatory disease characterized by the destruction of periodontal tissue caused by a variety of pathogenic microorganisms. Its pathogenesis may involve many factors. Periodontitis may have adverse effects on cardiovascular, respiratory, digestive and endocrine systems. Recent studies have found that chronic periodontitis is associated with the occurrence and development of benign prostatic hyperplasia and prostatitis, but the relationship is not clear. Therefore, further research is needed. This article elaborates on inflammation and benign prostatic hyperplasia and prostatitis, periodontitis and prostatitis, and periodontitis and benign prostatic hyperplasia, aiming to provide certain ideas for clinical research and diagnosis and treatment.
目的:探讨经尿道前列腺电切术(TURP)治疗高危良性前列腺增生症(BPH)的术中、术后常见并发症的原因、预防及治疗,提高手术安全性和有效性。方法: 回顾性分析62例高龄合并心肺疾患的前列腺增生症患者行经尿道前列腺电切术(TURP)的临床资料。结果: 62例排尿困难症状均改善,其中1例出现暂时性尿失禁,2月后好转,尿路感染7例,消炎治疗后好转,5例出现肉眼血尿,做对症处理后血尿消失,无输血病例,无经尿道电切综合征(TURS)发生。结论:采用TURP是良性前列腺增生症安全有效的外科治疗方法,疗效满意,并发症少,安全性高,住院时间短,费用低。
ObjectivesThe present network meta-analysis was conducted to evaluate the potential efficacy and safety of various surgical approaches in the treatment of benign prostatic hyperplasia with enlarged prostate.MethodsPubMed, EMbase, The Cochrane Library, Clinicaltrials.gov and CNKI databases were electronically searched to identify eligible studies. Two reviewers independently screened literature, extracted data and evaluated risk of bias and the ADDIS 1.16.8 software was used to conduct meta-analysis.ResultsA total of 23 studies involving 2 849 patients with 5 approaches including open prostatectomy (OP), holmium laser enucleation of the prostate (HoLEP), plasmakinetic/bipolar plasmakinetic enucleation of the prostate (PK/BPEP), transurethral vaporization of the prostate (TUVP), and laparoscopic prostatectomy (LSP) were included. HoLEP, PK/BPEP and OP were superior to the other methods in improving the objective indicators and subjective feelings of patients during both short and medium-term follow-up. However, compared with OP, HoLEP and PK/BPEP were observed to result in a significantly lower hemoglobin level (MD=1.65, 95%CI 0.35 to 4.41; MD=2.62, 95%CI 0.64 to 2.90), longer postoperative irrigation time (MD=4.67, 95%CI 1.29 to 10.66; MD=2.67, 95%CI 1.32 to 6.63), as well as indwelling catheter after operation (MD=1.64, 95%CI 0.48 to 4.15; MD=2.52, 95%CI 0.60 to 3.78). In terms of short-term complications, PK/BPEP (RR=0.45, 95%CI 0.13 to 1.29) was found to be significantly lower than that of OP.ConclusionsHoLEP and PK/BPEP can be probably used as a superior treatment option for large volume benign prostatic hyperplasia because of its better curative effect, higher safety and quick postoperative recovery.
Objective To evaluate the effect of pretreatment with epristeride on decreasing intraoperative bleeding during transurethral resection of prostate (TURP) and to study its mechanism. Methods A total of 60 patients with benign prostatic hyperplasia undergoing TURP were divided into two groups: 30 patients were pretreated with epristeride 5 mg×2 daily for 7 to 11 days before TURP, and 30 patients did not receive any pretreatment. The operations for the two groups of patients were conducted by the same doctors. The operation time, the weight of resected prostatic tissue, and the volume of irrigating fluid were recorded. Blood loss, bleeding index, and bleeding intensity were calculated. Microvessel density (MVD), vascular endothelial growth factors (VEGF), and nitric oxide synthase type III (eNOS) expression were measured by the immunohistochemistry SPmethod in prostatic tissue. Results In the epristeride and control groups, the mean blood loss was 179.51±78.29 ml and 237.95±124.38 ml (Plt;0.05); the mean bleeding index was 7.68±3.94 ml/g and 9.73±3.42 ml/g (Plt;0.05); the mean bleeding intensity was 2.43±1.03 ml/min and 3.30±1.50 ml/min (Plt;0.05); the mean value of MVD was 18.80±5.68 and 23.70±4.91 (Plt;0.05); the mean rank of VEGF was 23.48 and 31.77 (Plt;0.05); and the mean rank of eNOS was 22.36 and 31.14 (Plt;0.05), respectively. Conclusion Pretreatment with epristeride decreases intraoperative bleeding during TURP. The preliminary results suggest that angiogenesis in the prostatic tissue is suppressed.
