Danfeng Xu

Holmium Laser Enucleation of the Prostate Versus Transurethral Resection of the Prostate: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

OBJECTIVES To evaluate the efficacy and safety of holmium laser enucleation of the prostate (HoLEP) versus transurethral resection of the prostate (TURP) for relief of bladder outlet obstruction (BOO) on benign prostatic hyperplasia (BPH). METHODS A systematic literature search for randomized controlled trials (RCTs) comparing HoLEP and TURP in several databases from 1996 to 2011 were performed. Meta-analysis was conducted with the Review Manager Software. RESULTS Of 248 potential citations, 6 RCTs were included into our meta-analysis. There was no significant difference between the two groups in the maximum urinary flow rate (Qmax) and international prostate symptom score (IPSS) at 1 month (p=0.41 and p=0.87) or 6 months (p=0.07 and p=0.37) after treatment. However, at 12 months postoperatively, the Qmax and IPSS in the HoLEP group were significantly better than those in the TURP group (p<0.0001 and p=0.01). The results also suggested a benefit of HoLEP over TURP in blood loss (p=0.001), catheterization time (p<0.0001), hospital stay (p=0.001), and blood transfusion rate (p=0.04), while the results favored TURP over HoLEP for operative time (p=0.001) and the incidence of postoperative dysuria (p=0.003). CONCLUSIONS Comparing with TURP, HoLEP showed slightly better postoperative results in Qmax and IPSS during 12-month follow-up, as well as significantly better perioperative results and similarly low complication rates. However, the operative time and the incidence of postoperative dysuria favor TURP. Generally, HoLEP is a promising minimal invasive alternative to TURP for treatment of BPH.

Photoselective vaporization with the green light laser vs transurethral resection of the prostate for treating benign prostate hyperplasia: a systematic review and meta-analysis: PVP vs TURP for treating BPH

Despite high morbidities, TURP is still considered as the ‘gold standard’ for treatment of BPH. Photoselective vaporization of the prostate (PVP) is a promising technique that is emerging as a possible alternative to TURP. However, there remains some debate about the advantages of PVP over TURP and whether PVP will be able to replace TURP as the first‐line surgical treatment. We conducted a meta‐analysis of recent papers on this subject and herein provide the overall efficacy and safety of PVP for treatment of BPH.

MicroRNA-185 suppresses proliferation, invasion, migration, and tumorigenicity of human prostate cancer cells through targeting androgen receptor

Previous studies have shown that androgen receptor (AR) is involved in the progression of prostate cancer (CaP) by several mechanisms. However, how AR is regulated has not been fully understood. In this study, miR-185 was found to be down-regulated in clinical CaP samples. Targets prediction revealed that AR had putative complementary sequences to miR-185, which was confirmed by the following dual luciferase reporter assay. Overexpression of miR-185 could reduce the expression of AR protein but not mRNA in LNCaP cells. The proliferation of LNCaP cells was inhibited by overexpression of miR-185. Cell cycle analysis revealed cell cycle arrest at G0/G1 phase. The invasive and migration abilities of cells could also be suppressed by miR-185. Furthermore, miR-185 inhibited tumorigenicity in a CaP xenografts model. CDC6, one target of AR and an important regulatory molecule for cell cycle, was found to be down-regulated by overexpression of miR-185. Our findings suggest that miR-185 could function as a tumor-suppressor gene in CaP by directly targeting AR, and act as a potential therapeutic target for CaP.

Overexpression of transforming growth factor β1 in malignant prostate cells is partly caused by a runaway of TGF-β1 Auto-induction mediated through a defective recruitment of protein phosphatase 2A by TGF-β type i receptor

OBJECTIVES To elucidate the mechanism of transforming growth factor (TGF)-β1 overexpression in prostate cancer cells. METHODS Malignant (PC3, DU145) and benign (RWPE1, BPH1) prostate epithelial cells were used. Phosphatase activity was measured using a commercial kit. Recruitment of the regulatory subunit, Bα, of protein phosphatase 2A (PP2A-Bα) by TGF-β type I receptor (TβRI) was monitored by coimmunoprecipitation. Blockade of TGF-β1 signaling in cells was accomplished either by using TGF-β-neutralizing monoclonal antibody or by transduction of a dominant negative TGF-β type II receptor retroviral vector. RESULTS Basal levels of TGF-β1 in malignant cells were significantly higher than those in benign cells. Blockade of TGF-β signaling resulted in a significant decrease in TGF-β1 expression in malignant cells, but not in benign cells. Upon TGF-β1 treatment (10 ng/mL), TGF-β1 expression was increased in malignant cells, but not in benign cells. This differential TGF-β1 auto-induction between benign and malignant cells correlated with differential activation of extracellular signal-regulated kinase (ERK). Following TGF-β1 treatment, the activity of serine/threonine phosphatase and recruitment of PP2A-Bα by TβRI increased in benign cells, but not in malignant cells. Inhibition of PP2A in benign cells resulted in an increase in ERK activation and in TGF-β1 auto-induction after TGF-β1 (10 ng/mL) treatment. CONCLUSIONS These results suggest that TGF-β1 overexpression in malignant cells is caused, at least in part, by a runaway of TGF-β1 auto-induction through ERK activation because of a defective recruitment of PP2A-Bα by TβRI.

