ObjectiveTo investigate the effect of pelvic autonomic nerve preservation (PANP) with total mesorectal excision (TME) on sexual and urinary function in male rectal cancer patients. MethodsClinical data of eightyfour patients with rectal cancer from January 2008 to October 2010 in our hospital were analyzed. According to different operative techniques, all the patients were divided into two groups: PANP+TME group (n=41) and TME group (n=43). The sexual dysfunction, urination disorder rate, and local recurrence rate after operation of patients between two groups were compared. ResultsErectile dysfunction rate of patients in TME+PANP group and TME group was 29.3% (12/41) and 76.7% (33/43), ejaculation disorder rate was 26.8% (11/41) and 79.1% (34/43), and urination dysfunction rate was 24.4% (10/41) and 79.1% (34/43), respectively. The rate of sexual and urinary dysfunction of patients in TME+PANP group was significantly lower than that in TME group (Plt;0.05). Local recurrence rate of patients in TME+PANP group (9.8%, 4/41) was similar to that in TME group (11.6%, 5/43)， Pgt;0.05. ConclusionPANP based on TME can reduce effectively the rate of sexual and urinary dysfunction in male rectal cancer patients, which does not increase the local recurrence rate after operation.
Objective To systematically review the effect of bariatric surgery for male’s erectile function. Methods We electronically searched databases including PubMed, EMbase, The Cochrane Library (Issue 5, 2016), CNKI, VIP and WanFang Data from inception to May 30th 2016, to collect randomized controlled trials and before-after studies about bariatric surgery therapies for erectile function in obese male. Two reviewers independently screened literature, extracted data, and assessed the methodological quality of included studies. Then RevMan 5.3 software was used for meta-analysis. Results A total of 7 before-after studies involving 270 patients were included. The results of meta-analysis showed that: compared with before treatment, bariatric surgery could significantly improve 1-year erectile function score (MD=5.05, 95%CI 3.52 to 6.59, P < 0.000?01), 1-year sexual desire score (MD=0.99, 95%CI 0.47 to 1.51, P=0.000?2), 1-year contact satisfaction score (MD=2.70, 95%CI 0.21 to 5.19, P=0.004) and 1-year total satisfaction score (MD=1.68, 95%CI 0.27 to 3.09, P=0.002), but there was no significant difference in orgasm function score (MD= –0.21, 95%CI –0.74 to 0.33, P=0.45) between before and after treatment. Conclusion Bariatric surgery is effective in improving the erectile function, sexual desire and sexual satisfaction in morbidly obese male. Due to the limited quality and quantity of the included studies, the above conclusion needs to be verified by more large-scale high-quality studies.
Mitral regurgitation is one of the most common valvular heart diseases, with functional mitral regurgitation being the predominant type. Ventricular functional mitral regurgitation (VFMR) occurs due to impaired left ventricular systolic function combined with left ventricular dilation, leading to mitral annular enlargement and papillary muscle displacement, which cause relative tethering of the mitral leaflets despite structurally normal valve apparatus. Patients with VFMR often present with severe heart failure, face high surgical risks, and have a poor prognosis. In recent years, mitral valve transcatheter edge-to-edge repair (TEER) has emerged as a well-established interventional technique, offering a new treatment option for VFMR patients and significantly improving clinical outcomes. This review focuses on the advances in the pathogenesis, epidemiological characteristics, diagnosis, and management of VFMR, particularly the application and efficacy-influencing factors of TEER.
Objective To study the relationship between autonomic nerve preservation and sexual and urinary functions after total mesorectal excision in patients with cancer of the lower rectum, and to explore improved nursing methods for these patients. Methods Eligible patients with cancer of the lower rectum were non-randomly assigned to either a control group (n=278)or an autonomic nerve-preserving group （n=263）. The recovery time of micturition desire, catherization time, lower urinary tract infection rate, residual urine, severity of urinary disorders and sexual disorders were observed. Results The recovery time of micturition desire, catherization time, lower urinary tract infection rate, residual urine, severity of urinary disorders and sexual disorders were lower in the autonomic nerve-preserving group than in the control group. (Plt;0.05) . Conclusion Autonomic nerve preservation radical resection leads to better maintenance of urinary and sexual functions for patients with cancer of the lower rectum. Nursing should be focused on the prevention of urinary tract complications and the rehabilitation of sexual and urinary functions.
