Proceedings
of the Annual Meetings of the
World Chinese Urological Society
(WCUS)
2006 - 2011
Editors:
Kew-Kim Chew Run Wang Tom F Lue
Contents Page
The World Chinese Urological Society 2
Tom F Lue
The Scientific Committee 4
Run Wang
The Proceedings 5
Kew-Kim Chew
World Chinese Urological Society (WCUS) Meetings
1. WCUS Meeting 2006 6
Message 7
Program 9
2. WCUS Meeting 2007 12
Message 13
Scientific Committee 15
Program 18
Abstracts 24
3. WCUS Meeting 2008 65
Program 66
4. Meeting 2009 72
Message 73
Program 75
5. WCUS Meeting 2010 82
Message 83
Program 85
6. WCUS Meeting 2011 91
Message 92
Program 94
1
The World Chinese Urological Society
Tom F Lue
MD ScD (Hon) FACS
Founded by 8 urologists on 22 February 1902, the American Urological
Association (AUA), with a membership in 2011 of 17,690 including 3,877
international members, has been holding annual meetings at which world-class
urologists and uroscientists give state-of-the-art lectures and present new
discoveries in plenary sessions, poster sessions, symposiums and postgraduate
courses. There are more than 10,000 urologists of Chinese decent in the world and
many have actively participated in the activities of the AUA.
In 2005, the then AUA President Dr. Joseph N. Corriere Jr. and Secretary Dr. Carl
A. Olsson authorized the establishment of a Chinese urology program at the
annual AUA meeting. This idea received much enthusiastic support from Chinese
urologists worldwide and the first World Chinese Urological Society (WCUS)
meeting at the AUA was held in Atlanta, Georgia, on 20 May 2006. In 2009, the
WCUS became an official affiliate society of the AUA.
At the inaugural meeting in 2006, three academicians, Yinglu Guo, Luke S. Chang
and Tung-Tien Sun were among the moderators. The presidents of 5 Chinese
urological associations gave the State-of-Chinese-Urology lectures. They were
Yanqun Na, Chinese Urological Association; Dah-Shyong Yu, Taiwan Urological
Association; Christopher Cheng, Singapore Urological Association; Chi Wai Man,
Hong Kong Urological Association and Ho Chun, Macao Urological Association.
Leland Chung helped arrange the local program. This highest level of enthusiastic
support was unprecedented in the history of urology. It opened a new era of
cooperation, friendship, respect and love among Chinese urologists and
uroscientists.
2
The number of participants in the WCUS had increased to about 500 at the 2010
San Francisco AUA meeting, thanks to the hard work of the Scientific Committee
headed by Run Wang. The scientific program has also changed from presentations
toward more expert lectures and ―take home messages‖, in response to comments
and suggestions by participants and officials from the 5 urological associations. At
this time, we do not have an ―official‖ organization and membership. We are very
grateful to Pfizer, American Medical Systems and Bayer for their generous support
to make the meetings possible.
The WCUS is one of the most successful affiliate societies of the AUA. Despite a
number of growing pains and financial difficulty, it has survived and is growing
stronger. It is time that we review our goals and purpose, and plan ahead for the
future. The Society will thrive only if more urologists and uroscientists of Chinese
decent participate, contribute and lead. We hope the WCUS will be one of the best
urological societies in the world in the not too distant future.
3
The Scientific Committee
Run Wang
MD FACS
The most important event at the present time for WCUS is the Annual Meeting at
the AUA. Ensuring a high quality program is the major task of the Scientific
Committee. Year after year, many talented individuals volunteer their time and
expertise to select the best topics that cover cutting edge progress in urology,
particularly amongst the Chinese urological community worldwide. Each regional
society is also actively involved in the selection of speakers that will well represent
the respective society.
The Proceedings reminds us of the unselfish contributions of all the Committee
members and the hard work from each regional society.
Having the WCUS as one of the most attended sub-specialty meetings at the AUA
is a great reward for the efforts of all the speakers and moderators.
4
The Proceedings
Kew-Kim Chew
MBBS PhD FRCPEdin FRCPGlasg
With a record of the Inaugural Meeting and all the subsequent Annual Meetings,
The Proceedings has provided the historical perspective to the World Chinese
Urological Society (WCUS) from its inception in 2006.
Attendances at these Meetings are an indication of the relentless enthusiasm of
the many Chinese Urologists from all over the world. The presentations on basic
science, epidemiological and clinical research represent some of the magnificent
achievements and significant contributions to knowledge in the fields of Urology,
Sexual Medicine and Andrology.
For the attendees, The Proceedings is a reminder of their participation at these
Meetings in the pursuit and sharing of knowledge. For those who had been unable
to attend, it provides a summary of events and possibly a source of inspiration for
the awakening of talent and professional advancement.
5
1. WCUS Meeting 2006
Date: Saturday, May 20, 2006
Venue: Hyatt Regency, Atlanta, Georgia, USA
Theme: State-of-Chinese Urology
6
The Inaugural Pre-AUA Meeting of the World
Chinese Urological Association
Tom F. Lue and Leland W. K. Chung
Thanks to the great efforts of president Corriere and secretary Olsson, the
inaugural meeting of the World Chinese Urological Association will take place in
Atlanta prior to the Annual Meeting of the AUA on May 20, 2006. This opportunity
is warmly embraced by the Chinese-speaking urologists and urological scientists
from China, Taiwan, Singapore, Hong Kong and other countries who regularly
attend the AUA annual convention. The spirit of this inaugural meeting sponsored
by AUA is to provide a forum for exchanging views among Chinese and non-
Chinese speaking urologists and urological scientists, which will be a real asset for
our professional communications. This is a timely and even historic event,
expanding the current spectrum of international coverage of the AUA meeting.
We are particularly pleased to see the AUA leadership endorse this meeting since
an increasing number of Chinese-speaking urologists and urological scientists
attend the AUA meeting. Recent economic growth and political changes in
mainland China have increased the number of Chinese urologists and urological
scientists who visit institutions around the world, establish joint research and
training centers, and attend international meetings. There are more than 10,000
Chinese speaking urologists in the world and many of them consider the AUA
Annual Meeting to be the most prestigious and significant urology meeting
internationally. Language and cultural barriers that discourage them from attending
the meeting have been a major hurdle for communication. In the past 10 years, the
Postgraduate College of the Institutes of Urology, Peking University, Beijing, China
has held many urology courses as a part of their continued education effort. These
courses were taught by experts from China and abroad, and significantly elevated
the quality of urological care in both urban and rural China. We anticipate that an
7
increasing number of new Chinese-speaking urologists and urological scientists
will be joining the AUA. They will be eager to participate in our Annual Meeting and
other organized professional activities, presenting and exchanging innovative ideas
and experiences with urologists from America as well as other countries.
The presidents of the Chinese Urological Association, Association of Chinese
Urologists, Taiwan Urologic Association, Hong Kong Urological Association, and
Singapore Urological Association will each present on the state-of-urology in their
respective countries or regions. This will be followed by scientific presentations and
state-of-the-art lectures on various basic and clinical topics by top urologists and
urologic scientists. To facilitate free communication and interchange of ideas, and
foster closer ties and friendship among the participants, the language of the first
meeting will be Mandarin Chinese. The meeting will be held in Hyatt Hotel and will
be open to all who are interested in participating in this exciting new AUA event.
8
Program - 2006
8:00 - 8:10 am Welcome and introduction
Tom F. Lue, USA
8:10 - 9:10 am
Session I: State-of-Chinese Urology
Moderators: Yinglu Guo, China and Luke S. Chang, Taiwan
Yanqun Na, President, Chinese Urological Assoc.
Dah-Shyong Yu, President, Taiwan Urological Assoc.
Christopher Cheng, President, Singapore Urological Assoc.
Chi Wai Man, President, Hong Kong Urological Assoc.
Ho Chun, President, Macao Urological Assoc.
9:10 - 10:30 am
Session 2: Scientific Program
Upper urinary tract
Moderators: Yanqun Na, China and Leland Chung, USA
Treatment of staghorn calculi by Chinese minimally invasive percutaneous
nephrolithotomy
Xun Li, China
Retroperitoneal laparoscopic ureteropyeloplasty
Liqun Zhou, Nichen Li,Zhisong He, Ming Li, Shiliang Wu,Yanqun Na and Yinglu Guo,
China
Retroperitoneal laparoscopic techniques for nephron-sparing surgery: the
experience of Tongji Hospital
Xu ZHANG, China
Complete laparoscopic approaches to adrenal tumors— from hand-assisted to
pure needlescopic instruments
Shih-Chieh Chueh, Taiwan
Discussion
10:30 - 10:45 am Tea and Coffee Break
10:45 - 12:00 noon
Session 3: Scientific Program
9
Lower urinary tract
Moderators: Lili Liang, China and Tung-Tien Sun, USA
The management pathway for patients with LUTS
Keong Tatt Foo, Singapore
Continence urinary diversion in Hong Kong
Bill Tak-Hing Wong, Hong Kong
Is low PSA cutoff point applicable to Chinese men?
Ming Li, China
What’s new in urinary incontinence research?
Donna Deng, USA
Discussion
12:00 - 1:00 pm: Box Lunch
Special Lecture: History of Chinese Urology
Yinglu Guo, China
1:00 - 2:15 pm
Session 4: Scientific program:
Basic research
Moderators: Kew Kim Chew, Australia, and Ju-Ton Hsieh, Taiwan
Central control of sexual function
Kuang-Kuo Chen, Jen-Hwey Chiu, and Luke S. Chang, Taiwan
Traditional Chinese medicine in ED and PE
Zhong Cheng Xin, China
Akt-mediated phosphorylation of Ezh2 suppresses lysine 27 methylation in histone
H3
Tai-Lung Cha, Guang-Huan sun, Dah-Shyong Yu, Sun-Yran Chang, Mien-Chie Hung,
Taiwan
Androgen receptor functions as suppressor to prostate metastatic tumor
invasion: new challenge to current androgen ablation therapy.
Chawnshang Chang, USA
Discussion
2:15 - 2:30 pm: Tea and Coffee Break
2:30 - 3:45 pm
Session 5: Scientific Program
10
Topics of interest
Moderators: Hui Meng Tan, Malaysia and Run Wang, USA
Epidemiological studies on the prevalence of upper urinary calculi in Taiwan
Lee YH, Chang LS, Taiwan
Innovative techniques in GU surgery
Rei K. Chiou, USA
How to advance in the world of urology by Chinese urologists
Chung Lee , USA
Penile transplantation: a case report
Weilie Hu, China
Discussion
3:45 - 4:00 pm Closing Remarks
Yanqun Na, China & Luke S. Chang, Taiwan
11
2. WCUS Meeting 2007
Date: Saturday, May 19, 2007
Venue: The Hilton Towers, Anaheim, California, USA
Theme: State-of-World Chinese Urology
12
Welcome to WCUS meeting 2007
Dear Colleagues and Friends:
On behalf of the scientific committee, it is our great pleasure to invite you to attend
the 2nd AUA World Chinese Urological Society (WCUS) meeting which will be held
at the Hilton Anaheim hotel in Anaheim, California on May 19, 2007.
The 1st AUA WCUS meeting held in Atlanta, Georgia in 2006 was a great success
with more than 300 Chinese-speaking urologists and urologic scientists attending
the meeting. The 2007 meeting in Anaheim promises to be an even more exciting
event. The meeting will begin with a series of lectures by the presidents of the
urological associations of China, Taiwan, Singapore, Hong Kong and Macao on
the ―Highlights of Chinese Urology.‖ Following these lectures, experts in various
fields – including benign prostatic enlargement, bladder cancer, endourology,
pediatric urology, Nanomedicine and urinary stones – will lecture on ―Practical
Approaches to Patient Management.‖ In light of the tremendous advancements in
basic and clinical research from the countries and regions mentioned above, we
have also invited many accomplished urologists and scientists to present their
findings and discoveries. In addition, the conference will feature a poster session
that will provide yet another venue for discussion with the experts.
The purpose of the AUA WCUS meeting is to facilitate exchange of ideas and
experiences and foster communication and collaboration among Chinese-speaking
urologists and urological scientists. Our goal is to attract the best and brightest
Chinese scholars to attend and present at the annual AUA meetings. Although the
presentations will be in Mandarin, the slides and posters will be in English. We
welcome anyone with an interest in Chinese urology to attend the meeting.
13
Tom F. Lue, MD, FACS
Chairman, Scientific Committee
Run Wang, MD, FACS
Executive Chairman, Scientific Committee
Guiting Lin, MD, PhD
Secretary
14
Scientific Committee - 2007
Tom F. Lue, MD, FACS-Chair (USA)
Department of Urology
University of California at San Francisco
USA
tlue@urology.ucsf.edu
Run Wang, MD, FACS-Executive Chair (USA)
Department of Urology
University of Texas Medical School at Houston
University of Texas MD Anderson Cancer Center
USA
Run.Wang@uth.tmc.edu
Yinghao Sun, MD, PhD (Shanghai)
Department of Urology
nd
The 2 Military Medical University
Shanghai
China
sunyh@medmail.com.cn
Hong Li, MD (Chengdu)
Department of Urology
Sichuan University
Chengdu
China
hy7580@126.com
Ningchen Li, MD (Beijing)
Beijing Urology Institute
Beijing University
Beijing
China
ningchenli@yahoo.com
Liqun Zhou, MD (Beijing)
Beijing Urology Institute
Beijing University
Beijing
China
zhoulqmail@china.com
15
Yutian Dai, MD, PhD (Nanjing)
Department of Urology
Nanjing University Medical College
Nanjing
China
ytdai@hotmail.com
Joseph Chin, MD (Canada)
Department of Urology
University of West Ontario
London
Canada
Joseph.Chin@lhsc.on.ca
Eugen Yuhui Wang, MD, PhD (Sweden and Norway)
Department of Urology
Aker University
Oslo
Norway
yuhuiwang@msn.com
Shu Tung, MD (USA)
Division of Urology
University of Texas Medical School at Houston
USA
Tung.Shu@uth.tmc.edu
Philip Li, MD (USA)
Department of Urology
Cornell University Medical School
New York
USA
psli@med.cornell.edu
Jun Chen, MD (Taiwan)
chenjun@ha.mc.ntu.edu.tw
Ian Lap Hong, MD, PhD (Macau)
Department of Urology
CHCSJ Hospital
Macau
China
ianlap@macau.ctm.net
16
In-Hei Lee, MD (Taiwan)
yhlee@mail.chimei.org.tw
Tak-Hing Bill Wong, MD, FRCS (Hong Kong)
Department of Urology
Chinese University of Hong Kong
Hong Kong
China
billwong@pedderclinic.hk
Apichat Kongkanand, MD (Thailand)
Bangkok
Thailand
Kongkanand@yahoo.com
Hui Ming Tan, MD (Malaysia)
Kuala Lumpur
Malaysia
perandro@streamyx.com
Keong Foo, MD (Singapore)
keongfoo@yahoo.com
Leland Chung, PhD (USA)
Emory University
Atlanta
USA
lwchung@emory.edu
Kew- Kim Chew, MD, PhD (Australia)
Perth
Australia
kewkimchew@hotmail.com
17
Program - 2007
8:00 - 8:07 am Welcome and introduction
Tom F. Lue, USA
8:07 - 8:10 am Report from Scientific Program Committee
Run Wang, USA
8:10 - 9:00 am
Session 1: Highlight on Chinese Urology
Moderators: Chung Lee, USA; Luke S. Chang, Taiwan; Tak-Hing Bill Wong,
Hong Kong
8:10 - 8:20 am Yanqun Na, President, Chinese Urological Assoc.
8:20 - 8:30 am Han-Sun Chiang, President, Taiwan Urological Assoc.
8:30 - 8:40 am Christopher Cheng, President, Singapore Urological Assoc.
8:40 - 8:50 am Wai Sang Wong, President, Hong Kong Urological Assoc.
8:50 - 9:00 am Son Fat Ho, President, Macao Urological Assoc.
9:00 - 9:10 am WCUS awards
9:10 -10:30 am
Session 2: Scientific Program
Practical Approach to Patient Management
Moderators: Yanqun Na, China; Leland Chung, USA; Apichat Kongkanand, Thailand
9:10 - 9:30 am Revisit balloon dilation for BPH: 10-year experience
Yinglu Guo, Liqun Zhou, China
(Abstract 1)
9:30 - 9:50 am How do I manage patient with bladder cancer?
Joseph Chin, Canada
(Abstract 2)
9:50 - 10:10 am How do I handle difficult urological problems in children?
Chung Kwong Yeung, Hong Kong
(Abstract 3)
10:10 - 10:30 am Tricks on Management of Urinary Stone Disease?
Marshall Stoller, USA
(Abstract 4)
18
10:30 - 10:45 am Tea and Coffee Break
10:45 - 12:00 noon
Session 3: Scientific Program
Basic Science Forum
Moderators: Dalin He, China; Philip Li, USA; Hui Meng Tan, Malaysia
10:45 - 11:00 am Nanotechnology, Nanomedicine, and Nanosurgery: An Urologist’s
Perspective
Joseph C. Liao, USA
(Abstract 5)
11:00 - 11:15 am Intravesical and intraprostatic botulinum toxin administration in rat
models of interstitial cystitis and non-bacteria prostatitis (
Yao-Chi Chuang, Naoki Yoshimura, Chao-Cheng Huang, Po-Hui Chiang,
Pradeep Tyagi, and Michael B. Chancellor, Taiwan and USA
(Abstract 6)
11:15 - 11:30 am Effect of changes of detrusor-original excitability on the overactive
detrusor
Bo Song, China
(Abstract 7)
11:30 - 11:45 am Bladder primary sensory neuron block: animal and clinical
application
Zhichen Guan, China
(Abstract 8)
11:45 - 12:00 noon Discussion
12 Noon - 1:00 pm Box Lunch and Viewing of Posters and Videos
1:00 pm - 2:00 pm
Session 4: Scientific program
Discussion of Posters and Videos
Moderators: Shujie Xia, China; Eugen Y. Wang, Sweden; Jun Chen, Taiwan
Upper Urinary Tract
1:00 - 1:03 pm Pyeloplasty: retroperitoneal laparoscopic vs. open approaches
Xu Zhang, China
(Abstract 9)
19
1:03 - 1:06 pm Graft Outcome of Living Donor Renal Transplantation in the Elderly
Recipients
Feng-Pin Chuang, Andrew C Novick, Guang-Huan Sun, Michael Kleeman,
Stuart Flechner, V. Krishnamurthi, Charles Modlin, Daniel Shoskes, David
A.Goldfarb, Taiwan and USA
(Abstract 10)
1:06 - 1:09 pm Laparoscopic repair of injury to the inferior vena cava-report of three
cases (Video)
Liqun Zhou, China
(Abstract 11)
1:09 - 1:12 pm Retroperitoneal laparoscopic Radical Nephrectomy and regional
lymphadenectomy for Renal Cell Carcinomas
Wei Zhang, China
(Abstract 12)
1:12 - 1:15 pm Correlation of COX-2 Expression in Stromal Cells with High Stage,
High Grade and Poor Prognosis in Urothelial Carcinoma of Upper
Urinary Tracts
Chih-Hsiung Kang, Po-Hui Chiang, Shun-Chen Huang, and Hsuang-Lan
Yu, Taiwan
(Abstract 13)
1:15 - 1:18 pm Endoluminal ureteroplasty for ureteroenteric stricture – a feasibility
study in porcine model.
