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Lin KJ, Hou CP, Tsai HY, Tsao SH, Juang HH, Lin YH. Impact of age and anterior fibromuscular stroma preservation on post-enucleation voided volume. World J Urol 2024; 42:278. [PMID: 38691246 DOI: 10.1007/s00345-024-04996-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/11/2024] [Indexed: 05/03/2024] Open
Abstract
PURPOSE This study is centered on the critical role of anterior fibromuscular stroma (AFS) preservation in prostate enucleation, an emerging strategy aimed at minimizing postoperative urinary incontinence-a common concern in benign prostatic hyperplasia (BPH) surgeries. By focusing on postoperative voiding volumes (VV), our research investigates the efficacy of AFS preservation. This approach, distinct in its methodology, is hypothesized to improve urinary function post-surgery, thereby offering a potentially significant advancement in BPH surgical treatments. MATERIALS AND METHODS A retrospective analysis was conducted, comparing patients who underwent prostate enucleation in 2017 without intentional AFS preservation to those in 2019 with this technique. We examined variables including age, BMI, diabetes, hypertension, and preoperative VV to assess their effect on post-catheter removal VV. The study's methodology includes a thorough review of the primary statistical analysis methods employed. RESULTS Our analysis indicates that while the 2017 and 2019 cohorts were similar in most preoperative parameters, the 2019 group that underwent AFS-preserved surgery showed a significant improvement in postoperative VVs. This was less pronounced in the patient group aged over 70, underscoring the importance of this demographic in our study. CONCLUSIONS The study concludes that intentional preservation of AFS during prostate enucleation positively impacts early postoperative VVs, with limited improvement in older patients. These findings highlight the potential of AFS preservation not only in enhancing urinary outcomes post-surgery but also in shaping future BPH surgical procedures and research directions.
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Affiliation(s)
- Kuo-Jen Lin
- Department of Urology, Chang Gung Memorial Hospital-Linkou, 5 Fu-Shing Street, Kweishan, Taoyuan, 333, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital-Linkou, 5 Fu-Shing Street, Kweishan, Taoyuan, 333, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Han-Yu Tsai
- Department of Urology, Chang Gung Memorial Hospital-Linkou, 5 Fu-Shing Street, Kweishan, Taoyuan, 333, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Shu-Han Tsao
- Department of Urology, Chang Gung Memorial Hospital-Linkou, 5 Fu-Shing Street, Kweishan, Taoyuan, 333, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Horng-Heng Juang
- Department of Urology, Chang Gung Memorial Hospital-Linkou, 5 Fu-Shing Street, Kweishan, Taoyuan, 333, Taiwan
- Department of Anatomy, School of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan
| | - Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital-Linkou, 5 Fu-Shing Street, Kweishan, Taoyuan, 333, Taiwan.
- School of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
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Lin YH, Hou CP, Wu CT. Beyond traditional stenting: evaluating pigtail suture stents for reduced ureterorenoscopy symptoms. World J Urol 2024; 42:255. [PMID: 38656450 DOI: 10.1007/s00345-024-04999-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/26/2024] Open
Affiliation(s)
- Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital-Linkou, 5 Fu-Shing Street, Kweishan, Taoyuan, 333, Taiwan.
- School of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
| | - Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital-Linkou, 5 Fu-Shing Street, Kweishan, Taoyuan, 333, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Chun-Te Wu
- Department of Urology, Chang Gung Memorial Hospital-Linkou, 5 Fu-Shing Street, Kweishan, Taoyuan, 333, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
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Hsu TS, Weng SC, Lin YH, Chen CL, Tsao SH, Tsai HY, Juang HH, Chang PL, Hou CP. Surgical outcomes of endoscopic enucleation of the prostate in community aging males with or without preoperative urinary retention. Int Urol Nephrol 2024:10.1007/s11255-024-04007-7. [PMID: 38564078 DOI: 10.1007/s11255-024-04007-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/26/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES This study aims to investigate the surgical outcomes of endoscopic enucleation of the prostate in older males with or without preoperative urinary retention (UR). MATERIAL AND METHODS We conducted a study on selected patients with symptomatic benign prostatic hyperplasia (BPH) who underwent either thulium:YAG laser (vela XL) prostate enucleation (ThuLEP) or bipolar plasma enucleation of the prostate (B-TUEP) at the geriatric urology department of our institution. The studied patients were categorized into two groups, namely the UR group and the non-UR group, on the basis of whether they experienced UR in the 1 month preceding their surgery. Their clinical outcomes following prostate endoscopic surgery were evaluated and analyzed. RESULTS Our results revealed comparable outcomes for operation time, length of hospital stay, percentage of tissue removed, re-catheterization rate, and urinary tract infection rate within the 1 month between the B-TUEP and ThuLEP surgery groups, regardless of UR history. However, the non-UR B-TUEP group experienced more blood loss relative to the non-UR ThuLEP group (P = .004). Notably, patients with UR exhibited significantly greater changes in IPSS total, IPSS voiding, and prostate-specific antigen values relative to those without UR. CONCLUSIONS Both ThuLEP and B-TUEP were effective in treating BPH-related bladder outlet obstruction. Our study identified more pronounced changes in IPSS total, IPSS voiding, and prostate-specific antigens within the UR group. Moreover, the rate of postoperative UR in this group was not higher than that observed in the non-UR group. Our study also revealed that the presumed benefits of laser surgery in reducing blood loss were less pronounced for patients with UR.
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Affiliation(s)
- Tung-Shiun Hsu
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, 333, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Shu-Chuan Weng
- Department of Health and Management, Yuanpei University of Medical Technology, Hsinchu, 330, Taiwan
- Bachelor Degree Program of Senior Health and Management, Yuanpei University of Medical Technology, Hsinchu, 330, Taiwan
| | - Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, 333, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Chien-Lun Chen
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, 333, Taiwan
| | - Shu-Han Tsao
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, 333, Taiwan
| | - Han-Yu Tsai
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, 333, Taiwan
| | | | - Phei-Lang Chang
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, 333, Taiwan
| | - Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, 333, Taiwan.
- Department of Health and Management, Yuanpei University of Medical Technology, Hsinchu, 330, Taiwan.
- School of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
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Wu YC, Hou CP, Weng SC. Lifestyle and Diet as Risk Factors for Urinary Stone Formation: A Study in a Taiwanese Population. Medicina (Kaunas) 2023; 59:1895. [PMID: 38003945 PMCID: PMC10673421 DOI: 10.3390/medicina59111895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/05/2023] [Accepted: 10/12/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: Urinary tract stones have long been a common ailment afflicting the population, with a high incidence and a wide distribution across different age groups. Effectively preventing the occurrence of urinary tract stones is of paramount importance. The primary aim of this study is to investigate the correlations between individual characteristics, water consumption habits, dietary habits, exercise habits, and the occurrence of urinary tract stones in a Taiwanese population. Materials and Methods: This study is cross-sectional research conducted over one month in 2022. One hundred eligible urinary stone cases were recruited through physician screening at outpatient clinics, and an additional one hundred samples from surgical outpatients without urinary tract stones were included as the control group. A questionnaire survey was employed to gather information on demographic variables, dietary habits, water consumption, and exercise habits of the cases. Descriptive statistics, chi-square tests, and logistic regression were used to explore the impact of relevant factors on urinary stone formation. Results: The analysis results revealed that among the demographic variables, males exhibited a higher risk of contracting urinary tract stones than females, and the majority of cases fell within the 40- to 49-year-old age group. Unhealthy lifestyle habits such as smoking and betel nut chewing also demonstrated a higher susceptibility to urinary tract stones. A logistic regression analysis showed that individuals who engaged in physical activity more than three times per week and those with inadequate water intakes had a higher risk of developing urinary tract stones. Conclusions: There is a close relationship between lifestyle and urinary tract stones. It is recommended that individuals continue to hydrate adequately during exercise.
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Affiliation(s)
- Ya-Chun Wu
- Department of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu 300, Taiwan; (Y.-C.W.); (C.-P.H.)
- Hsinchu Branch, Taipei Veterans General Hospital, Hsinchu 310, Taiwan
| | - Chen-Pang Hou
- Department of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu 300, Taiwan; (Y.-C.W.); (C.-P.H.)
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
| | - Shu-Chuan Weng
- Department of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu 300, Taiwan; (Y.-C.W.); (C.-P.H.)
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Lin YH, Chang SY, Tsao SH, Hou CP, Chen CL, Lin WC, Tsui KH, Juang HH. Anterior fibromuscular stroma-preserved endoscopic enucleation of the prostate: a precision anatomical approach. World J Urol 2023; 41:2127-2132. [PMID: 36585497 DOI: 10.1007/s00345-022-04270-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Benign prostate obstruction (BOO) is becoming increasingly important in this aging society. Some urge/stress urinary incontinence (UUI/SUI) still occurs after endoscopic enucleation of the prostate (EEP). It remains unclear how post-EEP incontinence can be avoided. Currently, early apical release to ameliorate the traction of the external sphincter is the best technique for incontinence prevention. OBJECTIVE To describe our surgical technique of anterior fibromuscular stroma (AFS)-preserved EEP for BOO. DESIGN, SETTING, AND PARTICIPANTS The medical records of 60 consecutive patients who underwent AFS-preserved EEP for BOO in our center from September 2019 to December 2019 were retrospectively reviewed. SURGICAL PROCEDURE AFS-preserved EEP starts at the 12 o'clock position of the urethra, and the junction between the AFS and transitional zone (T-zone) was identified. The AFS and T-zone were separated first to protect the AFS in the initial operative procedure. Then, following the usual enucleation procedure, AFS-preserved EEP could be achieved. MEASUREMENTS Postoperative prostate-specific antigen (PSA), testosterone, urethral stricture, and voiding status, such as incontinence, uroflow, and postvoiding residual urine were assessed. RESULTS AND LIMITATIONS The data show that AFS-preserved EEP could achieve similar surgical outcomes as other early apical release approaches. CONCLUSIONS The preserved AFS provides a nice landmark at the 12 o'clock position during EEP.
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Affiliation(s)
- Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan.
- School of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
| | - Shin-Yuan Chang
- Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
| | - Shu-Han Tsao
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
- School of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
- School of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Chien-Lun Chen
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
- School of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Wen-Chou Lin
- Department of Urology, MacKay Memorial Hospital, Taipei 112, Taiwan
| | - Ke-Hung Tsui
- Department of Urology, Shuang Ho Hospital, Taipei Medical University, Taipei 112, Taiwan.
- TMU Research Center of Urology and Kidney (TMU-RCUK), Taipei Medical University, Taipei 112, Taiwan.
| | - Horng-Heng Juang
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan.
- Department of Anatomy, School of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 333, Taiwan.
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Yeh YJ, Weng SC, Lin YH, Chen CL, Tsao SH, Tsai HY, Juang HH, Chang PL, Hou CP. Comparative Analysis of Surgical Outcomes of Flexible Ureteroscopy and Da Vinci Robotic Surgery in Community Patients with Renal Pelvic Stones Larger than 2 cm. Medicina (Kaunas) 2023; 59:1395. [PMID: 37629685 PMCID: PMC10456386 DOI: 10.3390/medicina59081395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023]
Abstract
Background and Objectives: This study evaluated and compared the surgical outcomes of retrograde intrarenal surgery (RIRS) lithotripsy versus robot-assisted laparoscopic pyelolithotomy (RAPL) in community patients with renal pelvic stones larger than 2 cm. Materials and Methods: A total of 77 patients who underwent RIRS (RIRS group, n = 50) or RAPL (RAPL group, n = 27) at our institution between December 2016 and July 2022 were recruited. A single surgeon performed all surgical operations. Preoperative, operative, and postoperative data were recorded. The study evaluated various clinical outcomes, namely, urinary tract infections, analgesic use, emergency room readmissions, stone clearance rates, surgical complications, and medical expenditures associated with the treatment courses, and compared them between the groups. Results: The RAPL group had a larger mean stone diameter and higher degree of hydronephrosis than the RIRS group did. The RIRS group had superior outcomes regarding operative time, length of postoperative hospital stay, surgical wound pain, and medical expenditures. Regarding postoperative outcomes, comparable rates of postoperative urinary tract infection, prolonged analgesic use, and emergency room readmissions were observed between the groups. However, the RAPL group had a higher stone clearance rate than the RIRS group did (81.5% vs. 52.0%, p = 0.014). Conclusions: For the surgical treatment of renal pelvis stones larger than 2 cm, RAPL has a superior stone clearance rate than RIRS; however, RIRS achieves superior outcomes in terms of medical expenditures, length of hospital stay, and surgical wound pain. Both procedures were equally safe.
