BackgroundEstrogen homeostasis is crucial for the structure and function of the urethra, and estrogen deprivation resulting from menopause, ovariectomy, or ovarian dysfunction may lead to various urethral dysfunctions. However, the specific molecular mechanisms involved are still not fully understood.MethodsUrethras from three ovariectomized (OVX) rats and three Sham rats were collected for snRNA-seq analysis. Data analysis included unsupervised clustering using the UMAP algorithm to identify distinct cell types based on marker gene expression. Differential gene expression analysis was performed to identify changes in estrogen-related gene expression across different cell types. Functional enrichment analysis was conducted to elucidate biological pathways associated with differentially expressed genes. Additionally, cellular interactions and developmental trajectories were analyzed to characterize cellular dynamics during menopause.ResultsHere, we profiled 69,529 single-nucleus transcriptomes from rat urethra (three OVX rats and three Sham rats). The snRNA-seq analysis revealed pronounced cellular heterogeneity and menopause-associated transcriptional reprogramming. We identified Fos as a key transcription factor associated with epithelial cell communication and differentiation under estrogen-deprived conditions. In addition, basal epithelial cells displayed EMT-associated transcriptional programs and a potential epithelial-to-mesenchymal continuum toward a mesenchymal-like state in OVX rats. We also identified Tmem233 as a hub gene in a striated muscle contraction-related module enriched in type IIa myofibers, and observed heightened inflammatory activation in immune cells, particularly T cells, in OVX rats.ConclusionIn summary, our study provides a comparative analysis of the snRNA-seq data from the urethra of female rats, elucidating cellular and molecular changes during menopause.

Introduction and HypothesisThis study was aimed at investigating non-invasive indicators correlated with detrusor overactivity (DO) and at developing a prediction model for DO by reviewing clinical and urodynamic data of female patients.MethodsWe retrospectively enrolled 1,084 female patients who underwent a urodynamic study (UDS) at Tongji Hospital between September 2011 and April 2021. Associated factors and the independent prediction factors of DO were demonstrated by univariate and multivariate analysis. A non-invasive prediction model of DO was developed and validated by applying these data.ResultsA total of 194 patients (17.9%) were classified as having DO. A logistic regression of a multivariate nature showed that DO risk factors were independent of age, nocturia, urgency, urgency urinary incontinence (UUI), and the lack of stress urinary incontinence (SUI). The DO prediction model had good performance, with an area under the curve of 0.880 (95% CI 0.826-0.933), which was verified by urodynamic data of patients in Tongji Hospital to be 0.818 (95% CI 0.783-0.853). An outstanding correspondence between the anticipated probability and the observed frequency was revealed by the calibration curve. Decision curve analysis demonstrated that clinical net benefit can be obtained by applying the DO prediction model when the DO risk probability was between 8 and 97%.ConclusionsA non-invasive prediction model of DO was developed and validated using clinical and urodynamic data. Five independent factors associated with DO were identified: age, nocturia, urgency, UUI, and SUI. This prediction model can contribute to assessing the risk of female DO without the need for invasive urodynamic studies.