Victor Chia-Hsiang Lin, Allen W. Chiu, Mihir M. Desai, Inderbir S.
Gill,Taiwan and USA
(Abstract 14)
1:18 - 1:21 pm Laparoscopic radical nephroureterectomy with concomitant radical
cystectomy for multi-focal transitional cell carcinoma in uremic
patients: initial experience
Victor C. Lin, Allen W. Chiu, Y. H. Lee, T. J. Yu, Taiwan
(Abstract 15)
Prostatic Diseases
1:21 - 1:24 pm Prostate cancer management consensus and guidelines between
China and Taiwan
Chih-cheng Lu, Chia-Ho Lin, Dennis Chian-Shiung Lin, Eric W. Fan, Tse-
Chou Cheng, Taiwan
(Abstract 16)
1:24 - 1:27 pm The guidelines or consensus in managing benign prostatic
hyperplasia among China, Singapore and Taiwan
Chih-cheng Lu, Chia-Ho Lin, Dennis Chian-Shiung Lin, Eric W. Fan, Tse-
Chou Cheng, Taiwan
(Abstract 17)
20
1:27 - 1:30 pm Hemospermia associated with prostatic cyst: diagnosis by
transrectal ultrasonographic finding and endorectal coil MR
imaging. Twenty four case reports
Wei-Dong Song, Liang Chen, Zhong-Cheng Xin, Long Tian, Bao-Xing Liu,
Xiao-Jun Wu,China
(Abstract 18)
Andrology
1:30 - 1:33 pm China experience of penile prosthesis implantation for sever
erectile dysfunction
Zhong Cheng Xin, Zhi Chao Zhang, Wei Dong Song, Long Tian, China
(Abstract 19)
1:33 - 1:36 pm Sural Nerve Grafting During Laparoscopic Radical Prostatectomy -
Initial experiences of two patients
Xin Gao, China
(Abstract 20)
1:36 - 1:39 pm Erectile Dysfunction Following Transurethral Electrovapor
Resection for Different Sized Prostates
Chih-Kuang Liu, Ming-Chung Ko, Huey-Sheng Jeng, Wen-Kai Lee, Hong-
Jeng Yu, Han-Sun Chiang, Taiwan
(Abstract 21)
1:39 - 1:42 pm A mode of treatment for penilie incarceration ----an unusual
complication of masturbation
Jesun Lin, Gin-Bow Chang, Herng-Jye Jiang, Mon-I Yang, Huai-Long Tai,
and Bai-Fu Wang, Taiwan
(Abstract 22)
1:42 - 1:45 pm Effect of Cox7a2 on LH induced testosterone production and
expression of StAR protein, P450scc and 3β-HSD enzymes in TM3
mouse Leydig cells
Liang Chen,Zhong-Cheng Xin , Long Tian, Yi-Ming Yuan, Gang Liu ,
Ying-Lu Guo, China
(Abstract 23)
1:45 - 1:48 pm Association of the phenotype of seminal vesicles and cftr gene
mutation in patients with congenital bilateral absence of the vas
deferens
Chien-Chih Wu, Chia-Hung Liu, Han-Sun Chiang, Taiwan
(Abstract 24)
Urinary Bladder
1:48 - 1:51 pm Proteomic analysis of human urinary cancer proteome using
reverse phase nano-high-performance liquid chromatography /
electrospary ionization tandem mass spectrometry.
Tan Lia-Beng, Liao Pao-Chi, and Guo Haw-Ran,Taiwan.
(Abstract 25)
21
1:51 -1:54 pm Survival Analysis of Patients with Bladder Transitional Cell
Carcinoma after Open or Laparoscopic Radical Cystectomy
Allen W. Chiu, Thomas Y. Hsueh, Steven K. Huan, Yi-Hsiu Huang,
Taiwan
(Abstract 26)
Stem Cells
1:54 - 1:57 pm Characterization and Differentiation of Human Muscle Derived
Stem Cells.
Shing-Hwa Lu, An-Hang Yang, Chou-Fu Wei, Kuang-Kuo Chen,Luke S.
Chang, Taiwan
(Abstract 27)
1:57 - 2:00 pm Brief Break
2:00 - 2:40 pm
Session 5: CUA Lectures
Moderators: Liqun Zhou, China; Shu Tung, USA; Shaw W. Zhou, USA
2:00 - 2:20 pm Endourology in China: Current status and future direction
Yinghao Sun, China
(Abstract 28)
2:20 - 2:35 pm Evidence-based Urology: report from China
Qiang Wei, China
(Abstract 29)
2:35 - 2:40 pm Discussion
2:40 - 2:50 pm Tea and Coffee Break
2:50 - 3:50 pm
Session 6: Scientific Program
Research
Moderators: Hong Li, China; Po-Hui Chiang, Taiwan; Ningchen Li, China
2:50 - 3:05 pm The Incidence and Clinical Significance of High-Grade Prostatic
Intraepithelial Neoplasia on Prostate Biopsy in Taiwanese Asian
Men
Yen-Hwa Chang, Yi-Chun Chiu, Chin-Chen Pan, Kuang-Kuo Chen and
Luke S. Chang, Taiwan
(Abstract 30)
22
3:05 - 3:15 pm Prostate cancer in Macau S.A.R
Lap hong Ian, Macau
(Abstract 31)
3:15 - 3:30 pm Efficacy and Safety of Tolterodine and/or Tamsulosin in Men with
Lower Urinary Tract Symptoms (LUTS) Including Overactive
Bladder (OAB): Results from a Four-Arm, Placebo-Controlled Trial
Zhonghong (Eric) Guan, USA
(Abstract 32)
3:30 - 3:40 pm Laparoscopic Radical Cystectomy with Orthotopic Ileal Neobladder:
A Report of 85 Cases
Jian Huang, China
(Abstract 33)
3:40 - 3:50 pm "Sliding Knot Vesicourethrostomy" in LRP and LRC
Ho Son Fat, Macau
(Abstract 34)
3:50 - 4:00 pm Diabetic Erectile Dysfunction: Animal Studies
Yu-tian Dai, Yun Chen, Run Wang, Zeyu Sun, Rong Yang, Leshen Yao,
Dong Chen, Sanxiang Li, China
(Abstract 35)
4:00 - 4:10 pm Discussion
4:10 - 4:20 pm Closing Remarks
Yanqun Na, China & Luke S. Chang, Taiwan
23
Abstracts
1. Revisit balloon dilation for BPH: 10-year experience - The Treatment of BPH
by Muti-Balloon Dilation (MBD)
Yinglu Guo MD.
Department of Urology, First Hospital of Peking University, Urologist Training College of Peking University. Beijing,
100034, PR China
While China has stepped into the aged society, there are more then several ten millions people
are suffering from the BPH. An effective and economic therapy method is eagerly required for
those people of BPH because there is no good method to prevent and to eliminate it totally in
China nowadays. Also, lots of other factors have blocked the process to reach this aim in China,
such as equipments, skilled urologist, and the economic condition of those patients in the rural
areas.
The single balloon dilation, a method for treating BPH that had been applied in the clinic in the
middle of 80s’, was an effective approach to treat those patients with minimum symptoms,
although it has been abounded for bleeding after the dilation and the long-term effects. Ten
years later, this technique has been improved into another effective method, the muti-balloon
dilation (MBD), which was applied in the clinic successfully with an excellent outcome.
There are several key techniques were developed for the muti-balloon dilation. To stop the
bleeding after dilation, the period of dilation has been prolonged to 24 hr, which resulted the
necroses and apoptosis of glands and sympathetic nerve ending in the prostate. To increase
the effectiveness of dilation, several other tissues have been recruited in, such as bladder neck
and urethral sphincters. It is need to be noticed that the balloon on the site of urethral sphincters
was released immediately after dilation in case of the incontinence.
The muti-balloon dilation has been applied to treat those BPH patients with residual urine. Five
days later after the dilation, all the patients regained the urination although some of them with
temporary stress incontinence. The urination was successfully improved during the post dilation
period. The maximum urinate rates were reached to 11ml/s in all those patients and some of
them reached to 20ml/s even after 12 years of dilation.
To explore the mechanism of this new method, the animal experiments and more clinic trails will
be applied. Also, the catheter and the balloon will be improved for the best outcome.
24
2. How do I manage patient with bladder cancer?
Joseph Chin, MD
Professor of Surgery, UWO, Head, Surgical Oncology, London Health Sciences Centre, Victoria Hospital, Canada
The goals of therapy for non-invasive transitional cell bladder cancer are (1) Prevent recurrence
and progression, (2) Minimize morbidity and expense e.g. with cystectomy and (3) Identify
refractory/progressive disease before it becomes metastatic. One should remember that only
2% of TaG1-2 cancers progress. However, 50% of Tis progress and that 25% of T1G3 die of
TCC without extirpative therapy. Sixty percent of such patients are 60% cured with radical
cystectomy if they have timely aggressive intervention. Approximately 50% of those who pursue
bladder–sparing therapy can be cured with radical radiotherapy with or without systemic
chemotherapy, but 40% require salvage cystectomy.
Low-Risk Non-Invasive Cancers
Approximately 60% of newly diagnosed cases are low-risk (Grade 1 - 2, Stage Ta, T1).
Transurethral resection (TUR) should include biopsy of tumor base. Since approximately 50%
will recur and 15 - 25% recur with higher grade disease, the key question is whether and when
to institute intravesical therapy.
My criteria for intravesical therapy after initial TUR in non-invasive disease include :
1. Presence of CIS, 2. T1 disease, 3. Presence of multiple tumors, 4. Large initial tumor
(>3 cm.diameter), 5. Grade 3 disease.
A second TUR is performed within 6 weeks if the initial TUR failed to include muscularis propria
in the specimen or if there is doubt about the completeness of the initial resection.
Fluorescence-Assisted TUR may be useful in cases of suspected carcinoma in situ, to detect
―occult‖.
In case of early recurrences (within 2 -3 moths), intravesical therapy with BCG would be
instituted promptly. Another indication for intravesical therapy is presence of unresectable
superficial TCC due to difficult anatomy and location.
High Risk Non-Invasive Cancers
Since 80% of T1 Grade 3 disease, with or without concomitant CIS, will recur and since up to
45% of these may develop invasion and eventually become metastatic, T1G3 disease has to be
regarded as high-risk and treated aggressively. Intravesical therapy is used early in the disease
course. The threshold for radical cystectomy should be low, if there is any early sign of failure
of conservative therapy.
Intravesical Therapy
BCG is usually used as first-line with a 6 week-course. Maintenance regimen is routinely used
monthly for 3 months. Occasionally, more intensive and longer maintenance regimens (e.g. as
per Dr. Lamm) are used. Second-line therapy commonly sued are Mitomycin and low-dose BCG
plus interferon.
25
Invasive Disease and Failed Treatment in Non-Invasive Disease
Radical Cystectomy is usually undertaken in these circumstances, provided the patient’s
operative risks are reasonable. A bladder-sparing approach, with a combination of external
beam radiotherapy and systemic chemotherapy may be used, especially if the patient has high
risks with medical co morbidities.
The choice of urinary diversion depends on (1) patient age, (2) co-morbidities, (3) tumor
stage/type/location, (4) patient preference. My personal break-down is approximately 65%/35%
ileal conduit/Studer ileal neobladder.
Advanced Disease
Neoadjuvant chemotherapy (most commonly cis platinum and Gemcitabine combination) is
used occasionally to downsize locally advanced bulky cancers in patients being considered for
aggressive surgical therapy. The alternative is to proceed with cystectomy first and then institute
adjuvant chemotherapy in those deemed to likely benefit from adjunctive systemic therapy.
26
3. How do I handle difficult urological problems in children?
Chung Kwong Yeung,
Hong Kong
27
4. Tricks on Management of Urinary Stone Disease
Marshall Stoller
Department of Urology, University of California at San Francisco. USA
Percutaneous nephrolithotomy (PNL)
Positioning and Set up:
1. Flexible cystoscopy on gurney
2. Placement of localizing ureteral catheter
3. Connect ureteral catheter to extension tubing (12-14 inches), then a syringe of contrast (flush
tubing, careful not to get contrast into catheter)
4. Secure to Foley
5. Flip patient prone onto bolsters (made of rolled up blankets, gel rolls can compromise X-
ray/images)
6. Shoulders and elbows flexed less then 90 degrees
7. Pad all pressure points and secure patient to table
8. Ensure easy access to syringe for retrograde contrast injection
Imaging:
1. Lower room lights and bring patient as close to C-arm sensor (beam should come from
under the table to reduce radiation exposure)
2. Take scout film
3. Under active fluoroscopy, inject contrast via localizing catheter at a slow rate
4. Understand stone and renal collecting system anatomy
5. Lower pole inferior calyx is typically no the most inferior
Access:
1. Goal is to access the posterior calyx at its tip to minimize the distance of renal tissue
traversed (this will minimize bleeding)
2. The access tract should be straight onto the stone
3. 18ga needle with removable cutting inner obturator/stylet
Anatomy & Puncture Site:
1. Identify the 11th and 12th rib
2. Identify the paraspinous muscles
3. Start with X-ray in AP view
4. For lower pole punctures,
a. Enter skin 2cm later to the lateral edge of the paraspinous muscles
and 2cm inferior to the rib (Petit’s Triangle)
b. Enter at 30 degrees from the skin surface and aim towards
contralateral nipple
c. rotate C-arm sensor towards you to assess depth of puncture
d. If the needle is under the stone your needle is too superficial
28
5. For upper pole punctures,
a. Select either medial or lateral calyx
b. Enter directly over stone (―bull’s eye‖)
c. Use packing forceps to direct needle and reduce radiation exposure
d. Rotate C-arm sensor away from you to assess puncture depth
6. Aberrant anatomy may require ultrasound guidance or CT imaging
Tract Dilation:
1. Once in collecting system, pass J-tip, flexible wire into collecting system
do not spend much time trying to get guidewire down ureter and into bladder
2. If wire does not pass easily, you may be in an anterior calyx
3. In general, only dilate into a posterior calyx
4. Dilate tract via 8F fascial dilators (can increase stiffness by soaking in ice-slush)
5. ―Push/Pull‖ technique. As you advance the dilator, actively push and pull wire 1-2mm to keep
wire straight (this avoids kinking of the working wire)
6. Repeat process for the 8/10F safety wire introducer
7. Place a second, safety, wire when possible
8. If significant bleeding is encountered during dilation, place nephrostomy tube and clamp it to
tamponade bleeding, reassess after 5 minutes
Balloon system-
Tip of radiomarker advanced just into tip of calyx
Dilate to 24 or 30F under fluoroscopy
Advance sheath to the ―waist‖ of the balloon
Careful not to over advance sheath onto the ―cone‖
portion of the balloon
Alken-
Ensure tight and snug fit of all dilators in set Do not skip a dilator size
Control tip of dilator at all times
Amplatz
Dotter catheter must be placed over wire first
Dotter tip just into collecting system
Sequential dilation must not go too medial
Working sheath to the ―waist‖ of the dilator
Careful not to over advance sheath onto the ―cone‖ portion of the dilator
Initial Entry:
1. Rigid nephroscope must have adjustable suction (e.g., ultrasound lithotrite) when first
entering collecting system
2. Look up at 12 o’clock if can not find your way in
Operative hints:
1. Suction management
2. Irrigation management (both from nephroscope and from retrograde ureteral catheter
29
3. Use a broad front for larger stones
4. Use room temperature saline for irrigation (set at 30-40 cm above kidney) to help reduce
fogging of camera/lens
Physiology, minimizing bleeding
1. Avoid hypothermia, use active warming blanket system
2. Mannitol 12.5 g IV can decrease venous bleeding by swelling kidney
3. Avoid excessive torque and force on kidney (safer to use second puncture or flexible
nephroscope)
Nephrostomy Tube Placement
1. Direct a stiff wire or a 5F ureteral catheter into desired location
2. Cut off the tip of any Foley catheter 1mm distal to the balloon
3. ―Push/Pull‖ the Foley catheter into desire location (confirm with contrast in the balloon, then
with a nephrostogram)
4. In obese patients with thick subcutaneous tissue, place nephrostomy tube as far in as
possible (e.g., in an upper-pole calyx for a lower pole puncture; or in a lower-pole calyx for
an upper-pole puncture)
5. In obese patients, a nephroureteral catheter also can be used
30
5. Nanotechnology, Nanomedicine, and Nanosurgery: An Urologist’s
Perspective
Joseph C. Liao, M.D.
Department of Urology S-287, Stanford University School of Medicine, 300 Pasteur Dr. Stanford, CA 94305-
5118,USA
Intravesical and Intraprostatic Botulinum Toxin A Administration in Rat models of Interstitial
Nanotechnology is the understanding and manipulations of natural and manmade materials at
dimensions of 1 to 100 nanometers. This is the length scale of biological molecules (e.g. DNA
and proteins), where manmade materials exhibit unique properties that enable novel
applications. Nanomedicine is the highly specific medical intervention at the molecular scale for
curing disease or repairing damaged tissues. Nanomedicine holds the promise of
revolutionizing medical diagnostics with ultrasensitive nanosensors for detection of biological
molecules, imaging with nanoparticles for in vivo, real time visualization of disease processes,
and therapeutics through highly precise targeted drug delivery systems. While fundamental
understanding of nanoscale research may not be essential for the urologists, it is important to
grasp basic concepts of nanotechnology as it will undoubtedly impact the clinical practice in the
near future. Proof of concept clinical application of nanotechnology and its microscale
counterpart—microelectromechanical system (MEMS)—have already been demonstrated in
urology. This includes detection of urinary pathogens and cancer biomarkers using highly
sensitive micro/nanosensor arrays. Use of lymphotropic magnetic nanoparticles in conjunction
with MRI have been demonstrated to improve detection of numerous urological cancers,
including prostate, bladder, and penile. Therapeutic applications of nanoparticles have also
begun to emerge in pre-clinical settings for highly specific, targeted delivery of
chemotherapeutic agents for prostate cancer. Currently, nanomedicine is still at its infancy and
nanosurgery, as the ultimate minimally invasive surgery, has yet to be realized. Nanomedicine
is a highly translational research area that requires inter-disciplinary collaboration from
engineering, basic science and clinical medicine. Institutional commitment towards
development of centers of excellence that promote interdisciplinary collaboration is not only
preferred, but necessary. Participation of the urologist in the team is essential given the
potential for exciting novel diagnostic and therapeutic modalities for urological diseases.