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Affiliation(s)
- Yu-Ju Yeh
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (Y.-J.Y.); (Y.-H.L.); (C.-L.C.); (S.-H.T.); (H.-Y.T.); (P.-L.C.)
| | - Shu-Chuan Weng
- Department of Health and Management, Yuanpei University of Medical Technology, Hsinchu 330, Taiwan;
- Bachelor Degree Program of Senior Health and Management, Yuanpei University of Medical Technology, Hsinchu 330, Taiwan
| | - Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (Y.-J.Y.); (Y.-H.L.); (C.-L.C.); (S.-H.T.); (H.-Y.T.); (P.-L.C.)
| | - Chien-Lun Chen
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (Y.-J.Y.); (Y.-H.L.); (C.-L.C.); (S.-H.T.); (H.-Y.T.); (P.-L.C.)
| | - Shu-Han Tsao
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (Y.-J.Y.); (Y.-H.L.); (C.-L.C.); (S.-H.T.); (H.-Y.T.); (P.-L.C.)
| | - Han-Yu Tsai
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (Y.-J.Y.); (Y.-H.L.); (C.-L.C.); (S.-H.T.); (H.-Y.T.); (P.-L.C.)
| | | | - Phei-Lang Chang
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (Y.-J.Y.); (Y.-H.L.); (C.-L.C.); (S.-H.T.); (H.-Y.T.); (P.-L.C.)
| | - Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (Y.-J.Y.); (Y.-H.L.); (C.-L.C.); (S.-H.T.); (H.-Y.T.); (P.-L.C.)
- Department of Health and Management, Yuanpei University of Medical Technology, Hsinchu 330, Taiwan;
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Lin TC, Hou CP, Hsu YC, Chen Y, Yu KJ, Shao IH, Hsieh ML. Can the Sandwich Method Be an Alternative Treatment Choice for BPH Patients With Large Prostates? Urology 2023; 176:137-142. [PMID: 36963671 DOI: 10.1016/j.urology.2023.02.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/02/2023] [Accepted: 02/07/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVE To compare the efficacy and safety of the sandwich method with GreenLight photoselective vaporization (GLPVP) and bipolar transurethral resection (B-TURP) with those of the enucleation method in patients with BPH and a prostate volume ≥ 80 g. METHODS Patients with BPH who underwent either the sandwich method with GLPVP and B-TURP or the enucleation method between 2014 and 2021 were included in the analysis. The primary outcome was the comparison of uroflowmetry results between the 2 groups. Safety analysis of the complication rates was also compared. RESULTS The cohort included 55 patients in the sandwich group and 41 patients in the enucleation group. In the efficacy analysis, both groups showed comparable uroflowmetry results, except for a higher postoperative average flow rate in the enucleation group. Regarding perioperative parameters, the sandwich method required a longer operating time, and the enucleation group had a higher incidence of manual Foley irrigation. Both groups demonstrated similar postoperative complications. CONCLUSION The sandwich method exhibited comparable efficacy and safety to the enucleation method in patients with BPH with a prostate volume ≥ 80 g. Thus, for surgeons who are familiar with GLPVP and B-TURP, the sandwich method may be an alternative surgical approach for BPH patients with large prostates.
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Affiliation(s)
- Tsu-Chen Lin
- Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chen-Pang Hou
- Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Yu-Chao Hsu
- Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu Chen
- Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; School of Medicine, National Tsing Hua University, Hsinchu, Taiwan
| | - Kai-Jie Yu
- Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - I-Hung Shao
- Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Li Hsieh
- Division of Urology, Department of Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Chang KS, Chen ST, Sung HC, Hsu SY, Lin WY, Hou CP, Lin YH, Feng TH, Tsui KH, Juang HH. Androgen Receptor Upregulates Mucosa-Associated Lymphoid Tissue 1 to Induce NF-κB Activity via Androgen-Dependent and -Independent Pathways in Prostate Carcinoma Cells. Int J Mol Sci 2023; 24:ijms24076245. [PMID: 37047218 PMCID: PMC10093854 DOI: 10.3390/ijms24076245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/15/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
The androgen-dependent or -independent pathways are regarded as primary therapeutic targets for the neoplasm of the prostate. Mucosa-associated lymphoid tissue 1 (MALT1) acting as a paracaspase in the regulation of nuclear factor κB (NF-κB) signal transduction plays a central role in inflammation and oncogenesis in cancers. This study confirmed the potential linkages between androgen and NF-κB activation by inducing MALT1 in the androgen receptor-full length (ARFL)-positive LNCaP and 22Rv1 prostate cancer cells. Although androgen did not stimulate MALT1 expression in AR-null or ectopic ARFL-overexpressed PC-3 cells, the ectopic overexpression of the AR splicing variant 7 (ARv7) upregulated MALT1 to activate NF-κB activities in 22Rv1 and PC-3 cells. Since the nuclear translocation of p50 and p65 was facilitated by ARv7 to motivate NF-κB activity, the expressions of MALT1, prostate-specific antigen (PSA), and N-myc downstream regulated 1 (NDRG1) were therefore induced in ectopic ARv7-overexpressed prostate cancer cells. Ectopic ARv7 overexpression not only enhanced 22Rv1 or PC-3 cell growth and invasion in vitro but also the tumor growth of PC-3 cells in vivo. These results indicate that an androgen receptor induces MALT1 expression androgen-dependently and -independently in ARFL- or ARv7-overexpressed prostate cancer cells, suggesting a novel ARv7/MALT1/NF-κB-signaling pathway may exist in the cells of prostate cancer.
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Chang KS, Chen ST, Sung HC, Hsu SY, Lin WY, Hou CP, Lin YH, Feng TH, Tsui KH, Juang HH. WNT1 Inducible Signaling Pathway Protein 1 Is a Stroma-Specific Secreting Protein Inducing a Fibroblast Contraction and Carcinoma Cell Growth in the Human Prostate. Int J Mol Sci 2022; 23:ijms231911437. [PMID: 36232736 PMCID: PMC9570503 DOI: 10.3390/ijms231911437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/18/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
The WNT1 inducible signaling pathway protein 1 (WISP1), a member of the connective tissue growth factor family, plays a crucial role in several important cellular functions in a highly tissue-specific manner. Results of a RT-qPCR indicated that WISP1 expressed only in cells of the human prostate fibroblasts, HPrF and WPMY-1, but not the prostate carcinoma cells in vitro. Two major isoforms (WISP1v1 and WISP1v2) were identified in the HPrF cells determined by RT-PCR and immunoblot assays. The knock-down of a WISP1 blocked cell proliferation and contraction, while treating respectively with the conditioned medium from the ectopic WISP1v1- and WISPv2-overexpressed 293T cells enhanced the migration of HPrF cells. The TNFα induced WISP1 secretion and cell contraction while the knock-down of WISP1 attenuated these effects, although TNFα did not affect the proliferation of the HPrF cells. The ectopic overexpression of WISP1v1 but not WISP1v2 downregulated the N-myc downstream regulated 1 (NDRG1) while upregulating N-cadherin, slug, snail, and vimentin gene expressions which induced not only the cell proliferation and invasion in vitro but also tumor growth of prostate carcinoma cells in vivo. The results confirmed that WISP1 is a stroma-specific secreting protein, enhancing the cell migration and contraction of prostate fibroblasts, as well as the proliferation, invasion, and tumor growth of prostate carcinoma cells.
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Affiliation(s)
- Kang-Shuo Chang
- Department of Anatomy, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 33302, Taiwan
| | - Syue-Ting Chen
- Department of Anatomy, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 33302, Taiwan
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 33302, Taiwan
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Taoyuan 33302, Taiwan
| | - Hsin-Ching Sung
- Department of Anatomy, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 33302, Taiwan
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 33302, Taiwan
| | - Shu-Yuan Hsu
- Department of Anatomy, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 33302, Taiwan
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 33302, Taiwan
| | - Wei-Yin Lin
- Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Taoyuan 33302, Taiwan
| | - Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Taoyuan 33302, Taiwan
| | - Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Taoyuan 33302, Taiwan
| | - Tsui-Hsia Feng
- School of Nursing, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 33302, Taiwan
| | - Ke-Hung Tsui
- Department of Urology, Shuang Ho Hospital, New Taipei City 235041, Taiwan
- TMU Research Center of Urology and Kidney, Department of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Correspondence: (K.-H.T.); (H.-H.J.); Tel.: +886-3-2118800 (ext. 5071) (H.-H.J.); Fax: +886-3-2118112 (H.-H.J.)
| | - Horng-Heng Juang
- Department of Anatomy, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 33302, Taiwan
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 33302, Taiwan
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Taoyuan 33302, Taiwan
- Correspondence: (K.-H.T.); (H.-H.J.); Tel.: +886-3-2118800 (ext. 5071) (H.-H.J.); Fax: +886-3-2118112 (H.-H.J.)
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Tsao SH, Wang CH, Juang HH, Lin YH, Yang PS, Chang PL, Chen CL, Hou CP. Surgery for Xanthogranulomatous Pyelonephritis: A Comparison of Midline Transperitoneal and Flank Retroperitoneal Laparotomy Approaches to Nephrectomy. J Clin Med 2022; 11:jcm11154476. [PMID: 35956092 PMCID: PMC9369389 DOI: 10.3390/jcm11154476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/29/2022] [Accepted: 07/29/2022] [Indexed: 02/01/2023] Open
Abstract
Xanthogranulomatous pyelonephritis (XGP) is a rare inflammatory disease often associated with high morbidity and mortality. Whether the midline transperitoneal or the flank retroperitoneal approach is superior remains unknown. We searched through pathology databases and reviewed 86 patients with an XGP diagnosis from 2000 to 2021 at our institution. After the patients who did not meet the inclusion criteria were excluded, 35 patients who had undergone nephrectomy through the midline transperitoneal or the flank retroperitoneal laparotomy approach were recruited. Nine (25.71%) of the thirty-five patients underwent nephrectomy through a midline approach, whereas twenty-six (74.29%) received a flank approach. Patients in the midline approach group had a longer surgical time (p = 0.03) than those in the flank approach group. In addition, patients in the flank approach group took less time after surgery to resume oral intake than those in the midline approach group (p = 0.01). No significant differences in the rates of intraoperative and postoperative complications such as peritonitis or intraabdominal infection were observed between the groups. For the patients with XGP who are good candidates for surgery, nephrectomy is a relatively safe surgical treatment method. Both surgical methods produced favorable surgical outcomes, and the patients who received these methods had similar complication rates.
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Affiliation(s)
- Shu-Han Tsao
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (S.-H.T.); (H.-H.J.); (Y.-H.L.); (P.-S.Y.); (P.-L.C.); (C.-L.C.)
| | - Chien-Ho Wang
- Deartment of Emergency Medicine, Keelung Chang Gung Memorial Hospital, Keelung 204, Taiwan;
| | - Horng-Heng Juang
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (S.-H.T.); (H.-H.J.); (Y.-H.L.); (P.-S.Y.); (P.-L.C.); (C.-L.C.)
- School of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Department of Anatomy, School of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 333, Taiwan
| | - Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (S.-H.T.); (H.-H.J.); (Y.-H.L.); (P.-S.Y.); (P.-L.C.); (C.-L.C.)
| | - Pei-Shan Yang
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (S.-H.T.); (H.-H.J.); (Y.-H.L.); (P.-S.Y.); (P.-L.C.); (C.-L.C.)
| | - Phei-Lang Chang
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (S.-H.T.); (H.-H.J.); (Y.-H.L.); (P.-S.Y.); (P.-L.C.); (C.-L.C.)
| | - Chien-Lun Chen
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (S.-H.T.); (H.-H.J.); (Y.-H.L.); (P.-S.Y.); (P.-L.C.); (C.-L.C.)
| | - Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan; (S.-H.T.); (H.-H.J.); (Y.-H.L.); (P.-S.Y.); (P.-L.C.); (C.-L.C.)
- School of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Department of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu 300, Taiwan
- Correspondence:
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11
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Hou CP, Tsui KH, Chen ST, Chang KS, Sung HC, Hsu SY, Lin YH, Feng TH, Juang HH. The Upregulation of Caffeic Acid Phenethyl Ester on Growth Differentiation Factor 15 Inhibits Transforming Growth Factor β/Smad Signaling in Bladder Carcinoma Cells. Biomedicines 2022; 10:biomedicines10071625. [PMID: 35884930 PMCID: PMC9312961 DOI: 10.3390/biomedicines10071625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 11/16/2022] Open
Abstract
Growth differentiation factor 15 (GDF15) is known as a TGFβ-like cytokine acting on the TGFβ receptor to modulate target genes. GDF15 is regarded as a tumor suppressor gene in the human bladder and the caffeic acid phenethyl ester (CAPE) induces GDF15 expression to inhibit the tumor growth in vitro and in vivo. However, the interactions among GDF15, CAPE, and TGFβ/Smads signaling in the human bladder carcinoma cells remain unexplored. Results revealed that TGFβ downregulated the expression of GDF15 via the activation of Smad 2/3 and Smad 1/5. Induction of GDF15 on its downstream genes, NDRG1 and maspin, is dependent on the TGFβ/Smad pathways. Moreover, TGFβ blocked the CAPE-inducing expressions of GDF15, maspin, and NDRG1. Pretreatment of TGF receptor kinase inhibitor not only blocked the activation of TGFβ but also attenuated the activation of GDF15 on the expressions of maspin and NDRG1. The CAPE treatment attenuated the activation of TGFβ on cell proliferation and invasion. Our findings indicate that TGFβ downregulated the expressions of GDF15, maspin, and NDRG1 via TGFβ/Smad signaling. Whereas, CAPE acts as an antagonist on TGFβ/Smad signaling to block the effect of TGFβ on the GDF15 expression and cell proliferation and invasion in bladder carcinoma cells.