Abstract Background The efficacy of surgical treatment for benign prostatic hyperplasia (BPH) patients with detrusor underactivity (DU) remains controversial. Methods To summarize relevant evidence, three databases (PubMed, Embase, and Web of Science) were searched from database inception to May 1, 2023. Transurethral surgical treatment modalities include transurethral prostatectomy (TURP), photoselective vaporization of the prostate (PVP), and transurethral incision of the prostate (TUIP). The efficacy of the transurethral surgical treatment was assessed according to maximal flow rate on uroflowmetry (Qmax), International Prostate Symptom Score (IPSS), postvoid residual (PVR), quality of life (QoL), voided volume, bladder contractility index (BCI) and maximal detrusor pressure at maximal flow rate (PdetQmax). Pooled mean differences (MDs) were used as summary statistics for comparison. The quality of enrolled studies was evaluated by using the Newcastle–Ottawa Scale. Sensitivity analysis and funnel plots were applied to assess possible biases. Results In this study, 10 studies with a total of 1142 patients enrolled. In BPH patients with DU, within half a year, significant improvements in Qmax (pooled MD, 4.79; 95% CI, 2.43–7.16; P < 0.05), IPSS(pooled MD, − 14.29; 95%CI, − 16.67–11.90; P < 0.05), QoL (pooled MD, − 1.57; 95% CI, − 2.37–0.78; P < 0.05), voided volume (pooled MD, 62.19; 95% CI, 17.91–106.48; P < 0.05), BCI (pooled MD, 23.59; 95% CI, 8.15–39.04; P < 0.05), and PdetQmax (pooled MD, 28.62; 95% CI, 6.72–50.52; P < 0.05) were observed after surgery. In addition, after more than 1 year, significant improvements were observed in Qmax (pooled MD, 6.75; 95%CI, 4.35–9.15; P < 0.05), IPSS(pooled MD, − 13.76; 95%CI, − 15.17–12.35; P < 0.05), PVR (pooled MD, − 179.78; 95%CI, − 185.12–174.44; P < 0.05), QoL (pooled MD, − 2.61; 95%CI, − 3.12–2.09; P < 0.05), and PdetQmax (pooled MD, 27.94; 95%CI, 11.70–44.19; P < 0.05). Compared with DU patients who did not receive surgery, DU patients who received surgery showed better improvement in PVR (pooled MD, 137.00; 95%CI, 6.90–267.10; P < 0.05) and PdetQmax (pooled MD, − 8.00; 95%CI, − 14.68–1.32; P < 0.05). Conclusions Our meta-analysis results showed that transurethral surgery can improve the symptoms of BPH patients with DU. Surgery also showed advantages over pharmacological treatment for BPH patients with DU. Systematic review registration PROSPERO CRD42023415188.

Nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) was used to detect neurodegenerations in aged monkeys. Our previous studies have shown that aging-related NADPH-d positive bodies (ANBs) and megaloneurites appeared in the lumbosacral spinal cord of aged rats and dogs, respectively. To determine the occurrence of megaloneurites and ANBs in non-human primates, we used NADPH-d histochemistry to perform an advanced study of aging-related alterations in aged male monkeys. We identified two distinct abnormal NADPH-d positive alterations, which were expressed as ANBs and megaloneurites, mainly distributed in the superficial dorsal horn, dorsal gray commissure, lateral collateral pathway (LCP) and sacral parasympathetic nucleus of the sacral spinal cord in aged monkeys. Meanwhile, large diameter punctate NADPH-d abnormalities occurred and scattered in the lateral white matter of the LCP and dorsal root entry zone at the same level of megaloneurites in the gray matter. Immunohistochemical results showed that megaloneurites and ANBs are two distinct abnormal alterations, with megaloneurites co-localizing with vasoactive intestinal peptide immunoreactivity, whereas ANBs were not co-localized. Both ANBs and megaloneurites provide consistent evidence that the anomalous NADPH-d alterations in the aged sacral spinal cord are referred to as a specialized aging marker in the pelvic visceral organs in non-human primates.

Objective: To develop and validate a simple prediction model to diagnose female bladder outlet obstruction (fBOO) because of the invasive nature of standard urodynamic studies (UDS) for diagnosing fBOO. Methods: We retrospectively analyzed the data of 728 women who underwent UDS at Tongji Hospital between 2011 and 2021. The definition of fBOO was P-det.Qmax - 2.2 x Q(max) > 5 (BOOIf > 5). Independent predictive factors of fBOO were determined by multivariable logistic regression analysis. These predictive factors were incorporated into a predictive model to assess the risk of fBOO. Results: Of the 728 patients, 249 (34.2%) were identified as having fBOO and these women were randomly assigned to two groups, a model development group and a model validation group. Multivariate logistic regression demonstrated that age, Q(max) , flow time, and voiding efficiency were independent risk factors for fBOO. The predictive model of fBOO showed a satisfactory performance, with area under the curve being 0.811 (95% confidence interval [CI] 0.771-0.850, P < 0.001), which was confirmed to be 0.820 (95% CI 0.759-0.882, P < 0.001) with external validation. The calibration curve indicated that the predicted probability had an excellent correspondence to observed frequency. Decision curve analysis demonstrated a greater clinical net benefit compared with the strategies of treat all or treat none when the predicted risk was in a range of 3% and 75%. Conclusion: A novel predictive model of fBOO was developed and validated based on clinical features and noninvasive test parameters in female patients with lower urinary tract symptoms. The model is a quick and easy-to-use tool to assess the risk of fBOO for urologists in their routine practice without an invasive UDS.