ObjectiveTo systematically evaluate the efficacy and safety of simultaneous transurethral resection of bladder cancer and prostate (TURBT+TURP) in the treatment of bladder cancer with benign prostatic hyperplasia (BPH). MethodsWe searched PubMed, EMbase, The Cochrane Library, Web of Science, CBM, CNKI, WanFang Data and VIP from inception to January 2015, to collect randomized controlled trials (RCTs) and cohort studies investigating the efficacy and safety of TURBT with TURP in the treatment of bladder cancer with BPH. Two reviewers independently screened literature, extracted data, and assessed the risk bias of included studies, and then meta-analysis was performed using RevMan 5.3 software. Results3 A total of 3 RCTs (n=137) and 10 retrospective cohort studies (n=998) were included. The results of meta-analysis showed that there were no significant differences between the simultaneous resection group and the control group in the overall recurrence rate (RCT:OR=0.55, 95% CI:0.24 to 1.24, P=0.15; retrospective cohort study:OR=0.78, 95% CI:0.60 to 1.01, P=0.06), postoperative recurrence rate in the prostatic fossa/urethra (RCT:OR=1.40, 95% CI:0.28 to 7.60, P=0.68; retrospective cohort study:OR=1.36, 95% CI:0.49 to 3.74, P=0.55), progression rate (OR=0.93, 95% CI:0.53 to 1.61, P=0.79) and overall perioperative complication rate (RCT:OR=0.35, 95% CI:0.08 to 1.55, P=0.17; retrospective cohort study:OR=0.1.75, 95% CI:0.44 to 6.98, P=0.43). ConclusionCompared with only TURBT or sequential TURBT and TURP, simultaneous TURBT and TURP do not increase the overall recurrence rate, postoperative recurrence rate in the prostatic fossa/urethra, progression rate and overall postoperative complication rate. However, due to the limited quality and quantity of included studies, larger sample size and higher quality RCTs are needed to verify the above conclusion.
ObjectivesTo systematically evaluate the efficacy and safety of 1 470 nm laser vaporization vs. transurethral resection of prostate (TURP) for benign prostatic hyperplasia (BPH).MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) and non-randomized controlled trials (non-RCTs) about the efficacy and safety of 1 470 nm laser vaporization vs. TURP for BPH from inception to October 22nd, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 6 RCTs and 4 non-RCTs were included. The results of meta-analysis showed that: 1 470 nm laser vaporization was superior to TURP in reducing intraoperative bleeding (MD=−103.87, 95%CI −148.08 to −59.65, P<0.000 01), hospital stay (MD=−3.82, 95%CI −4.35 to −3.28, P<0.000 01), postoperative indwelling catheter time (MD=−2.24, 95%CI −3.45 to −1.02, P=0.000 3), postoperative hemoglobin (MD=−1.63, 95%CI −3.14 to −0.12, P=0.03) and rate of secondary hemorrhage (OR=0.13, 95%CI 0.03 to 0.48, P=0.002). There were no significant differences in operative time, bladder irrigation time, transient urinary incontinence and urethral stricture, IPSS Score and Qmax at 3 months after operation between the two groups (P>0.05).ConclusionCurrent evidence shows that 1 470 nm laser vaporization is superior to TURP in reducing intraoperative bleeding and secondary hemorrhage. It may be more suitable for prostate surgery in anticoagulant or coagulative dysfunction patients. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.