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Affiliation(s)
- Chen-Pang Hou
- Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 33302, Taiwan;
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Taoyuan 33302, Taiwan;
- Department of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu 300, Taiwan
| | - Ke-Hung Tsui
- Department of Urology, Shuang Ho Hospital, New Taipei City 235041, Taiwan;
- TMU Research Center of Urology and Kindey, Department of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Syue-Ting Chen
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 33302, Taiwan; (S.-T.C.); (K.-S.C.); (H.-C.S.); (S.-Y.H.)
- Department of Anatomy, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 33302, Taiwan
| | - Kang-Shuo Chang
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 33302, Taiwan; (S.-T.C.); (K.-S.C.); (H.-C.S.); (S.-Y.H.)
| | - Hsin-Ching Sung
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 33302, Taiwan; (S.-T.C.); (K.-S.C.); (H.-C.S.); (S.-Y.H.)
- Department of Anatomy, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 33302, Taiwan
| | - Shu-Yuan Hsu
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 33302, Taiwan; (S.-T.C.); (K.-S.C.); (H.-C.S.); (S.-Y.H.)
- Department of Anatomy, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 33302, Taiwan
| | - Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Taoyuan 33302, Taiwan;
| | - Tsui-Hsia Feng
- School of Nursing, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 33302, Taiwan;
| | - Horng-Heng Juang
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Taoyuan 33302, Taiwan;
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 33302, Taiwan; (S.-T.C.); (K.-S.C.); (H.-C.S.); (S.-Y.H.)
- Department of Anatomy, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan 33302, Taiwan
- Correspondence: ; Tel.: +886-3-2118800; Fax: +886-3-2118112
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12
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Chen YT, Hou CP, Juang HH, Lin YH, Yang PS, Chang PL, Chen CL, Weng SC, Tsui KH. Comparison of Outcome and Quality of Life Between Thulium Laser (VelaTM XL) Enucleation of Prostate and Bipolar Transurethral Enucleation of the Prostate (B-TUEP). Ther Clin Risk Manag 2022; 18:145-154. [PMID: 35237038 PMCID: PMC8885124 DOI: 10.2147/tcrm.s352583] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 02/15/2022] [Indexed: 01/10/2023] Open
Affiliation(s)
- Yu-Ting Chen
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
- Health and Management, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Horng-Heng Juang
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Department of Anatomy, School of Medicine, Chang Gung University, Tao-Yuan, Taipei, Taiwan
| | - Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Pei-Shan Yang
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Department of Anatomy, School of Medicine, Chang Gung University, Tao-Yuan, Taipei, Taiwan
| | - Phei-Lang Chang
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Chien-lun Chen
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Shu-Chuan Weng
- Health and Management, Yuanpei University of Medical Technology, Hsinchu, Taiwan
- Shu-Chuan Weng, Department of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu, Taipei, Taiwan, Email
| | - Ke-Hung Tsui
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Department of Urology, Shuang Ho Hospital, TMU Research Center of Urology and Kidney, School of Medicine, College of Medical, Taipei Medical University, Taipei, Taiwan
- Correspondence: Ke-Hung Tsui, Taiwan Innovative Medical Association, Department of Urology, Shuang Ho Hospital, College of Medical, Taipei Medical University, Taipei, Taiwan, Email
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13
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Chen PY, Chen SM, Juang HH, Hou CP, Lin YH, Yang PS, Chen CL, Chang PL, Lin KY, Tsui KH. Prostate-Specific Antigen Velocity Predicts Surgical Outcome of Thulium Laser Enucleation of the Prostate. Front Med (Lausanne) 2022; 8:783221. [PMID: 35047531 PMCID: PMC8761894 DOI: 10.3389/fmed.2021.783221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 11/23/2021] [Indexed: 11/14/2022] Open
Abstract
Background: We determined the effect of prostate-specific antigen velocity (PSAV) on the surgical outcome of thulium laser enucleation of the prostate (ThuLEP) in patients with benign prostatic hyperplasia (BPH). Methods: A retrospective review was performed of prospectively collected data of patients with BPH who underwent ThuLEP at any time from 2017 to 2019. Patients who had undergone BPH surgery or had prostate cancer previously were excluded, and patients with prostate-specific antigen (PSA) > 4 ng/ml were examined through transrectal ultrasound-guided prostate biopsy to rule out prostatic malignancy. Furthermore, patients were excluded if prostatic malignancy was diagnosed during postsurgery follow-up. Results: The PSA level, International Prostate Symptom Score (IPSS), and quality of life (QoL) of 27 male patients at 3 and 15 months postsurgery differed significantly from those at presurgery; the maximum flow rate (Qmax) and postvoid residual (PVR) significantly differed between 3 months postsurgery and presurgery; and 22 and 5 patients had good to excellent and fair to poor outcomes, respectively, at 15 months postsurgery. Patients were divided into two groups (fair and poor vs. good and excellent outcomes at 15 months postsurgery), which significantly differed with respect to PSAV at 3 months postsurgery (P = 0.04), IPSS presurgery (P < 0.02), surgical length (P = 0.01), and hospitalization duration (P = 0.04). In a receiver operating characteristic (ROC) analysis, the optimal cutoff value of PSAV of −0.52 ng/ml characterized effectiveness at 15 months after ThuLEP, and the area under the curve (AUC), sensitivity, and specificity were 0.82 (P < 0.02), 0.80, and 0.82, respectively. For PSAV < -0.52 and ≥-0.52 ng/ml, the percentages of reduction for IPSS, QoL, Qmax, and PVR were −78.6 and −71.4%, −33.3 and 0.0%, 94.4 and 40.0%, and −85.1 and −38.7%, respectively. Conclusions: Postsurgical PSAV was positively correlated with surgical success, and the PSAV cutoff was −0.52 ng/ml. PSAV can, thus, be used to guide the postsurgical follow-up treatment at 3 months after BPH surgery.
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Affiliation(s)
- Po-You Chen
- Department of Urology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shao-Ming Chen
- Department of Urology, Heping Campus, Taipei City Hospital, Taipei, Taiwan
| | - Horng-Heng Juang
- Department of Urology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Anatomy, School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chen-Pang Hou
- Department of Urology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Hsiang Lin
- Department of Urology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Anatomy, School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Pei-Shan Yang
- Department of Urology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Urology, Heping Campus, Taipei City Hospital, Taipei, Taiwan
| | - Chien-Lun Chen
- Department of Urology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Phei-Lang Chang
- Department of Urology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Kuo-Yen Lin
- Department of Urology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ke-Hung Tsui
- Department of Urology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Urology, Shuang Ho Hospital, School of Medicine, College of Medical, Taipei Medical University, Taipei, Taiwan.,TMU Research Center of Urology and Kidney (TMU-RCUK), Taipei Medical University, Taipei, Taiwan
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14
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Hou CP, Lin YH, Yang PS, Chang PL, Chen CL, Lin KY, Juang HH, Weng SC, Tsui KH. Clinical Outcome of Endoscopic Enucleation of the Prostate Compared With Robotic-Assisted Simple Prostatectomy for Prostates Larger Than 80 cm 3 in Aging Male. Am J Mens Health 2021; 15:15579883211064128. [PMID: 34903071 PMCID: PMC8679036 DOI: 10.1177/15579883211064128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 11/09/2021] [Accepted: 11/15/2021] [Indexed: 12/05/2022] Open
Abstract
This study investigated and compared the surgical outcomes of using endoscopic enucleation (thulium: YAG laser and bipolar plasma; ThuLEP) with robotic-assisted simple prostatectomy (RASP) in the treatment of prostates larger than 80 cm3. Records were obtained for the period from January 2014 to December 2020 for selected patients with BPO who underwent RASP, ThuLEP, or bipolar transurethral enucleation of the prostate (B-TUEP). Patients were excluded if they had active malignant disease, neurogenic bladder, lower urinary tract syndrome for reasons other than BPO, and a history of prostate surgery. Data of 396 patients who underwent B-TUEP, ThuLEP, and RASP were examined. A total of 112 patients met the including criteria, 85 of whom (B-TUEP: 29; ThuLEP: 41; RASP: 15) completed the final visit. The mean operation time and duration of postoperative hospital stays in the RASP group were significantly longer than those of the B-TUEP and ThuLEP groups. Only 1 patient in the RASP group required blood transfusion. The RASP group was superior to the other groups in voiding improvement including Qmax and IPSS voiding score. The pain score of the ThuLEP group after surgery was significantly lower than that of the other two groups during hospitalization, whereas the QoL scores were identical between the three groups at 2 weeks, 3 months, and 6 months post operation. The rates of returning to ER within the first postoperative month did not differ significantly between the three groups, and all the reasons for return involved minor complications that required no additional invasive treatment. These three surgical methods (B-TUEP, ThuLEP, and RASP) are all effective and safe for treating prostates larger than 80 cm3, with each having its particular advantages. B-TUEP requires the shortest operation time, ThuLEP causes the lowest postoperative pain, and RASP results in superior voiding function improvement.
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Affiliation(s)
- Chen-Pang Hou
- Department of Urology, Chang Gung
Memorial Hospital at Linkou, Taoyuan
- Graduate Institute of Clinical Medical
Sciences, College of Medicine, Chang Gung University, Taoyuan
- School of Medicine, Chang Gung
University, Kwei-shan, Tao-Yuan
| | - Yu-Hsiang Lin
- Department of Urology, Chang Gung
Memorial Hospital at Linkou, Taoyuan
- Graduate Institute of Clinical Medical
Sciences, College of Medicine, Chang Gung University, Taoyuan
- School of Medicine, Chang Gung
University, Kwei-shan, Tao-Yuan
| | - Pei-Shan Yang
- Department of Urology, Chang Gung
Memorial Hospital at Linkou, Taoyuan
- School of Medicine, Chang Gung
University, Kwei-shan, Tao-Yuan
| | - Phei-Lang Chang
- Department of Urology, Chang Gung
Memorial Hospital at Linkou, Taoyuan
- School of Medicine, Chang Gung
University, Kwei-shan, Tao-Yuan
| | - Chien-lun Chen
- Department of Urology, Chang Gung
Memorial Hospital at Linkou, Taoyuan
- School of Medicine, Chang Gung
University, Kwei-shan, Tao-Yuan
| | - Kuo-Yen Lin
- Department of Urology, Chang Gung
Memorial Hospital at Linkou, Taoyuan
- School of Medicine, Chang Gung
University, Kwei-shan, Tao-Yuan
| | - Horng-Heng Juang
- Department of Urology, Chang Gung
Memorial Hospital at Linkou, Taoyuan
- Department of Anatomy, School of
Medicine, Chang Gung University, Kwei-shan, Tao-Yuan
| | - Shu-Chuan Weng
- Bachelor Degree Program of Senior
Health and Management, Yuanpei University of Medical Technology, Hsinchu
| | - Ke-Hung Tsui
- Department of Urology, School of
Medicine, College of Medicine, Taipei Medical University, Taipei
- Department of Urology, Shuang Ho
Hospital, Taipei Medical University, New Taipei City
- TMU Research Center of Urology and
Kidney (TMU-RCUK), Taipei Medical University, Taipei
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15
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Hou CP, Tsui KH, Chang KS, Sung HC, Hsu SY, Lin YH, Yang PS, Chen CL, Feng TH, Juang HH. Caffeic acid phenethyl ester inhibits the growth of bladder carcinoma cells by upregulating growth differentiation factor 15. Biomed J 2021; 45:763-775. [PMID: 34662721 DOI: 10.1016/j.bj.2021.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 09/30/2021] [Accepted: 10/07/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Caffeic acid phenethyl ester (CAPE), a bioactive component of propolis, has beneficial effects on cancer prevention. Growth differentiation factor 15 (GDF15) is an antitumor gene of bladder cancer. Therefore, this study investigated the anti-cancer effect of CAPE on bladder carcinoma cells and related mechanisms. METHODS The expressions of GDF15, N-myc downstream-regulated gene 1 (NDRG1), and maspin, and the activations of ERK, JNK, p38, and AMPKα1/2 in human bladder cells after gene transfection or knockdown were determined by immunoblot, RT-qPCR, and reporter assays. The assays of 5-ethynyl-2'-deoxyuridine (EdU), CyQUANT cell proliferation, and Matrigel invasion, and the xenograft animal study were used to assess the cell proliferation, invasion, and tumorigenesis. RESULTS GDF15 expression in epithelial cells was negatively correlated with neoplasia in vitro. Also, GDF15 exhibits in bladder fibroblasts and smooth muscle cells. CAPE-induced expressions of NDRG1 and maspin decreased cell proliferation and invasion of bladder carcinoma cells in a GDF15-dependent manner in vitro. The xenograft animal study suggesting CAPE attenuated tumor growth in vivo. CAPE increased phosphorylation of ERK, JNK, p38, and AMPKα1/2 to modulate the GDF15 expressions. Pretreatments with ERK, JNK, or p38 inhibitors partially inhibited the CAPE effects on the inductions of GDF15, NDRG1, or maspin. Knockdown of AMPKα1/2 attenuated the CAPE-induced GDF15 expression and cell proliferation in bladder carcinoma cells. CONCLUSIONS Our findings indicate that CAPE is a promising agent for anti-tumor growth in human bladder carcinoma cells via the upregulation of GDF15.