We investigated aging-related changes in nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) in the spinal cord of aged dogs. At all levels of the spinal cord examined, NADPH-d activities were observed in neurons and fibers in the superficial dorsal horn (DH), dorsal gray commissure (DGC) and around the central canal (CC). A significant number of NADPH-d positive macro-diameter fibers, termed megaloneurites, were discovered in the sacral spinal cord (S1–S3) segments of aged dogs. The distribution of megaloneurites was characterized from the dorsal root entry zone (DREZ) into the superficial dorsal horn, along the lateral collateral pathway (LCP) to the region of sacral parasympathetic nucleus (SPN), DGC and around the CC, but not in the cervical, thoracic and lumbar segments. Double staining of NADPH-d histochemistry and immunofluorescence showed that NADPH-d positive megaloneurites co-localized with vasoactive intestinal peptide (VIP) immunoreactivity. We believed that megaloneurites may in part represent visceral afferent projections to the SPN and/or DGC. The NADPH-d megaloneurites in the aged sacral spinal cord indicated some anomalous changes in the neurites, which might account for a disturbance in the aging pathway of the autonomic and sensory nerve in the pelvic visceral organs.

Objectives: This work aimed to investigate the feasibility and diagnostic value of synthetic MRI, including T1, T2 and PD values in determining the severity of cervical spondylotic myelopathy (CSM).Methods: All subjects (51 CSM patients and 9 healthy controls) underwent synthetic MRI scan on a 3.0T GE MR scanner. The cervical canal stenosis degree of subjects was graded 0—III based on the method of a MRI grading system. Regions of interest (ROIs) were manually drawn at the maximal compression level (MCL) by covering the whole spinal cord to generate T1MCL, T2MCL, and PDMCL values in grade I-III groups. Besides, anteroposterior (AP) and transverse (Trans) diameters of the spinal cord at MCL were measured in grade II and grade III groups, and relative values were calculated as follows: rAP = APMCL/APnormal, rTrans = TransMCL/Transnormal. rMIN = rAP/rTrans.Results: T1MCL value showed a decreasing trend with severity of grades (from grade 0 to grade II, p < 0.05), while it increased dramatically at grade III. T2MCL value showed no significant difference among grade groups (from grade 0 to grade II), while it increased dramatically at grade III compared to grade II (p < 0.05). PDMCL value showed no statistical difference among all grade groups. rMIN of grade III was significantly lower than that of grade II (p < 0.05). T2MCL value was negatively correlated with rMIN, whereas positively correlated with rTrans.Conclusion: Synthetic MRI can provide not only multiple contrast images but also quantitative mapping, which is showed promisingly to be a reliable and efficient method in the quantitative diagnosis of CSM.

