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ABSTRACT: OBJECTIVE: To evaluate the efficacy and safety of topical anesthetic agents for patients with premature ejaculation (PE). METHODS: Eligible randomized controlled trials (RCTs) were identified from electronic databases (Cochrane Central Register of Controlled Trials, Medline, and EMBASE) without language restrictions. The database search, quality assessment, and data extraction were performed independently by 2 reviewers. The main outcome for the efficacy of topical anesthetic agents was intravaginal ejaculatory latency time (IELT). Efficacy and safety were explored using Review Manager, version 5.1.0 (Cochrane Collaboration, Oxford, UK). RESULTS: Eight trials met the inclusion criteria. Our pooled analysis showed that IELT in the topical anesthetic agent group was significantly improved compared to the placebo group (random-effect model; mean difference [MD] 5.82, 95% confidence interval [CI] 3.50-8.14, P <.00001). According to the subgroup analysis, a significant improvement was obtained in the domains of ejaculatory control, sexual satisfaction, and distress in the Index of Premature Ejaculation (IPE) questionnaire (random-effect model, MD 4.53, 95% CI 3.05-6.01, P <.00001). In terms of adverse events (AEs), the pooling outcome showed that the overall incidence of AEs was significantly higher in the topical anesthetic agent group than in the placebo group (random-effect model, relative risk [RR] 4.28, 95% CI 1.63-11.24, P = .003). However, nearly all of the AEs were mild and transient. CONCLUSION: Topical anesthetic agents have been shown to be effective and well tolerated for patients with primary PE, providing a significant improvement in IELT with a higher incidence of AEs that were not long-lasting or severe. High-quality RCTs are necessary to confirm the efficacy and safety of topical anesthetics for PE.
Urology 02/2013; · 2.43 Impact Factor
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ABSTRACT: Objective: This systematic review was performed to evaluate the efficacy and safety of phosphodiesterase-5 inhibitors (PDE5i) in the treatment of erectile dysfunction (ED) after radiotherapy for prostate cancer (PCa). Methods: A systematic search of PubMed, Embase and the Cochrane Library was performed to identify all randomized controlled trials (RCTs). All relevant studies on the outcomes and complications of PDE5i in the treatment of ED after radiotherapy for PCa were assessed. The outcomes and complications analyzed for this study included the International Index of Erectile Function (IIEF) questionnaire, Global Efficacy Questions (GEQs), Sexual Encounter Profile (SEP) diary and side effects. The Cochrane Collaboration Review Manager software (RevMan 5.1.4) was used for statistical analysis of the outcomes and complications. Results: A total of 4 RCTs were identified from the search strategy. Compared with placebo, the trials indicated that PDE5i significantly improved the IIEF scores, with the exception of two questions (questions 6 and 13), and statistically significantly more positive answers for the GEQs and SEP diary were acquired in intervention groups. Furthermore, almost all the side effects in both groups were mild or moderate, transient and well tolerated. Except for headache, flushing and dyspepsia, all other adverse events did not differ significantly between the two groups. Conclusions: The systematic review suggested significant advantages in the efficacy and safety of PDE5i in the treatment of ED after radiotherapy for PCa. PDE5i should be considered as the first choice for the treatment of PCa patients with ED after radiotherapy.
Urologia Internationalis 12/2012; · 0.99 Impact Factor
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ABSTRACT: Abstract Objective: To compare transperitoneal and retroperitoneal approaches of laparoscopic pyeloplasty (LP) for ureteropelvic junction obstruction (UPJO) with meta-analysis. Materials and Methods: All randomized controlled trials (RCTs) and controlled clinical trials (CCTs) comparing transperitoneal LP (TLP) and retroperitoneal LP (RLP) were included systematically using Medline, Embase, and The Cochrane Library. Outcomes were success rate, complications, operative time, conversion, presence of a crossing vessel, and length of hospital stay. Two reviewers independently extracted data and assessed quality. Meta-analysis used both fixed and random effects models with dichotomous data reported as relative risk and continuous data as a weighted mean difference with 95% confidence intervals. Results: One RCT and eight CCTs were identified (reporting 776 participants). Meta-analysis showed that TLP was associated with an operative time reduction of about 40 minutes (weighted mean difference -43.85, 95% confidence interval -58.06 to -27.63; P<.00001) and significantly lower conversion rate (relative risk [RR] 0.39, 95% confidence interval 0.21-0.74; P=.004) compared with RLP. The two approaches were similar in terms of presence of a crossing vessel (RR 1.24, 95% confidence interval 0.83-1.86; P=.28), length of hospital stay (weighted mean difference -0.24, 95% confidence interval -0.75 to 0.26; P=.35), success rate (RR 1.03, 95% confidence interval 0.97-1.09; P=.76), and complications (RR 0.83, 95% confidence interval 0.17-1.26; P=.61). Conclusions: LP as a minimally invasive treatment for UPJO can be performed through both the transperitoneal and retroperitoneal approaches, and either approach is associated with a high success rate and a low complication rate, although TLP provides a shorter operative time and lower conversion rate.
