Objectives To probe into the experience of diagnosis and treatment of ureterpelvic junction obstruetion.Methods Seventy-six cases with ureterpelvic junction obstruction were reviewed,66 were treated by Anderson-Hynes pyeloplasty.2 Y-V pyeloplasty and 8 loosen operation.Results Seventy-four cases gained success by one operation.60 cases were followed up for 6 month～12 years.1 case had ureteropelvic junction stenosis after operation 1 month.which was cured by a double-J tube placement 3 months.1 case was treated by loosen operation,which was no improvement in hydronephrosis after operation.Conclusions Anderson-Hynos pyeloplasty is the first choice of treatment for ureterpelvic junction obstruction.

Objectives To evaluate the clinical effects of tubularized incised plate urethroplasty(Snodgrass procedure)for hypospadias.Methods Thirty one caseswith hypospadias were trebled by tubulsrized incised plate urethroptiaty.The 31 cases aged from 1 to 14 years old with hypospadias were included 5 cases of the glans type,14cases penis type.4 cases peno-scrotal type and 8 cases were second stage uethral reconstruction.Results The 26 patients were cured.Urethral fistula occurred in 2 patients had been corrected by operation.Meatus stricture was noted in 3 patients had been corrected with urethral dilatation.Conclusions Tubularized incised plate urethroplasty can be used in most type of hypospadias.Tubularized incised plate urethroplasty is a simplified method and its success rate is high.

目的 探讨阴茎折断的诊断和治疗.方法 对11例阴茎折断伤患者的诊断和治疗进行回顾性分析.结果 11例均行手术治疗,术后随访时间2个月～7.5年,无阴茎勃起功能障碍、尿道狭窄等并发症.结论 早期手术是治疗阴茎折断的首选治疗.

Objective To study the diagnosis and therapy of cireumeaval ureter.Methods The diag-nosis of this disease depends on imaging examtions,such as mtravenous urograpny(IVU),retrogradure terophy(RU)or MRurograpy(MRU),showed risht hydronephosis with reveised"J shaped"or"S shaped"ureter.Surgicaloperation was used to treat this disease.The eomtpressed retrocaval portion of ureter was reseeted and end-endamastomosis Was performed antenor to the vena cava.Results 15 cases have been followed uD by IVU and ul-～asonography,and nO nephrohydrosis or stenosis of the amastomosis site has been noted.Conclusion IVU andRU ale the eardinal means for the diagnosis op eircumcaval ureter,segmental resestion of the ureter with end-to-end stomosis is the ideal procedure for the treatment of this disease.

Objectives To investigate the therapeutic effect of super-selective bladder arterial infusion chemotherapy and embolization on treating of middle and advanced stage of bladder cancer.Methods Eighteen cases were treated by trans-arterial infusion, and then followed by lipiodol 5-Fu and gelfoam embolization. Results CR+ PR 15 cases (15/18), NC for the three cases (3/ 18), and the total efficiency of 83.3%.Conclusions Super-selective bladder arterial chemo-embolization is the treatment of middle and advanced bladder cancer an effective palliative method can significantly increase the survival rate of patients.

Objectives To present an experience of diagnosis and treatment of renal trauma in 150 patients.Methods One hundred and fifty cases of renal trauma were retrospectively analyzed.Results The positive rate of renal injury detected by B-ultra sonography and CT were 95.7% and 100% respectively. One hundred and twenty-one cases were managed conservatively and 29 cases were treated by operation.Conclusions B-ultra sonography which was simple, reliable and harmless to the patients, is the first choice in detecting renal trauma. Accurate diagnosis rate is high with CT scanning. Surgical management is indicated in cases of severe injured kidney and open renal injury, and increase the opportunities for retaining kidney.

[Objective] To investigate the effects on the management of ureterolith street with ureteroscopic lithotripsy. [Methods] 5 cases of ureterolith street with complicating acute renal failure were treated by emergency ureteroscopic lithotripsy and double-J tubes indwelling. [Results] All cases were cured. [Conclusion] Ureteroscopic lithotripsy manipulation is believed to be a safe and effective method for the treatment of ureterolith street with complicating acute renal failure.

Objective: To investigate the expression of inhibitor of apoptosis protein survivin in the bladder transitional cell carcinoma(BTCC) and its clinical significance.Methods: Survivin was detected by SP immunohistochemistry technique in 47 cases of BTCC and 8 cases of normal bladder tissue.The correlations between the expression of survivin and tumor grade,stage and survival rates of the patients were closely studied.Results: The abnormal expression of survivin was in BTCC and no expression in the normal bladder tissue.The expression of survivin increased following the augment of tumor stage and grade.High expression of survivin was associated with poor prognosis of BTCC.Conclusion: The abnormal expression of survivin is common in BTCC.The expression of survivin may play an important role in BTCC invasion and metastasis and prognosis.

