Background Bladder cancer (BCa) remains a major global health challenge with high recurrence and progression rates. Although metabolic reprogramming is recognized as a hallmark of cancer, the molecular mechanisms driving glycolysis in BCa are incompletely understood. ATAD3A, a mitochondrial membrane protein implicated in various malignancies, has not been characterized in BCa. This study aimed to investigate the role of ATAD3A in BCa progression and elucidate the molecular mechanisms linking ATAD3A to tumor metabolism. Methods TCGA-BLCA data were analyzed to assess ATAD3A expression and its association with clinical outcomes. Functional assays, including CCK-8, colony formation, EdU incorporation, Transwell migration/invasion, wound healing, and Seahorse metabolic flux analysis (ECAR and OCR), were conducted in BCa cell lines with ATAD3A knockdown or overexpression. Subcutaneous xenograft models were used to evaluate tumor growth in vivo. Quantitative proteomics identified downstream pathways. Mechanistic studies included cycloheximide chase assays, proteasome inhibition, ubiquitination assays, immunofluorescence, and co-immunoprecipitation to explore the regulation of MYC stability by ATAD3A and USP10. Results ATAD3A was significantly upregulated in BCa and associated with advanced stage and poor prognosis. ATAD3A knockdown suppressed proliferation, migration, invasion, and tumor growth, whereas overexpression enhanced these malignant phenotypes. Proteomics revealed enrichment of glycolysis pathways upon ATAD3A overexpression, and functional assays confirmed ATAD3A-dependent increases in lactate production and glucose uptake. Glycolysis inhibition with 2-DG abolished ATAD3A-driven phenotypes. Mechanistically, ATAD3A stabilized MYC protein without affecting its mRNA levels, prolonging MYC half-life by suppressing ubiquitin-proteasome-mediated degradation. USP10 was identified as a key mediator, directly interacting with MYC and reducing its poly-ubiquitination. Rescue experiments confirmed that USP10 or MYC restoration overcame the suppressive effects of ATAD3A knockdown both in vitro and in vivo. Conclusion Our findings demonstrate that ATAD3A drives BCa progression by promoting USP10-mediated stabilization of MYC and enhancing glycolytic reprogramming. The ATAD3A-USP10-MYC axis represents a potential therapeutic target for BCa.

BackgroundThe kidney-sparing surgery (KSS) technique for upper tract urothelial carcinoma (UTUC) shows potential, yet its efficacy in treating high-risk UTUC is a topic of debate. This study seeks to assess and compare the impact of KSS versus radical nephroureterectomy (RNU) on renal function and long-term oncological outcomes in patients with localized high-risk UTUC.MethodsThis study retrospectively analyzed 115 patients diagnosed with high-risk UTUC and treated with KSS or RNU in the First Affiliated Hospital of Chongqing Medical University from January 2018 to June 2024. The primary endpoint of this study was overall survival (OS). Secondary endpoints included disease-free survival (DFS), metastasis-free survival (MFS), intravesical recurrence-free survival (IVRFS), and postoperative renal function changes. Additionally, predictors of OS, DFS, MFS, and IVRFS were evaluated through Cox regression models.ResultsThere were no significant differences in the 3-year OS (88.1% vs 78.5%), DFS (60.3% vs 53.9%), MFS (82.1% vs 71.9%), and IVRFS (80.2% vs 69.3%) rates between the KSS and RNU groups, which included 29 and 86 patients, respectively. 6 months after intervention, renal function decreased significantly in RNU group, but not in KSS group. In univariate Cox regression analysis, the surgical procedure did not exhibit significant associations with OS, DFS, MFS, or IVRFS. Subsequent multivariable Cox regression analysis revealed that preoperative creatinine levels, pathological stage, and intraoperative bleeding emerged as independent predictors of OS. Moreover, pathological stage was also an independent predictor for DFS and MFS.ConclusionsKSS exhibits similar oncological efficacy as RNU in managing localized high-risk UTUC, with less damage to patients and benefit of better preservation of renal function. Adverse factors such as elevated preoperative creatinine levels, advanced pathological stage, and increased intraoperative blood loss may correlate with inferior overall survival. Additional prospective research is necessary to confirm the validity of our findings.