Journal of Laparoendoscopic & Advanced Surgical Techniques 06/2012; 22(7):658-62. · 1.40 Impact Factor
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ABSTRACT: This study aims to evaluate the efficacy and safety of solifenacin for treating overactive bladder. Randomized controlled trials (RCTs) were identified and extracted from MEDLINE, Embase, and CENTRAL. The quality of the included RCTs was assessed using the Jadad score, and heterogeneity was analyzed using the chi-squared test. The data of the included RCTs were collected, extracted, and assessed by our protocol. A total of nine RCTs were identified from the search strategy. Compared with the placebo and tolterodine treatments, both short-term (mostly 12-week) trials indicated that solifenacin significantly reduced urgency episodes, micturitions, and incontinence episodes per 24 h. Compared with the solifenacin (5 mg) group, the solifenacin (10 mg) group was significantly better in terms of the number of micturitions per 24 h. With regard to adverse effects, the patients treated with solifenacin had significantly higher rates of constipation and blurred vision than patients treated with tolterodine. The solifenacin therapy was not inferior to tolterodine in terms of efficacy profiles and had a similar incidence of overall adverse events compared with tolterodine treatment. Solifenacin (5 mg) is thus a recommended dose because of its reported balance between efficacy and acceptable tolerability.
International Urogynecology Journal 02/2012; 23(8):983-91. · 1.83 Impact Factor
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ABSTRACT: To review the progress and clinical application of cellular therapy for stress urinary incontinence (SUI).
The literature about cellular therapy of SUI was extensively reviewed.
Because of having no or poor regeneration capacity, the clinical application of chondrocytes and myoblasts were limited. Based on the rapid progress in stem cell biology, an increasing number of animal experiments and clinical trials about cellular therapy of SUI have been reported with encouraging results. All these show that cellular therapy has great potential in clinical application. Stem cells are considered as ideal seeded-cells for treatment of SUI.
Cellular therapy, especially stem cells, provides a novel approach for treatment of SUI, but the mechanism needs further study.
Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery 02/2012; 26(2):182-5.
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ABSTRACT: Pulmonary sequestration is a rare congenital malformation mostly located in the thorax, while intra-abdominal pulmonary sequestration is an extremely rare type of pulmonary sequestration usually diagnosed during the first 6 months of life. Only 1 case of intra-abdominal pulmonary sequestration in a patient older than 60 years has been reported in the current literature. It is difficult to differentiate an intra-abdominal pulmonary sequestration from other retroperitoneal tumors. A definitive diagnosis is always made by histological examination. Intra-abdominal pulmonary sequestration commonly responds well to surgical resection and is associated with excellent results and prognosis. The authors present the case of a 74-year-old asymptomatic man with a retroperitoneal mass which was completely excised and revealed by histopathological study to be an intra-abdominal pulmonary sequestration.
Urologia Internationalis 09/2011; 88(1):121-4. · 0.99 Impact Factor
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ABSTRACT: To evaluate the efficacy and safety of phosphodiesterase-5 (PDE-5) inhibitors for treating lower urinary tract symptoms secondary to benign prostatic hyperplasia.
Randomized controlled trials were identified and extracted from MEDLINE, Embase, Cochrane Central, and relevant reference lists. The database search, quality assessment, and data extraction were independently performed by 2 reviewers. Heterogeneity was analyzed using the chi-square test and I(2) test. If lacking of heterogeneity, fixed-effects models were used for the meta-analysis, otherwise random-effects models were used.
A total of 5 studies (11 randomized controlled trials) were identified from the search strategy. Compared with placebo, short-term trials (≤12 weeks) indicated that PDE-5 inhibitors significantly improved the International Prostate Symptom Score (mean difference -2.60, 95% confidence interval [CI] -3.12 to -2.07; P < .00001), and statistical significance was observed in the International Prostate Symptom Score irritative and obstructive subscore, International Prostate Symptom Score quality of life and erectile function. However, no statistically significant difference was detected in maximal urinary flow rate (mean difference 0.21, 95% CI -0.21-0.64; P = .32) and postvoid residual urine volume (mean difference 0.09, 95% CI -4.71-4.89; P = .80). No statistically significant difference was found between the 2 groups in the incidence of serious adverse events (relative risk 0.52, 95% CI 0.25-1.07; P = .07), despite that adverse event with a greater incidence was detected in the PDE-5 group (relative risk 1.87, 95% CI 1.31-2.68; P = .0005).
As the first-line treatment of erectile dysfunction, the PDE-5 inhibitor is also effective and safe for lower urinary tract symptoms secondary to benign prostatic hyperplasia. It could be considered as the first-line treatment in the future for the treatment of patients with comorbid benign prostatic hyperplasia and erectile dysfunction.