Retroperitoneal Laparoscopic Ureteroureterostomy for Retrocaval Ureter: Report of 7 Cases

OBJECTIVES To report our techniques and experience with retroperitoneal laparoscopic ureteroureterostomy (LUUS) for retrocaval ureter. METHODS Between January 2004 and September 2008, 7 male patients underwent retroperitoneal LUUS. A 3-port, balloon-dissecting, retroperitoneal approach was used. Follow-up studies were performed with intravenous urography and renal ultrasonography. RESULTS All operations were completed laparoscopically, and no open conversions were required. The mean operating time was 128.6 minutes (range 97-189) and the mean anastomosis time was 36 minutes, for all cases. The mean blood loss was 20 mL (range 15-50). None of the patients required blood transfusion. No intraoperative complications occurred. Hydronephrosis in all patients was decreased substantially after surgery. CONCLUSIONS Our results have demonstrated that retroperitoneal LUUS is an excellent minimally invasive treatment option for a retrocaval ureter that can be accomplished reasonably quickly and safely.

Laparoscopic inferior mesenteric-gonadal vein bypass for the treatment of nutcracker syndrome

Nutcracker syndrome is a rare entity caused by extrinsic compression on the left renal vein (LRV) crossing between the superior mesenteric artery and the aorta. This article reports the treatment of two cases of nutcracker syndrome using laparoscopic inferior mesenteric-gonadal vein bypass, knowing that this treatment option would avoid renal reperfusion injury and LRV hypertension. In addition, it is easier to operate compared with laparoscopic splenorenal venous bypass and laparoscopic transposition of LRV into the inferior vena cava.

Transrectal sonoelastography in the detection of prostate cancers: a meta-analysis.

Study Type – Diagnostic (exploratory cohort)

Aquaporin 3 promotes prostate cancer cell motility and invasion via extracellular signal-regulated kinase 1/2-mediated matrix metalloproteinase-3 secretion

Aquaporins (AQPs) are known to be important in cancer progression. The present study used a cDNA microarray to demonstrate that AQP3, a member of the AQP family, was overexpressed in prostate cancer cells. In order to determine the role of AQP3 in prostate cancer, AQP3 expression was silenced by transfection with small interfering RNA, following which wound healing and invasion assays were conducted in DU‑145 and PC‑3 cells. Notably, the results showed that silencing of AQP3 suppressed prostate cancer cell motility and invasion. The possible mechanisms underlying the AQP3‑enhanced motility and invasion of prostate cancer cells was also investigated. Knockdown of AQP3 expression was shown to reduce extracellular signal‑regulated kinase 1/2 (ERK1/2) activation in DU‑145 and PC‑3 cells. Blocking the ERK pathway inhibited AQP3‑mediated motility and invasion of these cells. Finally, the results demonstrated that AQP3 upregulated matrix metalloproteinase‑3 (MMP‑3) expression and secretion in prostate cancer cells via activation of the ERK pathway. In conclusion, the present study suggests that AQP3 induces ERK1/2 activation, thereby increasing MMP‑3 expression and secretion, which in turn promotes prostate cancer cell motility and invasion. Thus, AQP3 may be considered to be a potential therapeutic target for prostate cancer.

Non-functional paraganglioma of the urinary bladder: a case report.

IntroductionParagangliomas that originate from the urinary bladder are extremely rare. In most series, bladder paragangliomas often cause micturitional attacks. Treatment modalities include transurethral resection and cystectomy (partial or total). Prognosis of bladder paraganglioma is similar to that of adrenal pheochromocytoma.Case presentationA 55-year-old Chinese woman presenting with the sole complaint of lower abdominal pain for one month was admitted to our hospital. Ultrasound and computed tomography revealed a mass on the dome of the bladder measuring 4.0 × 3.0 cm. The tumor was completed removed by laparoscopic partial cystectomy. Histological examination of the tumor indicated paraganglioma of the urinary bladder. The clinical features, diagnosis, management and pathological findings of paraganglioma of the urinary bladder are discussed.ConclusionsBladder paraganglioma should be considered as a differential diagnosis to neoplasm in the urinary bladder, although there is no characteristic symptom. Laparoscopic partial cystectomy may be the first choice in treating paraganglioma of the urinary bladder, offering several advantages such as less invasion, rapid recovery and early discharge from the hospital.

Retroperitoneal laparoscopic radical nephrectomy for renal cell carcinoma during pregnancy.

Renal cell carcinoma (RCC) during pregnancy is rare. We present a case of retroperitoneal laparoscopic radical nephrectomy for RCC in a 32-year-old pregnant female. The tumor was excised en bloc. Retroperitoneal laparoscopic radical nephrectomy appears to be a feasible and safe treatment option for RCC in pregnancy.