Bladder cancer (BC) is an aggressive and treatment-resistant malignancy with a high recurrence rate. Current first-line therapies only provide limited relief due to chemoresistance and toxicity. Natural products are emerging as promising chemotherapeutic agents due to their multi-target mechanisms and excellent safety profile. In this study, we evaluated the anti-BC effects of echinocystic acid (EA), a pentacyclic triterpenoid, on BC cells and investigated the underlying mechanism. We found that EA effectively inhibited proliferation, triggered G1-phase cell cycle arrest, and simultaneously suppressed cellular invasion and migration capabilities in vitro. Although EA did not obviously induce apoptosis in BC cells at the doses that were effective in suppressing their growth, it successfully triggered ferroptosis within these cells. Moreover, EA suppressed xenograft tumor growth of BC cells in vivo and demonstrated a favorable safety profile. Mechanistically, EA interacted with AKT1, reducing its phosphorylation and thereby inhibiting the AKT1/GSK3β/β-Catenin signaling pathway. Furthermore, EA exhibited synergistic effects with gemcitabine in inhibiting BC cells in vitro and in vivo. Overall, our results suggest that EA may exert its anti-BC effects, at least in part, by inhibiting the AKT1/GSK3β/β-Catenin signaling pathway. When combined with the clinically approved anti-tumor drug gemcitabine, EA may produce a synergistic anti-BC effect. Most importantly, this study identifies EA as a novel inducer of ferroptosis in BC and underscores its potential for clinical application.

Although lymphovascular invasion is a major predictor of bladder urothelial carcinoma, postoperative pathological biopsy-an intrusive procedure-remains the only reliable diagnostic technique for this condition. By combining logistic regression with various machine learning techniques, this work seeks to assess its risk factors and create a non-invasive preoperative prediction model. 520 patients who had never received treatment were included in the retrospective data collection from two centers, lymphovascular invasion was the main result. Based on the originating center, the cohort was split into an cross-center validation set (176 patients) and a training set (344 patients). Six machine learning techniques and univariate/multivariate regression were used to examine risk factors for lymphovascular invasion and build models. Multi-criteria evaluation was used to choose the best model, while SHapley Additive exPlanations(SHAP) was used for interpretability analysis. Ultimately, the best model was used to create an interactive online calculator. The area under the receiver operating characteristic curve(AUC) for the regression model based on traditional techniques was 0.968 on the training set and 0.972 on the cross-center validation set. With AUC values of 0.986 and 0.982, respectively, the random forest model outperformed all other machine learning models. In contrast to conventional analytical techniques, our model highlighted the relative influence of seven different risk factors on lymphovascular invasion and uncovered additional relevant factors, such as the neutrophil-to-lymphocyte ratio and alcohol consumption. A successful online lymphovascular invasion risk calculator was created.

To investigate the safety and effectiveness of retroperitoneal adrenalectomy via extra and intra perinephric fat approaches to provide experience and basis for resection of adrenal tumors through the retroperitoneal cavity. The clinical data of 284 patients undergoing retroperitoneal adrenalectomy in our hospital from December 2017 to March 2023 were collected. The basic characteristics of the two groups of patients and the changes in perioperative indicators were retrospectively analyzed. A total of 117 patients with intra perinephric fat approach (IPFA) were included,and 167 patients with extra perinephric fat approach (EPFA) were included. The estimated blood loss in the IPFA group (123.59 ± 50.76 ml) was higher than that in the EPFA group (99.10 ± 99.51 ml) (p = 0.015),and the operative time in the IPFA group(105.25 ± 42.25 min) was longer than that in the EPFA group(81.75 ± 30.45 min) (p < 0.001).The hospitalization expenses of IPFA patients (36,306.39 ± 7544.25RMB) were higher compared with patients receiving EPFA (32,122.77 ± 7284.00RMB) (p < 0.001).There were no significant differences between the two groups in terms of tumor size,blood transfusion times and postoperative hospitalization time. Retroperitoneal laparoscopic adrenalectomy is a safe and effective procedure that can be performed via extra and intra perinephric fat approaches.IPFA is associated with higher estimated blood loss, and the operation time of EPFA is shorter than IPFA. The choice of surgical approach may depend primarily on the experience of the surgeon, the characteristics of adrenal tumor, and the nature of perirenal adipose tissue.