Urology 01/2011; 77(1):123-9. · 2.43 Impact Factor
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ABSTRACT: The objective of this study was to conduct a systematic review and meta-analysis to evaluate the efficacy and safety of tubeless versus standard percutaneous nephrolithotomy (PCNL). Relevant randomized or quasi-randomized controlled trials studies were identified from electronic database (Cochrane CENTRAL, Medline and EMBASE et al.). The retrieval time ended in August 2010. The quality of the included trials was assessed and the data were extracted independently by two reviewers. We divided the participants who received standard PCNL into two subgroups: small tube (4-10 F) group and big tube (14-24 F) group to reduce heterogeneity and bias. Efficacy (hospital stay time, operative time, stone-free rate) and safety (postoperative pain and analgesia requirement, postoperative fever, blood transfusion, urine leakage) were explored by using review manager v5.0. Fourteen randomized controlled trials comprising 776 subjects met the inclusion criteria. Our meta-analysis showed that there were statistically significant differences in hospital stay, postoperative analgesic requirement and urine leakage between tubeless and standard PCNL. In operative time, significant difference was found between tubeless and big tube group. No statistically significant differences were found in stone-free rate, postoperative fever, and blood transfusion between tubeless and standard PCNL. In conclusion, Tubeless PCNL was an effective and safe procedure for treatment of renal stones in selected patients, with shorter hospital stay, less analgesic requirement, lower urine leakage and without increased complications. Patients can receive great benefit from tubeless PCNL and it will become more palatable to patients as well as more cost-effective than standard PCNL in the future.
Urological Research 01/2011; 39(5):401-10. · 1.23 Impact Factor
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ABSTRACT: To evaluate the efficacy and safety of percutaneous nephrolithotomy (PCNL) for patients in the supine position vs prone position.
Eligible studies were identified from electronic databases (Cochrane CENTRAL, Medline and EMBASE). The database search, quality assessment, and data extraction were independently performed by two reviewers. Efficacy (stone-free rate, operative time) and safety (complication, such as fever and transfusion rate) were explored by using Review Manager 5.0. Sensitivity analysis was performed to explore the influence of low-quality studies.
Two randomized controlled trials and two case-control studies including 389 patients met the inclusion criteria. Meta-analysis of extractable data showed that PCNL in the supine position was associated with a significantly shorter operative time than PCNL in the prone position (mean difference: -24.84; 95% confidence interval [CI]: -34.45 to -15.23; P < 0.00001). There was no difference between the positions with regard to success rate (odds ratio [OR]: 1.16; 95% CI: 0.68-1.48; P = 0.59), complication (OR: 1.09; 95% CI: 0.67-1.80; P = 0.72), transfusion rate (OR: 2.19; 95% CI: 0.93-5.13; P = 0.07), and fever rate (OR: 0.39; 95% CI: 0.13-1.16; P = 0.09).
PCNL in the supine position took a shorter operative time than the prone position, but both positions appeared to be equivalent with regard to the stone-free rate and complication rate, transfusion rate, and fever rate. In brief, PCNL in the supine position is as effective and safe as PCNL in the prone position and was an alternate option for removal of renal calculi in PCNL.
Journal of endourology / Endourological Society 12/2010; 24(12):1941-6. · 1.75 Impact Factor
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ABSTRACT: To evaluate the efficacy of interleukin-8 (IL-8) as a possible biomarker for diagnosis and treatment of benign prostatic hyperplasia (BPH) with chronic prostatitis. Histologic inflammation can be demonstrated in most BPH pathologic specimens. To provide objective parameters of inflammation, this prospective study quantified the IL-8 in expressed prostatic secretion (EPS) from BPH patients with or without histologic inflammation.
White blood cell (WBC) count and enzyme-linked immunosorbent assays of the EPS for IL-8 were done in 44 patients who underwent transurethral prostatic resection because of benign prostatic enlargement before the operations. The correlation between IL-8 and WBC count in EPS; prostatic specific antigen; and International Prostate Symptom Score, irritative, and obstructive subscores was determined by Pearson correlation analysis.
IL-8 was detectable in all patients (the threshold of detection for IL-8 is 5 pg/mL). Twenty-one (47.7%) BPH patients had chronic prostatitis. The mean level of IL-8 in EPS was higher in BPH with chronic prostatitis than in simple BPH (median +/- SE, 8175 +/- 3789 pg/mL vs 2806 +/- 1009 pg/mL). The catheter and age seemed to have no impact on the level of IL-8 in EPS. Statistically significant correlation was only found between IL-8 and WBC count. The sensitivity and specificity of IL-8 in EPS identifying the BPH with chronic prostatitis from the simple BPH were 85.7% and 91.3% respectively, at a cut-point of 3992 pg/mL.
IL-8 is significantly elevated in BPH patients with chronic prostatitis. IL-8 in EPS can serve as a reliable biomarker applicable to identifying BPH with chronic prostatitis from simple BPH.
Urology 06/2009; 74(2):340-4. · 2.43 Impact Factor
