ABSTRACT: Lifelong premature ejaculation (LPE) is a prevalent sexual dysfunction among men, while its precise pathologic mechanisms have remained poorly understood.
In our study, the correlation between excitability of bulbocavernosus reflex (BCR) to stimulation of the prostatic urethra and LPE was studied.
Twenty normal potent male volunteers and 42 patients with LPE were studied by inserting a specially designed Foley catheter with two electrodes mounted on its distal surface (intraurethral catheter electrode) into bladder to evoke the BCR to stimulation of prostatic urethra. Also, sensitivity of glans penis to electrical stimulation was detected by two surface electrodes.
Sensory thresholds of BCR to stimulation of prostatic urethra, thresholds to evoke stable BCR, latencies of BCR, and sensory thresholds of glans penis to electrical stimulation.
The mean sensory thresholds of BCR to stimulation of prostatic urethra, thresholds to evoke stable BCR, latencies of BCR, and sensory thresholds of glans penis were 12.38±3.71 mA (0.2 ms in duration, 1 Hz), 23.81±5.55 mA (0.2 ms, 1 Hz), 70.48±6.33 ms, and 11.89±2.26 mA (0.04 ms in duration,3 Hz) in the patients with LPE, respectively, and were 18.20±2.68 mA (0.2 ms, 1 Hz), 34.76 ± 4.15 mA (0.2 ms, 1 Hz), 71.20±5.77 ms, and 14.16±1.94 mA (0.04 ms, 3 Hz) in the normal potent men, respectively (mean±SD). Statistically significant differences were seen regarding the sensory thresholds of BCR to stimulation of prostatic urethra, the thresholds to evoke stable BCR and the sensory thresholds of glans penis between the two groups (P<0.001). No statistically significant differences were seen regarding the latencies of BCR between the two groups (P>0.05).
Patients with LPE might have hyperexcitable BCR to stimulation of prostatic urethra, which is probably one of the important factors for its etiology.
Journal of Sexual Medicine 11/2010; 7(11):3750-7. · 3.55 Impact Factor
ABSTRACT: To investigate the effect of mesenchymal stem cells (MSCs) in the process of tumor development and the possibility of MSCs differentiating into vascular endothelial cells in the tumor microenvironment.
Twenty male New Zealand rabbits were randomly divided into 2 groups: a test group and a control group. MSCs were isolated and cultured by bone marrow cell adherence. The bladder tumor models were built by embedding a VX2 mass in swelled bladder mucosa in all of the rabbits (n = 20). One week later, 4',6-diamidino-2-phenylindole-labeling MSCs were transplanted into tumor tissue in the test group (n = 10). Culture medium was injected into the tumor tissue of the control group (n = 10). The maximum diameter of the tumor mass was measured by ultrasound at 2 and 4 weeks after the VX2 tumor mass was embedded. All animals were sacrificed at 4 weeks. The double labeling immunofluorescence for CD146 was performed to reveal whether engrafted cells can differentiate into vascular endothelial cells. Vascular density was compared between the 2 groups.
There was no significant difference in the maximum diameters of the tumor masses between the 2 groups at 2 weeks (test group 0.77 +/- 0.15 cm vs. control group 0.71 +/- 0.15 cm, p > 0.05). The maximum diameters appeared larger in the test group at 4 weeks (test group 3.82 +/- 0.94 cm vs. control group 2.28 +/- 0.54 cm, p < 0.05). Immunofluorescence studies revealed some engrafted MSCs expressing a vascular endothelial cell phenotype (CD146). Furthermore, vascular density was augmented in the test group in comparison to the control group (10.1 +/- 0.70/0.2 mm(2) vs. 8.24 +/- 0.81/0.2 mm(2), p < 0.05).
Engrafted MSCs can differentiate into vascular endothelial cells and contribute to angiogenesis in the tumor microenvironment, which may be the major pathway of promoting tumor growth.
Urologia Internationalis 01/2010; 84(1):94-9. · 0.99 Impact Factor
ABSTRACT: To investigate the clinical characteristics of renal cell carcinoma (RCC) in female patients.
The clinical characteristics including sex, age at diagnosis, histological tumor size, histological subtype, Fuhrman nuclear grade and pathological tumor-node-metastasis (TNM) stage of 881 consecutive patients treated with (partial) nephrectomy for RCC from 1998 to 2006 were analyzed. Characteristics of different gender groups and different female age groups were compared. The one-way anova and t-test were used to compare means. Pearson's chi(2)-test and the likelihood ratio test were used to compare ratios.
Low-grade tumors accounted for 79.3% of female patients and 64.1% of male patients (P < 0.001). The percentage of stage T1-2 was 76.6% in female patients while it was only 68.5% in male patients (P = 0.011). Also, female patients had more T1-2N0M0 tumors (73.0% vs 64.3%, P = 0.009). Once female patients were classified into three groups according to age diagnosis (<or=40, 41-59 and >or=60 years) young female patients seemed to have more tumors with unfavorable histology (8.7% vs 5.1% vs 4.3%), Fuhrman grade 3-4 (23.9% vs 23.1% vs 17.7%) and stage T3-4 (28.3% vs 23.1% vs 22.0%).