31
6. Cystitis and Non-bacteria Prostatitis
1 2 3 1 2
Yao-Chi Chuang , Naoki Yoshimura , Chao-Cheng Huang , Po-Hui Chiang , Pradeep Tyagi , and
2
Michael B. Chancellor
1 3
Department of Urology , Pathology , Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung
University College of Medicine, Kaohsiung, Taiwan and Department of Urology, University of Pittsburgh School of
2
Medicine , Pittsburgh, Pennsylvania
Introduction and Objectives: There is increasing evidence that botulinum toxin A (BoNT-A)
might have analgesic properties but the mechanisms by which BoNT-A alter pain remains
largely unexplored. In the bladder, afferent nerve fibers contain calcitonin gene-related peptide
(CGRP), which modulates sensory transmission from the bladder. In this study we first
investigated the effect of intravesical BoNT-A administration on CGRP immunoreactivity and
bladder hyperactivity in acetic acid -induced bladder pain model in rats. Second, an animal
model for non-bacterial prostatitis in rats was developed using intraprostatic injection of
capsaicin, an agent thought to excite C-afferent fibers and cause neurogenic inflammation. The
analgesic and anti-inflammatory properties of BoNT-A was tested in this model.
Materials and Methods: For bladder experiments, experimental and control animals were
catheterized and intravesically exposed to protamine sulfate (PS, 1 ml, 10 mg/ml) followed by
BoNT-A (1 ml, 25 unit/ml, Allergan, Irvine, CA) or saline respectively. Three or seven days after
intravesical therapy, continuous cystometrograms (CMGs) were performed under urethane
anesthesia by filling the bladder (0.08 ml/min) with saline, followed by 0.3% acetic acid. Bladder
immunohistochemistry was used to detect CGRP. For prostate experiments, adult male S.D.
rats were injected with varying doses of capsaicin into the prostate. The nociceptive effects of
capsaicin were evaluated for 30 min by using a behavior approach and then the prostate was
removed for histology and cyclo-oxygenase (COX)-2 protein concentration measurement.
Evans blue (50mg/kg) was also injected intravenously to assess for plasma protein
extravasation. A second set of animals were injected with up to 20U of BoNT-A into the
prostates 1 week prior to intraprostatic injection of 1000 M capsaicin.
Results: For the bladder experiments, intercontraction interval (ICI) was decreased after
intravesical acetic acid (50.2% decrease, from 22.11.8 min to 11.31.8 min and 65.0%
decrease, from 20.62.1 min to 7.21.5 min) in the control group at day 3 and day 7,
respectively. However, rats that received BoNT-A showed a significantly reduced response (ICI
28.6 % decrease, from 26.92.4 min to 18.23.1 min) to acetic acid instillation at day 7. This
effect was not observed at day 3 (ICI 62.2 % decrease, from 26.20.9 min to 9.91.2 min).
Increased CGRP immunoreactivity was detected from BoNT-A treated group at day 7, which
was not detected at day 3. For the prostate study, capsaicin dose-dependently induced pain
behavioral modifications: closing of the eyes, and hypolocomotion, and induced inflammatory
changes: increase of inflammatory cell accumulation, COX-2 expression and plasma
extravasation at the acute stage, but completely recovered at 1 week. BoNT-A pretreatment
dose-dependently reversed pain behavior and inflammation. BoNT-A 20U significantly
32
decreased inflammatory cell accumulation, COX2 expression, and Evens blue extraction
(82.1%, 83.0%, and 50.4%, respectively), and reduced pain behavior (66.7% for eye score and
46.5% for locomotion score).
Conclusions: Intravesical BoNT-A administration blocked the acetic acid-induced bladder pain
responses and inhibited CGRP release from afferent nerve terminals. Protamine pretreatment
allows liquid BoNT-A to be physiological effective. These results support clinical application of
BoNT-A for the treatment of PBS/IC. Intraprostatic capsaicin injection induced neurogenic
prostatitis and prostatic pain and may be a useful research model. BoNT-A pretreatment
produced anti-inflammatory and analgesic effects and support clinical evaluation in nonbacterial
prostatitis.
33
7. Effect of changes of detrusor-original excitability on the overactive
detrusor
Bo Song, Longkun Li, Xiyu Jin, Qiang Fang, Gensheng Lu, Weibing Li
Urological center, Southwest Hospital, Third Military Medical University, Chongqing, PR China
Background: Overactive detrusor is due to an un-inhibitable detrusor contraction during
bladder storage, which always occurs in the pathologic changes such as bladder outflow
obstruction and neurogenical bladder. The mechanism is still not well clarified and several
hypotheses are presented , the most popular one is the neurogenical theory. Unfortunately the
antimuscarinic drugs are not always satisfactory for overactive detrusor according to this theory.
Besides the integrity innervation, is there any myocyte-original regulation on the bladder
excitability, like in the heart or the intestinal organs? Detrusor-original regulation on the bladder
excitability must have such characteristics: spontaneous excitability even undergone
denervation; existence of cell-to-cell excitability transconduction; peacemaker cells or
peacemaker spots initiating the excitability. To our knowledge, there are few reports on it.
Materials and methods: Three kinds of rats models with normal, super-sacral spinal cord
transsection and posterior urethral obstruction were constructed, the overactive detrusor from
the super-sacral spinal cord trans-section and the posterior urethral obstruction models were
selected for the studies. 1) The frequency and intensity of the detrusor spontaneous contraction
were evaluated with cystometry in vivo, whole-bladder cystometry in vitro, and detrusor muscle
strip test in vitro. The effect of the activators of autonomic nerves on the three models were
accessorily detected. 2) The gap junctional intercellular communication in the overactive
detrusor was observed with fluorescent bleach technique. 3)To find out the interstitial cells of
Cajal (ICC)-like cell with histochemistry, which may behavior as the peacemaker in
gastrointestinal. The action potential of the ICC-like cell was also studied with patch-clamp.
Results and Conclusions: 1) The stretch load which can induce the contraction in overactive
detrusor was much less than that in normal detrusor, but with no significant difference between
the overactive detrusor models in neurogenic and bladder outflow obstruction; the activators of
autonomic nerves were effective on the frequency of detrusor-original contraction secondary to
the stretch load, but cannot eliminate the contraction. Moreover, even tetrodotoxin cannot
eliminate the stretch-induced spontaneous detrusor contraction. 2) The gap junction can
transfer the cell-cell communication, and this function was enhanced in overactive detrusor
myocytes, which indicated the existence of the detrusor-original gap junctional intercellular
communication. 3) ICC-like cell exists in bladder, and with the similar potential characteristic as
the heart peacemaker, which implied a potential peacemaker in bladder excitability.
Prospect: Bladder excitability is always thought as one thing between the autonomic and non-
autonomic. Our series of studies verified the existence of detrusor-original element in excitability
regulation, and also verified the importance of detrusor-original excitation in the occurrence of
overactive detrusor. But the role of detrusor-original excitability in normal bladder still need
further studies.
34
8. Bladder primary sensory neuron block: animal and clinical application
Zhichen Guan M.D.
Department of Urology, Peking University Shen Zhen Hospital, China
Objective To study the role of primary sensory neurons block using intravesical vanilloids
(capsaicin and resiniferatoxin) both in animal and human.
Material and Method From 1994 to 2004, six studies using 27 dogs and 123 rats were done to
evaluate the urodynamic, neurotransmitter (substance p) and histological changes after bladder
instillation of Capsaicin. Consequently, three studies including 102 patients were carried out
using intravesical capsaicin or resiniferatoxin (RTX). The intravesical concentration of capsaicin
was 1uM – 2MM/L and RTX was 100nM /L.
Result During the first 35 minutes, multiple spontaneous bladder contractions were elicited in
85.71% and 50% of dogs after 100 uM and 1 uM capsaicin bladder instillation, respectively. A
significant increase in the bladder volume at leakage point (82.93+3.51 cc vs. 122.22+11.32 cc)
was noted. The SP concentration was 2.88+0.55pg/g in control group and the SP concentration
were 1.54+0.25 pg/g and 1.29+0.16 pg/g in 1 uM and 100 uM groups after 12 weeks bladder
instillation, respectively. Capsaicin reversibly abolished the bladder instability, improved bladder
function and increased the ability to compensate in rats with partial bladder outflow obstruction.
In a study of 30 OAB cases, RTX instillation didn’t cause vesical irritation and no local
anaesthesia was required. The symptoms were improved immediately in all the patients after 1
day of RTX intervention. The decreases in both diurnal (5 to 15 times, mean 8.9 times) and
nocturnal (0 to 5 times, mean 3.0 times) frequencies were significant (p<0.001) according to
voiding diaries at 1 week and 1 month after treatment.
Conclusion The experimental and clinical evidence demonstrated that vanilloids regulated the
volume threshold for eliciting micturition reflex, improved bladder response to partial bladder
outflow obstruction, had long lasting effects on overactive bladder resulting from a variety of
reason. RTX, which produced both an immediate and a prolonged desensitization, appeared to
be less irritating than capsaicin and it may be more useful clinically.
35
9. Pyeloplasty: retroperitoneal laparoscopic vs. open approaches
Xu ZHANG*, Hong-Zhao LI, Xin MA, Tao ZHENG, Bin LANG, Jun ZHANG, Bin FU, Kai XU
Departments of Urology, Tongji Hospital (XZ, XM, BL, JZ, BF, KX), Tongji Medical College, Huazhong University of
Science and Technology, Wuhan 430030, Xiangya Hospital of Central South University (HZL), Changsha and
Xiangfan Central Hospital (TZ), Tongji Medical College, Huazhong University of Science and Technology, Xiangfan,.
Purpose: We evaluated the clinical value of retroperitoneal laparoscopic dismembered
pyeloplasty for ureteropelvic junction obstruction compared with open surgery.
Materials and Methods: The clinical data of 56 patients who underwent retroperitoneal
laparoscopic dismembered pyeloplasty were retrospectively compared with those of 40 patients
who underwent open dismembered pyeloplasty through a retroperitoneal flank approach.
Student t-test, Pearson Chi-square test and Mann-Whitney rank sum test were applied for
statistical analysis as appropriate.
Results: Patient's demographic data were similar between the two groups. In the laparoscopic
group, operative time (80 vs 120minutes), estimated blood loss (10 vs 150mL), recovery of
intestinal function (1 vs 2days), analgesic requirements (75 vs 150mg), incision length (3.5 vs
21cm), and postoperative hospital stay (7 vs 9days) were better than in the open group
(p<0.001 for all). No intraoperative complications occurred in either group. The incidence of
postoperative complications (2 of 56, 3.6% vs 3 of 40, 7.5%, p =0.729) and success rates (55 of
56, 98.2% vs 39 of 40, 97.5%, p = 0.058) were equivalent in the 2 groups.
Conclusions: Retroperitoneal laparoscopic dismembered pyeloplasty is a minimally invasive,
safe and effective therapy for ureteropelvic junction obstruction with low morbidity, shorter
convalescence and excellent outcomes and can be accomplished reasonably quickly in
experienced hands.
36
10. Graft Outcome of Living Donor Renal Transplantation in the Elderly
Recipients
1,2 1 2 1
Feng-Pin Chuang , Andrew C Novick , Guang-Huan Sun , Michael Kleeman,Stuart Flechner , V.
1 1 1 1
Krishnamurthi ,Charles Modlin , Daniel Shoskes , David A.Goldfarb
1 2
Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA; Division of Urology, Department
of Surgery, Tri-Service General Hospital, NationalDefense Medical Center, National Defense College, Taipei, Taiwan,
R.O.C.
Background: Living donor renal transplantation is a treatment option for patients on dialysis in
view of the ever-growing transplantation waiting lists and the stagnation in the number of
deceased donors. In the past, advanced age has been considered to be not a good candidate
for living donor renal transplantation. The aim of this study is to analyze whether old age affects
the outcome of living donor renal transplantation.
Methods: 527 first-time living donor kidney transplants were performed between January 1,
1995 and January 1, 2006. The patient population was divided into two subgroups base on the
patient’s age at the time of transplant. Old patients were all recipients age 60 years old and
above at time of transplant; the control group was all other patients.
Results: There is a significant difference in readmission rate (p= 0.031) and patient survival
rate (p< 0.001) between two groups. There is not a significant difference in graft survival rate
(p=0.808), acute rejection rate (p= 0.7), serum creatinine level and length of stay between these
two groups (t=1.75, p=0 .083).
Conclusions: Living donor renal transplantation has been controversial in elder recipients.
From the clinical reviews, our results confirm that many older patients may benefit from living
donor renal transplantation.
37
11. Laparoscopic repair of injury to the inferior vena cava-report of three cases
(Video)
Liqun Zhou*, Zhisong He, Ningchen Li, Ming Li.
Department of Urology, Peking University First Hospital
The Institute of Urology, Peking University
8 Xi Shi Ku Street, West District, Beijing 100034, China
Introduction and Objective: During laparoscopic surgery, the injury to large vessels, such as
inferior vena cava (IVC), often leads to open procedure for repair to avoid bleeding in large
amount. We report our primary experience of 3 cases to repair IVC injury laparoscopically and
evaluate the safety and efficacy of such laparoscopic repair.
Methods: From March of 1992 to August of 2006, we have done 1,668 cases of laparoscopic
procedures and met 3 cases (0.18%) of IVC injury, which were partial adrenalectomy, radical
nephrectomy and radical ureteronephrectomy. These injuries were caused by dissection with
electrocautery hook and harmonic scalpel and 1.2cm, 0.2 cm (2 0.2cm fissures in 1 case) and
0.5cm in length respectively. We repaired the fissures of IVC laparoscopically with intermittent
sutures of 3-0 Vincryl threads. The key point for suturing is to work in suction and needle holder
in order to show the fissures clearly and suture them accurately.
Results: All 3 cases were repaired successfully under laparoscopy and needed 4, 2 and 1
suture respectively. It took 21, 13 and 11 minutes and the amount of bleeding was just 120, 80
and 65ml for repair separately. One case developed partial unconsciousness, language and
arm disability after operation and computerized tomography showed several small infarction foci
in brain, which might be caused by gas embolism. She recovered full consciousness 1 week
later and normal language and arm ability 6 weeks later, but remained the intermittent and slight
headache for 3 months. Other 2 cases had no complications. There may be no bleeding at all
when IVC injury just occurs and can’t be found in time due to much higher pressure used for
pneumoperitonium (14mmHg) than that of IVC (12cmH2O). It would make more gas enter into
IVC and gas embolism develop, which is more dangerous for patient.
Conclusion: Laparoscopic repair of IVC injury is safe and effective on skilled hands. The earlier
the injury is found and repaired, the less complications the patient develops.
38
12. Retroperitoneal laparoscopic Radical Nephrectomy and regional
lymphadenectomy for Renal Cell Carcinomas
Wei Zhang, Changjun Yin, Wei Zhang, Min Gu, Xiaoxin Meng, Qiang Lv, Lixin Hua, Zhengquan Xu,
Yuangeng Sui
Department of Urology, The First Affiliate Hospital of Nanjing Medical University, Nanjing 210029, China
Objective: To investigate the feasibility and the clinical application value of the retroperitoneal
laparoscopic radical nephrectomy and regional lymphadenectomy of renal cell carcinoma
(RCC).
Methods: Between July 2000 and May 2006, 242 patients (159 males and 83 females)
underwent retroperitoneal laparoscopic radical nephrectomy of RCC, of which 58 cases also
underwent regional lymphadenectomy.
Result: All cases finished successfully. The mean operation time was 170 min (range from 150-
200 min); the mean blood lose was 150 ml (range from 100-170 ml); the mean tumor diameter
ranged from 3-7cm. No case of local or systemic relapse or adrenal metastases, but three
cases of lymph node positive and five cases of homonymy adrenalectomy were observed by a
follow-up of 1-5 years.
Conclusion: The retroperitoneal laparoscopic and open radical nephrectomy of RCC can
achieve the same effect, and the former has the advantages of minimal invasion and quicker
recovery; however, the former should obey the same operative principle with the latter.
39
13. Correlation of COX-2 Expression in Stromal Cells with High Stage, High
Grade and Poor Prognosis in Urothelial Carcinoma of Upper Urinary Tracts
Chih-Hsiung Kang, Po-Hui Chiang, Shun-Chen Huang*, and Hsuang-Lan Yu
Department of Urology and *Pathology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung
University, Taiwan
Introduction: To investigate cyclooxygenase-2 (COX-2) expression in carcinoma and stromal
cells in patients with urothelial carcinoma of upper urinary tracts (UCUUT), and determine
whether expression patterns are associated with clinical characteristics and survival.
Methods: Immunohistochemistry for COX-2 was performed on paraffin embedded tumors from
UCUUT specimens from 79 patients. The level of expression in carcinoma cells, the presence of
stromal cell expression, and the infiltration of inflammatory cells were evaluated.
Results: Strong and moderate expression of COX-2 in carcinoma cells was observed in 19
(24.1%) and 46 (58.2%) cases, respectively. In 36 (45.6%) cases COX-2 expression was
present in stromal cells. The level of COX-2 expression in carcinoma cells was not correlated
with pathological stage ( P = 0.22), and not with grade (P = 0.45). COX-2 expression in stromal
cells was correlated with high stage (P < 0.0001) and high grade (P < 0.0001). The patient’s
survival was reduced if the tumor revealed strong or moderate expression of COX-2 in
carcinoma cells (P = 0.03), the presence of COX-2 expression in stromal cells (P < 0.0001), and
infiltrating inflammatory cells (P = 0.0001) by log rank test. Prognosis was poor if the tumor was
positive for both COX-2 expression in stromal cells and inflammatory cell infiltrate (P < 0.0001).
Conclusion: COX-2 expression in stromal cells shows greater correlation with high stage and
high grade than strong COX-2 expression in carcinoma cells. It is suggested that stromal COX-2
expression could be used as a marker of poor prognosis in patients with UCUUT.