目的:提高肾上腺偶发瘤早期诊断水平,指导临床治疗。方法:19例肾上腺偶发瘤患者均行手术治疗。结果:19例患者中,术后病理诊断为:髓质脂肪瘤3例,腺瘤3例,皮质癌2例,囊肿5例,假性囊肿2例,节神经细胞瘤1例,肉瘤1例,转移癌1例,神经鞘瘤1例。19例患者术后均获随访,随访5个月~10年,4例恶性肿瘤者死亡,15例良性病变者未见肿瘤复发。结论:肾上腺偶发瘤术前定性诊断困难,应积极手术治疗。

Objective To evaluate the safety, efficacy and morbidity of transurethal electrovaporization of superficial bladder tumor (TVBt). Methods TVBt was performed in sixty seven patients with superficial bladder tumor. Results The tumor was resected in one-stage for 67 cases. The mean operative time was 38 minutes. Intraoperative bladder perforation occurred in two cases. No patients needs blood transfusion for bleeding. The mean duration of an indwelling urethral catheter was 72 h. 42 cases was follwed up for twenty four months, and the recurrence rate was 26.9%. Conclusions TVBt is a simple, effective and safe surgery for the treatment of superficial bladder tumor.

对我们应用输尿管镜直视下气压弹道碎石术治疗输尿管结石151例分析如下. 1 临床资料 1.1 一般资料 本组男75例,女76例,年龄23～65(平均42.5)岁.中段结石31例,下段结石120例,结石直径0.3～1.7 cm.其中并发输尿管狭窄3例,输尿管息肉4例,轻度肾积水125例,中重度肾积水12例.病程3 d～3.8 a.原发性高血压21例,糖尿病15例,有盆腔手术史8例.本组151例术前经X线摄片及B超检查确诊;另138例经X线摄片+尿路造影证实.

Objective To understand the biologicalb ehavior, the histopathological and clinical features of malignant melanoma of the penis. Methods A case of malignant melanoma of the penis was reported. The incidence ,the clinical feature, histopathology, diagnosis and therapeutic considerations are analyzed withl iterature review. Results Thep atientu nderwent partial amputation of the penis and died withl ung metastaticc ancer 12 monthsa fterd iagnosis. Immunohistochemicals tainingw as performed, S-P method(S-P): HMB45 (+),S-100(+),Vimentin(+),Actin(SM)(-),Cytokeratin(-)。Conclusion In general, the prognosis for patients with malignant melanoma of the penis is poor and most patients die with a few years due to distantm etastasis.

目的探讨与泌尿生殖系相关的多原发恶性肿瘤(MPMNs)问题.方法对21例与泌尿生殖系相关的MPMNs患者临床资料进行回顾性分析,并结合文献复习就其诊断标准、发病情况、发病因素及预后进行讨论.结果癌切除术后生存1.5年者1例,2年者3例,3年以上者5例,5年者3例.结论MPMNs的预后明显优于单原发恶性肿瘤的复发或转移,鉴别多发癌是多原发癌还是转移癌具有重要的临床意义.

对我院1995-01～2005-01前列腺增生(BPH)合并糖尿病(DM)75例的围手术期处理总结分析如下.

Objective To investigate the expression and significance of p27 and cyclin E in trasitional cell carcinoma(TCC).Methods p27 and Cyclin E expressions were examined by immunohistochemical technique in 45 cases of TCC and 8 cases of normal bladder tissues.Results The expression levels of p27 and cyclin E protein were significantly different between TCC and normal tissues.The expressions of p27 and cyclin E was correlating with TCC stage and grade.There was a highly significant inverse correlation between the expressions of p27 and cyclin E.Conclusion p27 and cyclin E might be an useful prognosis marker for bladder carcinoma.

肾上腺皮质癌临床上较罕见,恶性度高,预后差.我院收治3例,现报告如下,并对该病诊疗方法进行分析.

Objective To evaluate the clinical value of transurethral electro-vaporization (TVBt) vs partial cystectomy for the treatment of bladder cancer.Methods The clinical data of 52 cases receiving TVBt and 58 cases receiving partial cystectomy were retrospectively analyzed.Operating time, the blood loss during operation, stay in bed after operation,kept catheterization after operation, post-operative hospital stay, total cost of hospitalization were compared between the two groups.Results In the TVBt group,operating time, stay in bed after operation,kept catheterization after operation, post-operative hospital stay were all better than those in the partial cystectomy group(P=0.000);the blood loss during operation, the total cost of hospitalization were better than those in the partial cystectomy group(P0.001).Conclusion TVBt is a simple, effective and safe surgery for the treatment of bladder cancer.

隐睾或睾丸下降不全是男性常见的生殖系统先天性疾病,大量的病例证明隐睾与睾丸肿瘤之间存在着极为密切的关系,隐睾是与睾丸肿瘤发生认识最一致的相关危险因素,约10%的睾丸肿瘤起源于下降不全的睾丸,隐睾者发生睾丸肿瘤的机会比正常睾丸者大20～40倍.我院自1982～2002年收治隐睾恶变8例,现报告如下.

目的探讨改良腹膜后途径手术治疗精索静脉曲张的价值.方法回顾性分析22例左侧精索静脉曲张采用改良腹膜后途径高位结扎治疗的效果及恢复情况.结果 22例手术均获成功.手术时间20～45 min,平均30 min.术中无明显出血.随访3～15个月无复发、阴囊水肿、睾丸鞘膜积液、输精管损伤或睾丸萎缩病例.结论改良腹膜后途径治疗精索静脉曲张疗效确切,副损伤小,尤其适用于经腹股沟管结扎失败及不宜经腹腔镜手术的病例.

我们对1987～1999年26例膀胱肿瘤合并前列腺增生病人行同期开放手术,结合文献对其术后肿瘤复发问题进行探讨,现报告如下.