Compared with male patients, female patients had lower stage and grade tumors. However, younger female patients had more tumors with unfavorable histology, and higher stage and grade compared to older female patients.
International Journal of Urology 06/2009; 16(6):554-7. · 1.75 Impact Factor
ABSTRACT: To assess the safety and efficacy of holmium laser resection for primary, clinically nonmuscle-invasive, bladder cancer (HoLRBT) compared with standard transurethral resection of bladder tumor (TURBT).
The data from a total of 212 consecutive patients with primary nonmuscle-invasive bladder cancer were collected in this study. These patients were treated by holmium laser resection (HoLRBT group) or transurethral electroresection (TURBT group) and were divided into 2 groups. The patients in each group were stratified into 3 risk subgroups (low, intermediate, and high risk) according to the prognostic factors for recurrence using the European Association of Urology guidelines. The intraoperative complications and postoperative characteristics of the HoLRBT and TURBT groups were compared. Efficacy, indicated by the recurrence-free survival in the overall group and stratified subgroups, was analyzed and compared using the Kaplan-Meier technique and the log-rank test.
The patient demographics and tumor characteristics in the 2 groups were comparable. HoLRBT was superior to TURBT in terms of intraoperative complications and postoperative catheterization time (P < .001). Recurrence-free survival after HoLRBT was similar to that after TURBT (P = .283).
Our results have indicated that HoLRBT is a feasible, safe, and effective alternative for the management of primary, clinically nonmuscle-invasive, bladder cancer compared with TURBT, with similar recurrence-free survival and fewer perioperative complications. It also can provide sufficient material for the pathologic evaluation.
Urology 09/2008; 72(3):608-12. · 2.43 Impact Factor
ABSTRACT: Normal human prostatic secretion is remarkably rich in citrate (EPS-citrate). Prostate inflammation will result in reduction of EPS-citrate level. So EPS-citrate was determined to investigate whether EPS-citrate level was also decreased in category IIIB prostatitis and whether it is feasible for EPS-citrate to be used as a diagnostic marker for category IIIB prostatitis.
21 category II outpatients, 25 category IIIA outpatients, 25 category IIIB outpatients and 21 normal controls without any prostatic diseases were included. All category II, IIIA and IIIB outpatients had not received any management. The EPS-citrate was determined by high-performance liquid chromatography.
The mean EPS-citrate values were 3.32 +/- 0.79, 3.41 +/- 0.88, 4.37 +/- 0.77 and 8.55 +/- 1.20 mg/ml in groups II, IIIA, IIIB and normal controls, respectively. Compared to normal controls, the EPS-citrate levels were significantly decreased in category II, IIIA and IIIB patients. Furthermore, there was no overlap of EPS-citrate values between category IIIA and IIIB patients and the normal control group.
The EPS-citrate level is decreased in category IIIB prostatitis and it is feasible for EPS-citrate to be used as a useful diagnostic indicator for category IIIB prostatitis.
Urologia Internationalis 02/2007; 78(3):230-4. · 0.99 Impact Factor
ABSTRACT: To discuss the clinical significance of urodynamic studies in neurogenic bladder dysfunction caused by intervertebral disk hernia.
Thirty patients with neurogenic bladder dysfunction caused by intervertebral disk hernia were divided into three groups according to the category of detrusor muscle activity: neurogenic detrusor overactivity without detrusor sphincter dyssynergia (DSD), neurogenic detrusor overactivity with DSD, or detrusor underactivity. The patients were divided into three groups according to the condition of urinary retention and incontinence: urinary retention, urinary incontinence, or neither urinary retention nor urinary incontinence. Also they were divided into three groups according to the location of the intervertebral disk hernia: cervical hernia, thoracic hernia, or lumbar hernia. All patients underwent computer tomography (CT), magnetic resonance imaging (MRI), and urodynamic study. The results were analyzed statistically.
There was significant correlation between the category of detrusor muscle activity, bladder compliance (BC, P < 0.05), and the pressure at maximum flow (P(det,Qmax), P < 0.01). There were significant differences in post void residual (PVR), cystometric capacity (CC), and maximum flow rate (Qmax) between the three groups of urinary retention, urinary incontinence, and the group of neither retention nor incontinence (P < 0.05). There was statistical correlation between the location of the intervertebral disk hernia and the urodynamic results. There was significant correlation between the BC (the threshold was 15 ml/cmH(2)O), detrusor pressure (Pdet, the threshold was 40 cmH(2)O), DSD, the location of intervertebral disk hernia, and the upper urinary tract lesion (P < 0.01).
Urodynamic studies are indispensable in the classification, diagnosis, treatment, and prognosis of the neurogenic bladder dysfunction caused by intervertebral disk hernia.
Neurourology and Urodynamics 01/2006; 25(5):446-50. · 2.96 Impact Factor