Objective To explore the short-term efficacy of neoadjuvant endocrine therapy (NET) for localized prostate cancer and preliminary exploration of NET in patients with bone metastases. Methods Analyze clinical data of patients undergoing radical prostatectomy (RP) in the First Affiliated Hospital of Chongqing Medical University from January 2017 to January 2021 retrospectively. Patients with localized prostate cancer undergoing NET+RP were selected as the experimental group. The ones who only received RP were chosen as the control group, and the peri- and post-operative outcomes such as down-staging, pathological complete response, positive margin, intraoperative blood loss, and operation time were compared between the two groups. In addition, collect the information of patients with bone metastatic prostate cancer, excluding organ metastases, who received NET+RP over the same time-period and analyzed the short-term efficacy and quality of life. Results In the experimental group, there were more down-staging (13.08% vs. 4.67%, P=0.031), more pathological complete response (12.15% vs. 0.93%, P=0.001), less positive margin (9.35% vs. 29.91%, P< 0.001) and less blood loss (171.45±16.19 vs. 177.76±23.28, P=0.022). NET+RP also showed a satisfying short-term efficacy in patients with bone metastases, with well quality of life. Conclusion NET combined with RP can provide good short-term prognosis and patient satisfaction in patients with prostate cancer, and it is a potential option for patients with bone metastases without organ metastases.

Objective: To assess the effects of metabolic syndrome (MetS) and its components on the survival and prognosis of patients with local-ized clear cell renal cell carcinoma (ccRCC).Design and methods: This retrospective cohort study in Chongqing, China, identified patients with localized ccRCC from two medical centers of Chongqing Medical University between January 1, 2011, and December 31, 2020. The Chinese Medical Association Diabetes Society criteria of 2004 were used to diagnose MetS. Univariate and multivariate Cox proportional hazards regression analyses were con-ducted to identify independent risk factors for ccRCC. The outcomes were overall survival (OS), progression-free survival (PFS), and can-cer-specific survival (CSS).Results: In our cohort, 378 eligible patients with localized ccRCC were included (median age, 56; range, 30-85; 255 men [67.5%]), and 87 patients (23.0%) were diagnosed with MetS. The median follow-up time was 66 months (1-126 months). Kaplan-Meier and log-rank analyses showed shorter PFS (P = 0.043) and CSS (P = 0.009) in patients with MetS. Univariate and multivariate Cox regression analyses found that MetS and dyslipidemia were independent risk factors for CSS in patients with localized ccRCC (P = 0.047; P = 0.035). When we analyzed MetS separately, the 4 components of MetS (hypertension, hyperglycemia, overweight/obesity, and dyslipidemia) did not show significant differences in OS, PFS, and CSS.Conclusion: MetS and dyslipidemia are independent adverse prognostic factors for CSS in patients with localized ccRCC. It is sug-gested to assign comprehensive therapy and follow-up to this patient population. & COPY; 2023 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Primary aldosteronism (PA) is one of the most common causes of secondary hypertension and is potentially curable. However, a large number of patients still undergo persistent hypertension (PHT) after unilateral adrenal surgery. This research retrospectively studied the factors associated with this clinical difficulty and established a prediction model for the postoperative PHT; Methods: 353 patients from 2014 to 2021 with PA undergoing unilateral adrenal surgery were enrolled in this study. Clinical and biochemical characteristics were reviewed and the associating factors were examined using univariate and multivariate analysis. A nomogram-based prediction model was established correspondingly; results: 46.2% (163/190) of patients had post-surgical PHT. Multivariate analysis suggested that BMI >= 25, diabetes, duration of hypertension, male gender, and ARR were independent predictors of PHT after surgery. The prediction model based on the nomogram showed good discrimination ability (the C index of the training group and the validation group were 0.783 and 0.769, respectively), and the calibration curves and the Hosmer-Lemeshow test were good as well. Clinical usefulness was quantified using the decision curve analysis; This nomogram is an integration of the clinical and biochemical data of patients before surgery, and is a reliable tool with high accuracy for predicting the postoperative PHT in patients with PA.