目的 探讨雌性犬尿道不同节段和同一节段不同象限上呈现的尿道压力和尿道壁组织内血管窦结构的关系.方法 取健康成年雌性杂种犬6只,采用恒压恒速液体灌注法描记尿道前壁(12点钟)、后壁(6点钟)、左侧壁(3点钟)及右侧壁(9点钟)4个方向的静态尿道压力图(rest urethral pressure profile,RUPP).对实验犬行活体血管染色后,取尿道、膀胱、阴道及周围部分组织行连续冰冻切片,体视显微镜下观察全程尿道壁内血管形态,并用Image J软件计算和比较同一节段尿道前、后、左、右壁组织内的血管密度.结果 实验犬在3、6、9、12点钟方向所测得的功能尿道长度(func-tional urethral length,FUL)分别为(4.82±0.22)cm、(5.35±0.34)cm、(4.93±0.40)cm、(4.41±0.33)cm;最大尿道闭合压(maximum urethral closure pressure,MUCP)在尿道 3、6、9、12 点钟方向的测定值为(25.39±1.49)cmH2O、(21.46 ±3.24)cmH2O、(24.61±1.07)cmH2O、(28.89±1.01)cmH2O.6 点钟方向的 FUL 和 12 点钟方向的 MUCP 明显大于其他3个方向(均P＜0.05).与RUPP相对应,MUCP相近的尿道两侧壁3点和9点钟方向的血管窦的形态结构和血管密度百分比相近(P＞0.05).MUCP相对较大的12点钟方向所对应的尿道前壁和6点钟方向所对应的尿道后壁内血管窦的形态结构和密度呈现显著的不均匀性分布,12点钟方向的最高血管密度明显高于6点钟方向(P＜0.05).结论 雌性犬静态尿道压力和尿道壁内血管窦在前后壁方向上具有显著的方向性变异,而左右两侧具有对称性和一致性.雌性犬尿道不同节段和同一节段不同方位上呈现的尿道压力的方向性变异与尿道壁内血管窦结构具有潜在的相关性.

Objective: To investigate the feasibility of laser speckle contrast imaging (LSCI) for monitoring urethral blood flow (UBF).Materials and methods: In this study, 18 healthy, virgin female Sprague-Dawley rats aged 8-week-old were used. The animals were divided into the sham group (n = 9) and the vaginal distension (VD) group (n = 9). The sham group underwent one catheterization of the vagina without distension and the VD group underwent one VD. Following the VD or sham treatment for one week, LSCI assessment of urethral blood flow was performed during bladder filling and leak point pressure (LPP) process.Results: During the LPP process, in the VD group, the mean LPP was significantly lower than in the sham group (p < 0.05) and the mean UBF level was also significantly lower than in the sham group (p < 0.05) in the LPP condition. The mean relative change of UBF (Delta Flow) was significantly different between the sham group and VD group. The value was 0.646 +/- 0.229 and 0.295 +/- 0.19, respectively (p < 0.05). During the bladder filling process, the VD group had a significant lower mean UBF level than the sham group under full bladder conditions (p = 0.008). The mean Delta Flow was also significantly lower than in the sham group. The value was 0.115 +/- 0.121 and 0.375 +/- 0.127, respectively (p = 0.016).Conclusions: The results confirmed that LSCI was able to determine UBF in female rats. The VD group had lower baseline UBF and lower increases in UBF during bladder filling and LPP process compared with the sham group.

The purpose of this study was to investigate the morphological and histological changes in the urethra in beagle dogs after intraurethral Er:YAG laser irradiation in nonablative mode to confirm the safety of this therapy. Six 2-year-old healthy female virgin beagle dogs (13 ± 1.51 kg) were used in this study. The animals were divided into 2 groups: the sham group, which received sham treatment (n = 3) involving insertion of an intraurethral cannula and laser delivery handpiece into the urethra without laser irradiation, and the experimental group (n = 3), which received intraurethral Er:YAG laser irradiation. The laser irradiation parameters were set according to clinical criteria (4 mm spot size, 1.5 J/cm2, 1.4 Hz, and 4 pulses) in nonablative mode. All animals received three sequential sessions at 4-week intervals. Urethrography and urethroscopy were performed in the 12th week and 13th week, respectively, after the first treatment. After urethroscopy, the animals were sacrificed, and urethral tissue was harvested for histological investigations. All procedures were performed under general anesthesia (40 mg/kg 3% sodium pentobarbital, i.v.). Transforming growth factor β1 (TGF-β1) and α-smooth muscle actin (α-SMA) expression levels were measured to evaluate the biochemical characteristics of the scar. Urethral stricture was not found by urethrography or urethroscopy in either group. Urethral epithelium thickness and collagen expression under the urethral mucosa were significantly increased in the experimental group compared with the sham group. However, there were no significant differences in TGF-β1 and α-SMA expression between the experimental group and sham group (p > 0.05). Urethral stricture is not found in beagle dogs after clinically relevant intraurethral nonablative mode Er:YAG laser irradiation. Proliferation of urethral collagen and the urethral mucosa may be one of the mechanisms by which urine leakage symptoms can be improved.