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Affiliation(s)
- Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ke-Hung Tsui
- Department of Urology, Shuang Ho Hospital, New Taipei City, Taiwan; Department of Medicine; TMU Research Center of Urology and Kindey, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kang-Shuo Chang
- Department of Anatomy, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsin-Ching Sung
- Department of Anatomy, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shu-Yuan Hsu
- Department of Anatomy, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Pei-Shan Yang
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Chien-Lun Chen
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Tsui-Hsia Feng
- Department of Anatomy, College of Medicine, Chang Gung University, Taoyuan, Taiwan; School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Horng-Heng Juang
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Department of Anatomy, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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16
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Chen JW, Lin WJ, Lin CY, Hung CL, Hou CP, Tang CY. An Automatic Bleeding-Rank System for Transurethral Resection of the Prostate Surgery Videos Using Machine Learning. Diagnostics (Basel) 2021; 11:diagnostics11101767. [PMID: 34679465 PMCID: PMC8535166 DOI: 10.3390/diagnostics11101767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 11/16/2022] Open
Abstract
Benign prostatic hyperplasia (BPH) is the main cause of lower urinary tract symptoms (LUTS) in aging males. Transurethral resection of the prostate (TURP) surgery is performed by a cystoscope passing through the urethra and scraping off the prostrate piece by piece through a cutting loop. Although TURP is a minimally invasive procedure, bleeding is still the most common complication. Therefore, the evaluation, monitoring, and prevention of interop bleeding during TURP are very important issues. The main idea of this study is to rank bleeding levels during TURP surgery from videos. Generally, to judge bleeding level by human eyes from surgery videos is a difficult task, which requires sufficient experienced urologists. In this study, machine learning-based ranking algorithms are proposed to efficiently evaluate the ranking of blood levels. Based on the visual clarity of the surgical field, the four ranking of blood levels, including score 0: excellent; score 1: acceptable; score 2: slightly bad; and 3: bad, were identified by urologists who have sufficient experience in TURP surgery. The results of extensive experiments show that the revised accuracy can achieve 90, 89, 90, and 91%, respectively. Particularly, the results reveal that the proposed methods were capable of classifying the ranking of bleeding level accurately and efficiently reducing the burden of urologists.
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Affiliation(s)
- Jian-Wen Chen
- Department of Computer Science, National Tsing Hua University, Hsinchu 30013, Taiwan; (J.-W.C.); (C.-Y.T.)
| | - Wan-Ju Lin
- Department of Mechanical Engineering, National Taiwan University, Taipei 10617, Taiwan;
| | - Chun-Yuan Lin
- Department of Computer Science and Information Engineering, Asia University, Taichung 41354, Taiwan;
| | - Che-Lun Hung
- Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
- Department of Computer Science and Communication Engineering, Providence University, Taichung 43301, Taiwan
- Correspondence: (C.-L.H.); (C.-P.H.)
| | - Chen-Pang Hou
- Department of Urology, Linkou Chang Gung Memorial Hospital, Taoyuan 33302, Taiwan
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Correspondence: (C.-L.H.); (C.-P.H.)
| | - Chuan-Yi Tang
- Department of Computer Science, National Tsing Hua University, Hsinchu 30013, Taiwan; (J.-W.C.); (C.-Y.T.)
- Department of Computer Science and Information Engineering, Providence University, Taichung 43301, Taiwan
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17
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Juang HH, Chen SM, Lin G, Chiang MH, Hou CP, Lin YH, Yang PS, Chang PL, Chen CL, Lin KY, Tsui KH. The Clinical Experiences of Urine Metabolomics of Genitourinary Urothelial Cancer in a Tertiary Hospital in Taiwan. Front Oncol 2021; 11:680910. [PMID: 34395249 PMCID: PMC8362851 DOI: 10.3389/fonc.2021.680910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/11/2021] [Indexed: 12/19/2022] Open
Abstract
Few studies have addressed the impact of diagnostic urine metabolites and the clinical outcomes associated with genitourinary urothelial (GU) cancer to date. Furthermore, longitudinal analysis of the dynamics of urine metabolites contributing to the detection of GU cancer has not yet been fully investigated; therefore, the discovery of novel diagnostic urine biomarkers is of enormous interest. We explored the correlation of the urine metabolomic profiles to GU cancers. The aqueous metabolites of the GU cancer and the control were also identified and analyzed through high-resolution1H nuclear magnetic resonance (NMR) spectroscopy. Compared with the control, the urine metabolites of the tumor were studied in relation to changes over time in a linear mixed model for repeated measures. The urine metabolites of sixty-three (44 male and 19 female) patients with GU cancers were systemically analyzed. The urine metabolite profile in GU cancer was significantly higher than those in the control group (p<0.05). Sevenurine metabolites including histidine, propylene glycol, valine, leucine, acetylsalicylate, glycine, and isoleucine as well as other pathways were identified statistically and were significantly associated with GU cancer detection with longitudinal analysis. We discovered that histidine, propylene glycol, valine, leucine, acetylsalicylate, glycine, isoleucine, succinic acid, lysine2-aminobutyric acid, and acetic acid are involved significantly in all types of male patients in whom the type (upper tract) of urine metabolites were found to be statistically significant compared with the control. We did not find any statistical significance in urine biomarkers between female and male patients. However, a statistically insignificant correlation was found among the grade and stage with the metabolites.
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Affiliation(s)
- Horng-Heng Juang
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Department of Anatomy, School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shao-Ming Chen
- Department of Urology, Taipei City Hospital, Heping Campus, Taipei, Taiwan
| | - Gigin Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Imaging Core Laboratory, Institute for Radiological Research, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Meng-Han Chiang
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Imaging Core Laboratory, Institute for Radiological Research, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Pei-Shan Yang
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Phei-Lang Chang
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chien-Lun Chen
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kuo-Yen Lin
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ke-Hung Tsui
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Department of Urology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
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Tsui KH, Chang KS, Sung HC, Hsu SY, Lin YH, Hou CP, Yang PS, Chen CL, Feng TH, Juang HH. Mucosa-Associated Lymphoid Tissue 1 Is an Oncogene Inducing Cell Proliferation, Invasion, and Tumor Growth via the Upregulation of NF-κB Activity in Human Prostate Carcinoma Cells. Biomedicines 2021; 9:biomedicines9030250. [PMID: 33802402 PMCID: PMC8000469 DOI: 10.3390/biomedicines9030250] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/21/2021] [Accepted: 02/26/2021] [Indexed: 11/16/2022] Open
Abstract
Prostate cancer is one of the most common seen malignancies and the leading cause of cancer-related death among men. Given the importance of early diagnosis and treatment, it is worth to identify a potential novel therapeutic target for prostate cancer. Mucosa-associated lymphoid tissue 1 (MALT1) is a novel gene involved in nuclear factor κB (NF-κB) signal transduction by acting as an adaptor protein and paracaspase, with an essential role in inflammation and tumorigenesis in many cancers. This study investigated the functions and the potential regulatory mechanisms of MALT1 in the human prostate cancer cells. We found that MALT1 is abundant in prostate cancer tissues. MALT1 facilitated NF-κB subunits (p50 and p65) nuclear translocation to induce gene expression of interleukin 6 (IL-6) and C-X-C motif chemokine 5 (CXCL5) in prostate carcinoma cells. MALT1 promoted cell proliferation, invasion, and tumor growth in vitro and in vivo. MALT1 enhanced NF-κB activity in prostate carcinoma cells; moreover, NF-κB induced MALT1 expression determined by reporter and immunoblot assays, implying there is a positive feedback loop between MALT1 and NF-κB. In conclusion, MALT1 is a NF-κB-induced oncogene in the human prostate carcinoma cells.
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Affiliation(s)
- Ke-Hung Tsui
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan 33302, Taiwan; (K.-H.T.); (Y.-H.L.); (C.-P.H.); (P.-S.Y.); (C.-L.C.)
| | - Kang-Shuo Chang
- Department of Anatomy, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan; (K.-S.C.); (H.-C.S.); (S.-Y.H.)
| | - Hsin-Ching Sung
- Department of Anatomy, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan; (K.-S.C.); (H.-C.S.); (S.-Y.H.)
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan
| | - Shu-Yuan Hsu
- Department of Anatomy, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan; (K.-S.C.); (H.-C.S.); (S.-Y.H.)
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan
| | - Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan 33302, Taiwan; (K.-H.T.); (Y.-H.L.); (C.-P.H.); (P.-S.Y.); (C.-L.C.)
| | - Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan 33302, Taiwan; (K.-H.T.); (Y.-H.L.); (C.-P.H.); (P.-S.Y.); (C.-L.C.)
| | - Pei-Shan Yang
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan 33302, Taiwan; (K.-H.T.); (Y.-H.L.); (C.-P.H.); (P.-S.Y.); (C.-L.C.)
| | - Chien-Lun Chen
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan 33302, Taiwan; (K.-H.T.); (Y.-H.L.); (C.-P.H.); (P.-S.Y.); (C.-L.C.)
| | - Tsui-Hsia Feng
- School of Nursing, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan;
| | - Horng-Heng Juang
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan 33302, Taiwan; (K.-H.T.); (Y.-H.L.); (C.-P.H.); (P.-S.Y.); (C.-L.C.)
- Department of Anatomy, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan; (K.-S.C.); (H.-C.S.); (S.-Y.H.)
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan
- Correspondence: ; Tel.: +886-3-2118800; Fax: +886-3-2118112
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Abstract
The surgical outcomes of patients with single ureteral stones who had undergone ureteroscopic Holmium laser lithotripsy as outpatients and compare them with those of patients who had received the same procedure as inpatients. Records were obtained from January 2012 to December 2016 for selected patients who had undergone the above mentioned procedure at our institution. Patients were excluded if their ECOG performance status was ≥2, presented with multiple stones or concomitant renal stones, had histories of cancer or congenital urinary system abnormalities, or had undergone urinary system reconstruction surgery. Patients could decide whether to receive the procedure as an outpatient or inpatient. All surgeries were performed by a single surgeon. Patients preoperative, operative, and postoperative data were recorded. The clinical results, such as urinary tract infection, analgesic requirement, rate of returning to the emergency room, stone clearance, surgical complications, and medical expenditure for the treatment courses were analyzed and compared between the 2 cohorts. In total, 303 patients met the inclusion criteria. Among them, 119 patients decided to receive ureteroscopic laser lithotripsy as outpatients, whereas 184 decided to be inpatients. The outpatient cohort was younger (P < .001), had smaller stone diameters (P < .001), and fewer comorbidity factors (P = .038). Patients with a history of stone manipulation favored receiving the procedure under admission (P < .001). After 1:1 propensity score matching, no significant differences were discovered between the cohorts with regard to operative time, rate of lithotripsy failure, and operative complications. Furthermore, rates of stone clearance, post-op urinary tract infection, analgesic requirement, and returning to the emergency room were comparable between the 2 groups. However, the medical expenditure was significantly lower in the outpatient cohort (P < .001). Our data revealed that outpatient ureteroscopic lithotripsy with a Holmium laser was more economical compared with the inpatient group and achieved favorable outcomes for patients with a single ureteral stone.
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Affiliation(s)
- Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital at linkou
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taiwan
| | - Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital at linkou
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taiwan
| | - Horng-Heng Juang
- Department of Urology, Chang Gung Memorial Hospital at linkou
- Department of Anatomy, School of Medicine, Chang Gung University, Kwei-shan, Tao-Yuan
| | - Phei-Lang Chang
- Department of Urology, Chang Gung Memorial Hospital at linkou
- School of Medicine
| | - Chien-lun Chen
- Department of Urology, Chang Gung Memorial Hospital at linkou
- School of Medicine
| | - Pei-Shan Yang
- Department of Urology, Chang Gung Memorial Hospital at linkou
- School of Medicine
| | - Chen-Che Lee
- Department of Urology, Chang Gung Memorial Hospital at linkou
- School of Medicine
| | - Ke-Hung Tsui
- Department of Urology, Chang Gung Memorial Hospital at linkou
- School of Medicine
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Lin YH, Tsui KH, Chang KS, Hou CP, Feng TH, Juang HH. Maspin is a PTEN-Upregulated and p53-Upregulated Tumor Suppressor Gene and Acts as an HDAC1 Inhibitor in Human Bladder Cancer. Cancers (Basel) 2019; 12:cancers12010010. [PMID: 31861435 PMCID: PMC7016534 DOI: 10.3390/cancers12010010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 12/03/2019] [Accepted: 12/12/2019] [Indexed: 02/06/2023] Open
Abstract
Maspin is a member of the clade B serine protease inhibitor superfamily and exhibits diverse regulatory effects in various types of solid tumors. We compared the expressions of maspin and determined its potential biological functions and regulatory mechanisms in bladder carcinoma cells in vitro and in vivo. The results of RT-qPCR indicated that maspin expressed significantly lower levels in the bladder cancer tissues than in the paired normal tissues. The immunohistochemical assays of human bladder tissue arrays revealed similar results. Maspin-knockdown enhanced cell invasion whereas the overexpression of maspin resulted in the opposite process taking place. Knockdown of maspin also enhanced tumorigenesis in vivo and downregulated protein levels of acetyl-histone H3. Moreover, in bladder carcinoma cells, maspin modulated HDAC1 target genes, including cyclin D1, p21, MMP9, and vimentin. Treatment with MK2206, which is an Akt inhibitor, upregulated maspin expression, whereas PTEN-knockdown or PTEN activity inhibitor (VO-OHpic) treatments demonstrated reverse results. The ectopic overexpression of p53 or camptothecin treatment induced maspin expression. Our study indicated that maspin is a PTEN-upregulated and p53-upregulated gene that blocks cell growth in vitro and in vivo, and may act as an HDAC1 inhibitor in bladder carcinoma cells. We consider that maspin is a potential tumor suppressor gene in bladder cancer.