40
14. Endoluminal Ureteroplasty for Ureteroenteric Stricture – A Feasibility Study
in Porcine Model
1 2 3 3
Victor Chia-Hsiang Lin , Allen W. Chiu , Mihir M. Desai , Inderbir S. Gill
1 2 3
E-Da Hospital/I-Shou University, Kaohsiung, Taiwan, Chung-Hsiao Mucinipal Hospital, Taipei, Taiwan, Cleveland
Clinic, Cleveland, USA
Introduction: We describe a novel technique of endoluminal endoscopic ureteroplsty for
ureteroenteric stricture in which the conventional longitudinal incision is precisely repaired by
sutures via the stoma of ileal conduit in a survival porcine model.
Method: Under general anesthesia, totally 9 farm pigs underwent laparoscopic cystectomy and
ileal conduit. Left ureteroenteric stricture was created by an additional suture near the
ureteroenteric junction. 3-4 weeks later, these 9 pigs received endoluminal ureteroplasty. The
first 3 pigs underwent the procedures in acute setting to establish and standardize the optimal
technique. The latter 6 pigs underwent the operation in chronic setting and were sacrificed 4
weeks later. The serum creatinine, electrolyte, intravenous urography and loopgram were
performed before reconstruction and before euthanasia. The tissue near ureteroenteric junction
was sent for histopathologic exams.
Result: The mean operation time for laparoscopic cystectomy and ileal conduit were 291.7
minutes. The mean operation time for endoluminal ureteroplasty was 60 minutes. Intravenous
urography before reconstruction revealed left hydronephrosis and hydroureter in all 6 pigs with
significant in 3, moderate in 2 and mild in 1. After correction, all the 6 pigs revealed patent
ureteroenteric junction on loopgram. However, 2 pigs had complication of ileal stoma stenosis.
Conclusion: Endoluminal endoscopic ureteroplasty is technical feasible, safe and effective.
The merits of minimal invasiveness can be maintained without the need of new incision and the
good full-thickness healing with primary intent, minimal urinary extravasation can be achieved.
We believe the techniques can be spread to human surgery in the near future.
41
15. Laparoscopic Radical Nephroureterectomy With Concomitant Radical
Cystectomy for Multi-Focal Transitional Cell Carcinoma in Uremic Patients:
Initial Experience
1 2 3 1
Victor C. Lin , Allen W. Chiu , Y. H. Lee , T. J. Yu
1 2 3
E-Da Hospital/I-Shou University, Kaoshiung, Chung-Hsiao Municipal Hospital, Taipei, Chi-Mei Medical Center,
Tainan, Taiwan
Introduction: Transitional cell carcinoma (TCC) is the most common urinary tract cancer in
patients on dialysis in Taiwan. It tends to be multi-focal, high recurrent, and intolerant to
chemotherapy and radiotherapy. We present our experience of one session en-bloc
laparoscopic unilateral or bilateral nephroureterectomy with radical cystectomy to treat
multifocal TCC in uremic patients.
Method: 7 uremic patients who were diagnosed multifocal TCC were enrolled. 4 patients were
male and 3 patients were female. 5 had undergone ipsilateral nephroureterectomy or radical
nephrectomy due to previous history of unilateral upper tract cancer. These 5 patients
underwent laparoscopic unilateral nephroureterectomy and concomitant radical cystectomy due
to multifocal recurrence of urothelial carcinoma. The other 2 female patients had simultaneous
upper tract and bladder TCC in the first time diagnosis and both underwent one session
laparoscopic bilateral nephroureterectomy with concomitant radical cystohysterectomy. 6 trocar
ports were used in our series. Bilateral nephroureterectomy was performed under lateral
position by turning the operation table and the cystectomy was performed under the
Tredelenberg position. The specimen was retrieved either from vaginal route in female patients
or from old scar or midline in male patients.
Result: Mean time for unilateral nephrectomy was 90 minutes. Mean time to complete radical
cystecotmy with prostatectomy or hysterectomy was 147 minutes. Mean blood loss was 530 ml.
Mean postoperative hospital stay was 7 days.
Conclusion: In our initial experience, laparoscopic nephroureterectomy with concomitant
radical cystectomy for multifocal TCC in uremic patients is a technically feasible, safe and
efficacious modality.
42
16. Prostate cancer management consensus and guidelines between China
and Taiwan
Chih-cheng Lu, Chia-Ho Lin, Dennis Chian-Shiung Lin, Eric W. Fan, Tse-Chou Cheng
Divisions of Urology, Department of Surgery, Chimei Foundation Hospital, Liouying, Tainan, Taiwan
Purpose: To compare the clinical practice guidelines in managing prostate cancer(CaP)
between China and Taiwan.
Materials and Methods: The printed and online materials in medical guidelines or consensus
for CaP by Chinese Urological Association(CUA), and Taiwan Cooperation Oncology
Group(TCOG) were reviewed. It consisted of published date, revision history, diagnostic
methods, and especially the treatment options.
Results: The online guidelines for CaP by CUA were available since July, 2006. The TCOG
had the first edition of CaP practice guidelines since 1999, and the second edition in 2003.
While China version was made by CUA, the Taiwan version was by interdisciplinary experts in
TCOG. Magnetic resonance image (MRI) was suggested before transrectal prostatic biopsy in
China but not in TCOG. Both agreed to start checking prostate specific antigen(PSA) level when
the patient was 45 year-old with a family history of CaP or 50 year-old. PSA normal range was
based on Chinese people data with age specific consideration by CUA and based on USA data
by TCOG. In predicting local staging and lymph nodes, MRI was considered more informative
by CUA than TCOG. The staging system was based on AJCC 2002 by CUA and AJCC 1997 by
TCOG, respectively. At least there were no T2c in AJCC 1997 edition. In treatment, HIFU(high
intensity focused ultrasound) and CSAP(cryo-surgical ablation of the prostate) was informed by
CUA only. Hormone refractory CaP was clearly defined with biochemical data by CUA and
mainly based on clinical condition by TCOG. Neither CUA nor TCOG suggested phytotherapy
as an option of treatment.
Conclusions: In this limited study, we demonstrated several varieties in the guidelines between
both regions. Urologists should be aware of the differences between the Chinese versions when
applying CaP guidelines to evaluate the Mandarin speaking patients with prostate cancer.
43
17. The Guidelines or Consensus in Managing Benign Prostatic Hyperplasia
among China, Singapore and Taiwan
Chih-cheng Lu, Chia-Ho Lin, Dennis Chian-Shiung Lin, Eric W. Fan, Tse-Chou Cheng
Divisions of Urology, Department of Surgery, Chimei Foundation Hospital, Liouying, Tainan, Taiwan
Purpose: To analyze the updating guidelines or consensus in managing benign prostatic
hyperplasia (BPH) around the Asian Chinese. It included China, Singapore and Taiwan.
Materials and Methods: The printed and online materials in guidelines or consensus for BPH
by Chinese Urological Association(CUA), Singapore and Taiwanese Urological
Association(TUA) were reviewed. Several statements were compared including published date,
revision history, any Chinese translation version, patient selection, diagnostic methods, and
treatment options.
Results: The online guidelines for BPH by CUA were available before August 2006. The TUA
had the Chinese translation(complex characters) of International Prostate Symptom
Score(IPSS) and consensus of combination medical therapy in February and May 2006,
respectively. The earliest Chinese version of IPSS was published by Ministry of Health of
Singapore. Both of the Chinese version by CUA and Singapore were written in simplified
characters. Neither CUA nor TUA interpreted precisely IPSS, which consists of 8 questions. The
summed score 0 to 35 is from the 7 urinary indexing symptoms. Among these Chinese editions
of IPSS, only the translated title was the same. The following 7 urinary symptoms indexing
questions and the eighth question about quality of life were semantically different. Only in the
guidelines by Singapore established trans-abdominal prostatic grading and staging systems for
BPH as non-invasive methods for evaluation and treatment. Either trans-abdominal or trans-
rectal route for sonography was accepted by all. The Age over 50 was announced suitable for
guidelines both in CUA and Singapore. There were documented industrial support in building
the guidelines or consensus; it was Merck for CUA and Yamanouchi(now as Astellas) for TUA.
The CUA considered 5-alpha reductase inhibitors as options of the first line therapy; while the
TUA restricted them to be the second line therapy. The use of 5-alpha reductase inhibitors by
TUA was not compatible with the rules set by National Health Insurance of Taiwan. Long term of
phytotherapy for clarification was suggested by CUA and Singapore while no consensus was
done by TUA.
Conclusions: Mandarin is currently used without significant difficulty around these regions.
People are traveling and communication more and more; the urologists should be aware of the
differences among the Chinese versions when applying IPSS to evaluate the Mandarin
speaking patients. Also, this updating comparison could do some help in establishing the
practice guidelines, which is unpublished, in managing BPH by TUA, since the consensus
remains fragmented.
44
18. Hemospermia Associated With Prostatic Cysts: Diagnosised by
Transrectile Ultrasonographic and Endocrectal Coil MR Imaging
SONG Wei-dong, XIN Zhong-cheng, ZHANG Zhi-chao, GAO Bing, TIAN Long, LIU Bao-xing, WU Yi-
guang, WU Xiao-jun, GUO Ying-lu
Andrology Center, Peking University First Hospital, Peking University,Beijing(100009), China
Objective: Hemospermia often associated with prostate cysts or perioprostatic tissues the
radiological diagnosis of prostatic or periprostatic cysts could be an ideal methods for define the
relationship of a cyst to surrounding structures, such as the vas deferens, seminal vesicles, and
ejaculatory ducts. To evaluate the role of transrectal ultrasonography (TRUS) and endorectal
coil MR in the diagnosis of hemospermia associated with prostatic cysts.
Methods: One hundred twenty patients with hemospermia were performed transrectal
ultrasound between August 2005 and March 2007, and 28 cases (23.3%) were found medical
prostatic cysts, among of them 24 cases were further evaluated clinical symptoms and
performed endorectal coil MR.
Results: Of the 24 men, 16 (67%) complained of prostatitis-like symptoms, 12 (50%) with
scrotal pain, 7 (29%) with small volume ejaculation, and 5 (21%) with painful ejaculation. All
patients had normal follicle stimulating hormone levels, normal or low fructose levels in the
seminal fluid. On the basis of MR imaging appearance, 18 (75%) had no anatomic ejaculatory
duct abnormalities. Of the remaining patients, 4 (17%) had seminal vesicle dilatation, 2 (8%)
had seminal vesicle hypoplasia. Prostatic cysts are easily identified on MR imaging by virtue of
their high signal on T2-weighted images and can be characterized because of their typical
locations and the high resolution and multiple imaging planes provided by MR.
Conclusion: With these results suggested that TRUS and endorectal coil MR are important
non-invasive diagnostic tools that minimize the need for more invasive studies in the evaluation
of hemospermia, particularly when associated with prostatic cysts. TRUS and endorectal coil
MR were not only helpful in establishing the diagnosis but also in determining the choice of
treatment.
45
19. China Experience of Penile Prosthesis Implantation for Sever Erectile
Dysfunction
Zhong Cheng Xin, Zhi Chao Zhang, Wei Dong Song, Long Tian
Andrology Center of Peking University First Hospital, Peking University, Beijing(100009),China
Purpose: In order to evaluate the effects of different kinds of penile prosthesis implantation for
Chinese patients with sever erectile dysfunction (SED).
Subjects and methods: Total 98 cases of Chinese patients with SED were treated by different
kinds of penile prosthesis implantation during Oct. 2001-Jan. 2007 were followed up using
questionnaire form. Mean age of patients was 33.410.6 years old and duration of SED was
5.54.5 years. Among of them the vasculargenic SED was 63 cases (64.3%), neurogenic ED
was 20 cases (20.4%), DM 10 cases(11.2%), Peyronine’s disease 4 cases(4.1%). Three piece
penile prosthesis AMS700 CXM for 69 cases(70.4%) and Manto alpha I for 3 cases(3.1%) and
AMS 650 malleable prosthesis 26 cases(26.6%). Among of them, 3 cases were performed one
stage implantation of AMS700CXM with visual internal urethrotomy. Patients and partner’s
satisfaction with penile prosthesis implantation were followed up with questionnaires form.
Results: Among of patients 2 cases (2.0%) mechanical malfunction, 1 case mechanical
malfunction with tube rupture in DM patients with sever cacernosum fibrosis was reimplanted
AMS650 malleable and I case malfunction with fluid leakage, however, the patients was
satisfied with oral medication with PDE5i such as Sildenafil, Tadanafil and Vardenafil. Patients
and partner’s satisfaction with penile prosthesis implantation were 92.4% and 89.8%.
Conclusion: Different kinds of penile prosthesis implantation was ideal methods for treatment
of SED in Chinese patients, and one stage implantation AMS700CXM with visual internal
urethrotomy seams safe and effective method for treatment of SED with urethra stricture.
46
20. Sural Nerve Grafting During Laparoscopic Radical Prostatectomy - Initial
experiences of two patients
Xin Gao, Xiaopeng Liu, Jianguang Qiu, Hengjun Xiao, Tujie Si
Dept. of Urology, the Third Affiliated Hospital of Sun Yat-sen University, 510630, Guangzhou, China.
Introduction and Objectives: Sural nerve grafting for patients undergoing radical
prostatectomy (RP) has been previously reported using open and robotic laparoscopic methods.
We report our initial experiences with sural nerve interposition during laparoscopic radical
prostatectomy (LRP).
Methods:Between April and July 2005, two potent men were underwent sural nerve grafting
during LRP in our department. The age of patient was 59 and 61, respectively. A plastic surgery
team harvested 10 to 15 cm of sural nerve from the left leg. The neurovascular bundles (NVB)
were extensively excised in left side of patient 1 and both sides of patient 2. With the hem-o-lock
located the stump of NVB, sural nerve interposition was performed using 2 stitches of each end
with 6-0 polypropylene. Postoperative sexual rehabilitation included oral small dosage of
sidenafil (25mg/d) after catheter removed and intracavernosal injection of PGE1 10-30μg, once
weekly, which helped the penile engorgement occasionally. Postoperative potency was defined
as the ability to penetrate and complete sexual intercourse with or without the use of oral
agents. The follow-up was 14-18 months. Patients’ potency was evaluated with IIEF-5 and NPT
test by Rigiscan.
Results:The sural nerve grafting through LRP was performed successfully in both patients with
mean operating time of 5.5 hours. During a follow-up of 6 months, both patients reported penile
engorgement with sidenafil but not sufficient for penetration. At the 12th month, patient 1
reported spontaneous erection without any help, erectile number was 1-2/night, erection time
was 13±3.5min (70-80%rigidity or greater). Patient 2 was potent enough to penetrate with oral
sidenafil, erectile number was 0-1/night, and the erection time was 25±6.5min (20-40%rigidity).
Conclusions:Sural nerve graft interposition during LRP is technically feasible and benefits for
postoperative erection. Post-operative sexual rehabilitation is safe and useful for potency
recovery.
47
21. Erectile Dysfunction Following Transurethral Electrovapor Resection for
Different Sized Prostates
1, 3 1, 3 1, 2 1 2
Chih-Kuang Liu , Ming-Chung Ko , Huey-Sheng Jeng , Wen-Kai Lee , Hong-Jeng Yu , Han-
3
SunChiang
1
Department of Urology, Taipei City Hospital, 2Department of Urology, National Taiwan University Hospital, 3College of Medicine,
Fu-Jen Catholic University, Taipei, Taiwan
Objective: To assess and compare the relationship between erectile function and intraoperative
rectal temperature changes of potent patients with different prostate sizes undergoing
transurethral electrovapor resection treatment (TUVRP).
Patients and Methods: 86 potent patients with lower urinary tract symptoms (LUTS) secondary
to benign prostatic hyperplasia (BPH) were recruited. Patients were divided to group1-small
prostates (＜ 40 ml), and group 2-large prostates (≧40 ml) as determined by transrectal
ultrasound (TRUS) measurement. The intraoperative rectal temperature was evaluated by
transrectal thermosensor and the temperature differences (the highest intraoperative
temperature minus the preoperative temperature) were recorded. The erectile function at
baseline, 3 months and 1 year postoperatively were assessed by the International Index of
Erectile Function-5 (IIEF-5) Questionnaire.
Results: The intraoperative rectal temperature differences were 0.54 ± 0.24 oC in the group 1
(n=45) versus 0.44 ± 0.20 in the group 2 (n=41), (p=0.04). The erectile function data were
available for 84 and 78 patients at 3 and 12 months, respectively. The IIEF-5 scores were
20.9±1.6 (group1) versus 20.6±1.6 (group 2) at baseline (p=0.32), 17.3±2.9 versus 18.7±3.2
(p=0.037) at 3 months, and 17.9±2.7 versus 18.7±3.0 (p=0.17) at 1 year postoperatively,
respectively. The deterioration of erectile function at baseline and 3-month postoperatively were
observed (p＜ 0.001) for both groups. The percentage of retrograde ejaculation between two
groups were not significant (p=0.33) at 3-month postoperatively.
Conclusions: Our study reveals that higher intraoperative rectal temperature difference caused
by transurethral electrovapor resection for treatment of symptomatic prostatic hyperplasia might
affect the postoperative erectile function, particularly in a small prostate.
48
22. A Mode Of Treatment For Penilie Incarceration – An Unusual Complication
Of Masturbation
Jesun Lin, Gin-Bow Chang, Herng-Jye Jiang, Mon-I Yang, Huai-Long Tai,and Bai-Fu Wang
Department of Urology, Changhua Christian Hospital, Changhua, Taiwan
Purpose: We investigated a technique for releasing an incarcerated penis from the hole of a
thick steel plate with minimal invasion.
Material and Methods: The patient had his penis incarcerated in a 2 cm diameter hole with 2
cm thick steel plate. We aspirated the congested blood from the glans penis and incised the
edema and ecchymosis prepuce to facilitate the escape of subcutaneous congestion blood and
fluid. A rubber band was wrapped around the penile shaft immediately distal to the thick steel
plate. A fine mosquito hemoclamp was then inserted to grasp the end of the rubber band
through the hole. The thick steel plate was gradually worked along the penile shaft until it was
free from incarceration.
Results: This mode can be used to release the penis from incarcerating objects in emergency
situation. The method can be performed in an operating room with minimal equipments and
simple technique. The penis is able to sustain very little injury.
Discussion: The penile incarceration in a thick steel plate. It is impossible to cut the thick steel
without injury of the penis in an emergency state. The patient has been followed up for more
than ten years and no any deficit in sexual or urinary condition.
Conclusion: We recommend this procedure for the treatment of penile incarceration in similar
conditions because it is simple and effective.
