Baojun Gu

Improving voiding efficiency in the diabetic rat by a 5-HT1A serotonin receptor agonist†‡

Serotonin affects micturition in the normal rat through actions not only on ascending and descending spinal pathways and supraspinal centers but also on the lumbosacral spinal cord level. The selective 5‐HT1A receptor agonist, 8‐OH‐DPAT((R)‐(+)‐8‐hydroxy‐2‐(di‐n‐propylamino) tetralin), reversed detrusor‐sphincter dyssynergia (DSD) in the spinal cord injury (SCI) rat. Rats with experimental diabetes mellitus (DM) have been shown to have both bladder and urethral dysfunction during reflex voiding. We therefore examined the effects of 8‐OH‐DPAT on micturition in DM rats.

The RevoLix 2 Micron Continuous Wave Laser Vaporesection for the Treatment of High-Risk Patients with Benign Prostatic Hyperplasia

OBJECTIVE To evaluate the safety and efficacy of the RevoLix 70W 2 micron continuous wave laser vaporesection in the treatment of high-risk patients with benign prostatic hyperplasia (BPH). BACKGROUND DATA Forty-six high-risk patients (mean age, 82.6 y old) with BPH underwent 2-μm continuous wave laser vaporesection. MATERIALS AND METHODS The operative time, drop in hemoglobin, drop in serum sodium, indwelling catheterization time, operative complications, international prostatic symptom scores (IPSS), quality of life (QoL), urinary flow rate (Qmax), and post voiding residual urine volume (PVR) were observed. RESULTS All 46 patients recovered without incident. The mean operative time was 68 ± 16.3 min. Occasional venous hemorrhage occurred during the operation, but no arterial hemorrhage was observed. Hemoglobin decreased from preoperative 15.0 g/dL to postoperative 14.3 g/dL, serum sodium decreased from preoperative 142.4 mmol/L to postoperative 141.6 mmol/L. IPSS decreased from preoperative 22 ± 6.2 to postoperative 9 ± 3.3, QoL scores decreased from 5.1 ± 0.7 to 2.1 ± 0.7, Qmax increased from 8.4 ± 5.2 to 21.2 ± 12.3 mL/sec, PVR decreased from 94.2 ± 60.2 to 21.6 ± 6.4 mL. The parameters were significantly different between pre- and postoperative results. CONCLUSIONS The RevoLix 70W 2-μm continuous wave laser vaporesection is safe and effective in the treatment of high-risk patients with BPH.

Urethral Cystoscopic Realignment and Early End-to-End Anastomosis Develop Different Influence on Erectile Function in Patients with Ruptured Bulbous Urethra

The objective of this study is to compare the influence on erectile function between urethral cystoscopic realignment and early end-to-end anastomosis treating ruptured bulbous urethra. 58 cases were selected, 32 had urethral cystoscopic realignment (group I) and 26 cases had urethral end-to-end anastomosis (group II). The parameters of P-CDU (Penile Color Duplex Ultrasound), NPT (Nocturnal Penile Tumescence), and IIEF-5 (International Index of Erectile Function) were compared between the two groups 6 months after operation. Group I was higher than group II in IIEF (21 vs 14) with significant differences. With P-CDU we observed an improvement in penile vascularization in group I as confirmed by the detection of an increase in peak systolic velocity (PSV) (26 cm/s vs 16 cm/s, p < 0.01) and a decrease in end diastolic velocity (EDV) (3 cm/s vs 6 cm/s p < 0.05), resulting in an increase in resistive index (RI) (0.85 vs 0.56, p < 0.05). The parameters of NPT showed a significant increase compared to group II (p < 0.01) in satisfactory erection number (5 vs 1.5), maximum rigidity (80% vs 42%), and total time that the increase in circumference was greater than 30% of baseline during sleep (100 sec vs 30 sec). Urethral cystoscopic realignment treating ruptured bulbous urethra can reduce the incidence of erectile dysfunction [ED]. A long term follow-up should be studied.

Serotonin (5-HT)2A/2C receptor agonist (2,5-dimethoxy-4-idophenyl)-2-aminopropane hydrochloride (DOI) improves voiding efficiency in the diabetic rat.

To examine the effects of the serotonin (5‐HT)2A/2C receptor agonist (2,5‐dimethoxy‐4‐idophenyl)‐2‐aminopropane hydrochloride (DOI) on micturition in rats with diabetes mellitus (DM).

Chronic spinal cord injury causes up-regulation of serotonin (5-HT) 2A and 2C receptors in lumbosacral cord motoneurons

To investigate whether the voiding dysfunction caused by spinal cord injury (SCI) in rats can be improved by i.v. administration of the serotonin (5‐HT)2A/2C receptor agonist 2,5‐dimethoxy‐4‐iodophenyl‐2‐aminopropanehydrochloride (DOI), and to discuss whether the mechanism can be ascribed to 5‐HT2A and 5‐HT 2C receptor upregulation in lumbosacral cord motoneurons.