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Affiliation(s)
- Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan 33302, Taiwan; (Y.-H.L.); (K.-H.T.); (C.-P.H.)
- Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan
| | - Ke-Hung Tsui
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan 33302, Taiwan; (Y.-H.L.); (K.-H.T.); (C.-P.H.)
| | - Kang-Shuo Chang
- Department of Anatomy, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan;
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan
| | - Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan 33302, Taiwan; (Y.-H.L.); (K.-H.T.); (C.-P.H.)
- Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan
| | - Tsui-Hsia Feng
- School of Nursing, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan;
| | - Horng-Heng Juang
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan 33302, Taiwan; (Y.-H.L.); (K.-H.T.); (C.-P.H.)
- Department of Anatomy, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan;
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan
- Correspondence: ; Tel.: +886-3-2118800; Fax: +886-3-2118112
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21
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Tsui KH, Hou CP, Chang KS, Lin YH, Feng TH, Chen CC, Shin YS, Juang HH. Metallothionein 3 Is a Hypoxia-Upregulated Oncogene Enhancing Cell Invasion and Tumorigenesis in Human Bladder Carcinoma Cells. Int J Mol Sci 2019; 20:ijms20040980. [PMID: 30813460 PMCID: PMC6413184 DOI: 10.3390/ijms20040980] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 02/19/2019] [Accepted: 02/20/2019] [Indexed: 12/18/2022] Open
Abstract
Metallothioneins have been viewed as modulators in a number of biological regulations regarding cancerous development; however, the function of metallothionein 3 (MT3) in bladder cancer is unexplored. We determined the regulatory mechanisms and potential function of MT3 in bladder carcinoma cells. Real-Time Reverse Transcriptase-Polymerase Chain Reaction (RT-qPCR) assays revealed that TSGH-8301 cells expressed more MT3 levels than RT-4, HT1376, and T24 cells. Immunoblot and RT-qPCR assays showed that arsenic (AS₂O₃) treatments enhanced the gene expression of MT3. Hypoxia induced HIF-1α, HIF-2α, and MT3 expression; furthermore, HIF-2α-knockdown attenuated hypoxic activation on MT3 expression. Ectopic overexpression of MT3 increased cell proliferation, invasion, and tumorigenesis significantly in T24 and HT1376 cells in vitro and in vivo; however, MT3-knockdown in TSGH-8301 cells had the reverse effect. Moreover, knockdown of MT3 enhanced arsenic-induced apoptosis determined by the Annexin V-FITC apoptosis assay. MT3-overexpression downregulated the gene expressions of N-myc downstream regulated gene 1 (NDRG1), N-myc downstream regulated gene 2 (NDRG2), and the mammary serine protease inhibitor (MASPIN) in HT1376 and T24 cells, whereas MT3-knockdown in TSGH-8301 cells had the opposite effect. The experiments indicated that MT3 is an arsenic- and hypoxia-upregulated oncogene that promotes cell growth and invasion of bladder carcinoma cells via downregulation of NDRG1, NDRG2, and MASPIN expressions.
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Affiliation(s)
- Ke-Hung Tsui
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan 33302, Taiwan.
| | - Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan 33302, Taiwan.
- Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan.
| | - Kang-Shuo Chang
- Department of Anatomy, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan.
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan.
| | - Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan 33302, Taiwan.
- Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan.
| | - Tsui-Hsia Feng
- School of Nursing, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan.
| | - Chiu-Chun Chen
- Department of Medicine, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan.
| | - Yi-Syuan Shin
- Department of Medicine, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan.
| | - Horng-Heng Juang
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan 33302, Taiwan.
- Department of Anatomy, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan.
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan 33302, Taiwan.
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22
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Hou CP, Lin YH, Chen TH, Chang PL, Juang HH, Chen CL, Yang PS, Tsui KH. Transurethral resection of the prostate achieves favorable outcomes in stroke patients with symptomatic benign prostate hyperplasia. Aging Male 2018; 21:9-16. [PMID: 28763255 DOI: 10.1080/13685538.2017.1358260] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES To evaluate the surgical outcomes of stroke patients with symptomatic benign prostatic hyperplasia (BPH) who underwent transurethral resection of the prostate (TURP) and compare the clinical outcomes between patients with stroke and those without stroke receiving this procedure. METHODS This retrospective cohort study analyzed claims data collected during the period of 1997-2012 from Taiwan National Health Insurance Research Database. We enrolled 6625 patients who had persistent lower urinary tract symptoms and underwent TURP for BPH. They were categorized into a stroke (n = 577) and nonstroke (n = 6048) group. Patient characteristics, postoperative clinical outcomes, medication records, and medical expenses were compared. RESULTS Compared with the stroke group patients, those in the nonstroke group were younger, had fewer comorbidities, and more favorable postoperative clinical outcomes. Nevertheless, TURP achieved favorable outcomes in stroke patients with symptomatic BPH. In the stroke group, the rate of urinary tract infection (UTI) decreased from 34.7% during 1 year preoperatively to 29.8% during 1 year postoperatively (p = .05). The rate of urinary retention (UR) also decreased from 55.5% during 1 year preoperatively to 22.5% during 1 year postoperatively (p = .05). TURP reduced the overall medical expenses of patients with stroke. Annual patient medical expense during 1 year preoperatively, 1 year postoperatively, 2 years postoperatively, and 3 years postoperatively was NT$659,000, NT$646,000, NT$560,000, and NT$599,000, respectively. CONCLUSIONS In patients with stroke, TURP reduces the risks of UTI and UR and annual total medical expense.
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Affiliation(s)
- Chen-Pang Hou
- a Department of Urology , Chang Gung Memorial Hospital at Linkou , Tao-Yuan , Taiwan, Republic of China
- b School of Medicine , Chang Gung University , Tao-Yuan , Taiwan, Republic of China
| | - Yu-Hsiang Lin
- a Department of Urology , Chang Gung Memorial Hospital at Linkou , Tao-Yuan , Taiwan, Republic of China
- b School of Medicine , Chang Gung University , Tao-Yuan , Taiwan, Republic of China
- c Graduate Institute of Clinical Medical Sciences, College of Medicine , Chang Gung University , Tao-Yuan , Taiwan, Republic of China
| | - Tien-Hsing Chen
- b School of Medicine , Chang Gung University , Tao-Yuan , Taiwan, Republic of China
- d Division of Cardiology, Department of Internal medicine , Chang Gung Memorial Hospital , Keelung , Taiwan, Republic of China
| | - Phei-Lang Chang
- a Department of Urology , Chang Gung Memorial Hospital at Linkou , Tao-Yuan , Taiwan, Republic of China
- b School of Medicine , Chang Gung University , Tao-Yuan , Taiwan, Republic of China
| | - Horng-Heng Juang
- e Department of Anatomy, School of Medicine , Chang Gung University , Tao-Yuan , Taiwan, Republic of China
| | - Chien-Lun Chen
- a Department of Urology , Chang Gung Memorial Hospital at Linkou , Tao-Yuan , Taiwan, Republic of China
- b School of Medicine , Chang Gung University , Tao-Yuan , Taiwan, Republic of China
| | - Pei-Shan Yang
- a Department of Urology , Chang Gung Memorial Hospital at Linkou , Tao-Yuan , Taiwan, Republic of China
- b School of Medicine , Chang Gung University , Tao-Yuan , Taiwan, Republic of China
| | - Ke-Hung Tsui
- a Department of Urology , Chang Gung Memorial Hospital at Linkou , Tao-Yuan , Taiwan, Republic of China
- b School of Medicine , Chang Gung University , Tao-Yuan , Taiwan, Republic of China
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23
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Tsui KH, Chang YL, Feng TH, Hou CP, Lin YH, Yang PS, Lee BW, Juang HH. Capillarisin blocks prostate-specific antigen expression on activation of androgen receptor in prostate carcinoma cells. Prostate 2018; 78:242-249. [PMID: 29164633 DOI: 10.1002/pros.23463] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 11/03/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Capillarisin (Cap), an active ingredient of Artemisia capillaris extracts, has known for its anti-inflammatory, antioxidant, and anticancer properties. Functions of Cap in prostate cancer are not clear. We investigate effects of Cap on downregulation of prostate specific antigen (PSA) via modulation of androgen receptor (AR) in prostate carcinoma cells. METHODS Cell proliferation was measured by water-soluble tetrazolium-1 (WST-1) cell proliferation assays. The PSA and AR expressions were assessed by immunoblotting and RT-qPCR assays. Effects of Cap on PSA expressions were determined by ELISA, immunoblotting, and reporter assays. Co-immunoprecipitation and immunoblotting assays were used to define the effects of Cap on dissociation of AR-heat shock protein 90 (Hsp90) interaction. RESULTS Cap inhibited LNCaP cell growth in a dose- and/or time-dependent way without inducing poly ADP-Ribose Polymerase (PARP) cleavage. Cap not only effectively suppressed AR and PSA protein expressions, but also attenuated activations of synthetic androgen (R1881) on PSA promoter activity dose- and time-dependently. The Cap pretreatment abrogated effects of R1881 on AR activity by reducing AR translocation to the nucleus. Immunoblotting assays indicated that Cap promoted a degradation of AR proteins dose-dependently in either cycloheximide pretreated-LNCaP cells or AR-ectopic expressed PC-3 cells. Pretreatment of MG132, a proteasome inhibitor, attenuated effect of Cap on AR degradation. Cap lessened AR stability by dissociation of AR-Hsp90 interaction. CONCLUSIONS Our results indicated that Cap inhibited growth of LNCaP cells. Cap effectively suppressed androgen activation on AR-mediated transactivation, which is AR-dependent through AR degradation and dissociation of AR-Hsp90 in prostate carcinoma cells.
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Affiliation(s)
- Ke-Hung Tsui
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan, Taiwan
- Department of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan
| | - Ying-Ling Chang
- Department of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan
- Graduate Institute of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan
| | - Tsui-Hsia Feng
- School of Nursing, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan
| | - Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan, Taiwan
| | - Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan, Taiwan
| | - Pei-Shan Yang
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan, Taiwan
| | - Bing-Wei Lee
- Graduate Institute of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan
| | - Horng-Heng Juang
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan, Taiwan
- Department of Anatomy, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan
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24
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Yang PS, Chen CL, Hou CP, Lin YH, Tsui KH. An open-label, prospective interventional study of the tolerability and efficacy of 0.4 mg oral tamsulosin oral controlled absorption system in men with lower urinary tract symptoms associated with benign prostatic hyperplasia who are unsatisfied with treatment with 0.2 mg tamsulosin. Clin Interv Aging 2018; 13:235-242. [PMID: 29445269 PMCID: PMC5808696 DOI: 10.2147/cia.s152701] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aim of this study was to investigate the efficacy and tolerability of switching from 0.2 mg tamsulosin to 0.4 mg tamsulosin oral controlled absorption system (OCAS) over a 12-week period in Taiwanese men with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). PATIENTS AND METHODS Taiwanese male patients who were dissatisfied with treatment with 0.2 mg tamsulosin were enrolled in this clinical study and switched to 0.4 mg tamsulosin OCAS. Efficacy was assessed over a 12-week period by an International Prostate Symptom Score (IPSS) questionnaire and analysis of urinary flow by uroflowmetry. RESULTS A statistically significant improvement was observed in total IPSS scores from baseline (14.94±7.41, moderate) to 12 weeks (7.36±5.77, mild) in 81 patients who were switched from 0.2 to 0.4 mg tamsulosin OCAS (P<0.001). The IPSS subscores for storage, voiding, nocturia, and quality of life (QOL) were also significantly improved over the 12-week period. Uroflowmetry analysis demonstrated significantly increased maximum flow rate, average flow rate, and mean voided volume from baseline to the end of the 12-week period. The 0.4 mg tamsulosin OCAS dose was well tolerated, with only mild dizziness (five patients) and headache (two patients) as the most frequent adverse events. No clinically significant reduction was observed in blood pressure or vital signs. CONCLUSION Treatment with 0.4 mg tamsulosin OCAS in Taiwanese men with LUTS associated with BPH who were dissatisfied with 0.2 mg tamsulosin significantly improved IPSS scores, urinary flow, and QOL and was well tolerated, suggesting that this should be the recommended dose offered to Taiwanese male patients.