49
23. Effect of Cox7a2 on LH induced testosterone production and expression of
StAR protein, P450scc and 3β-HSD enzymes in TM3 mouse Leydig cells
Liang Chen, Zhong-Cheng Xin， ， Long Tian, Yi-Ming Yuan, Gang Liu , Ying-Lu Guo
Andrology Center, Peking University, First Hospital, Peking University, Beijing 100009, China
Objective: The cloning of Cox7a2 one respiratory chain related gene showed highly expressed
in aging male testis tissue in previous study and the effect of Cox7a2 on steroidogenesis and
the involved mechanism was investigated.
Methods: In the present study, TM3 cells are over-expressed Cox7a2 by transient transfection
of recombinant Cox7a2 cDNA plasmid. LH-induced testosterone production is observed by
ELISA, and the expression of StAR, P450scc and 3β-HSD was investigated by Western blotting
in TM3 cells over-expressing Cox7a2 fusion protein.
Results: Cox72 inhibited the LH-induced testosterone in TM3 mouse Leydig cells. In the results
of Western blotting, the expression of StAR protein decreased in TM3 cells over-expressed
Cox7a2, but the expression of P450scc and 3β-HSD did not altered obviously.
Conclusion: Data presented here reveal an unknown role of Cox7a2 in the regulation of the
expression of StAR protein, and in its consequent mediating androgen biosynthesis. In TM3
cells, the negative regulatory effect of Cox7a2 on steroidogenesis is, at least, a result of the
decreased expression of StAR protein.
50
24. Association of the phenotype of seminal vesicles and CFTR gene mutation
in the patients with congenital bilateral absence of the vas deferens
1,2 2 1,3
Chien-Chih Wu , Chia-Hung Liu , Han-Sun Chiang
1
Department of Urology, School of Medicine, Taipei Medical University, Taipei, Taiwan
2
Department of Urology, Taipei Medical University Hospital, Taipei, Taiwan
3
Fu Jen Catholic University, Taipei, Taiwan
Purpose: Cystic fibrosis (CF) is caused by the mutation of cystic fibrosis transmembrane
conductance regulator (CFTR) gene; different composition of the mutated genes resulted in
varied degrees of anomaly in phenotype. Among these, congenital bilateral absence of the vas
deferens (CBAVD) is recognized as a mild form of CF. Besides the defect of bilateral vas
deferens in CBAVD patients, there are various anomalies in the expression of seminal vesicles,
including agenesis, hpoplasia, and even normal expression. This study is to analyze the
association of seminal vesicle phenotype and the mutation spectrum of CFTR gene in CBAVD
patients.
Materials and Methods: DNA samples were collected from 20 CBAVD patients. Temporal
temperature gradient gel electrophoresis (TTGE) followed by DNA sequencing was used to
screen CFTR mutation for all collected DNA samples, which were then classified into
homozygous (the same mutations both in 2 alleles), compound heterozygous (2 different
mutations separately in each allele), heterozygous (one mutation in one of the 2 alleles), and
wild (no mutation detected in both alleles). Transrectal ultrasound was applied for these 20
CBAVD patients to record the phenotype of the seminal vesicles, the results were classified into
agenesis, hypoplasia, and present.
Results: The CFTR mutations were homozygous in 4 of the patients, and their seminal vesicles
showed agenesis in 2 of them (50%), hypoplasia in the other 2 (50%). The CFTR mutations
were heterozygous in 9 of the patients, and their seminal vesicles showed agenesis in 1
(11.1%), hypoplaisa in 7 (77.7%) and present in 1 (11.1%) respectively. No CFTR mutation was
detected in the rest 7 patients, and their seminal vesicles showed agenesis in 1 (14.3%),
hypoplasia in 6 (85.7%). No compound heterozygous mutation was detected in all 20 CBAVD
patients.
Conclusion: Our result shows that the frequency and severity of seminal vesicles, although not
statistically significant, has the tendency to be related to the CFTR genotype; the phenotype of
seminal vesicles has the tendency to show agenesis when CFTR mutation shows homozygous
or compound heterozygous, while the seminal vesicles show mainly hypoplasia when CFTR
screen shows heterozygous mutation or wild.
51
25. Proteomic analysis of human urinary cancer proteome using reverse
phase nano-high-performance liquid chromatography / electrospary ionization
tandem mass spectrometry.
Tan Lia-Beng 1, Liao Pao-Chi 2 , and Guo Haw-Ran 2
Departement of Urology, God Help Hospital ,Taipou, Chai Hsien, Taiwan 1Department of Enviromental and
Occupational Health, Cheng-Kung University, Tainan, Taiwan.
Purpose : The development of certain disease may change contents of protein in body fluids,
and these proteins are potential markers for the diagnosis and mechanistic research. Because
urine can be easily obtained without invasive procedures, the analysis of proteins in urine is an
ideal candidate for diagnosing bladder cancer. The application of reverse phase nano-high
performance liquid chromatography / electrospary ionization tandem mass spectrometry (nano-
HPLC -ESI-MS/MS) is possible to identify proteins in urine. The purpose of this study is plan to
apply this novel technology in the diagnosis of bladder cancer.
Materials and Methods : Patients age and sex-matched cancer and healthy urine specimens
were collected through catheterization. To concentrate proteins and remove salts from the urine
samples, 5KDa cutt-off centrifugal tube was applied for ultrafiltration and chose multiple affinity
removal system (MARS) column to enrich protein identification in urine. To enable us to identify
proteins otherwise undetectable due to the high abundance of organic and inorganic substances
in urine, the urine was solubilized in TCA in acetone. The protein pellet was resolubilized and
digested by trypsin for LC-MS/MS analysis. A nano-HPLC -ESI-MS/MS was used to generate
SELDI patterns from 16 primary transitional cell carcinoma (TCC) urine, including 8 with sex and
age-matched healthy urine specimens. Quantitative proteomics was applied to one urine
specimen and the expression pattern was verified by western blotting.
Results : A total of 3192 peptides, corresponding to 934 unique proteins were identified from
the urine samples, in which 60 proteins with higher confidence levels. Three proteins, including
transferring, prostaglandin D2 synthase (PTGDS), and SET domain and mariner transposase
fusion gene (SETMAR) identified in this study are those have not been reported in the urine of
bladder TCC before. In addition, we found that lopocalin-type prostaglandin D2 synthase
(PTGDS) , as depressed in malignant stages. These proteins could originate from blood and /or
bladder cancer tissue of the patients. They also represent potential candidates of useful
biomarkers of bladder TCC and could be measured in the urine. Further studies directed toward
a multitude of possible protective mechanisms of this enzyme in bladder cancer are warranted.
Conclusions : Nano-HPLC -ESI-MS/MS is enables detection of cancer-specific proteins in
complex biological mixtures such as urine. These tumor specific urine proteins may proved to
be useful for developing a novel of non-invasive, highly sensitivity and acceptable specificity
screening tests for the asymptomatic of early-stage bladder caner.
52
26. Survival Analysis of Patients with Bladder Transitional Cell Carcinoma after
Open or Laparoscopic Radical Cystectomy
1
Allen W. Chiu, Thomas Y. Hsueh, Steven K. Huan , Yi-Hsiu Huang
Section of Urology, Department of Surgery, Taipei City Hospital, Section of Urology, Department of Surgery, Chi Mei
1
Medical Center, Tainan ,
Department of Urology, National Yang-Ming University, Taipei Medical University, School of Medicine, Taipei, Taiwan
Purpose: To evaluate the stage and grade specific survival at a mean follow up of 3 years in
patients with bladder transitional cell carcinoma received open or laparoscopic radical
cystectomy
Patients and Methods: A total of 62 patients with bladder transitional cell carcinoma treated
with either open (n=21) or laparoscopic radical cystectomies (n=41) were enrolled in this study.
Perioperative and pathological data were collected by retrospective chart review. The mean
follow-up period was 38.4 months in open and 38.7 months in laparoscopic group. Bilateral
limited pelvic lymphadenectomy was performed in selected patients in both groups. There were
5 patients in open and 8 patients in laparoscopic group survived longer than 5 years. Survival
analysis with stage and grade stratification was analyzed by Kaplan Meyer method, and the
local recurrence and distant metastasis rate were reported.
Results: The surgical mortality was 9.5% in the open and 2.4% in the laparoscopic group. The
5-year disease specific survival of pT1 patients was 100% in the open group while 81.8% in the
laparoscopy group (p=0.329). The 5-year disease specific survival was 60% in the open and
72.9% in the laparoscopic group in pT2 (p=0.259) patients. As for stage pT3, the 5-year survival
was 66.7% in the open group while 85.0% in the laparoscopic group (p=0.269). The grade
stratified survival analysis showed no difference in patient received either open or laparoscopic
operation. The incidence of local recurrence after the operation was 9.5% in the open group and
9.7% in the laparoscopy group. The incidence of distant metastasis after the operation was
9.5% in the open group while 14.6% in the laparoscopy group.
Discussion: The value of pelvic lymphadenectomy in open or laparoscopic radical cystectomy
regarding the similar survival analysis in this study. The stage or grade specific survival showed
no statistical significance in patient received open or laparoscopic radical cystectomy in a mean
follow-up of 3 years. However, a prospective study with longer follow-up is required to verify the
real role of laparoscopic radical cystectomy for bladder cancer.
53
27. Characterization and Differentiation of Human Muscle Derived Stem Cells
1,2,5 3 2 3,5 3,5
Shing-Hwa Lu , An-Hang Yang , Chou-Fu Wei , Kuang-Kuo Chen , Luke S. Chang
1
Department of Urology, Taipei City Hospital ;
3 2 4
Division of Urology , Department of Surgery , and Department of Pathology , Taipei-Veterans General Hospital;
5
Department of Urology, National Yang-Ming University
Purposes: To isolate, purify, characterize and differentiation of the human muscle derived stem
cells (MDSCs).
Materials and Methods: Isolation of human muscle derived stem cells with modified preplate
technique, CD 34-positive stem cell isolation, invitro differentiation of MDSCs, myogenic,
adipogenic and osteogenic induction of D 34+ cells, immunolabeling procedures for flow
cytometry, flow cytometry analysis, immunohistochemical staining, lipid droplet staining with Oil
Red O, Alkaline phosphatase staining, and immunofluorescence study were done.
Results: The MDSCs were isolated using modified preplate technique and were purified using
Dyna-bead method. The growth doubling time of MDSCs was about 45 hours.
Immunohistochemical staining showed positive for several CD markers, VCAM, VEGFR-2,
CXCR4, CD56, and Desmin staining. Using special growth factors, the MDSCs could be
differentiated into smooth muscle, skeletal muscle, adipocyte, and osteocyte. The differentiation
was proved by immunohistochemical study.
Conclusions: The isolation, purification, characterization and differentiation of MDSCs were
successfully conducted. The MDSCs may provide another novel way for the management of
urinary sphincter deficiency and bladder reconstitution.
54
28. Endourology in China: Current status and future direction
Yinghao Sun, MD, PhD
nd
Department of Urology, The 2 Military Medical University, Shanghai, China
During the past 30 years, the endourology in China has been improved dramatically. For the
treatment of BPH, TUR had been introduced to China in the late 1970’s, and now this technique
has been spreaded widely in the country as a gold standard of BPH therapy. On the other hand,
other emerging techniques for BPH treatment, such as laser prostatectomy, have become
available in general practice outside of the investigational setting in China during the past 10
years. On the therapy of stone, ureteroscopy and PCN technique have been popular.
Furthermore, some new ideas have been offered, such as the application of high power
holmium laser in PCNL.
Laparoscopic nephrectomy and Laparoscopic adrenalectomy have also been routine practice.
Some complicated operations have also been performed in the Medical Center of metropolis, for
example radical prostatectomy, radical cystectomy and partial nephrectomy.It is the main
problem that the endourology in china develops disparately. In some regions, such as Peking,
Shanghai, Guangzhou, et al, total technical level is relatively high. However, in most of other
regions, the endourological technique still occupies lagging status. In the same region, there is
distinguished gap between large medical center and basic medical institution.
In order to improve the status, Chinese urological Association found the group of Endourology in
1985, which goes in for spreading endourological technique and encouraging communication.
Up to date, Chinese endourology has gained full-grown progression. We believe that Chinese
endourology should keep up with the world in the near future.
55
29. Evidence-based Urology: report from China
Wei Qiang, Han Ping
Department of Urology, West China Hospital, Sichuan University, Chengdu, P. R. China
Background: Along with progress of evidence-based medicine, clinical medicine is undergoing
transformation from empirical medicine into evidence-based medicine, which can not be ignored
by urological surgeons as much as other clinical physicians. To learn and master evidence-
based medicine, and to combine the best evidence reflected by modern urologic investigation
with expertise of urologic physicians will greatly help us to improve the clinical diagnostic and
therapeutic levels, providing patients with the best management decisions.
Object: To introduce the current status of popularization, application and research of evidence-
based medicine of urology in China.
Methods: Databases (including MEDLINE, EMBASE, CBMA and Cochrane Library), journals,
guidelines and literatures were searched to extract and analyze the information concerning
research on evidence-based medicine of urology in China.
Results: Concepts of evidence-based medicine were popularized mainly by special theses
published in professional journals of urology in China. Since 2003, Chinese Journal of Urology
has continuously published a series of special columns on evidence-based medicine,
systematically introducing basic concepts and origins of evidence-based medicine, best
evidences, the relationship between urology and evidence-based medicine, as the leading
platform for promoting and popularizing evidence-based medicine in China. Chinese Urological
Association (CUA) organized specialists in all fields of urology of China to systematically
analyze and review relevant domestic and international literatures according to principles and
measures of evidence-based medicine. Based on the best results of urologic surgery, the CUA
evidence-based Guidelines on BPH, OAB, RCC and PCA were compiled and established,
which are helpful and active for standardizing diagnostic and therapeutic principles for common
diseases in urology and directing clinical practice of urological surgeons in China. For studying
evidence-based medicine, together with my colleagues, we successfully registered multiple
research proposals in Cochrane Library and published several systematic reviews and meta-
analysis in Journal of Urology, Journal of Andrology, Asian Journal of Andrology, Chinese
Journal of Urology, Chinese Journal of Evidenced Based Medicine, covering prevention,
diagnostics and therapies of urologic diseases as update clinical evidence for practice in
urology.
Conclusion: Great effort was made by Chinese professionals for popularization, promotion,
application and research of evidence-based medicine in urology, which contributed much for
about 200 thousand urologic physicians in China to perform clinical management and improve
medical treatment quality with best evidences of evidence-based medicine.
56
30. The Incidence and Clinical Significance of High-Grade Prostatic
Intraepithelial Neoplasia on Prostate Biopsy in Taiwanese Asian Men
1 1 2 1 1
Yen-Hwa Chang , Yi-Chun Chiu , Chin-Chen Pan , Kuang-Kuo Chen and Luke S. Chang
1 2
Division of Urology, Department of Surgery, and Department of Pathology, Taipei Veterans General Hospital and
Department of Urology, School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C
Purpose: High-grade prostatic intraepithelial neoplasia (HGPIN) is considered a prostate
cancer-associated lesion. There is little information about the characteristics of HGPIN among
Asian men. We retrospectively reviewed patients with HGPIN on prostate needle biopsy to
analyze the clinical significance of HGPIN among Taiwanese men and to postulate the
implication for patient care.
Materials and Methods: From August 1999 to April 2004, 4250 patients who underwent
transrectal ultrasound (TRUS)-guided prostate biopsy at our hospital due to elevated PSA
and/or abnormal digital rectal examination (DRE). Patients with HGPIN were recommended to
have follow-up biopsy unless it was rejected. Clinical parameters and characteristics of these
patients were evaluated.
Results: A total of 112 (2.63%) had HGPIN. The mean age at diagnosis was 73.8 years (range,
51–93). Of these HGPIN patients, 95 (84.8%) had isolated HGPIN and 17 (15.2%) had
concurrent HGPIN and prostate cancer (PCa). 69 out of 95 (73.6%) patients with isolated
HGPIN underwent follow-up biopsy, and PCa was identified in 18.8% of patients with 92.3% of
PCa detected on the first two follow-up biopsies. There was no correlation between clinical
parameters (PSA value, DRE and TRUS findings) and the risk of PCa on subsequent biopsy.
Conclusions: HGPIN in Taiwanese men is uncommon comparing to those reported in the
contemporary Western series. Clinical findings are not predictive of PCa on repeat biopsy. If
cancer is not found on the first two follow-up biopsies, the risk of PCa is low. These patients
should then be followed up clinically to determine whether subsequent biopsy is required.
57
31. Prostatic Cancer in Macau S.A.R.
Lap Hong Ian M.D
Department of Urology, Centro Hospitalar C.S. Januario, Macau S.A.R.
Prostate cancer is the second leading cause of cancer-related death men in the United States.
The incidence of prostate cancer in Asia is far more lower which may be related to multiple
factors including genetic, diets, and economic environment. As the rapid economic and social
development of Asia countries and areas, such as Macau S.A.R., in the last 10 years, the
incidence and cancer-related mortality of prostate cancer in men are increasing markedly in
trace. Screening, early detection, improved imagiology and surgical technology of prostate
cancer are become the major goal in Urologic Oncology in Macau S.A.R.
58
32. Efficacy and Safety of Tolterodine and/or Tamsulosin in Men with Lower
Urinary Tract Symptoms (LUTS) Including Overactive Bladder (OAB): Results
from a Four-Arm, Placebo-Controlled Trial
Zhonghong (Eric) Guan, MD, PhD
Medical Director, Global Medical, Urology, Pfizer
Background: As the storage domain of LUTS, OAB is a syndrome characterized by urinary
urgency, with or without urgency urinary incontinence, usually with increased micturition
frequency during the day and at night. OAB is often attributed to detrusor overactivity (DO), a
condition characterized by involuntary detrusor contractions during bladder filling. In men,
detrusor overactivity may coexist with or be secondary to bladder outlet obstruction (BOO) due
to benign prostatic hyperplasia (BPH). Since both BOO and DO contribute to LUTS, it is logic to
target both prostate and bladder for the pharmaceutical intervention for LUTS including OAB.
The current standard of care for male lower urinary tract symptoms is treatment with α-
adrenergic receptor antagonists. However, many men with LUTS including OAB may not
respond to monotherapy with α-receptor antagonists.
Methods: This is the first study to evaluate the efficacy and safety of tolterodine, an
antimuscarinics for the treatment of OAB, and/or tamsulosin, α-receptor antagonist for the
treatment of BPH, in men who met research criteria for both OAB and BPH. In this randomized,
double-blind, placebo-controlled trial, men (≥40 y) with total International Prostate Symptom
Score (IPSS) ≥12; IPSS quality-of-life (QoL) item score ≥3; self-rated bladder condition of at
least moderate bother; and bladder diary-documented micturition frequency (≥8 micturitions/24
h) and urgency (≥3 episodes/24 h), with or without urgency urinary incontinence were included.