目的 分析儿童肾发育不良合并慢性肾脏病(CKD)的临床特征及肾功能恶化的危险因素,为儿童肾发育不良的诊疗和管理提供依据.方法 回顾性分析2012—2022年于重庆医科大学附属儿童医院就诊的肾发育不良合并CKD患儿的临床及随访资料,对其性别、确诊年龄、生长指标、伴发畸形、合并症等信息进行分析.CKD的诊断标准依据KDIGO2020指南并进行分期,将疾病转归为CKD 4～5期定义为转归组,通过Cox分析影响转归组患儿肾功能恶化的因素.结果 共纳入肾发育不良合并CKD患儿122例.其中,CKD 4～5期66例(54.1％),男性多于女性.双侧肾发育不良88例(72.13％)、单侧34例(27.87％),64例(52.46％)合并其他泌尿系统疾病.体质量、身高及体质量指数(BM I)在CKD 1～5期之间比较差异具有统计学意义(P<0.01).CKD发病年龄<10岁,BMI低于我国同性别、同年龄第3百分位,双侧肾发育不良,合并1种以上其他先天性肾脏和尿路异常(CAKUT)为肾功能恶化的危险因素(P<0.05).结论 肾发育不良合并CKD儿童中男性居多,双侧肾发育不良占比高.双侧肾发育不良,CKD发病年龄<10岁,BMI低于同年龄、同性别第3百分位,合并其他CAKUT是肾发育不良合并CKD儿童肾功能恶化的重要影响因素.

Bladder cancer is a common tumour of the urinary system, and more than 90% is urothelial carcinoma. Therefore, it is important for discovering the key target genes and molecules of bladder tumour cell metastasis and invasion. Our research initially explored the regulation of deltaN p63 on the progression and metastasis of bladder cancer and found that deltaN p63 can influence the occurrence of EMT through PTEN and ultimately regulate the growth and metastasis of bladder cancer. In summary, this study identified a new EMT regulator, deltaN p63, further revealed the mechanism of the invasion and metastasis of bladder cancer cells, and provided a theoretical basis for finding new target molecules and drugs to treat bladder cancer. In conclusion, this study will further reveal the mechanism of tumour cell invasion and metastasis and provide a theoretical basis for cancer treatment to find new target molecules and drugs.

目的 探究原发性醛固酮增多症患者术后高血压持续存在的影响因素.方法 回顾性分析2014年1月至2020年12月该院收治的294例原发性醛固酮增多症高血压患者资料,根据术后血压恢复情况分为高血压组及治愈组,分析比较两组性别、年龄、血压、BMI、高血压病程、高血压家族史、糖尿病、高血压性心脏病、难治性高血压史、服药种类、血浆醛固酮/肾素(ARR)、醛固酮、肾素、最低血钾、估计肾小球滤过率(eGFR)、肿瘤直径、病变部位、手术方式、病理结果等资料,随访患者术后血压、醛固酮、肾素,并纳入分析.结果 与治愈组比较,高血压组年龄更大,男性比例、收缩压、舒张压、BMI、高血压家族史、糖尿病、高血压性心脏病、难治性高血压患者比例更高,高血压病程更长,服药种类更多,ARR、醛固酮、eGFR水平更低,肾素、最低血钾、甘油三酯水平更高,肿瘤直径更小,病理检查结果提示增生的患者比例更高,差异有统计学意义(P＜0.05).多因素logistic回归分析结果显示,男性、高血压病程、糖尿病、ARR均为术后高血压持续存在的影响因素(P＜0.05).结论 应针对原发性醛固酮增多症术后影响血压的危险因素进行干预.

Bladder cancer is a common tumour of the urinary system, and more than 90% is urothelial carcinoma. Therefore, it is important for discovering the key target genes and molecules of bladder tumour cell metastasis and invasion. Our research initially explored the regulation of deltaN p63 on the progression and metastasis of bladder cancer and found that deltaN p63 can influence the occurrence of EMT through PTEN and ultimately regulate the growth and metastasis of bladder cancer. In summary, this study identified a new EMT regulator, deltaN p63, further revealed the mechanism of the invasion and metastasis of bladder cancer cells, and provided a theoretical basis for finding new target molecules and drugs to treat bladder cancer. In conclusion, this study will further reveal the mechanism of tumour cell invasion and metastasis and provide a theoretical basis for cancer treatment to find new target molecules and drugs.