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Affiliation(s)
| | | | | | | | - Ke-Hung Tsui
- Department of Urology
- Prostate Health Laser Center, Chang Gung Memorial Hospital-Linkou, Chang Gung University, College of Medicine, Taipei, Taiwan, Republic of China
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Lin YH, Hou CP, Chen TH, Juang HH, Chang PL, Yang PS, Chen CL, Tsui KH. Transurethral resection of the prostate provides more favorable clinical outcomes compared with conservative medical treatment in patients with urinary retention caused by benign prostatic obstruction. BMC Geriatr 2018; 18:15. [PMID: 29338688 PMCID: PMC5771192 DOI: 10.1186/s12877-018-0709-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 01/03/2018] [Indexed: 11/28/2022] Open
Abstract
Background To evaluate the long-term surgical outcomes of patients with urinary retention (UR) caused by a benign prostatic obstruction (BPO) who underwent transurethral resection of the prostate (TURP), and compare their outcomes with those of patients who received medication without surgical intervention. Methods This retrospective cohort study analyzed claims data collected during the period of 1997–2012 from Taiwan’s National Health Insurance Research Database. We examined geriatric adverse events among patients who had received a diagnosis of symptomatic benign prostatic hyperplasia and whom experienced UR, and compared those who received TURP and medication only. Primary outcomes included urinary tract infection (UTI), UR, inguinal hernia, hemorrhoids, stroke, acute myocardial infarction, and bony fracture. We excluded patients who had concomitant prostate cancer, bladder cancer, or a long-term urinary catheter indwelling, as well as those who did not receive α-blocker medication regularly. Those aged <50 or >90 years were also excluded. The enrolled patients were categorized into TURP (n = 1218) and medication only (n = 795) groups. After 1:1 propensity score matching, we recorded and compared patients’ characteristics, postoperative clinical outcomes, and geriatric adverse events. Results The TURP cohort had a lower incidence of UTI and UR during the postoperative follow-up period from 2 months to 3 years than did the medication only group (20.7% vs. 28.9% and 12.5% vs. 27.6%, respectively, p < 0.001). The life-long bone fracture incidence was also lower in the TURP cohort (7.9% vs. 9.2%, p = 0.048). The incidence of other outcomes during the postoperative follow-up period did not differ between the two groups. Conclusions Compared with conservative treatment, TURP provides more favorable clinical outcomes in patients with UR caused by BPO. Patients who underwent TURP had a lower risk of UTI, repeat UR episodes, and emergent bony fracture. Thus, early surgical intervention should be considered for such patients.
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Affiliation(s)
- Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital-Linkou, 5 Fu-Shing Street, Kweishan, Taoyuan, 333, Taiwan, Republic of China.,School of Medicine, Chang Gung University, 259 Wen-Hwa 1 st Road, Kweishan, Taoyuan, Taiwan, Republic of China.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital-Linkou, 5 Fu-Shing Street, Kweishan, Taoyuan, 333, Taiwan, Republic of China.,School of Medicine, Chang Gung University, 259 Wen-Hwa 1 st Road, Kweishan, Taoyuan, Taiwan, Republic of China
| | - Tien-Hsing Chen
- School of Medicine, Chang Gung University, 259 Wen-Hwa 1 st Road, Kweishan, Taoyuan, Taiwan, Republic of China.,Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, 222, Maijin Road, Keelung, Taiwan, Republic of China
| | - Horng-Heng Juang
- Department of Anatomy, School of Medicine, Chang Gung University, Kwei-shan, Tao-Yuan, Taiwan, Republic of China
| | - Phei-Lang Chang
- Department of Urology, Chang Gung Memorial Hospital-Linkou, 5 Fu-Shing Street, Kweishan, Taoyuan, 333, Taiwan, Republic of China.,School of Medicine, Chang Gung University, 259 Wen-Hwa 1 st Road, Kweishan, Taoyuan, Taiwan, Republic of China
| | - Pei-Shan Yang
- Department of Urology, Chang Gung Memorial Hospital-Linkou, 5 Fu-Shing Street, Kweishan, Taoyuan, 333, Taiwan, Republic of China.,School of Medicine, Chang Gung University, 259 Wen-Hwa 1 st Road, Kweishan, Taoyuan, Taiwan, Republic of China
| | - Chien-Lun Chen
- Department of Urology, Chang Gung Memorial Hospital-Linkou, 5 Fu-Shing Street, Kweishan, Taoyuan, 333, Taiwan, Republic of China.,School of Medicine, Chang Gung University, 259 Wen-Hwa 1 st Road, Kweishan, Taoyuan, Taiwan, Republic of China
| | - Ke-Hung Tsui
- Department of Urology, Chang Gung Memorial Hospital-Linkou, 5 Fu-Shing Street, Kweishan, Taoyuan, 333, Taiwan, Republic of China. .,School of Medicine, Chang Gung University, 259 Wen-Hwa 1 st Road, Kweishan, Taoyuan, Taiwan, Republic of China.
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Tsui KH, Chang YL, Yang PS, Hou CP, Lin YH, Lin BW, Feng TH, Juang HH. The inhibitory effects of capillarisin on cell proliferation and invasion of prostate carcinoma cells. Cell Prolif 2017; 51:e12429. [PMID: 29271007 DOI: 10.1111/cpr.12429] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 12/01/2017] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES Capillarisin (Cap), an active component of Artemisia capillaris root extracts, is characterized by its anti-inflammatory, anti-oxidant and anti-cancer properties. Nevertheless, the functions of Cap in prostate cancer have not been fully explored. We evaluated the potential actions of Cap on the cell proliferation, migration and invasion of prostate carcinoma cells. MATERIALS AND METHODS Cell proliferation and cell cycle distribution were measured by water-soluble tetrazolium-1 and flow cytometry assays. The expression of cyclins, p21, p27, survivin, matrix metallopeptidase (MMP2 and MMP9) were assessed by immunoblotting assays. Effects of Cap on invasion and migration were determined by wound closure and matrigel transmigration assays. The constitutive and interlukin-6 (IL-6)-inducible STAT3 activation of prostate carcinoma cells were determined by immunoblotting and reporter assays. RESULTS Capillarisin inhibited androgen-independent DU145 and androgen-dependent LNCaP cell growth through the induction of cell cycle arrest at the G0/G1 phase by upregulating p21 and p27 while downregulating expression of cyclin D1, cyclin A and cyclin B. Cap decreased protein expression of survivin, MMP-2, and MMP-9 and therefore blocked the migration and invasion of DU145 cells. Cap suppressed constitutive and IL-6-inducible STAT3 activation in DU145 and LNCaP cells. CONCLUSIONS Our data indicate that Cap blocked cell growth by modulation of p21, p27 and cyclins. The inhibitory effects of Cap on survivin, MMP-2, MMP-9 and STAT3 activation may account for the suppression of invasion in prostate carcinoma cells. Our data suggest that Cap might be a therapeutic agent in treating advanced prostate cancer with constitutive STAT3 or IL-6-inducible STAT3 activation.
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Affiliation(s)
- Ke-Hung Tsui
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan, Taiwan.,Department of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan
| | - Ying-Ling Chang
- Department of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan.,Graduate Institute of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan
| | - Pei-Shan Yang
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan, Taiwan
| | - Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan, Taiwan
| | - Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan, Taiwan.,Graduate Institute of Clinical Medicine Science, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan
| | - Bing-Wei Lin
- Graduate Institute of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan
| | - Tsui-Hsia Feng
- School of Nursing, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan
| | - Horng-Heng Juang
- Department of Urology, Chang Gung Memorial Hospital-Linkou, Kwei-Shan, Tao-Yuan, Taiwan.,Department of Anatomy, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan
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Kan HC, Hou CP, Lin YH, Tsui KH, Chang PL, Chen CL. Prognosis of prostate cancer with initial prostate-specific antigen >1,000 ng/mL at diagnosis. Onco Targets Ther 2017; 10:2943-2949. [PMID: 28652776 PMCID: PMC5476709 DOI: 10.2147/ott.s134411] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose Prostate cancer patients with surprisingly high prostate-specific antigen (PSA) are encountered clinically. However, descriptions of this group of patients are extremely rare in the published literature. This study reports treatment outcome and long-term prognosis for this group of patients. Patients and methods Between January 2007 and December 2012, 2,064 patients with PCa diagnosed at a tertiary medical center were retrospectively reviewed. A total of 90 PCa cases were identified with initial PSA (iPSA) >1,000 ng/mL at diagnosis. A retrospective study was conducted in this cohort, with comparison among stratified patient age groups, PSA, treatment options, and overall survival. Results The mean PSA at PCa diagnosis in this cohort was 3,323 ng/mL (1,003–23,126, median: 2,050 ng/mL). Most patients were in the age group 65–79 years (55/90, 61%). Males older than 80 years had a poor prognosis (P<0.001). Forty-six patients (51%) underwent orchiectomy with a median follow-up period of 16.2 (1.3–72.7) months, compared to 44 patients treated with medical castration and a median follow-up of 9.1 (0.3–70.5) months. Kaplan–Meier analysis revealed survival benefit from treatment with orchiectomy (P<0.001). PSA reduction >90% of iPSA following primary androgen deprivation therapy (reaching true nadir) could be a predictor of longer survival (P<0.001). Cox regression revealed the hazard ratio (HR) of variables were age (HR: 4.57, 95% confidence interval [CI]: 1.45–14.37, P=0.009), reaching true nadir (HR: 0.12, 95% CI: 0.03–0.58, P=0.008), and the treatment option with orchiectomy (HR: 0.22, 95% CI: 0.65–0.76, P=0.016). Conclusion Age ≥80 years indicated poor overall survival in PCa patients with iPSA >1,000 ng/mL. Reaching a true nadir of PSA following primary androgen deprivation therapy could be a predictor of longer survival. Bilateral orchiectomy is recommended for this group of patients.
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Affiliation(s)
| | - Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital.,School of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital.,School of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Ke-Hung Tsui
- Department of Urology, Chang Gung Memorial Hospital.,School of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Phei-Lang Chang
- Department of Urology, Chang Gung Memorial Hospital.,School of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Chien-Lun Chen
- Department of Urology, Chang Gung Memorial Hospital.,School of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
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Lin YH, Hou CP, Chen TH, Juang HH, Chang PL, Yang PS, Lin YS, Chen CL, Tsui KH. Is diabetes mellitus associated with clinical outcomes in aging males treated with transurethral resection of prostate for bladder outlet obstruction: implications from Taiwan Nationwide Population-Based Cohort Study. Clin Interv Aging 2017; 12:535-541. [PMID: 28356725 PMCID: PMC5360412 DOI: 10.2147/cia.s126207] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
PURPOSE We assessed the lower urinary tract symptoms (LUTSs) and clinical outcomes between diabetes mellitus (DM) patients and non-diabetic (non-DM) patients receiving transurethral resection of prostate (TUR-P). METHODS This analysis was a retrospective cohort study using 13 years (2000-2012) of claims data from Taiwan's National Health Insurance Research Database (NHIRD). A total of 4,887 patients who had persistent LUTSs and underwent TUR-P for prostate enlargement (benign prostate enlargement [BPE]) were enrolled and divided into two groups: DM and non-DM groups. The patients' characteristics, postoperative clinical outcomes, and the medication records after TUR-P were compared. Chi-square test was used for categorical variables and independent samples t-test for continuous variables. Multivariable logistic regression analysis was used to compare the risk of postoperative outcomes. Finally, we estimated the medication-free survival rate after TUR-P using Kaplan-Meier method and compared it between study groups using log-rank test. RESULTS DM group patients had a higher prevalence of comorbidities. Postoperatively, the DM group had lower rates of urinary tract infection (UTI; odds ratio [OR], 0.78; P=0.009) and higher rates of urinary retention requiring catheterization (OR, 1.35; P=0.01) within 1 month after TUR-P. A higher proportion of patients with DM took anti-muscarinics (OR, 1.23; P=0.032) within the first 3 months and α-blockers (OR, 1.18; P=0.049) during 3-12 months after receiving TUR-P. Overall, the DM group patients had a worse postoperative medication-free survival compared to that of non-DM group patients (95% confidence interval [95% CI], 1.14; P=0.005). CONCLUSION DM patients require higher rates of continuing medication after TUR-P, especially anti-muscarinics in 3 months postoperatively and alpha-blocker after 3 months postoperatively. DM patients also had higher incidence of urine retention after surgery. DM patients had relatively poor treatment outcomes compared to DM-free patients.