Patients were randomized to placebo (n=222), tolterodine ER (4 mg; n=217), tamsulosin (0.4
mg; n=215), or tolterodine ER/tamsulosin (n=225) for 12 weeks.
Results: A significantly greater percentage of patients receiving tolterodine ER/tamsulosin
(80%) reported treatment benefit by week 12 compared with placebo (62%, P<0.0001),
tamsulosin (71%, P<0.05), or tolterodine ER (65%, P<0.01). The tolterodine ER/tamsulosin
group (vs placebo) demonstrated significant reductions in urgency urinary incontinence (−0.88
vs −0.31, P<0.01), urgency episodes without incontinence (−3.33 vs −2.54, P<0.05),
micturitions per 24 hours (−2.54 vs −1.41, P<0.001), and micturitions per night (−0.59 vs −0.39,
P<0.05). Tolterodine ER also reduced urgency urinary incontinence (−0.83 vs −0.31, P<0.01).
Patients receiving tolterodine ER/tamsulosin demonstrated significant improvements on the total
IPSS (−8.02 vs placebo, −6.19, P<0.01) and QoL item (−1.61 vs −1.17, P<0.01). The post hoc
analysis found that, in patients with larger prostate and higher PSA, only tolterodine plus
tamsulosin significantly improved OAB/storage LUTS symptoms; however, in patients with
smaller prostate and lower PSA, tolterodine monotherapy was almost as effective as
combination of tolterodine and tamsulosin on OAB/storage LUTS symptoms. All interventions
were well tolerated; the incidence of acute urinary retention requiring catheterization was low
(tolterodine ER/tamsulosin, 0.4%; tolterodine ER, 0.5%; tamsulosin, 0%; placebo, 0%).
Tolterodine with or without tamsulosin did not significantly change Qmax and PVR.
59
Conclusions: These results strongly suggest that treatment with tolterodine ER with or without
tamsulosin is a safe and effective pharmacotherapy for men with LUTS including OAB.
60
33. Laparoscopic Radical Cystectomy with Orthotopic Ileal Neobladder: A
Report of 85 Cases
Jian Huang2, Tianxin Lin， Kewei Xu, Hai Huang, Chun Jiang , Jinli Han , Yousheng Yao,
Zhenghui Guo and Wenlian Xie
Department of Urology, Second Affiliated Hospital, Sun Yat-sen University, Guangzhou 510120, China
Introduction: The preliminary results of laparoscopic radical cystectomy in 85 cases were
presented in this study. The functional and oncological outcomes of this procedure in these
cases were discussed.
Patients and Methods: Between December 2002 and May 2006, we performed 85 cases of
laparoscopic radical cystectomies with orthotopic ileal neobladder for bladder cancer on 77 male
and 8 female patients. A 5-port transperitoneal approach was applied. The standard bilateral
pelvic lymphadenectomy was done first, the radical cystectomy was then completed
laparoscopically. The construction of ileal neobladder and the anastomosis of ureter-neobladder
were performed extracorporeally. The neobladder was anastomosed to the urethral stump
under laparoscopy. The nerve sparing procedure was performed for 8 cases.
Results: The mean operation time was 326 min, and the mean blood loss was 316 ml.
Conversion to open surgery was not necessary for all patients. The average time to oral intake
after operation was 3.9 days. There were no peri-operative mortalities. The complication rate
was 14.1% (12/85), including 3 uretero-pouch anastomotic stricture, 1 vesico-urethral
anastomotic stricture, 1 pouch-vaginal fistula, 1 caceo -pouch fistula,1 ileo-pouch fistula ,3
partial ileus,1 pneumonia and 1 urinary tract infection. The daytime continence rate was 94.1 %
and nighttime continence rate was 91.2 % in 6 month postoperatively. The neobladder capacity
was about 343 ml. Surgical margins were tumor free for all cases. 4 of the 8 nerve-sparing
patients had potency for intercourse. Over a follow-up of 1 to 41 months (average 23.3 months),
3 cases had local recurrence, 1 case had trocar site seeding, 6 cases had distant metastasis
and 5 of whom died.
Conclusions: Laparoscopic radical cystectomy with extracorporeal formation of neobladder is a
feasible procedure with low morbidity and acceptable neobladder function. Long term follow-up
is needed to confirm the oncological outcomes.
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34. "Sliding Knot Vesicourethrostomy" in LRP and LRC
Ho Son Fat
Urology Department, CHCSJ, Macau
Lapoaroscopy Radcal Prostatectomy and Laparoscopy Radical Cystoprostatectomyectomy are
difficult urologic operations, and the vesicourethrostomy is the most difficult step in these two
operations, especially for the beginner. Bsaed on continue suture method of
vesicourethrostomy, I created "Sliding Knot Vesicourethrostomy" method. I have used "Sliding
Knot Vesicourethrostomy" in 13 Lapoaroscopy Radcal Prostatectomies and 2 Laparoscopy
Radical Cystoprostatectomyectomies, it make the Vesicourethrostomy simple, easy, quick and
safe.
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35. Diabetic Erectile Dysfunction: Animal Studies
1 1 2 1 1 1 1
Yu-tian DAI , Yun CHEN , Run WANG , Zeyu SUN , Rong YANG , Leshen YAO , Dong CHEN ,
1
Sanxiang LI
1 Department of Urology, Affiliated Drum Tower Hospital, Nanjing University ， School of Medicine, Nanjing, Jiangsu
210008, China
2 Department of Urology, University of Texas Health Science Center at Houston and MD Anderson Cancer Center,
Houston 77030, USA
Diabetes mellitus (DM) and its complications are major causes of morbidity and mortality in the
developed countries. Erectile dysfunction (ED) is one of the most common complications in
diabetic men. Sometimes, ED can even be the first sign of DM. The pathogenesis of diabetic
erectile dysfunction is very complex, involved in nerve, neurotransmitter, blood vessel,
endothelial function, metabolism, endocrine and so on.
The neural factor plays a crucial role. Without influence of vascular pathological changes, there
was found diffuse neuropathic changes in penis and pelvic ganglia in the BB/WOR rat model. We
did some work on the neural factors. We found that the proteins of NGF, BDNF, NT-3 and NT-4
were all detected in the cavernous tissue. We found that NGF, NT-3, NT-4 proteins expression in
cavernous tissue of diabetic ED rats were all up-regulated compared to normal control rats while
BDNF was down-regulated. The exogenous administration of NGF or using AdV vector mediated
NGF or using HSV vector mediated NT-3 can partly revise the erectile function of diabetic ED
rats.
The neurotransmitter factor is a very important role. As we all known, the relaxation of the corpus
cavernosum was mediated by the L-Arg-NO-cGMP pathway. In diabetic ED rats, we could find
the decreased level and activity of penile nitric oxide synthase (NOS) and increased expression of
arginase II. Arginase is the enzyme that may downregulate NO production by competing with
NOS for L-Arg. Gene transfer of endothelial NOS (eNOS) recombinant adenovirus or calcitonin
gene related peptide （ CGRP） recombinant adeno-associated virus or vasoactive intestinal
polypeptide (VIP) cDNA could enhance the erectile response in diabetic rats.
Macroangiopathy caused the defect of hemoperfusion to penis, and microangiopathy caused the
ultrastructural changes of penis in diabetic animals. Blood vessel endothelium function is another
factor. The impaired endothelium caused the increased level of endothelin-1 (ET-1) and
endothelin receptor B (ETRB), and the cavernous smooth muscle contracted. The penile
expression of vascular endothelial growth factor (VEGF) and its receptors were decreased. The
exogenous of VEGF could improve the erectile response in diabetic rats. We found the increased
level of angiotensin-I and the decreased level of angiotensin subtype 1 receptor in the diabetic ED
rats. Valsartan, the effective antagonist of AT1R, can reverse the erectile dysfunction of DM rats.
Metabolism factor contains the evaluated advanced glycation end-products (AGEs) and
superoxide anion. The treatment with the Chinese drug ―Jiang Tang Qi Wei He Ji‖or extracellular
superoxide dismutase gene therapy can partly reverse the erectile dysfunction of DM rats.
63
The upregulated RhoA/Rho-kinase pathway in diabetic rats mediated ED through decreased
production of NO in the penis. The inhibition of RhoA/Rho-kinase improves eNOS protein content
and activity thus restoring erectile function in diabetes. The ion channel and cell gap junction also
have some effect on DM ED.
Though the multiple factors may play some roles on pathogenesis of DMED, we should use
combined therapy according to the multifactorial pathogenesis of diabetic ED, in order to elevate
the therapeutic effect on DMED.
The most important treatment is to regulate the blood glucose level to normal. In the same time,
we should protect the pelvic splanchnic nerves, vessel endothelium function, L-Arg-NO-cGMP
pathway, oxidative stress-antioxidative system, androgen supplement, cleaning of AGEs, and so
on. We believed that gene therapy could bring us a surprise in the future.
64
3. WCUS Meeting 2008
Date: Saturday, May 17, 2008
Venue: Orlando, Florida, USA
Theme: State-of-World Chinese Urology
65
Program - 2008
8:00 - 8:07 am Welcome and introduction
Tom F. Lue, USA
8:07 - 8:10 am Report from Scientific Program Committee
Run Wang, USA
8:10 - 9:00 am
Session 1: Highlight on Chinese Urology
Moderators: Yinglu Guo, China; Luke S. Chang, Taiwan; Keong Foo, Singapore
8:10 - 8:20 am Yanqun Na, President, Chinese Urological Assoc.
8:20 - 8:30 am Han-Sun Chiang, President, Taiwan Urological Assoc.
8:30 - 8:40 am Chin Chong Min, Vice-President, Singapore Urological Assoc.
8:40 - 8:50 am Wai Sang Wong, President, Hong Kong Urological Assoc.
8:50 - 9:00 am Son Fat Ho, President, Macao Urological Assoc.
9:00 - 9:10 am Integration of Chinese and Western Medicine in Urology
Yaqiang Zhang, China
9:10 - 9:20 am WCUS awards
9:20 -10:45 am
Session 2: Scientific Program
Renal and Urothelial Tumours
Moderators: Yanqun Na, China; Rei K. Chiou, USA; Chi-Rer Yang, Taiwan
9:20 - 9:30 am Epithelial-mesenchymal transition/mesenchymal-epithelial transition
and tumor invasion
Dalin He, China
9:30 - 9:40 am The relationship between bladder and upper urinary tract in
urothelial neoplasm
Guang Sun, China
9:40 - 9:50 am Proteomic analysis of human urinary bladder cancer proteome
using reverse phase nano-high performance liquid
66
chromatography/electrospray inonization tandem mass
spectrometry
Lia-Beng Tan, Taiwan
9:50 - 10:00 am Laparoscopic radical cystecomy with orthotopic ileal neobaldder in
woman
Jian Huang, China
10:00 - 10:10 am Robotic-assisted laparoscopic radical cystectomy in the
management of bladder cancer
Guan Wu, USA
10:10 - 10:20 am Endoscopy-assisted radical nephrectomy
Chuize Kong and Xiankui Liu, China
10:20 - 10:30 am Data Analysis of 1228 Patients with Renal Cell Carcinoma in East
China
Yiran Huang and Baijun Dong, China
10:30 - 10:45 am Discussion
10:45 - 11:00 am Tea and Coffee Break
11:00 - 12:00 noon
Session 3: Scientific Program
Prostate Cancer
Moderators: Yinghao Sun, China; Leland Chung, USA; Apichat Kongkanand, Thailand
11:00 - 11:10 am Dietary factors and prostate cancer
Bill Nelson, USA
11:10 - 11:20 am Prostate cancer treatment in Sweden: an update
Yuhui Wang, Sweden and Norway
11:20 - 11:30 am Robot-assisted laparoscopic radical prostatectomy: where we stand
in 2008
Li-Ming Su, USA
11:30 - 11:40 am Salvage therapies following radiation failure for prostate cancer
Joseph Chin, Canada
11:40 - 11:50 am Comparison of robotic and open radical prostatectomy:
histopathologic outcomes
Steven Shen, USA
11:50 - 12:00 noon Discussion
12 Noon - 1:00 pm Box Lunch and Viewing of Posters and Videos
67
1:00 pm - 2:00 pm
Session 4: Scientific program
Poster Presentations and Discussion (I)
Moderators: Guang Sun, China; Son Fat Ho, Macao; Liqun Zhou, China
Adrenal Disease
1:00 - 1:03 pm Laparoscopic surgery on ectopic para-aortic pheochromocytoma
(report of 2 cases)
Liming Li, Yi Lin, Jun Zhu, Hui zhang, China
1:03 - 1:06 pm Clinical analysis of cystic mass at the site of adrenal gland.
Liming Li, Yi Lin, Jun Zhu, Hui zhang, China
Upper Urinary Tract
1:06 - 1:09 pm A comparison of perioperative data between open and laparoscopic
nephroureterectomy for upper urinary tract transitional cell
carcinoma
Ning-chen Li, Li-qun Zhou, Ming Li, Zhi-song He, Yan-qun Na, China
1:09 - 1:12 pm Rare cases of non-tuberculosis, non-reflux, and non-obstructive
megaureter in an adult
Allen W. Chiu, Taiwan
1:12 - 1:15 pm Gasless hand assisted retroperitoneoscopic nephroureterectomy
Po Hui Chiang, Taiwan
1:15 - 1:18 pm Urine chemokine/cytokine change in patients with urolithiasis
Yii-Her Chou, Taiwan
Prostatic Diseases
1:18 - 1:21 pm Outcome of incidental prostate cancer in Macau
Lao Hoi Fai, Ian Lap Hong, Macau
1:21 - 1:24 pm FACT-P survey for quality of life among patients with advanced
prostate cancer in China
Kan Gong, Kai Zhang, Li-qun Zhou, Yan-qun Na, China
1:24 - 1:27 pm Thurlium-YAG laser vaporesection of prostate for patients with
BPH-Taipei city hospital experience.
Shing-Hwa Lu, Taiwan
1:27 - 1:30 pm PSA, % fPSA and prostate volume as diagnostic parameters of
prostate carcinoma for Chinese men.
Chuanliang Xu, Yinghao Sun, Xiaofeng Gao, et al, China
1:30 - 1:33 pm Characterization of normal prostate on transabdominal ultrasound
Lim Kok Bin, Singapore
1:33 - 1:36 pm Intraprostatic botulinum toxin A injection inhibits cox-2 expression
and suppresses prostatic pain on capsaicin induced prostatitis
model in rat
Yao-Chi Chuang, Taiwan
68
1:36 - 1:39 pm The radiation response of hormone-resistant prostate cancer
induced by long-term hormone therapy
Chun-Te Wu, Taiwan
1:39 pm - 2:12 pm
Session 5: Scientific program
Poster Presentations and Discussion (II)
Moderators: Jianye Wang, China; Kenneth C. Hsiao, USA; JT Hsieh, Taiwan
Adrology
1:39 - 1:42 pm Traditional medicine in ED in Asia-experience from the Asian males
Hui Meng Tan, Chirk Jenn NG, Malaysia
1:42 - 1:45 pm The role of meiosis regulator BOLL and its downstream substrate
CDC25A in human spermatogenesis.
Yung-Ming Lin, Taiwan
1:45 - 1:48 pm Array-CGH identifies copy number alterations (CNAS) of
reproduction-related genes in Taiwan congenital bilateral absence
of the vas deferens
Chien-Chih Wu, Taiwan
1:48 - 1:51 pm The effect of different severity in bladder dysfunction on corpus
cavernosum smooth muscle and Rho-kinase in rabbits.
Wei-Yu Lin, Taiwan
Urinary Bladder
1:51 - 1:54 pm Pure laparoscopic radical nephroureterectomy with concomitant
radical cystectomy for multi-focal transitional cell carcinoma in
uremic patients
Victor C. Lin, Taiwan
1:54 - 1:57 pm A training model of laparoscopic urethrovesical anastomosis
Tianxin Lin, Jian Huang, Kewei Xu et al, China
1:57 - 2:00 pm The enhancement of neovascularization for the tissue engineering
urinary bladder, A experiment study in vivo and in vitro
Yutian Dai, Bin Yang, Zeyu Sun, China
2:00 - 2:03 pm Immunotherapy for orthotopic murine bladder cancer using BCG
recombinant protein MPT-64
Dah-Shyong Yu, Taiwan
2:03 - 2:06 pm Functional effects of suburethral sling on female bladder outlet:
comparison between fascial sling and prolene mesh tape sling.
Alex T.L, Lin, Taiwan
2:06 - 2:09 pm Beneficial effects of antrodia comphorata on bladder function
before and after ischemia/reperfusion of rabbit bladder.
Alpha Dian-Yu Lin, Taiwan
Medical Legal Issues
69
2:09-2:12pm Experience of reducing medical legal issues from an award-wining
personal website.
Chih-Cheng Lu, Taiwan
1212 - 2:15 pm Brief Break
2:15 - 2:40 pm
Session 6: TUA Lectures
Moderators: Zeyu Sun, China; Hui Meng Tan, Malaysia; Jun Chen, Taiwan
2:15 - 2:25 pm Prognostic significance of P53 and x-ray repair cross-
complementing group 1 polymorphisms on PSA recurrence after
radical prostatectomy.
Shu-Pin Huang, Taiwan
2:25 - 2:35 pm The effect and mechanism of epimedium brevicornum maxim
extract on rat penile and rabbit clitorial intracavernous pressure.
Kuang-Kuo Chen, Taiwan
2:35 - 2:40 pm Discussion
2:40 - 2:50 pm Tea and Coffee Break
2:50 - 3:55 pm
Session 7: Scientific Program
New Technology and Practice Tips in Urology
Moderators: Zhangqun Ye, China; Bill Wong, Hong Kong; Kuang Kuo Chen, Taiwan
2:50 - 3:00 pm Mechanism of pelvic pain syndrome
Bo Song, China
3:00 - 3:10 pm Indications of Robot in Urology
Tung Shu, USA
3:10 - 3:20 pm Retroperitoneoscopic ligation of renal lymphatic vessels for the
treatment of chyluria-----Surgical tips and our experience
Gongxian Wang, China
3:20 - 3:30 pm Laser Prostatectomy in 2008
Carson Wong, USA
3:30 - 3:40 pm Sacral neuromodulation for lower urinary tract dysfunction caused
by spinal cord injury
Ho Son Fat, Macau
3:40 - 3:50 pm Male identity: a missing link in the formula to promote men’s health
70
Chirk Jenn NG and Hui Meng Tan, Malaysia
3:50 - 3:55 pm Discussion
3:55 - 4:00 pm Closing Remarks
Yanqun Na, China; Luke S. Chang, Taiwan
71
4. WCUS Meeting 2009
Date: Saturday, April 25, 2009
Venue: Hyatt Regency, McCormick Place, Chicago, USA
Theme: State-of-World Chinese Urology 2009
The World Chinese Urological Society (WCUS)
meeting in Chicago, 2009
Tom F. Lue, MD, FACS and Run Wang, MD, FACS
The World Chinese Urological Society (WCUS) has been very active at the AUA
annual meetings. The number of participants has increased from 300 at the 1 st
meeting held in Atlanta, Georgia in 2006 to more than 500 at the 3 rd meeting held
in Orlando, Florida in 2008. Chinese-speaking urologists and urologic scientists
attended the meeting from all corners of world including China, Taiwan, Hong
Kong, Macao, Singapore, Thailand, Malaysia, Australia, Europe and North
America.