We can hardly overlook origin of initial characters in our earliest era for language civilization and anatomical history. As Compared with prehistoric cave painting and Egyptian hieroglyph, the etymology of Chinese characters based on the Hear 心, brain脑 and meanings of thinking 思 demonstrated that the China ancestors performed anatomy and consequential thinking in order to invention their depiting characters in ancient China. We focused on bronze inscriptions 金文(Jinwen) hear 心 in San Family Plate 散氏盘 (857 B.C.- 842 B.C.) and review them altered scripts , which showed comparative anatomy of the hearts in different species. Actually, bronze inscription and seal script were officially authentic as formal writing system for thousands of years in ancient China. By review the variants, we try to discuss its detailed information by anatomical way of thinking. Besides modern characters, Chinese ancestors had motivation to interpret what else of their characters on what they observed and thought. Both the archaic character and its variant(s) should be tracked to the original intention. Different to Egyptian hieroglyph, the original anatomical-depicting Chinese characters are still used, acknowledged and definitely respected generation by generation, especially as Chinese Hand writing art in contemporary China. We believe that these Chinese characters are full of something biological nature and humanity understanding. We hope that the paper can be accepted and taught the creating idea of archaic Chinese depictions related anatomy in ancient China in the beginning of the medical classes.

This article reviewed the recent advances in the research of noninvasive diagnostic methods for bladder outlet obstruction. Penile cuff test, detrusor wall thickness, ultrasound-estimated bladder weight and near-spectroscopy showed a promising diagnostic results. However, more rigorous and higher level clinical trials with larger sample size are needed to validate the diagnostic value of these tests.

Objective:To explore the features of free uroflow(FF) curve patterns in female patients with detrusor underactivity(DU) and their clinical significance.Methods:Data of 275 adult female patients with lower urinary tract symptoms(LUTS) underwent urodynamic studies(UDS) at urology center of our hospital from June 2014 to June 2016 were analyzed retrospectively. The uroflow curve patterns of patients with DU were classified and analyzed in the context of parameters of FF, cystometry (CM), and pressure-flow study(PFS). The prevalence of each abnormal uroflow curve pattern in DU patients were calculated and compared with those in non-DU patients.Results:No bell-shaped curve was found in 141 patients with DU. The abnormal curve patterns can be divided into 5 types: Type Ⅰ (bell-shaped curve with saw tooth) in 20 cases (14.2%), Type Ⅱ (box-like curve) in 34 cases (24.1%), Type Ⅲ (triangle curve with decreasing slop) in 62 cases(43.9%), Type Ⅳ (triangle curve with increasing slop) in 4 cases (4.3%), Type Ⅴ (tide-wave curve)in 19 cases (13.5%). Maximum flow rate of free uroflow(Q max.FF) of type Ⅰ [(28.4±9.7) ml/s] was significantly greater than that of type Ⅱ, Ⅲ and Ⅴ[(17.0±4.1), (15.8±5.4) and (12.9±6.4) ml/s, P<0.05]. Flow time of free uroflow(FT.FF) of type Ⅲ and Ⅴ [(43.7±17.2) and (50.1±28.9)s] were significantly longer than that of type Ⅰ and Ⅱ [(18.5±7.3)s and (27.2±9.7)s, P<0.05]. Post voided residual > 50ml was noted in 19 cases (30.6%) of type Ⅲ, 7 cases (36.8%) of type Ⅴ, 1 case (2.9%) of type Ⅱ and no one in type Ⅰ and Ⅳ. Abnormal manifestations in cystometry mainly included bladder hypersensitivity, detrusor overactivity, and stress urinary incontinence. Detrusor pressure at Q max (Pdet.Q max) of type Ⅴ [(7.4±5.0) cmH 2O] was significantly lower than that of type Ⅰ, Ⅱ, Ⅲ [(11.8±6.7), (12.0±5.3), (12.1±5.0) cmH 2O, P<0.05]. Among 134 cases of non-DU, there were type Ⅰ curves in 88 cases (65.7%), type Ⅱ curves in 4 cases (2.9%), type Ⅲ curves in 15 cases (11.2%), type Ⅳ curves in 1 cases (0.7%), type Ⅴ curves in 7 cases (5.2%). And normal bell-shaped curves in 19 cases(14.2%). The prevalence of type Ⅱ, Ⅲ and Ⅴ in DU patients was significantly higher than that in the non DU patients ( P<0.05). Conclusions:This study reveals that the characteristics of reduced detrusor contractility and duration, prolonged bladder emptying or incomplete emptying can be reflected in the patterns of free uroflow curve in female patients with DU. The abnormalities of these free uroflow curve patterns, especially type Ⅱ, Ⅲ and Ⅴ will be helpful in preliminarily screening DU in females.

