Objective:To compare the effects of disposable circumcision suture device,Shangring and circumcision.Methods:90 patients were randomly divided into 3 groups: circumcision group,ShangRing group and disposable circumcision suture device(DCSD) group. Evaluation indicators included:operation time,blood loss,intraoperative pain score,postoperative pain score, the pain duration of postoperative,postoperative treatment,postoperative edema,incision dehiscence,postoperative bleeding, postoperative blood,reoperation after operation,postoperative infection,healing days,postoperative scar,postoperative adhesion, satisfactory evaluation of penis appearance,overall satisfactory evaluation,cost,etc.Results:Intraoperative blood loss and operation time of ShangRing group and DCSD group were all lower than that of circumcision group (P<0.001).Intraoperative pain of DCSD group was less than that of circumcision group and ShangRing group(P<0.001).The postoperative pain of circumcision group was higher than that of the other two groups(P<0.001).The appearance satisfaction of penile of DCSD group and ShangRing was higher than that of the circumcision group(P<0.05).The overall satisfaction of DCSD group was higher than that of ShangRing group and circumcision group(P<0.05).Conclusion:DCSD can shorten the operation time and healing time,reduce intraoperative and postoperative pain,and reduce the postoperative infection and postoperative scar and postoperative adhesion,which can improve patients?appearance satisfaction of penile and overall satisfaction.

2003年10月至2009年5月,笔者对12例膀胱癌患者施行技术改进的studer回肠代膀胱术,避免了因肠管切除过多而可产生腹泻和维生素B12缺乏症,将输入道改为8 cm,术后患者无肾积水,无返流,效果满意.

ObjectiveTo investigate the curative effects of laparoscope operation and spermatic veins operation in patients with spermophlebectasia.MethodLaparoscopic ligation of spermatic cord veins was conducted for 20 cases,and inguenligation of spermatic cord veins was performed on 22 patients,followed up for 3～24 months.ResultsAfter operation,the count,vigour and activity of sperm of all patients were significantly improved (P0.05).As compared with routine operation,the count,vigour,and activity of sperm were obviously improved in the laparoscope group after operation (P0.05).ConclusionAt high locational laparoscope ligation of spermatic cord veins has the advantages of minimal trauma,good curative effect,less complication.It is an optimal method to cure spermophlebectasia.

目的:提高腔内手术治疗尿道狭窄及闭锁的治疗效果。方法:总结87例尿道内切开加经尿道疤痕电切术治疗尿道狭窄或闭锁的经验。结果:87例全部手术成功,其中6例行腔内2次手术。87例术后随访6~24个月,皆排尿通畅,15例须定期尿道扩张。结论:腔内手术损伤轻,适应证广泛,疗效好,可作为治疗尿道狭窄及闭锁的首选方法。术前准确了解尿道狭窄部位、长度及走行方向,选择敏感抗生素控制感染,术中冷刀沿正道充分切开疤痕后换用电刀彻底切除疤痕,并消灭假道,术后视尿道长度及术中情况决定导尿管留置时间为手术成功保证。

目的 比较经尿道前列腺电切术(TURP)和经尿道前列腺气化切除术(TUVP)的治疗结果.方法 随机配对研究前列腺增生(BPH)患者,TURP组与TUVP组各974例,术前条件具有可比性,比较两种手术的安全性和有效性.结果 两种术式患者手术后前列腺症状评分(I-PSS)、生活质量评分(QOL)、最大尿流率(Qmax)均有显著改善(P＜0.01),但组间比较差异无统计学意义(P＞0.05).TURP组的手术时间明显短于TUVP组(P＜0.01),术中失血量多于TUVP组(P＜0.01);电切综合征(TURS)的发生率组间无明显差异(P＞0.05).TURP组术后出血、暂时性尿失禁发生率少于TUVP组,阳痿发生率少于TUVP组(P＜0.01).结论 两种术式均为BPH安全而有效的治疗方法.TURP具有切除层次清晰、快捷、精确度高、术后并发症少的优点.TUVP操作较简便、出血少、手术从容,尤其适合于初学者和中小医院.

目的:探讨经尿道汽化电切术治疗浅表性膀胱癌疗效和治疗经验.方法:对106例浅表性膀胱癌患者行经尿道汽化电切术治疗的资料进行总结.结果:106例膀胱肿瘤一次切除,平均手术时间36min,无膀胱穿孔及大出血,全组无输血,术后平均留置导尿48h,99例随访24个月,复发15例(15%).结论:经尿道汽化电切术治疗浅表性膀胱癌具有出血少、视野清晰、瘤体组织清除彻底,术后并发症低等优点.

Objective To evaluate the treatment and p re vention of urethral stricture complicated by transurethral vapo-resection of pr ostate (TVP). Methods Retrospective analysis was conduct ed by reviewing medical records and following up the patients under study.Among 3012 patients with benign prostatic hyperplasia treated with TVP, urethral stric ture occurred 4 weeks to 22 months following surgery in 95 cases (3.15 %), inclu ding anterior in 47 (49.5%),posterior in 31 (32.6 %) and bladder neck contractur e or occlusion in 17 (17.9%).Their mean age was 68.7 years (range, 55 to 85 year s). Results The 95 patients were followed up for 4～36 m o nths (mean,14 months).Of them,65 cases underwent conventional dilation, in them 59 (90.8%) were cured and 6 had failure,then turning to internal urethrotomy;19 cases underwent internal urethrotomy plus dilation,in them,13 (68.4%) were cured and 6 had failure,then turning to urethroplasty;17 cases of bladder neck contra cture or occlusion underwent transurethral resection of bladder neck scar tissue ,with a cure rate of 88.2% (15 were cured and 2 experienced failure). Conclusions Urethral stricture is a common complication after TVP. The key points of managing the strictures are patients’ alert,close follow-up and early effective treatment.

前列腺癌(PCa)的发生及发展依赖于雄激素的作用.切除睾丸可以去除体内大部分雄激素,但仍有肾上腺分泌的少量雄激素.

目的观察康士得治疗晚期前列腺癌(PCa)的疗效.方法康士得治疗晚期PCa患者.结果①46例原发PCa治疗三个月,血清前列腺特异抗原(PSA)降至4.56±2.47μg/L,与治疗前比较差异有极显著意义(P＜0.01).其中39例完全降至正常,7例下降＞85%.患者临床症状改善,前列腺体积明显缩小(P＜0.01).治疗12-18个月,2例出现反跳.②未行睾丸切除术4例,每日服用康士得150mg,可获得同样效果.结论康士得治疗晚期PCa有较好疗效.

1998年2月以来,我们采用汽化切割圈(Vapor-tome)行经尿道前列腺汽化电切术(TUEVAP)治疗前列腺增生症(BPH)126例,效果满意,报告如下.

目的探讨阴囊Paget病的临床特点、治疗方法,提高本病的诊治水平.方法结合文献对11例阴囊Paget病的病因病理、临床特点、治疗方法和预后进行分析.结果该病病史长,早期无特异临床症状,易于误诊.11例病理切片均可见Paget病的典型特征,其中A1期6例,A2期4例,B期1例.结论对于可疑阴囊Paget病应尽早行病灶活检确诊,病灶广泛切除术效果好、预后满意.