Based on the suggestions from previous participants we will have several new
and exciting features at the 2009 Chicago meeting. These include more time for
the participants to mingle and make new friends at the poster session, expert
panels to discuss prostatitis and cystitis, two commonly mismanaged conditions
in China, as well as highlight sessions on various subspecialties that will help the
participants to be familiar with the state-of-the-art of urology.
The meeting will begin as usual with updates by the presidents of the urological
associations of China, Taiwan, Singapore, Hong Kong and Macao. This will be
followed by a two-hour poster session so that the participants have plenty of time
to discuss the science and practice of urology as well as getting to know one
another. Following this session, experts from different regions will present their
practical approaches to prostatitis which is a very common, yet, controversial
topic in China. The afternoon session will begin with a panel discussion of cystitis
glandularis that has caused a management dilemma in China recently. In light of
the overwhelming information and limited time during the AUA, the meeting will
invite accomplished urologists and scientists to give the AUA abstract highlights
for kidney, bladder and prostate cancers, BPH, voiding dysfunction/female
73
urology, sexual dysfunction, and infertility. We hope this will stimulate the
members of WCUS to participate in the remaining AUA scientific activities.
The annual AUA-WCUS meeting is designed as a platform for effective
communication among Chinese-speaking urologists and urological scientists.
However, it will also serve as a venue to share the advancements in basic and
clinical research from the countries and regions mentioned above with the AUA
members from other parts of the world since the slides and posters will be in
English. We certainly welcome you to attend this meeting and to meet the best
and brightest Chinese colleagues.
74
Program - 2009
8:00 - 8:07 am Welcome and introduction
Tom F. Lue, USA
8:07 - 8:10 am Report from Scientific Program Committee
Run Wang, USA
8:10 - 9:00 am
Session 1: Highlight on Chinese Urology
Moderators: Zeyu Sun, China; Kuang Kuo Chen, Taiwan; Richard Lo, Hong Kong
8:10 - 8:20 am Yanqun Na, President, Chinese Urological Assoc.
8:20 - 8:30 am Jong Khing Huang, President, Taiwan Urological Assoc.
8:30 - 8:40 am Chin Chong Min, Vice-President, Singapore Urological
Assoc.
8:40 - 8:50 am Ming Kwong Yiu, President, Hong Kong Urological Assoc.
8:50 - 9:00 am Hong Lap Ian, Secretary, Macao Urological Assoc.
9:10 - 9:20 am WCUS awards
9:20 - 11:20 am
Session 2: Scientific Program
View and Discuss Posters
Moderators: Tinghao Sun, China; KK Chew, Australia; Wai Hong Pun, Macau
Kidney Disease and Urinary Stone
The Effects of Irrigating Fluid Absorption in Percutaneous Nephrolithotripsy
Shaobin Ni, China
The Treatment and the Composition of Melamine-Contaminated Infant Formula
Induced Upper Urinary Calculi
Guohua Zeng, China
Treatment of Upper Ureteral Stones with Ntrap Combined with Ultrasonic and
Pneumatic Lithotripter under Ureteroscopy
Tiejun Pan, China
Safety of PNL in Solitary Kidney
Jianxing Li, China
Non-enhanced helica CT Three-dimensional Reconstruction Axis Rotation Movie
Images in Percutaneous Nephrolithotripsy and its Clinical Significance.
Linwu Chen, China
75
Recent advances in the management of RCC in China
Ding Wei Ye, China
"Marginal donors in renal transplantation: our experience"
VY Chung, LY Ho, HH Hung, J Fenn; Hong Kong
The effect of ―Shiwei― on the urine biochemistry of male patient suffering form
urinary calculi.
CF Ng, K Ip, D Gohel; Hong Kong
Comparing extracorporeal shock wave lithotripsy (SWL) with percutaneous
nephrolithotomy (PCNL) for lower pole stones larger than 10 mm: Tuen Mun
Hospital experience
MA Wai-Kit, YU Cheong, LAM Kin-Man, CHU Sau-Kwan Peggy, MAN Chi-Wai; Hong
Kong
Percutaneous nephrostomy versus internal stenting in the management of acute
pyonephrosis, a retrospective study.
HY Ngai, PS Szeto, HS So, V Velayudhan; Hong Kong
Flexible Ureteroscope in management of upper ureteric stone
Chan Tai Ip, Macau
Results of urological screening for adults claiming to have ingested melamine-
contaminated diary foods in a community hospital in Taiwan.
Yuh-Chen Kuo , Taiwan
Overexpression of her-2 is a poor prognostic factor in upper tract urothelial
carcinoma post-radical nephroureterectomy
Chun-Hsiung Huang, Taiwan
Innovated concept in percutaneous nephrolithotomy – single institute 780 case
report
Cheng-Huang Shen, Taiwan
Bladder Diseases
Clinical Investigation on the Relationship between Upper Urinary Tract
Obstruction and the Accompanied Chronic Cystitis
Aihua Li, China
Pelvic Floor Innnervation and LUTS
Bo Song, China
The Study of Diagnostic Criteria of Bladder Outlet Obstruction in Female
Kexin Xu, et al., China
76
Radical Cystectomy for Carcinoma of the Bladder in Older Patients
Chen Xiao, et al., China
Improvements and Long-term Outcomes of Orthotopic Urinary Diversion (376
cases)
Jiong-ming LI, China
Use of Intravesical Hyaluronic Acid in Patients with ―Street Ketamine‖-
Aassociated Bladder Dysfunction: A Pilot Study
MA Wai Kit, CHU Wing Hong, YIU Ming Kwong; Hong Kong
Differential roles of neuronal- and urothelium-derived no in the spontaneous
activity of mouse detrusor smooth muscle
En Meng, Taiwan
Cystitis glandularis – case analysis
Ching-Hsin Chang, Taiwan
Prostate Cancer
Robot-assisted Radical Laparoscopic Prostatectomy (16 cases)
Jiangping Gao, China
Brachytherapy for localized Prostate Cancer in Hong Kong Patients
Richard Lo; Hong Kong
Does extended transrectal ultrasound-guided prostate biopsy protocol improve
cancer detection in Chinese patients – Transitional zone versus Peripheral zone
approach.
KL Ho, SM Chu, PC Tam; Hong Kong
Short-term Outcome of Patients with Robot-assisted Versus Open Radical
Prostatectomy: Prince of Wales Hospital, Hong Kong Experience
S Yip, KL Lo, A Wong, CF Ng; Hong Kong
Prostate Valume is a effective predictor of cancer detection with serum PSA
between 4 and 10ng/ml
Ian Lap Hong, Lao Hio Fai, Pun Wai Hong, Li Kin, Tse Man Kin, Ho Son Fat; Macau
Association study of rs1447295 at 8q24 with prostate cancer in Taiwanese men
Marcelo Chen , Taiwan
Glycemia disorders and risk of prostate cancer mortality: an evidence for the
insulin hypothesis
Hui-Ming Chung , Taiwan
A multivariable logistic regression equation to screen for prostate cancer
Jhih-Cheng Wang, Taiwan
77
Clinicopathological Characteristics and Long-term Prostate-Specific Antigen
Recurrence -free Survival of Prostate Cancer Post Radical Prostatectomy in
Taiwan
Shu-Pin Huang , Taiwan
Update of Guidelines in Managing Benign Prostatic Hyperplasia among China,
Singapore and Taiwan
Chih-Cheng Lu, Taiwan
hK7 promotes the invasion and induces the epithelial-mesenchymal transition
(EMT) like morphological changes of human prostate cancer cell DU145
Zengnan Mo et al, China
The impact of estrogen in prostate development and cancer
Shuyuan Yeh, PhD, USA
BPH / LUTS
The vaporesection for Management of Benign Prostatic Hyperplasia Using 2
Micron Continuous Wave Laser: A Prospective Trial with 1-year Follow-up
Weiju Fu, China
The Detection and Treatment of Satellite Lesion of Bladder Tumor Using Narrow
Band Imaging Flexible Cystoscopy
Jingchun Xing, China
Survey on Current Situation of Pathogenesis of Prostate Hyperplasia in Multi-
centers of Beijing Communities
Ye Tian, China
Transurethral Electrovaporisation of Prostate in Saline: Histology Study
SWH Chan, HP Mo, NH Chan, MK Yiu; Hong Kong
Long-term outcome of TURP: a local experience
LY Ho, MH Wong, HY Lau, KL Lo, VY Chung, HH Hung, J Fenn; Hong Kong
Metabolic syndrome and prostate volume
Hsu-Han Wang, Taiwan
Laparoscopic simple prostatectomy with prostatic urethra preserved for benign
prostatic hyperplasia
Nianzeng Xing et al, China
Andrology / Sexual Dysfunction
Initial Study on Gene Recombination Induced Human Protein OCTN2 and
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Epididymis Sperm Maturation
Dongming Gong, et al., China
Knock Down PDE5A3 Gene of Human Corpus Cavernosum
Smooth Muscle Cells by siRNA in vitro
Ji-Hong Liu et al, China
Biodegradable poly-lactic-co-glycolic acid Maxpol-T/S as novel scaffold for adipose
derived stem cells and fibroblast growth in vitro
Zhong-Cheng Xin et al, China
Effect of TGF-beta/Smad signaling on sertoli cell and possible mechanism
related to complete sertoli cell-only syndrome.
Zhongcheng Xin et al, China
Use of Organ Culture to Study the Mouse Genital Tubercle Development: Effect
of Exogenous Estrogen
Zhong Wang et al, China
Macau Sex Survey
Pun Wai Hong, Macau
Cardiovascular disease subsequent to erectile dysfunction – the new dimension
to an intimate nexus: findings of a linked dataset.
KK Chew, Australia
Erectile dysfunction: Two common social habits, two divergent implications
KK Chew, Australia
The efficacy and safety of microsurgical parafrenular penile dorsal nerve
neurotomy in the treatment of premature ejaculation
Yu Chen, Taiwan
Erectile Dysfunction Evaluated by the Use of Erection Hardness Score and
Quality of Erection Questionaire in Taiwan
TIS Hwang, Taiwan
Electrical stimulation of cavernous nerve elicits simultaneous increase of
intracavernous and seminal vesical pressure in the rat
Kuang-Kuo Chen, Taiwan
Priority of sex and importance of erection hardness among Chinese
Thomas IS Hwang, Taiwan
Epidemiology / Other
The link between Obesity and Urological conditions
- Findings from Subang Aging Male Study (SAM)
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Hui Meng Tan, Malaysia
Prevalence and Correlates of OAB in a multiethnic population
Hui Meng Tan, Malaysia
11:20 -12:00 noon
Session 3: Scientific Program
Prostatitis – Clinical Strategy
Moderators: Guang Sun, China; Ming Kwong Yiu, Hong Kong; Jong Khing Huang,
Tawain
11:20 - 11:30 am North America Experience
Durwood Neal, USA
11:30 - 11:40 am Experience from China
Jihong Liu, China
11:40 - 11:50 am Experience from Taiwan
Po-Hui Chiang, Taiwan
11:50 - 12:00 noon Experience from Malaysia
Men Long Liong, Malaysia
12:00 - 12:10 pm Discussion
12:10 - 1:00 pm Lunch
1:00 - 1:30 pm
Session 4: HKUA Lectures
Moderators: Jianye Wang, China; Rei K. Chiou, USA; Lap Hong Ian, Macao
1:00 - 1:10 pm Use of Photoselective Vaporization of the Prostate for BPH
in Hong Kong Chinese Patients"
Richard Lo, Francis Lee and Bill Wong, Hong Kong
1:10 - 1:20 pm The destruction of the urinary tract by ketamine- HK
perspective
Peggy CHU Sau Kwan, Hong Kong
1:20 - 1:30 pm Discussion
1:30 - 2:10 pm
Session 5: Panel Discussion
Cystitis Glandularis - what is it?
Moderators: Shan Chen, China; Joseph Chin, Canada; Thomas IS Hwang, Taiwan
1:30 - 1:40 pm Cystitis Glandularis - what is it?
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Kuang Kuo Chen, Taiwan
1:40 - 1:50 pm The situation and challenge of Cystitis Glandularis in China
QiangWei, China
1:50 - 2:00 pm Pathology nature of cystitis glandularis
Steven Shen, USA
2:00 - 2:10 pm Discussion
2:10 - 3:50 pm
Session 6: 2009 AUA Abstract Highlights
Moderators: Liping Xie, China; Yuhui Wang, Sweden; Hui Meng Tan, Malaysia
2:10 - 2:20 pm Kidney Cancer
Casey K. Ng, USA
2:20 - 2:30 pm Prostate Cancer
Joseph Chin, Canada
2:30 - 2:40 pm Bladder Cancer
Guan Wu, USA
2:40 - 2:50 pm BPH
Carson Wong, USA
2:50 - 3:00 pm Voiding Dysfunction / Female Urology
Donna Deng, USA
3:00 - 3:10 pm Sexual Dysfuntion
Rei K. Chiou, USA
3:10 - 3:20 pm Infertility
Philip Li, USA
3:20 - 3:30 pm Urolithiasis/Endourology
Yuhui Wang, Sweden and Norway
3:30 - 3:40 pm Laproscopy/Robotic Surgery
Tung Shu, USA
3:40 - 3:50 pm Urological Oncology: basic research
Edmund Chiong, Singapore
3:50 - 4:00 pm Closing Remarks
Zhangqun Ye, China; Jong Khing Huang, Taiwan
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5. WCUS Meeting 2010
Date: Saturday, May 29, 2010
Venue: Moscone Centre, San Francisco, USA
Theme: The Challenge in the World Chinese Urology
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The 5th World Chinese Urological Society (WCUS)
meeting in San Francisco, 2010.
Tom F. Lue, MD, FACS and Run Wang, MD, FACS
Since the inception of the 1st World Chinese Urological Society (WCUS) meeting
at the AUA annual meeting held in Atlanta, Georgia in 2006, the WCUS has
become one of the most active sub-specialty societies at the AUA. The initial
participants included members from China, Taiwan, Hong Kong, Macau,
Singapore, Thailand, Malaysia, Australia and North America. This was expanded
to include people from Europe at the 2nd WCUS meeting held in Anaheim,
California in 2007. At the upcoming 5th Annual WCUS meeting in San Francisco,
we anticipate that more than 500 Chinese-speaking urologists and urologic
scientists will be in attendance from all corners of the world including urologists
from Mongolia who will be joining the family of the WCUS.
The 5th Annual WCUS meeting will be condensed from the previous full day
meeting to a full morning session with a noon poster assembly to allow plenty of
time for all participants to mingle and make new friends. The theme of the 2010
meeting is the challenges for World Chinese Urologists, particularly facing the
injuries from natural disasters and wars. These features are emphasized in this
meeting from the lessons learned by the devastating earth quakes in China, 2008
and in Taiwan, 2009.
The meeting will begin with a session to discuss experiences treating urethral
strictures, a very common trauma disorder in Asia. Experts from China, Hong
Kong and North America will review the evidence-based information and give
their personal experiences regarding ideal surgical techniques for various
complex urethral strictures or disruption. Following this session, two urologists
with military backgrounds from China and North America will present their first
hand experience facing natural disasters and war which may confront us during
our careers. In light of the overwhelming information and limited time during the
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AUA, we will continue to invite accomplished urologists and scientists to give the
AUA abstract highlights for kidney, bladder and prostate cancers, BPH, voiding
dysfunction/female urology, sexual dysfunction, and infertility. The AUA abstract
highlight session in the last WCUS meeting was regarded highly by participants
to catch the cutting edge of the basic and clinical science of urology.
Again, holding the WCUS meeting during the annual AUA meeting serves as a
venue to share the advancements in basic and clinical research in urology from
the countries and regions mentioned above with the AUA members from other
parts of the world. Even though our goal is to provide a platform for effective
communication among Chinese-speaking urologists and urological scientists, the
slides and posters will be presented in English, and we certainly welcome
urologists and urological scientists from the entire world to attend this meeting
and to meet our friendly and gifted Chinese colleagues.
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Program - 2010
8:00 - 8:07 am Welcome and introduction
Tom F. Lue, USA
8:07 - 8:10 am Report from Scientific Program Committee
Run Wang, USA
8:10 - 9:00 am
Session 1: Urethral Stricture – What is the Ideal Procedure?
Moderators: Yanqun Na, China; Thomas IS Hwang, Taiwan; PC Tam, Hong Kong
8:10 - 8:20 am North America Experience
Allen Morey, USA
8:20 - 8:30 am Mainland China Experience
Yuemin Xu, China
8:30 - 8:40 am Hong Kong Experience
Peggy Chu, Hong Kong
8:40 - 8:50 am Discussion
8:50 - 9:00 am WCUS awards
9:00 - 10:00 am
Session 2: Urological Surgeons Facing War and Disasters
Moderators: Zeyu Sun, China; Jong-Khing Huang, Taiwan; Tan Yeh Hong, Singapore
9:00 - 9:30 am Surgeon’s Challenge in Wars
Arthur Smith, USA
9:30 - 9:50 am Surgeon’s Challenge in Earthquake
Fengshuo Jin, China
9:50 - 10:00 am Discussion
10:00 -10:30 noon
Session 3: MUA Lectures
Moderators: Guang Sun, China; Ho Lap Yin, Hong Kong; Chi-Rei Yang, Taiwan
10:00 - 10:10 am Outcome of Radical Prostatectomy
Li Kin, Pun Wai Hong, Ian Lap Hong, Lao Hio Fai, Tse Man Kin,
Ho Son Fat; Macau
10:10 - 10:20 am Local Experience of Flexible Ureteroscopic Application
Chan Tai Ip; Macau
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10:20 - 12:10 pm
Session 4: 2010 AUA Abstract Highlights
Moderators: Jianye Wang, China; Ian Lap Hong, Macau; Hui Meng Tan, Malaysia
10:20 - 10:30 am Kidney Cancer
Dingwei Ye, China
10:30 - 10:40 am Prostate Cancer
Ming Li, China
10:40 - 10:50 am Bladder Cancer
Guan Wu, USA
10:50 - 11:00 am BPH
Xianghua Zhang, China
11:10 - 11:20 am Voiding Dysfunction/Female Urology
Dongwen Wang, China
11:20 - 11:30 am Sexual Dysfunction
Yutian Dai, China
11:30 - 11:40 am Infertility
Philip Li, USA
11:40 - 11:50 am Urolithiasis/Endourology
Simon SM Hou, Hong Kong
11:50 - 12:00 noon Laproscopy/Robotic Surgery
Yuhui Wang, Sweden and Norway
12:00 - 12:10 pm Urological Oncology: basic research
Benyi Li, USA
12:10 - 1:00 pm
Session 5: View and Discuss Posters
Kidney Disease and Renal Surgery
Moderators: Shan Chen, China; Edmund Chiong, Singapore; Sidney Yip, Hong Kong
1. Is Contrast Enhanced Ultrasound a valid alternative diagnostic tool for
Renal Cell Carcinoma in patients with renal impairment?