【摘要】 目的 探討在恥骨后前列腺癌根治術中尿控功能和性功能保護的手術技巧和療效。 方法 2001年8月-2010年1月，行恥骨后前列腺癌根治術21例，其中2例經腹腔鏡。所有患者均早期控制縫扎背靜脈復合體，并妥善處理前列腺尖和尿道。21例通過保護控尿神經、尿道橫紋括約肌，保護了尿控功能；17例通過保留神經血管束技術（12例保留雙側，5例保留一側）保護性功能。 結果 手術均成功完成，無圍手術期嚴重并發癥。2周拔出尿管后，排尿通暢，無尿道狹窄。術后3、12個月內恢復尿控能力患者分別為6、13例，持續性輕-中度尿失禁2例。21例患者中，術前勃起功能正常；術中保留神經血管束17例，術后3、12個月內勃起功能恢復分別為2、8例，4例勃起功能減弱，3例不能勃起。術后病理報告均為前列腺癌，未侵及精囊、膀胱頸、雙側淋巴結陰性。后尿道切緣陽性1例。術后6、24、54個月各有1例出現生化復發。 結論 手術精細解剖并注意技巧，可有效保護尿控功能和性功能，并達到腫瘤根治的療效。【Abstract】 Objective To evaluate the surgical technique for the protection of urinary continence and erectile function in radical prostatectomy for prostate cancer and observe its clinical efficacy. Methods Twenty-one patients with prostate cancer had undergone radical prostatectomy during August 2001 to January 2010, in which two patients were operated through extraperitoneal laparoscope. Dorsal vein complex was sewed and ligated at early stage of surgery and prostate apex along with urethra were appropriately handled in all patients. By a serial measures consisting of protection for continence nerve and striated urethral sphincter, the function of urinary continence was managed to be spared in twenty-one patients, erectile function was managed to be spared through reservation of neurovascular bundle in seventeen patients (Bilateral neurovascular bundles were reserved in twelve patients, unilateral neurovascular bundle was reserved in five patients). Results All surgeries were successful without severe perioperative complications. The catheters were removed fourteen days after surgery in all patients, and it was observed that micturition was fluent in twenty-one patients. Functional recovery of urinary continence occurred within three months after surgery in six patients and twleve months in thirteen patients, continuous mild-moderate incontinece occurred in two patients. Erectile function was normal before surgery and neurovascular bundle was reserved during surgery in seventeen patients. The recovery of erectile function occurred within three months after surgery in two patients and twelve months in eight patients, erectile function was impaired in four patients, erectile dysfunction occurred in three patients, pathological diagnosis indicated prostate adenocarcinoma in all cases, while seminal vesicle and bladder neck were not invaded and bilateral pelvic lymph nodes were not metastasized, moreover, the pathological diagnosis of resected edge of posterior urethra was positive in one patient. One patient of bio-chemical recurrence occurred respectively within six months, twenty-four months and fifty-four months after surgery. Conclusion During radical prostatectomy for prostate cancer, delicately anatomizing and appropriate surgical technique could effectively protect erectile function and urinary continence and consequently achieve radical resection of tumor at the same time.
Objective To investigate the influence of Lamotrigine (LTG) on sex hormone, seminal fluid and sexual function in male epilepsy patients. Methods The blood sex hormone levels and sperm quality were detected in 20 normal controls and 16 male epilepsy patients in Epilepsy Center of Sichuan Province People's Hospital from April 2015 to November 2016. All participants were detected before taking medicine and after being treated with LTG monotherapy for 1 year. The international index of erectile function-5 (IIEF-5) was employed to assess the sexual function in the groups above, and the results were compared. Results Compared with the control group, the total number of sperm, the rate of forward movement, survival, normal sperm and the score of IIEF-5 in the untreated group were less (P<0.05). LTG treatment group's sperm parameters and the score of IIEF-5 seemed improve, but there was no statistically significant difference (P>0.05). There was no significant difference in sexual hormones between the groups above (P>0.05). Conclusions Semen quality and the score of IIEF-5 in epileptic male decline more easily; LTG might improve the semen quality and sexual function, but no significant difference has being found.