目的 比较腹腔镜下肾部分切除术(LPN)与腹腔镜下根治性肾切除术(LRN)在T2N0M0期肾癌中的临床疗效及安全性.方法 回顾性分析2010年1月至2018年12月该院收治的T2期肾癌患者临床资料,以TNM分期标准分为T2a期和T2b期,再根据手术方式将T2a期分为LPNa组(n=214)和LRNa组(n=105),T2b期分为LPNb组(n=29)和LRNb组(n=61),比较不同术式下患者的一般临床资料、肿瘤特征、手术相关指标、切缘阳性、二次手术、术后复发、肾功能变化等指标.结果 LPNa组和LPNb组R.E.N.A.L评分分别较LRNa组和LRNb组低,估计失血量、术后住院时间、术后血红蛋白(Hb)下降水平、术后6个月估计肾小球滤过率(eGFR)水平分别较LRNa组和LRNb组高,差异有统计学意义(P＜0.05).LPNa组平均热缺血时间为(28.15±12.30)min,LPNb组为(38.60±17.00)min.与LRNb组比较,LPNb组手术时间更长,二次手术率更高,差异有统计学意义(P＜0.05).结论 LPN对T2a肾癌患者安全有效,而对T2b肾癌术后保护肾功能更有优势.

BACKGROUND:Several groups proved kidney-sparing surgery (KSS) had equivalent oncological outcomes compared with radical nephroureterectomy (RNU) for the low-risk upper urinary tract urothelial carcinoma (UTUC) patients. Whereas, the clinical efficacy of KSS for high-risk UTUC, especially for distal high-risk ureteral carcinoma, remains unclear. OBJECTIVE:To evaluate the feasibility of KSS for patients with distal high-risk ureter cancer. MATERIALS AND METHODS:Our study included 22 patients who diagnose the distal high-risk ureter cancer and underwent KSS between May 2012 and July 2021 in the First Affiliated Hospital of Chongqing Medical University. Overall survival (OS), confirmed as the primary endpoint of present study, was assessed by a blinded independent review committee (BIRC). The secondary endpoints included the postoperative SF-36 (the short form 36 health survey questionnaire) score, progression-free survival (PFS), postoperative complications, and so on. RESULTS:Overall, 17 (77.3%) and 5 (22.7%) patients underwent segmental ureterectomy (SU) and endoscopic ablation (EA), respectively. By the cut-off date, the mean OS was 76.3 months (95% Cl: 51.3-101.1 months) and the mean PFS was 47.0 months (95% Cl: 31.1-62.8 months), respectively. And the SF-36 score in a majority of patients was >300 (90.9%). CONCLUSION:This is a daring endeavor to explore the clinical efficacy of KSS in distal high-risk ureter cancer based on the high-risk UTUC criteria, which shows satisfactory results in the long-term prognosis and operation-associated outcomes. However, future randomized or prospective multicenter studies are necessary to validate our conclusions.

目的 比较保留膀胱的综合治疗与根治性膀胱切除术治疗T2期肌层浸润性膀胱癌(MIBC)的临床疗效.方法 以该院2017年4月至2020年4月收治的120例MIBC患者为研究对象,根据治疗方法分为两组:综合治疗组82例采用经尿道1470激光膀胱肿瘤整块切除术联合术后规律卡介苗膀胱灌注治疗及GC方案(吉西他滨+顺铂)化疗的综合治疗,根治组38例采用根治性全膀胱切除术并行尿流改道术.随访6～36个月,比较两组患者围术期情况、并发症发生情况、生活质量评分、肿瘤复发情况[复发率、无复发生存率(RFS)]及3年总生存率(OS).结果 综合治疗组手术时间[(46.20±27.93)min vs.(327.47±106.40)min]、术中出血量[(51.26±73.13)m L v s.(410.00±219.86)m L]、住院时间[(10.06±4.13)d v s.(23.31±8.42)d]、并发症发生率均明显低于根治组(P<0.05),两组复发率(25.6％vs.21.1％)、RFS(74.4％vs.78.9％)及3年OS(88.1％v s.87.8％)未见明显差异(P>0.05),综合治疗组术后生活质量评分更高[(77.83±9.18)分v s.(60.74±12.40)分,P<0.05].结论 保留膀胱的综合治疗与根治性切除术对T2期M IBC治疗的肿瘤复发情况无明显差异,且前者提高了患者的生活质量,减少了手术并发症的发生,对高度选择的T 2期M IBC是一种可行的治疗方案.