Tay KJ, Ho H, Low A, Cheng C, Singapore
2. Laparoscopic Partial Nephrectomy Made Easy
Francis Lee, Bill Wong, Richard Lo, Hong Kong
3. Severe renal infections - A review of clinical outcomes
James C.M.Li, Chung Y, Tai CK, Fan CW; Hong Kong
4. 10 years Outcome of Radical Nephrectomy.
Pun Wai Hong, Zhang Chong Yu, Ian Lap Hong, Li Kin, Lao Hio Fai, Tse
Man Kin, Ho Son Fat, Macau
5. Retroperitoneal laparoscpic partial nephrectomy.
Changjun Yin, Xiaoxin Meng, Ji Li, China
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6. The long-term follow-up for living-related donors undergoing laparoscopic
nephrectomy (158 cases).
Lulin Ma, China
7. The experience of single-port laporoscopic surgery.
Yinhao Sun, China
8. Impact of Kidney Disease Outcomes Quality Initiative (KDOQI) Guidelines
on the Prevalance of Chronic Kidney Disease (CKD) After Living Donor
Nephrectomy
Tan L, Wu Fiona, Raman L, Tai BC, Consigliere D, Tiong HY; Singapore
Adrenal Surgery and Urinary Lithiasis
Moderators: Jian Huang; China, SK Mak; Hong Kong; George Lee, Malaysia
9. Experience of laparoscopic treatment of complicated pheochromocytoma.
Hanzhong Li, Weigang Yan, Weifeng Xu, China
10. The risk factor analysis of the 24-hour urine components for patients with
lithiasis
Guohua Zeng, China
11. Treatment of renal calculi with Holmium laser lithotripsy through digital
flexible ureteroscope.
Yue Cheng, Xiaodong Shi, Jiasheng Hu, Zejun Yan; China
12. Anterograde flexible ureteroscopic lithotripsy in the management of
ureterointestinal anastomotic calculus in patients with Bricker urinary
divesion.
Wei Xue, China.
13. Study on expression of Calcium oxalate crystals stimulating macrophages
NADPH oxidase.
Yaoliang Deng , Binghua Sun, Chengyang Li; China.
14. Experimental investigation of the idiopathic hyperoxaluria formation
mechanism in rats.
Zhiqiang Chen, China
Bladder Diseases and Surgery
Moderators: Liping Xie, China; Po-Hui Chiang, Taiwan; Kavirach Tantiwongse,
Thailand
15. A Retrospective Review of the Effect of Botulinum Toxin A on Non-
neurogenic Detrusor External Sphincter Dyssynergia (DESD)
Tricia Kuo, Ng Lay Guat, Singapore
16. In vitro and in vivo Relaxation of Urinary Bladder Smooth Muscle by the
Selective Myosin II Inhibitor, Blebbistatin
Xinhua Zhang, Dwaraka Srinivasa R Kuppam, Arnold Melman, Michael E
DiSanto, USA
17. The mechanism of the detrusor damage for patients with diabetes.
Dongwen Wang, China
18. The prevalence of OAB in China.
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Kexin Xu,China
19. Overative bladder (OAB) and its relationship with prostatic calcification
Tan WS, Malaysia
20. Management of the Distal Ureter/Bladder Cuff in Laparoscopic
Nephroureterctomy
Richard Lo, Bill Wong, Francis Lee, Hong Kong
Prostate Cancer
Moderators: Qiang Ding, China; Shu-Pin Huang, Taiwan; Berry Fung, Hong Kong
21. Robotic-assisted transperineal prostate biopsy: 3-years experience
Henry Ho, Preethi M, Yuen JY, Lim E, Li DL, Ng WS, Cheng C, Singapore
22. Pathologic outcome in men with prostate cancer suitable for active
surveillance after radical prostatectomy
Grace Tan, Weber Lau, Huang HH, C Cheng, Singapore
23. Infectious Complication after Transrectal Ultrasound-guided Prostate
Biopsies: A Review of 1525 Cases
CH Cheng, CH Yee, Y Chiu, WF Lee, HC Chan, CK Tai, C Yu, HS So, SK Chu,
CW Fan, MK Yiu, V Velayudhan, CW Man; Hong Kong
24. Early continence outcomes after robotic radical prostatectomy - impact of
vesicourethral reconstruction
Ho KL, Wong CW, Au WH, Chu SM, Tam PC, Hong Kong
25. Experience of Hormone Therapy for Advanced Prostate Cancer.
Lao Hio Fai, Ian Lap Hong, Pun Wai Hong, Li Kin, Tse Man Kin, Ho Son Fat;
Macau
26. Extraperitoneal laparoscopic radical prostatectomy (162 cases).
Jian Huang, Tianxin Lin, Cun Chang; China
27. The survey of the PSA level of 16233 healthy Chinese male.
Zhicheng Gua; China
28. Zoledronic Acid Enhanced Growth Inhibition and Apoptosis in Both
Hormone-Refractory and Hormone-Sensitive Prostate Cancer Cell Lines
Yi-Chia Lin, Taiwan
29. Localized Prostate Cancers Treated with CyberKnife Delivered
Hypofractionated Radiotherapy：An initial Experience and Outcome
Analysis
Chia-Cheng Su, Taiwan
30. Association Analysis of the WNT Pathway Genes on Prostate Specific
Antigen Recurrence after Radical Prostatectomy
Shu-Pin Huang, Taiwan
31. Prognostic Significance of Prostate Cancer Susceptibility Variants on
Prostate-Specific Antigen Recurrence after Radical Prostatectomy
Shu-Pin Huang, Taiwan
BPH/LUTS/Urethral Disease
Moderators: Daling He, China; Gregory Y. Jia, USA; Nansalmaa Naidan, Mongolia
32. A randomized control trial on the prevention of secondary haemorrhage
after TURP with perioperative antibiotics prophylaxis
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CH Yee, LY Ho, Hong Kong
33. Metabolic Syndrome & LUTS
Tan HM, Malaysia
34. LUTS & QoL issue
Tong SF, Malaysia
35. The associations among enos g894t gene polymorphism, erectile
dysfunction, and benign prostate hyperplasia-related lower urinary tract
symptoms
Shu-Pin Huang, Taiwan
36. The experience in the treatment of complicated urethral stricture.
Hong Li, China
37. Application of Animal Tissue Model for 2 micro Laser Technique Training.
Gang Zhu, China
38. Iatrogenic Urethra Trauma of Male Patient Results from Urethra
Catheterization---- A Private Community Hospital Experience
Shiang-Ming Lin, Taiwan
39. Inlay Buccal Mucosal Graft: A Novel Technique for Re-operative Posterior
Urethroplasty
Shou-Hung Tang, Taiwan
40. The experience of treatment for severe hypospadias in 25 years
Jesun Lin, Taiwan
41. Prevalence of the lower urinary tract symptoms in Chinese males: Results
of the Chinese EPIC study
Yan B, Lin TL, Yang Y, Chan CK, USA, Taiwan, China, Hong Kong
Andrology / Sexual Dysfunction
Moderators: Xiaofeng Wang, China, Li Man Kay, Singapore; KK Chew, Australia
42. Pattern of mortality in men with erectile dysfunction
KK Chew, Australia.
43. The Streptozotocin-induced Type 1 Diabetes (T1D) Rat Model Exhibits Altered
Smooth Muscle Myosin Isoform Composition Consistent with Heightened Corpus
Cavernosum Smooth Muscle Tone and Erectile Dysfunction
Xinhua Zhang, Dwaraka Srinivasa R Kuppam, Arnold Melman, Michael E
DiSanto, USA
44. Diabetes Upregulates the Sphingosine-1-Phosphate (S1P) and
RhoA/Rho-kinase Signaling Pathways in Both Rat and Human CCSM
Resulting in Enhanced S1P-induced CCSM Contractility
Xinhua Zhang, Dwaraka Srinivasa R Kuppam, Arnold Melman, Michael E
DiSanto, USA
45. Sphingosine-1-phosphate in vitro and in vivo Modulates Corpus
Cavernosum Smooth Muscle Tone
Xinhua Zhang, Dwaraka Srinivasa R Kuppam, Arnold Melman, Michael E
DiSanto, USA
46. Sexuality and Management of Benign Prostatic Hyperplasia with Alfuzosin
Thomas IS Hwang, Taiwan
47. Elicitation of simultaneous increase of bilateral seminal vesical pressures
after electrical stimulation of lesser splanchnic nerve in the rat
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Kuang-Kuo Chen, Taiwan
48. Response of corpus cavernosum to vasoactive agent in the
hyperprolactinemic rat
Kuang-Kuo Chen, Taiwan
49. The prevalence of and risk factors for androgen deficiency in aging
Taiwanese men
Shu-Pin Huang, Taiwan
50. Update of the Asian Journal of Andrology 2010
Dangqing Ren, AJA
51. Vacuum therapy in penile rehabilitation via anti-hypoxic, anti-apoptotic
mechanism
Jiuhong Yuan, Haocheng Lin, Angel Paredes, Yutian Dai, O. Lenaine Westney,
Run Wang, USA
52. Gene Therapy with SuperEnzyme for ED after cavernosal nerve crush
injury in rat
Haocheng Lin, Jiuhong Yuan, Ke-He Ruan, Yutian Dai, Run Wang, USA
1:00 - 1:10 pm Abstract Award and Closing Remarks
Zhangqun Ye, China; Ming-kwong Yiu, Hong Kong
2010 WCUS Best Posters.
1. The long-term follow-up for living-related donors undergoing laparoscopic
nephrectomy (158 cases).
Lulin Ma, China
2. Study on expression of Calcium oxalate crystals stimulating macrophages
NADPH oxidase.
Yaoliang Deng , Binghua Sun, Chengyang Li; China.
3. Management of the Distal Ureter/Bladder Cuff in Laparoscopic
Nephroureterctomy
Richard Lo, Bill Wong, Francis Lee, Hong Kong
4. Robotic-assisted transperineal prostate biopsy: 3-years experience
Henry Ho, Preethi M, Yuen JY, Lim E, Li DL, Ng WS, Cheng C, Singapore
5. The associations among enos g894t gene polymorphism, erectile
dysfunction, and benign prostate hyperplasia-related lower urinary tract
symptoms
Shu-Pin Huang, Taiwan
6. Gene Therapy with SuperEnzyme for ED after cavernosal nerve crush
injury in rat
Haocheng Lin, Jiuhong Yuan, Ke-He Ruan, Yutian Dai, Run Wang, USA
6. WCUS Meeting 2011
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Date: Saturday, May 14, 2011
Venue: Walter E Washington Convention Centre,
Washington DC, USA
Theme: Prostate, Evidence Based Medicine and Men’s
Health
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The 6th World Chinese Urological Society (WCUS)
meeting in Washington DC, 2011.
Tom F. Lue, MD, ScD (Hon), FACS and Run Wang, MD, FACS
The World Chinese Urological Society (WCUS) will hold its 6th annual meeting in
Washington DC on May 14, 2011. The WCUS is a thriving organization that is
enthusiastically supported by the AUA, the Chinese Urological Association
(CUA), Taiwanese Urological Association (TUA), Hong Kong Urological
Association (HKUA), Macao Urological Association (MUA) and the Singapore
Urological Society as well as numerous urologists from all over the world. It has
become one of the most active sub-specialty societies at the AUA. We anticipate
that more than 500 Chinese-speaking urologists and urologic scientists will be in
attendance from all corners of the world.
The 6th Annual WCUS meeting will be a 5-hour session with special lectures,
topic-oriented mini-symposiums and AUA highlights. Dr. Paul Lange will give the
inaugural Lo Ping-wan Memorial Lecture entitled ―Provenge and the
endangered surgeon scientists‖. Chinese urologists and uro-scientists hold the
key to deliver world-class urologic care for the more than 1.3 billion Chinese
people worldwide. All the above-mentioned societies and governments are
making great efforts to support and encourage physicians to engage in research
and scientific discovery and we hope this lecture will inspire many in the
audience to purse an exciting career.
Lower urinary tract symptom (LUTS) from benign prostatic hyperplasia (BPH) is
one of the most common urologic diseases in Chinese patients. The plethora of
treatment is often confusing to the public as well as many practicing urologists. A
mini- symposium to address diagnosis and various treatment options will help
clarify the confusion. The past decade has seen an increasing incidence of
prostate cancer in Chinese speaking regions of the world. Another mini-
symposium will be devoted to this topic. A male health symposium that will
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feature a lecture on ―Obesity and Testosterone deficiency‖ and a lecture entitled
―prosthetic devices for men‖. Although far from perfect, evidence-based medicine
is a well-established practice in the US. Dr. Steven Canfield, the AUA evidence
based medicine course director will also give a special lecture to explain and
encourage this practice. Three industry-sponsored lectures will be given by Dr.
Harn Chorng Kuo (Pfizer), Dr. Farid Saad (Bayer) and Dr. Run Wang (AMS).
In consideration of the overwhelming information and limited time during the AUA
meeting, we will continue to invite accomplished urologists and scientists to give
the AUA abstract highlights for kidney, bladder and prostate cancers, BPH,
voiding dysfunction/female urology, stone, endourology/robotic surgery, sexual
dysfunction and infertility. The AUA abstract highlight sessions in the past
WCUS meetings were rated highly by participants.
Holding the WCUS meeting during the annual AUA meeting serves as a venue to
share cutting edge information in basic and clinical urology for Chinese speaking
urologists and friends as well as for social networking. Even though our goal is to
provide a platform for effective communication among Chinese-speaking
urologists and urological scientists, the slides will be presented in English, and
we welcome all urologists and urological scientists to attend this meeting and to
meet our friendly and gifted Chinese colleagues.
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Program - 2011
8:00 - 8:05 am Welcome and introduction
Tom F. Lue, USA
8:05 - 8:10 am Scientific Program
Run Wang, USA
8:10 - 8:35 am
Session 1: Lo Ping-wan Memorial Lectureship
Moderators: Richard Lo, Hong Kong; Hong-Jeng Yu, Taiwan; Apichat Kongkanand, Thailand
8:10 - 8:30 am Provenge and the endangered surgeon scientists
Paul Lange, USA
8:40 - 8:50 am Discussion
8:35 - 9:10 am
Session 2: Endourology and BPH
Moderators: Zeyu Sun, China; Tung Shu, USA; Ming-Kwong Yiu, Hong Kong
8:35 - 8:45 am The first step to be a good endourologist: urologists training
with simulators in China
Yanqun Na, China
8:45 - 8:55 am Revisiting the management of Male LUTS – can we use
symptoms to guide initial diagnosis and treatment?
Kuo Harn Chorng, Taiwan
8:55 - 9:05 am TUR in saline plasma vaporization (Button)
Peggy Chu, Hong Kong
9:05 - 9:10 am Discussion
9:10 - 9:15 am WCUS awards
9:15 - 9:50 am
Session 3: Evidence Based Medicine in Urology
Moderators: Yinghao Sun, China; Yao-Chi Chuang, Taiwan; Kavirach Tantiwongse, Thailand
9:15 - 9:30 am Evidence Based Medicine for Urologists: a review from AUA
evidence based medicine course director
Steven Canfield, USA
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9:30 - 9:45 am Evidence Based Medicine for Urologists: status in China
Qiang Wei, China
9:45 - 9:50 am Discussion
9:50 - 10:40 pm
Session 4: Radical Prostatectomy: Surgical Tips and
Outcomes
Moderators: Guang Sun, China; Steve Chan, Hong Kong; Edmund Chiong, Singapore
9:50 - 10:05 am Robotic Assistant
Christopher Cheng, Singapore
10:05 - 10:20 am Laparoscopic
Lulin Ma, China
10:20 - 10:35 am Open
Chi-Rei Yang, Taiwan
10:35 - 10:40 am Discussion
10:40 - 11:15 am
Session 5: Men’s Health Issues
Moderators: Tiejun Pan, China; Shaw Zhou, USA; Ban-Ping Jiann, Taiwan
10:40 - 10:55 am Combined surgical therapy for male stress incontinence and
ED
Run Wang, USA
10:55 - 11:10 am Obesity and testosterone deficiency - why this is of interest
for the urologist
Farid Saad, Germany
11:10 - 11:15 am Discussion
11:15 - 12:35 pm
Session 6: 2011 AUA Abstract Highlights
Moderators: Liping Xie, China; Lao Hio Fai, Macau; Carson Wong, USA
11:15 - 11:25 am Kidney Cancer
Liping Xie, China
11:25 - 11:35 am Bladder Cancer
Dai-Lung Cha, Taiwan
11:35 - 11:45 am Prostate Cancer
Ningchen Li, China
11:45 - 11:55 am BPH
Chan Tai Ip, Macau
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11:55 - 12:05 pm Voiding Dysfunction/Female Urology
Dominic Lee, Australia
12:05 - 12:15 pm Urolithiasis/Endourology
Kwan Lun Ho, Hong Kong
12:15 - 12:25 pm Sexual Dysfunction / Andrology/Infertility
Eric Chung, Australia
12:25 - 12:35 pm Laproscopy/Robotic Surgery
Yuhui Wang, Sweden and Norway
12:35 - 12:40 pm
Session 7: Scientific Publication
Moderators: Guan Wu, USA; Philip Li, USA; Yutian Dai, China
12:35-12:45pm How to get your urological-andrology research published at the AJA
successfully?
Danqing Ren, AJA
12:45-12:55pm How to demonstrate the research outcomes?
Suning You, Chinese Medical Association
12:55 - 1:00 pm Closing Remarks
Zhangqun Ye, China
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