PurposeWe conducted the first meta-analysis to determine the diagnostic value of non-invasive methods for diagnosing bladder outlet obstruction (BOO) in men with lower urinary tract symptoms (LUTS).MethodsWe searched a range of databases for relevant publications up to June 2022, including PubMed, Embase, Web of Science, and the Cochrane Library. Retrieved studies were then reviewed for eligibility and data were extracted. The risk of bias (RoB) was assessed using the QUADAS-2 tool. We then performed a formal meta-analysis to evaluate the accuracy of various non-invasive methods for diagnosing BOO in men.ResultsWe identified 51 eligible studies including 7,897 patients for meta-analysis. The majority of the studies had a low overall RoB. Detrusor wall thickness (DWT) (pooled sensitivity (SSY): 71%; specificity (SPY): 88%; diagnostic odds ratio (DOR): 17.15; area under curve (AUC) 0.87) and the penile cuff test (PCT) (pooled SSY: 87%; SPY: 78%; DOR: 23.54; AUC: 0.88) showed high accuracy for diagnosing BOO. Furthermore, data suggested that DWT had the highest pooled SPY (0.89), DOR (32.58), and AUC (0.90), when using 2 mm as the cut-off.ConclusionOf the non-invasive tests tested, DWT and PCT had the highest levels of diagnostic accuracy for diagnosing BOO in men with LUTS. DWT, with a 2 mm cut-off, had the highest level of accuracy. These two methods represent good options as non-invasive tools for evaluating BOO in males.

INTRODUCTION AND HYPOTHESIS:Transurethral catheterization in pressure-flow study (PFS) may interfere with the function of the lower urinary tract and produce an incorrect urodynamic diagnosis. We aimed to investigate the influence of a 7F catheter on urinary flow parameters in PFS and its significance for urodynamic diagnosis. Our hypothesis was that intubation causes adverse effects on urinary flow rate and further influences the urodynamic diagnosis. METHODS:We reviewed a urodynamic database of men and women referred for evaluation of lower urinary tract symptoms. The urinary flow parameters of PFS and free flow (FF) were compared. The influence of intubation on urodynamic diagnosis was determined by re-evaluating bladder outlet obstruction (BOO) and detrusor underactivity (DU), with the maximum flow rate of PFS (Qmax.P) being replaced by Qmax of FF (Qmax.F). RESULTS:We initially screened 1,791 patients and included 1,144 for the analysis. Overall, PFS had a lower Qmax (p < 0.001), longer flow time (p < 0.001), and a similar voided volume (p > 0.05). However, Qmax.P displayed inconsistent changing directions: Qmax.P decreased in 72.8% of male patients and 83.5% of female patients but increased in 14.7% of male patients and 9.5% female patients. Qmax.P was unchanged in the remaining patients. The urodynamic diagnosis of BOO and DU changed correspondingly in both the decreased group and the increased group when Qmax.P was replaced by Qmax.F. CONCLUSIONS:Compared with Qmax.F, the changing directions and magnitude of Qmax.P varied with each individual, which could have a significant impact on urodynamic diagnosis. Thus, when a similar volume is voided in FF and PFS, and Qmax.P differs obviously from Qmax.F, replacing Qmax.P with Qmax.F for evaluating BOO and DU may be a sensible choice.