Urine-derived stem cells (USC) are isolated from voided urine and have demonstrated potential for use in tissue engineering and regenerative medicine therapies. Clear cell renal cell carcinoma (ccRCC) is a common urological malignancy that originates in the kidney. Since USC also originate in the kidney, the objective of this study was to investigate any biological differences between USC isolated from healthy patients and those isolated from ccRCC patients (rc-USC). We found that USC can be isolated from the voided urine of ccRCC patients (rc-USC) and have a morphology and function similar to those isolated from healthy donors. However, the rc-USC showed greater proliferation and invasion capacity than USC, and possessed some features of cancer cells; but the rc-UC were not able to form xenografts when implanted in vivo. We further performed RNA sequencing of rc-USC and USC and found several differentially expressed lncRNAs and mRNAs; however subsequent GO and KEGG enrichment analysis showed few pathway differences between these cells. Bioinformatic analyses and RT-PCR showed the expression of several known ccRCC-related genes in rc-USC expressed, as compared to USC derived from healthy donors. This study demonstrates that rc-USC displayed several cellular and genetic features of ccRCC cells, which suggests that this population of cells could provide a non-invasive approach for for the diagnosis, predication, disease modeling and therapeutic strategies targeting ccRCC.

目的 对比达芬奇机器人辅助腹腔镜下肾部分切除术(RAPN)、开放性肾部分切除术(OPN)和传统腹腔镜下肾部分切除术(LPN)治疗局限性肾癌(RCC)的围术期疗效.方法 回顾性分析该院2012年1月到2019年9月收治的进行肾部分切除术(PN)的313例T1～T2期RCC患者的临床资料,根据手术方式分为RAPN组(n=55),LPN组(n=200),OPN组(n=58),比较3组患者的一般资料、肿瘤学特征,同时,根据R.E.N.A.L评分将病例进行分层:包括低风险组(4～6分)91例,中风险组(7～9分)138例和高风险组(10～12分)84例,并比较中、高风险组内3种手术方式的手术指标差异.结果 RAPN组和OPN组的平均肿瘤最大径、R.E.N.A.L评分均大于LPN组(P<0.05).在中风险组中,LPN组和RAPN组的血红蛋白(Hb)下降值和术后住院时间均小于OPN组(P<0.05).在高风险组中,RAPN组和OPN组的热缺血时间(WIT)短于LPN组(P<0.05),RAPN组和LPN组的术后估计肾小球滤过率(eGFR)下降值、Hb下降值和术后住院时间均小于OPN组(P<0.05),RAPN组的Trifecta达标率高于LPN组和OPN组(P<0.05).结论 在肾PN中,对于中风险RCC,LPN和RAPN在术后住院时间和术后Hb下降方面较OPN有明显优势.对于高风险RCC,RAPN在WIT、术后eGFR下降值、Hb下降值、术后住院时间和Trifecta的达标率方面较LPN、OPN有明显优势.RAPN治疗高风险RCC肾功能损伤小、术后恢复快.

单侧病变的原发性醛固酮增多症以醛固酮瘤最为常见,手术治疗有望达到治愈的效果.对于手术方式选择,目前国内医生观点与国外指南推荐存在分歧.本文重点就目前国内对醛固酮瘤手术方式的认识误区作一评述.

目的 探讨不同手术方式治疗前列腺增生症对患者性功能的影响.方法 以该院收治的370例接受不同手术方式的前列腺增生患者作为研究对象,其中160例行经尿道前列腺等离子电切术(等离子电切组),120例行经尿道前列腺激光切除术(激光切除组),90例经尿道前列腺激光剜除术(激光剜除组).比较各组患者的临床信息、手术情况,术前术后勃起功能国际问卷评分(IIEF-5)、术前术后射精功能评分(CIPE),治疗前后前列腺症状评分[前列腺症状评分(IPSS)及生活质量评分(QOL)]、最大尿流率(Qmax).结果 激光切除组包膜穿孔、尿失禁的发生率最少,3组间两两比较差异均有统计学意义(P<0.05).3组患者治疗前后IPSS、QOL分数、Qmax组间比较,差异无统计学意义(P>0.05),3组患者治疗前后IIEF-5、CIPE比较,差异均有统计学意义(P<0.05);3组间两两比较IIEF-5、CIPE得分、逆行射精发生率差异有统计学意义(P<0.05).单因素分析中留置尿管时间、出血量、膀胱冲洗时间、包膜穿孔与术后性功能障碍的发生相关(P<0.05).多元Logistic回归分析中,仅发现术中包膜穿孔与术后发生性功能障碍密切相关(P<0.05).结论 不同手术方式治疗前列腺增生均有确切效果,但对患者性功能均有一定影响,其中激光切除术对患者性功能影响较小,行激光剜除术患者性功能障碍发生率高于行其他手术方式患者.术中包膜穿孔是患者术后发生性功能障碍的高危因素.