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Affiliation(s)
- Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital - Linkou; School of Medicine; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University
| | - Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital - Linkou; School of Medicine
| | - Tien-Hsing Chen
- School of Medicine; Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung
| | - Horng-Heng Juang
- Department of Anatomy, School of Medicine, Chang Gung University, Kwei-shan, Tao-Yuan
| | - Phei-Lang Chang
- Department of Urology, Chang Gung Memorial Hospital - Linkou; School of Medicine
| | - Pei-Shan Yang
- Department of Urology, Chang Gung Memorial Hospital - Linkou; School of Medicine
| | - Yu-Sheng Lin
- School of Medicine; Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan, Republic of China
| | - Chien-Lun Chen
- Department of Urology, Chang Gung Memorial Hospital - Linkou; School of Medicine
| | - Ke-Hung Tsui
- Department of Urology, Chang Gung Memorial Hospital - Linkou; School of Medicine
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Yang PS, Lin YH, Chang PL, Tsui KH, Hsu YC, Hou CP. Corrigendum to “Less pain perceived in transrectal ultrasound of prostate using microconvex transducer as compared to biplaned linear transducer” [Urol Sci 27 (2015)]. Urological Science 2016. [DOI: 10.1016/j.urols.2016.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Hou CP, Lin YH, Chen CL, Tsai YL, Chang PL, Tsui KH. Impact of the static prostatic urethral angle on men with lower urinary tract symptoms. Urological Science 2016. [DOI: 10.1016/j.urols.2014.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Yang PS, Lin YH, Chang PL, Tsui KH, Hsu YC, Hou CP. Less pain perceived in transrectal ultrasound of prostate using microconvex transducer as compared to biplaned linear transducer. Urological Science 2016. [DOI: 10.1016/j.urols.2015.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Hsu YC, Lin YH, Chou CY, Hou CP, Chen CL, Chang PL, Tsui KH. Economic Evaluation Study (Cheer Compliant) Laser Prostatectomy for Benign Prostatic Hyperplasia: Outcomes and Cost-effectiveness. Medicine (Baltimore) 2016; 95:e2644. [PMID: 26844483 PMCID: PMC4748900 DOI: 10.1097/md.0000000000002644] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To determine which surgical treatment for lower urinary tract symptoms, which is suggestive of benign prostatic hyperplasia (BPH), is more cost-effective and yields a better patient's preference. Treatment outcome, cost, and perioperative complications to assess the treatment effectiveness of using laser prostatectomy as a treatment for BPH were investigated in this study.This retrospective study included 100 patients who underwent transurethral resection of prostate (TUR-P) and another 100 patients who received high-powered 120 W (GreenLight HPS) laser prostatectomy between 2005 and 2011.International Prostate Symptom Score and uroflow parameters were collected before the surgery and the uroflow and postvoiding residual volumes were evaluated before treatment and at 3, 6, 12, and 24 months after treatment. The results of 100 treatments after HPS laser prostatectomy were compared with the results of 100 patients who received TUR-P from the same surgeon. Complication rates and admission costs were analyzed.From 2005 to 2011, 200 consecutive patients underwent endoscopic surgery. Study participants were men with BPH with mean age of 71.3 years old. The peak flow rate went from 8.47 to 15.83 mL/s for 3 months after laser prostatectomy. Laser therapy groups showed better improvement in symptom score, shortened length of stay, and quality of life score when compared with those of TUR-P procedures. The estimated cost for laser prostatectomy was high when compared with cost of any other TUR-P procedural option at Chang Gung Hospital (P = 0.001). All admission charges were similar except for the cost of the laser equipment and accessories (mainly the laser fiber) (P = 0.001). Due to this cost of equipment, it increased the total admission charges for the laser group and therefore made the cost for the laser group higher than that of the TUR-P group.Perioperative complications, such as the need for checking for bleeding, urinary retention rate or urosepsis rate within 30 days after the surgery, held no significant differences between both groups.Compared with alternative treatment options, laser prostatectomy of the prostate is clinically effective but yields a high cost of treatment for symptomatic BPH.
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Affiliation(s)
- Yu-Chao Hsu
- From the Department of Urology and Medicine, Prostate Health Laser Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan (Y-CH, Y-HL, C-PH, C-YC, C-LC, P-LC, K-HT) and Department of Urology, Show Chwan Memorial Hospital, Changhua, Taiwan (C-YC)
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Hou CP, Lin YH, Hsu YC, Chen CL, Chang PL, Tsui KH. Using a Harmonic Scalpel "Drilling and Clamping" Method to Implement Zero Ischemic Robotic-assisted Partial Nephrectomy: An Observation Case Report Study. Medicine (Baltimore) 2016; 95:e2349. [PMID: 26817867 PMCID: PMC4998241 DOI: 10.1097/md.0000000000002349] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Robot-assisted partial nephrectomy (RAPN) has gradually become a popular minimally invasive nephron-sparing surgical option for small renal tumors. Ischemic injury should be minimized because it impacts renal function outcomes following partial nephrectomy. Herein, the authors detail the technique and present initial perioperative outcomes of our novel harmonic scalpel "drilling and clamping" method to implement zero-ischemic RAPN. The authors prospectively collected baseline and perioperative data of patients who underwent zero ischemic RAPN performed by our harmonic scalpel "drilling and clamping" method. From April 2012 to December 2014, a total of 19 consecutive zero ischemic RAPN procedures were performed by a single surgeon. For 18 of the 19 patients, RAPN using our harmonic scalpel "Drilling and Clamping" method was successfully completed without the need for hilar clamping. The median tumor size was 3.4 cm (range: 1.8-6.2); operative time was 3.2 hours (range: 1.9-4.5); blood loss was 100 mL (range: 30-950); and postoperative hospital stay was 4 days (3-26). One patient required intraoperative blood transfusion. Two patients had intra or postoperative complications: 1 was converted to traditional laparotomy because of massive bleeding, whereas another had postoperative stress ulcer. Pathology confirmed renal cell carcinoma in 13 patients (63.2%), angiomyolipoma in 6 patients: (31.5%), and oncocytoma in 1 patient (5.3%). Mean pre- and postoperative serum creatinine (0.82 mg/dL and 0.85 mg/dL, respectively), estimated glomerular filtration rate (84.12 and 82.18, respectively), and hemoglobin (13.27 g/dL and 12.71 g/dL, respectively) were comparable. The authors present a novel zero-ischemic technique for RAPN. They believe that this technique is feasible and reproducible.
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Affiliation(s)
- Chen-Pang Hou
- From the Department of Urology, Chang Gung Memorial Hospital at Linkou (K-HT, P-LC); School of Medicine, Chang Gung University (K-H T, P-LC, C-PH, Y-HL, Y-CH, C-LC); Kwei-Shan, Tao-Yuan, Taiwan
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Hou CP, Chang PL, Chen CL, Lin YH, Chih-Yuan C, Tsui KH. Identifying the variables associated with pain during transrectal ultrasonography of the prostate. Urological Science 2015. [DOI: 10.1016/j.urols.2015.06.173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Lin CT, Hou CP, Lin YH, Tsui KH, Chang PL, Chen CL. Acute urinary retention in a man with prostate cancer still eligible for transurethral resection of prostate. Urological Science 2015. [DOI: 10.1016/j.urols.2015.06.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Yang PS, Lin YH, Hou CP, Hsu YC, Chen CL, Tsui KH, Chang PL. Less Pain Perceived in Transrectal ultrasound of Prostate using Micro-convex Transducer than Bi-planed linear Transducer. Urological Science 2015. [DOI: 10.1016/j.urols.2015.06.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Hou CP, Lin YH, Hsieh MC, Chen CL, Chang PL, Huang YC, Tsui KH. Identifying the variables associated with pain during transrectal ultrasonography of the prostate. Patient Prefer Adherence 2015; 9:1207-12. [PMID: 26347225 PMCID: PMC4556256 DOI: 10.2147/ppa.s83073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE The purpose of this study was to prospectively investigate the degree of pain experienced by the patients receiving transrectal ultrasonography (TRUS) of the prostate by applying a visual analog scale. We also identified the clinical parameters influencing pain during the TRUS examination. MATERIALS AND METHODS Records were obtained from a prospective database for male patients who received TRUS of prostate in the outpatient department of Chang Gung Memorial Hospital, Taiwan, from January 2014 to June 2014. The patients underwent a detailed physical examination and medical history review. Immediately after the TRUS examination, the patients completed questionnaires based on a ten-point visual analog pain scale. The variables of interest were age, body mass index, prostate volume, prostate sagittal length, prostate-specific antigen, previous TRUS experience, external hemorrhoids, anal surgical history, prostate calcification, and image artifact caused by stool in the rectum. All variables were correlated to the visual analog scale by applying multivariate regression analysis. RESULTS By using linear regression analysis, we identified the independent factors that affected the pain score during the TRUS examination. The patients who received the examination for the first time or had longer prostate sagittal lengths, external hemorrhoids, anal surgical history, or stool stored in the rectum experienced more pain during the TRUS examination. Furthermore, the pain was reduced when we provided the patients with a detailed explanation before the procedure and allowed them to observe the real-time images during the examination. CONCLUSION Although a TRUS examination is uncomfortable for patients, after having identified the factors affecting pain, physicians can assist patients in reducing pain during the procedure, thus providing higher quality examinations.
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Affiliation(s)
- Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Kwei-Shan, Tao-Yuan, Taiwan
- School of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan
| | - Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Kwei-Shan, Tao-Yuan, Taiwan
- School of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan
| | - Meng-Chiao Hsieh
- Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital at Chiayi, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan
| | - Chien-Lun Chen
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Kwei-Shan, Tao-Yuan, Taiwan
- School of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan
| | - Phei-Lang Chang
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Kwei-Shan, Tao-Yuan, Taiwan
- School of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan
| | - Ying-Chen Huang
- School of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan
| | - Ke-Hung Tsui
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Kwei-Shan, Tao-Yuan, Taiwan
- School of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan
- Correspondence: Ke-Hung Tsui, Department of Urology, Chang Gung Memorial Hospital at Linkou, Chang Gung University, 5 Fu-Shing Street, Kwei-Shan, Tao-Yuan 333, Taiwan, Tel +886 3 328 1200 Extension 2137, Fax +886 2 2735 8775, Email
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Shao IH, Lin YH, Hou CP, Juang HH, Chen CL, Chang PL, Tsui KH. Risk factors associated with ineligibility of adjuvant cisplatin-based chemotherapy after nephroureterectomy. Drug Des Devel Ther 2014; 8:1985-90. [PMID: 25364228 PMCID: PMC4211848 DOI: 10.2147/dddt.s72197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE Radical nephroureterectomy (RNU) is a standard treatment for upper urinary tract urothelial carcinoma. However, RNU can result in decreased renal function and cannot be treated with adjuvant chemotherapy. We performed a risk group stratification analysis to determine the preoperative factors that are predictive of diminished renal function after RNU. MATERIALS AND METHODS We retrospectively evaluated the medical records of all patients who underwent nephroureterectomy for upper urinary tract urothelial carcinoma at the Chang Gung Memorial Hospital from 2001 to 2008. We analyzed the association between perioperative glomerular filtration rate and preoperative parameters including cancer characteristics, serum creatinine level, and kidney size measured on computed tomographic images. RESULTS A total of 242 patients fulfilled the inclusion criteria. The average decrease in renal function 1 month after RNU was 19.7%. Using 60 mL/min/1.73 m(2) as the eligibility cutoff for cisplatin-based chemotherapy, 42.1% of the population was eligible prior to nephroureterectomy, whereas following surgery only 15.2% remained eligible. Using a cutoff of 45 mL/min/1.73 m(2), 59.9% of the cohort was eligible for fractionated cisplatin dosing preoperatively, whereas only 32.6% remained above the cutoff postoperatively. The most significant predictors of poor postoperative renal function were body mass index >25 kg/m(2), age >65 years, contralateral kidney length less than 10 cm, and absence of ipsilateral hydronephrosis. CONCLUSION Our results suggest that older age, higher body mass index, smaller contralateral renal length, and absence of ipsilateral hydronephrosis are predictive of decreased renal function after RNU.
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Affiliation(s)
- I-Hung Shao
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taiwan, Republic of China ; Department of Urology, Lotung Poh-Ai Hospital, Chang Gung University, Taiwan, Republic of China
| | - Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taiwan, Republic of China
| | - Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taiwan, Republic of China
| | - Horng-Heng Juang
- Department of Anatomy, Chang Gung University, Taiwan, Republic of China ; Bioinformation Center, Chang Gung Memory Hospital, Kwei-Shan, Tao-Yuan, Taiwan, Republic of China
| | - Chien-Lun Chen
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taiwan, Republic of China
| | - Phei-Lang Chang
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taiwan, Republic of China ; Bioinformation Center, Chang Gung Memory Hospital, Kwei-Shan, Tao-Yuan, Taiwan, Republic of China
| | - Ke-Hung Tsui
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taiwan, Republic of China ; Bioinformation Center, Chang Gung Memory Hospital, Kwei-Shan, Tao-Yuan, Taiwan, Republic of China
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Hou CP, Chen CL, Lin YH, Tsai YL, Chang PL, Juang HH, Tsui KH. Prostatic urethral angle might be a predictor of treatment efficacy of α-blockers in men with lower urinary tract symptoms. Drug Des Devel Ther 2014; 8:937-43. [PMID: 25075177 PMCID: PMC4106922 DOI: 10.2147/dddt.s62428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Purpose We investigated the association of the prostatic urethral angle (PUA) with peak urinary flow rate (Qmax) and the severity of lower urinary tract symptoms (LUTS) on the aging male. We also evaluated the effect of the PUA on the treatment efficacy of tamsulosin on men with LUTS. Materials and methods The records were obtained from a prospective database for first-visit male patients with LUTS in the outpatient department of our institution. These patients underwent a detailed physical examination and taking of medical history. A transrectal ultrasound was performed on these patients. The prostate size, length of intravesical prostatic protrusion (IPP), PUA, and International Prostate Symptom Score (IPSS) of the patients were evaluated. Uroflowmetry and a bladder scan for residual urine were also performed on every patient. Tamsulosin 0.2 mg per day was prescribed. The IPSS and uroflowmetry were reevaluated after they had received treatment for 3 months. Results A total of 178 patients were included, and 149 of them completed this cohort study. The mean PUA was 48.32°±13.74°. The mean prostate volume was 39.19±20.87 mL, and the mean IPP was 5.67±7.85 mm. On multivariate linear regression analysis, the PUA was independently associated with the IPSS (P<0.001), Qmax (P=0.004), post-treatment IPSS change (P=0.032), and post-treatment Qmax change (P<0.001). However, the prostate volume and IPP were not associated with these clinical items. Conclusion The PUA is significantly associated with Qmax and IPSS in men with LUTS. The PUA is also inversely correlated with changes in Qmax and IPSS after tamsulosin treatment. Namely, the PUA might be a predictor for the treatment efficacy of α-blockers in aging men with LUTS.