目的:探讨尿道内置7F三腔测压管对压力-流率测定(pressure-flow study,PFS)时尿流率的影响.方法:回顾性分析2011年9月-2016年4月在华中科技大学同济医学院附属同济医院行尿动力学检查的患者资料,筛选出女性压力性尿失禁(stress urinary incontinence,SUI)、逼尿肌活动低下(detrusor underactivity,DU)、膀胱出 口梗阻(bladder outlet obstruction,BOO)、逼尿肌过度活动(detrusor overactivity,DO)患者,共计 875 例.剔除置管前后尿流量相差超过20％的患者,最终406例患者被纳入研究.PFS采用7F三腔测压管,对比自由尿流率(free flow,FF)和PFS时的参数:最大尿流率(maximum flow rate,Qmax),尿流时间(flow time,FT),尿流量(voided volume,VV)以及尿流曲线形态变化.结果:各组的Qmax-PFS＜Qmax-FF且FT-PFS＞FT-FF.在女性患者中,SUI组的Qmax下降比例大于DU组.置管前后尿流曲线发生明显改变者在男性BOO组、DO组、DU组分别占 35.0％、30.4％、14.7％;在女性 DO 组、SUI 组、BOO 组、DU 组分别占 52.9％、50.3％、41.5％、30.0％.结论:尿道内置7F三腔测压管会降低Qmax并延长尿流时间,测压管对尿流率的影响程度可能与性别和膀胱尿道的病理生理状态有关.

Aim. We aimed to perform a meta-analysis to determine whether antibiotic prophylaxis reduces the incidence of urinary tract infections (UTIs) after urodynamic studies (UDS). Methods. We conducted a systematic search of PubMed, Web of Science, Ovid, Elsevier, ClinicalKey, Embase, Cochrane Library, Medline, and Wiley Online Library. Randomized controlled trials (RCTs) comparing the effectiveness of prophylactic antibiotics with placebo or no treatment in preventing UTI after UDS were included. Two reviewers extracted data independently, and RevMan 5.3 software was used to analyze relative risk (RR) with 95% confidence intervals (CI). Heterogeneity was assessed by the Q test and I2 test. Results. The final meta-analysis included 1829 patients in 13 RCTs. Compared with the placebo or no treatment group, prophylactic antibiotics could significantly reduce the risk of bacteriuria ( RR=0.42 , 95% CI: 0.30-0.60) and the risk of symptomatic UTI ( RR=0.65 , 95% CI: 0.48-0.88). In addition, there was no statistically significant difference in the risk of adverse events ( RR=4.93 , 95% CI: 0.61-40.05). No significant heterogeneity or publication bias was found in this study. Conclusions. Current evidence showed that prophylactic antibiotics could reduce the risk of asymptomatic bacteriuria and symptomatic UTI after UDS without increasing the incidence of adverse events.