Efficacy of different spinal nerve roots for neuromodulation of micturition reflex in rats

Electrical stimulation of peripheral nerves controlling the bladder is an alternative, nondestructive medical treatment for urinary incontinence and retention. In this study, we aimed to identify the most efficient sensory and motor spinal nerve roots involved in the micturition reflex. Unilateral L5-S2 dorsal and ventral roots were electrically stimulated, and bladder reflex contractions were recorded under isovolumetric conditions. Repeated stimulation of the L6 and S1 dorsal roots not only abolished bladder reflex contractions but also induced a poststimulation inhibitory effect, whereas repeated stimulation of the L5 and S2 dorsal roots had no effect. Only the L6 ventral root directly caused bladder contraction when ventral roots L5-S2 were stimulated in sequence. Upon retrograde tracing using pseudorabies virus (PRV), the sacral parasympathetic nucleus of the L6 segment had more PRV-positive cells than the other segments, though the S1 segment of the dorsal root ganglia had the highest density of PRV-positive neurons. These results suggest the L6 ventral root is most efficient in producing detrusor muscle contraction, and the S1 dorsal root best inhibits the micturition reflex.

Is repeat Botulinum Toxin A injection valuable for neurogenic detrusor overactivity—A systematic review and meta-analysis

To investigate the value of repeat botulinum toxin A (BTX‐A) injections in patients with neurogenic detrusor overactivity (NDO).

Effect of 5-HT2A receptor antagonist ketanserin on micturition in male rats

OBJECTIVES This study aimed to investigate the effects of ketanserin on micturition mediated via the 5-HT2A receptor in the motoneuron nucleus of the Lumbosacral cord, as reflected in high frequency oscillations (HFOs) of intravesical pressure and the external urethral sphincter electromyogram (EUS-EMG) in anesthetized male rats. METHODS：: Male Sprague-Dawley rats were used. Cystometry and EUS-EMG were performed in all rats under urethane anesthesia to examine the variations after successive intrathecal (i.t.) administration of various doses of ketanserin into the lumbosacral cord. Immunofluorescence staining and Western blotting were made to observe the distribution of 5-HT2 A and -2C receptors in the lumbosacral cord motor neurons. RESULTS Compared to the controls, ketanserin-treated rats showed a declined trend of dose-dependent manner in the HFOs, in accordance with the variation of EUS-EMG, while decreased micturition volume, voiding efficiency, and increased post-void residual volume was only observed at the dose of 0.1 mg/kg. The effects of ketanserin on the HFO and EUS-EMG activity were partially or completely reversed by the 5-HT2A/2C receptor agonist, DOI. Meanwhile, immunofluorescence staining and Western blot analysis showed that immunoreactivity of 5-HT2A receptor was higher than that of 5-HT2C, labeling in the lumbosacral cord motoneurons. CONCLUSIONS The intrathecally administrated 5-HT2A receptor antagonist ketanserin can weaken the EUS bursting activity, decrease HFOs, and reduce voiding efficiency as dose dependently. The effects of ketanserin on micturition may be mainly mediated via the 5-HT2A receptors in the motoneuron nucleus of the lumbosacral cord.

The serotonin (5-hydroxytryptamine) 5-HT7 receptor is up-regulated in Onuf's nucleus in rats with chronic spinal cord injury

To examine the effect of intrathecal (i.t.) serotonin (5‐hydroxytryptamine) 5‐HT7 agonist administration on voiding function in the urethane‐anesthetised rat, and the change in 5‐HT7 receptor (5‐HT7R) expression in the lumbosacral cord Onufs nucleus after spinal cord injury (SCI).

The Characteristics of the Transitional Zone in Prostate Growth With Age

OBJECTIVE To investigate the age-related growth variation in prostatic parameters by transrectal ultrasound with a simultaneous evaluation of the transitional zone measurements in different prostate volumes. METHODS A retrospective study of 2001 subjects derived from the outpatient clinic at our institution (Shanghai Jiao Tong University Affiliated Sixth Peoples Hospital in Shanghai) who were diagnosed with benign prostatic hyperplasia (BPH) and prostatitis was reviewed. All subjects were evaluated by the International Prostatic Symptom Score and transrectal ultrasound of the prostate. Statistical analysis was conducted between prostatic parameters and age. RESULTS The prostate volume, index, length, and width of transitional zone were the parameters most closely associated with increasing age. Notably, the transitional zone measurements showed a significant difference among individuals greater than 50 years old. Moreover, the fastest increasing rate of prostatic parameters was found to be between the ages of 50 and 69. Additionally, we also discovered that the difference between transitional zone parameters and different prostate volumes varies along with increasing age. CONCLUSION These results suggest that transitional zone growth is the main contributor to total prostate growth, especially at the ages of 50-69, which may elucidate the higher incidence of the lower urinary tract symptoms from BPH. In view of the increasing rate of transitional zone and the level of total prostate volume, further research is needed to identify the underlying mechanism for such differences in prostate growth.