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Affiliation(s)
- Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Chien-Lun Chen
- Department of Urology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Yu-Lun Tsai
- Department of Urology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Phei-Lang Chang
- Department of Urology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Horng-Heng Juang
- Department of Anatomy, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Ke-Hung Tsui
- Department of Urology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
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Lee WC, Lin YH, Hou CP, Chang PL, Chen CL, Juang HH, Tsui KH. Prostatectomy using different lasers for the treatment of benign prostate hyperplasia in aging males. Clin Interv Aging 2013; 8:1483-8. [PMID: 24255595 PMCID: PMC3832386 DOI: 10.2147/cia.s52697] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose Endoscopic lasers have become a treatment option for benign prostate hyperplasia (BPH). The study reported here sought to elucidate the benefits and drawbacks of different laser systems in the treatment of patients with BPH. Methods The study enrolled 741 patients diagnosed with lower urinary tract symptoms secondary to BPH during the period January 2005 to December 2011. The techniques used in the study were photoselective vaporization of the prostate, thulium laser prostatectomy, and diode laser prostatectomy. Patients were assigned to one of three groups according to the type of laser treatment they received. Outcomes were evaluated using the International Prostate Symptom Score (IPSS), quality of life, maximal urinary flow rate, post-voiding residual urine volume, and prostate-specific antigen (PSA) level. Results The baseline characteristics of patients who received diode laser prostatectomy show a significant elevated risk and high American Society of Anesthesiology score (P=0.001). Operative time and catheter removal time differed significantly between the three groups (P=0.001). No cases were converted to transurethral resection of the prostate intraoperatively due to bleeding (P=0.142). Among the three groups, there were no significant differences in maximal flow rate, lower post-void residual urine, and postoperative PSA level during the entire follow-up period (P<0.05). Further, no significant differences in postoperative IPSS, quality of life, or bladder neck contracture (P=0.23) were observed. However, a significant difference was observed with regard to prolonged use of Foley catheters and prolonged hospital stay among patients in the diode laser group (P=0.001). Conclusion Laser prostatectomies are effective in dealing with lower urinary tract symptoms. Early subjective functional results (maximal flow rate, IPSS, and post-void residual urine) appeared the same as those obtained following laser prostatectomy. Thus, it appears that lasers are safe and effective as long as the patients are carefully selected for treatment.
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Affiliation(s)
- Wei-Chang Lee
- Department of Urology, Chang Gung Memorial Hospital-Linko and Chang Gung University, College of Medicine, Taiwan
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Abstract
Purpose Primary small cell carcinoma of the urinary bladder is a rare malignant disease. It accounts for less than 1% of all urinary bladder carcinomas. The purpose of this study is to review the clinical features, the treatment modalities, and the overall survival of these patients. We also compare the clinical outcomes between patients of bladder small cell carcinoma (SCC) and bladder urothelial carcinoma (UC). Materials and methods We reviewed the charts of patients with bladder tumors from January 1995 to December 2012 in the Chang Gung Memorial Hospital. A total of 2421 malignant bladder tumor patients were reviewed and there were 18 patients who were diagnosed with primary bladder SCC. The patients’ characteristics, including age, gender, smoking history, presented symptoms, tumor size, locations, clinical stages, treatment modalities, pathology appearance, recurrence conditions, and survival conditions were all recorded. We also compared the clinical outcomes and the overall survival rates between patients with bladder SCC and those with UC. Results Bladder SCC accounted for about 0.74% of all bladder malignancies in our institution. The mean age at diagnosis was 70.67 years, and the male-to-female ratio was 2.6:1. Thirteen patients had a history of cigarette smoking. All patients presented with symptoms of gross hematuria, and three of them had bladder tamponade requiring blood clot evacuation by cystoscopy. Only one patient had T1 disease, ten patients had stage III disease, and seven patients had lymph node or distant metastasis (stage IV disease). The mean tumor size was 4.29 cm in diameter. For the majority (61.11%) of patients, SCC coexisted with UC components. The average survival time was 10.92 months. Patients with bladder SCC had worse overall survival rates than those of stage III and stage IV bladder UC. Performing radical cystectomy does not significantly improve their overall survival rates. None of the clinicopathologic parameters, including the presence of coexisting nonsmall cell carcinoma component (P = 0.831), receiving radical cystectomy (P = 0.194), distant metastasis (P = 0.062), and gender (P = 0.564), were significantly associated with survival. Conclusion SCC of the urinary bladder is a rare condition, and standard treatment outlines have not been well established. Most of the presented cases have a very poor prognosis. Prospective, multi-institutional, randomized studies are required to assess better treatment modalities. To the best of our knowledge, this is the largest reported case analysis of primary bladder SCC in a Taiwanese population.
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Affiliation(s)
- Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital-Linko, Taiwan, Republic of China ; College of Medicine, Chang Gung University, Taiwan, Republic of China
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Hou CP, Chen TY, Chang CC, Lin YH, Chang PL, Chen CL, Hsu YC, Tsui KH. Use of the SF-36 quality of life scale to assess the effect of pelvic floor muscle exercise on aging males who received transurethral prostate surgery. Clin Interv Aging 2013; 8:667-73. [PMID: 23766642 PMCID: PMC3679969 DOI: 10.2147/cia.s44321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose We used the Short Form (SF)-36® Health Survey scale to assess the effect of pelvic floor muscle exercise (PFE) on aging males who received transurethral resection of the prostate (TUR-P). Methods From April 2010 to December 2010, a total of 66 patients who underwent TUR-P were enrolled in this study. They were randomized into two groups (with 33 patients in each group) – an experimental group who performed postoperative PFE every day and a control group. Data, including the International Prostate Symptom Score (IPSS), uroflowmetry study, and the SF-36 quality of life measure, were collected before the operation, and at 1, 4, 8, and 12 weeks after the operation. We analyzed the differences between the two groups with respect to their IPSS scores, maximal urinary flow rate, residual urine amount, and life quality. Results A total of 61 patients (experimental group: 32 patients, and control group: 29 patients) completed this study. We found that at 12 weeks postop, patients who performed PFE every day had a better maximal urinary flow rate (16.41 ± 6.20 vs 12.41 ± 7.28 mL/min) (P = 0.026) compared with patients in the control group. The experimental group had a much greater decrease in IPSS score (P < 0.001). As for the SF-36 scale, the experimental group had higher scores than did the control group on both the physiological domain (54.86 vs 49.86) (P = 0.029) and the psychological domain (61.88 vs 52.69) (P = 0.005). However, there were no significant differences with respect to the postvoiding residual urine between the two groups (57.24 ± 52.95 vs 64.68 ± 50.63 mL) (P = 0.618). Conclusion Compared with the control group, patients who performed PFE for 12 weeks after TUR-P showed improvement in their maximal urinary flow rate and lower urinary tract symptoms, and had a better quality of life. The immediate initiation of PFE is suggested for patients who undergo TUR-P.
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Affiliation(s)
- Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital Linko, Chang Gung University, Taiwan, Republic of China
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Shao IH, Hou CP, Chen SM, Chen CL, Lin YH, Chang PL, Tsui KH. The safety and efficacy of aspirin intake in photoselective vaporization laser treatment of benign prostate hyperplasia. Clin Interv Aging 2013; 8:265-9. [PMID: 23662050 PMCID: PMC3646392 DOI: 10.2147/cia.s41270] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Indexed: 12/04/2022] Open
Abstract
Endoscopic surgical treatment has become an option to treat benign prostate hyperplasia. We
evaluated the safety and effectiveness of photoselective vaporization of the prostate (PVP) in
patients. We evaluated preoperative and perioperative parameters, functional outcomes, and adverse
events up to 12 months postoperatively of patients on oral anticoagulation therapy undergoing PVP,
and compared the results with patients who did not take anticoagulation therapy. A total of 89
patients who received photoselective vaporization laser for benign prostate hyperplasia from May
2006 to February 2011 in our hospital were enrolled in our study. The patients were divided into two
groups based on whether or not they were taking oral aspirin; 23 (25.8%) patients were
taking aspirin derivatives (aspirin group), and 66 (74.2%) were not taking aspirin
derivatives (control group). The mean prostate volume (58.8 mL vs 51 mL; P
= 0.16) and mean energy consumption (235,268 J vs 289,793 J; P =
0.097) were comparable between the aspirin group and control group. The average postoperative
results of hemoglobin were 13.4 mg/ dL for the aspirin group versus 13.9 mg/dL for the control group
(P = 0.327). A significantly higher maximum flow rates and 80%
improved post-void residual urine were noted during the followup. Postoperatively all variable
showed significant improvement starting at month 1 of followup and remained improved for the 12
month followup. Postoperative complications were low and comparable between groups. PVP was
characterized by excellent hemostatic properties and a very low intraoperative complication rate,
even in the patients who were taking aspirin. On the basis of our perioperative results, we
recommend PVP as a safe and effective procedure for patients with symptomatic benign prostate
hyperplasia when taking an aspirin derivative.
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Affiliation(s)
- I-Hung Shao
- Department of Urology, Chang Gung Memorial Hospital-Linko and Chang Gung University College of Medicine, Taiwan, Republic of China
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Hou CP, Chang PL, Chen CL, Lin YH, Tsui KH. Does adequate bladder cuff excision impact outcomes in patients undergoing nephroureterectomy for upper tract urothelial carcinoma. Chang Gung Med J 2011; 34:496-505. [PMID: 22035894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Nephroureterectomy with bladder cuff excision has been the gold standard surgical treatment for upper tract urothelial carcinoma. In this study, we determined the independent prognostic factors for upper tract urothelial carcinoma. METHODS The records of 285 consecutive patients undergoing nephroureterectomy with bladder cuff excision at our institution between 2003 and 2007 were reviewed. Kaplan-Meier survival curves were used to determine the 5-year cancer-specific survival rates for all patient groups. Cox proportional hazard regression was performed to determine the factors that had an independent impact on the survival of patients with upper tract urothelial carcinoma. RESULTS A total of 192 patients matching the inclusion criteria were enrolled in our study. The mean follow-up time was 43.81 months. We found that the female gender, a lower ureter free of invasion, and an adequate bladder cuff excision were independent factors for a better tumor recurrence-free survival rate. The pathology stage and recurrence (none, intravesical or extravesical) were independent factors for the overall survival rate. A non-adequate ureterectomy including the bladder cuff was associated with a high body mass index (BMI) and the infiltrating tumor pattern of urothelial carcinoma. CONCLUSION Nnephroureterectomy together with adequate bladder cuff excision plays an extremely important role in the surgical treatment of upper urinary tract urothelial carcinoma. Patients with incomplete resections of the bladder cuff are at increased risk of tumor recurrence.
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Affiliation(s)
- Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
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Hou CP, Chiang YJ, Chu SH, Ng KF, Wang HH. Mixed epithelial and stromal tumor of the kidney--a case report. Chang Gung Med J 2010; 33:693-698. [PMID: 21199615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A 45-year-old woman had gross hematuria without flank pain for two weeks. She visited our hospital and a renal echo showed a heterogenous mass on the left kidney. Abdominal computed tomography showed a multicystic tumor, about 7 cm, on the left renal pelvis and the proximal ureter. The tumor was enhanced after contrast injection. Ureteroscopy showed an intraluminal polypoid tumor. Cystic renal cell carcinoma or urothelial carcinoma was suspected preoperatively. We performed a hand-assisted laparoscopic nephroureterectomy, and the post-operative course was uneventful. The pathology report demonstrated that the tumor was composed of an admixture of stroma and flattened to cuboidal urothelium. The tumor stromal cells expressed both estrogen and progesterone receptors, and no malignant cells were found. There has been no recurrence or deterioration of the patient's renal function since surgery. We suggest keeping in mind the diagnosis of mixed epithelial and stromal tumor of the kidney when encountering perimenopausal women with renal cystic tumors.
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Affiliation(s)
- Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC
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