Abstract:Transurethral enucleation resection of the prostate is safe and feasible for the treatment of symptomatic benign prostatic hyperplasia (BPH). However, long-term results of this treatment in patients with BPH have not been reported. To assess the efficacy and safety of this procedure, this study retrospectively evaluated long-term outcomes in 1400 consecutive patients who underwent transurethral enucleation resection of the prostate for BPH between 2008 and 2014. Patients were followed up at 1, 3, 6, and 12 months, and every year thereafter. At a median follow-up of 70.1 months, mean Qmax increased from 6.43 to 22.1 ml/s and mean IPSS decreased from 22.3 to 2.9. PVR decreased from 123.0 to 12.0 cc, and mean TRUS volume decreased from 65.4 to 21.4 ml (P<0.0000). QOL score improved from 4.96 to 1.0, and PSA concentrations decreased from 6.87 to 0.75 ng/ml (P<0.0000). Complications included bladder neck contracture in 1.0% of patients and urethral stricture in 1.3%. These long-term results showed that transurethral enucleation resection of the prostate is durable, safe, and effective for patients with BPH, with patients not requiring reoperation.

Congenital insensitivity to pain (CIP) is a rare autosomal recessive genetic disease, the main clinical manifestations are loss of pain or dullness, accompanied by a series of complications. We followed up a patient with CIP for 9 years, and a total of 4 fractures in 6 parts of the lower limbs were found. The patient presented with typical pain retardation, accompanied by osteomyelitis, multiple fractures, self-harm behavior (biting the tip of the tongue and fingers), and not being afraid of heat. A mutation was found on the sodium channel type IX a subunit (SCN9A) gene (chr2: 167056320 (EX27E), NM_002977. 3: c. 4796G>T (p. Arg1599Leu)). There is currently no effective treatment for this disease. We have adopted a combination of conservative and surgical treatment for this child's orthopedic disease (osteomyelitis and fracture). During the 4th fracture hospitalization, with the informed consent of the family, we used zoledronic acid to prevent fractures caused by low energy. Follow-up for 3 years found that zoledronic acid not only promoted fracture healing, but also avoided new fracture formation. Through reviewing the literature, we observe that this is the first report of using zoledronic acid to successfully avert new fractures in this type of patient. Now we summarize the treatment experience and review the literature in order to provide reference for the clinical treatment of this disease and enrich the SCN9A gene mutation spectrum.