为了评价经尿道联合经阴道Smooth模式铒激光(Er∶YAG)照射治疗女性压力性尿失禁(SUI)的安全性和有效性,本研究选取了2018年10月—2019年9月期间于我院门诊就诊的21例患有轻中度SUI的已婚成年女性.所有患者均在局部麻醉下分3次接受经尿道联合经阴道Smooth模式铒激光照射治疗,每次治疗间隔4周并对治疗前、治疗后1个月和3个月的疗效以及相关不良事件分别进行统计和随访.疗效的统计随访采用国际尿控学会(ICS)标准化1 h尿垫试验(ICS-pad test)和国际尿失禁咨询委员会尿失禁问卷简表(ICIQ-SF),统计学分析采用配对样本t检验.结果显示,治疗后1个月和3个月随访的ICIQ-SF评分和1 h尿垫试验显著下降(P＜0.05),术后3个月有效率为81％,治疗后均未出现严重不良反应.提示经尿道联合经阴道Smooth模式铒激光照射治疗方式具有治疗时间短、治疗效果明显的优势,对治疗轻中度女性SUI是安全有效的.

Objectives. To evaluate the effects of pentobarbital dosages on lower urinary tract function and to define an appropriate dosage of sodium pentobarbital that would be suitable for urodynamic studies in which recovery from anesthesia and long term survive were needed for subsequent experiment.Methods. Twenty-four 8-week-old, female, virgin, Sprague-Dawley rats (200-250 g) were used in this study. Rats in study groups received gradient doses of pentobarbital intraperitoneally, and those in the control group received urethane intraperitoneally. External urethral sphincter electromyography (EUS-EMG) was recorded simultaneously during cystometry and leak point pressure tests. The toe-pinch reflex was used to determine the level of anesthesia.Results. Micturition was normally induced in both the urethane group and 32 mg/kg pentobarbital group. However, in groups of 40 mg/kg or 36 mg/kg pentobarbital, micturition failed to be induced; instead, nonvoiding contractions accompanied by EUS-EMG tonic activity were observed. There were no significant differences in leak point pressure or EUS-EMG amplitude or frequency between the urethane and 32 mg/kg pentobarbital groups.Conclusions. This study confirmed significant dose-dependent effects of pentobarbital on lower urinary tract function and 32 mg/kg pentobarbital as an appropriate dosage for recovery urodynamic testing, which enable the achievement of expected essential micturition under satisfactory anesthesia in female rats.

Objective:To investigate the safety and efficacy of sacral neuromodulation(SNM)therapy for the treatment of lower urinary tract dysfunction(LUTD)in elderly patients.Methods:Clinical data of 91 elderly patients with LUTD from multiple medical institutions who received SNM during the period from January 2012 to December 2016 were retrospectively analyzed.Patients were divided into four groups: the interstitial cystitis(IC)group(n=28), the neurogenic bladder(NB)group(n=36), the overactive bladder syndrome(OAB)group(n=13)and the idiopathic dysuria(ID)group(n=14). Different sets of evaluation parameters were used for different diseases.Patients’ baseline data and data in stage I(test phase)and stage Ⅱ(permanent SNM)were recorded, statistically analyzed and compared.Results:Ninety-one people underwent SNM treatment.Of them, 53 patients received permanent implants(stage Ⅱ), and the total conversion rate of stage I to stage Ⅱ was 58.2%(53/91). Patients receiving permanent implants(stage Ⅱ)had a preoperative period ranging from 3 months to 30 years, and were followed up for 2 to 58 months after treatment, with an average follow-up of 19.6 months.The improvement rates in stage I for urinary urgency, daily urination frequency, daily nocturnal urination frequency, maximum urine volume, daily average urine volume, daily urine leakage frequency, and quality of life score were 35.4%, 31.6%, 33.7%, 32.6%, 49.2%, 43.2% and 13.2%, respectively.The improvement rates in stage Ⅱ for urinary urgency, daily urination frequency, daily nocturnal urination frequency, maximum urine volume, daily average urine volume, daily urine leakage frequency, and quality of life score were 43.2%, 40.0%, 37.8%, 50.5%, 70.5%, 70.4% and 43.2%, respectively.Three adverse events occurred, including 1 case of recurrent symptoms, 1 case of moderate infection, and 1 case of electrical lead dislocation.Conclusions:Sacral nerve stimulation has definitive and consistent curative effects on LUTD in elderly people.The follow-up time should be extended to further study the safety of sacral nerve stimulation.