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Objective:To discuss the diagnostic approaches and treatment choices of low-flow priapism.Methods:35 cases of patients suffered from the low-flow priapism in our hospital from September 2010 to October 2016 were selected and diagnosed with the low-flow (ischemic) priapism by combining cavernous blood gas analysisand and color duplex ultrasonography.The priapism lasted 12 to 240 h with a mean of 72 h.31 patients of them had ever been induced by Polysaccharide Sulfate.One appeared priapism after sexual life.One appeared priapism after micturition.2 of them were not known what drug they had taken.Results:The symptoms disappeared in 5 cases as a result of using cold compress,sedation method and intracavemous lavage in hospital.But 30 cases were still priapism.Their penis were in a flaccid state after they were performed with the operation of glandular cavemosum shunting.During the 6-24 months of follow-up,31 patients developed erectile dysfunction.Among them,13 cases were light to mid erectile dysfunction,10 cases were mildly and 8 cases were the worst.Conclusion:(1) Using cavernous blood gas analysis and color duplex ultrasonography is important way to diagnose priapism.(2) Cold compress,sedation method and intracavemous lavage are the first treatments for the the low-flow priapism.If they are not the effectual cure,the operation of glandular cavemosum shunting should be performed in time.
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<p><b>BACKGROUND</b>Amplatz dilation and balloon dilation are different methods in creating the accesses during percutaneous nephrolithotomy (PCNL). The aim of this study was to review the surgical experiences of managing staghorn calculi by Amplatz dilation and balloon dilation for 3 years.</p><p><b>METHODS</b>We retrospectively analyzed clinical data from 125 patients (129 kidneys) with staghorn kidney stones who underwent PCNL from January 2010 to December 2012, of whom 60 patients underwent Amplatz dilation (AD group) and 65 underwent balloon dilation (BD group) during PCNL.</p><p><b>RESULTS</b>The AD and BD groups were similar in age, male-female ratio, stone burden, stone type, hydronephrosis, and proportion of patients who had undergone extracorporeal lithotripsy. However, these two groups showed significant differences in terms of duration of percutaneous access (15.1 ± 3.6) minutes vs. (10.0 ± 3.3) minutes, one-attempt success rate of dilation via a single access 88.9% (72/81) vs. 97.8% (91/93), hemoglobin drop after surgery (3.5 ± 0.9) g/dl vs. (1.7 ± 0.9) g/dl, number of cases requiring intraoperative and postoperative blood transfusion 27.9% (n = 17) vs. 13.2% (n = 9), changes of central venous pressure before and after surgery (2.3 ± 1.2) cmH2O vs. (1.2 ± 0.7) cmH2O, number of patients who experienced postoperative fever >37.5°C 21 (34.4%) vs. 13 (19.1%) (all P < 0.05). No injury of adjacent organs, including pleura, liver, spleen, or bowel, was noted in patients.</p><p><b>CONCLUSIONS</b>During ultrasound-guided PCNL for staghorn stones, balloon dilation and Amplatz dilation are all effective and safe. Compared with Amplatz dilation, balloon dilation is a better choice, as it has a higher access creation success rate, shorter access creation time less blood loss, and lower proportions of circulatory overload and postoperative fever.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Kidney Calculi , General Surgery , Nephrostomy, Percutaneous , Methods , Retrospective StudiesABSTRACT
Objective To evaluate the efficacy and safety of holmium laser for treatment ureteric stones in patients with acute obstructive renal impairment.Methods Thirty-two patients were included in this study.None of the patients had a ureterie stent or nephrostomy tube before the ureteroseopy.All patients were treated with holmium laser.Results 30 patients with ureter stones in middle and inferior segment were free of stones by ureteroscopic lithotripsy.The success rate for treatment of ureteral stones lithotripsy and calculus removal was 93.7%.Ureter stones located in superior segment in two patients were sent back pelvis.Extracorporeal shock-wave lithotripsy were performed.The two patients were free of any stone fragmens a month later.In all patients, including the five with obstructive anuria,the renal impairment resolved or improved as evidenced by normalization or fall in blood urea and creatinine.100% of the patients were free of any stone fragments postoperatively.Conclusion A holmium laser was a safe and effective modality of ureteroscopic lithotripsy in patients with significant renal impairment or even obstructive anuria.It also had merits of small wound and fast postoperation recovery.Treatment of both-side ureteral stones could be handled at the same time.The use of holmium laser by ureteroacopy could be considered the first choice in patients with acute obstructive renal impairment.
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Objective To observe the effect and safety of the treatment of urethral stricture with guide wires leading a balloon dilatation catheter.Methods The clinical date of 25 cases of male patients suffering traumatic posterior urethral stricture were analyzed retrospectively,was treated with a balloon dilation catheter led by guide wires.Results All our patients were cured successfully with a guide-wire-leading balloon dilatation catheter expanding only once and there were no complications such as urethral perforation,rectal injury etc.Although 2 cases had not been ohviously improved risht after dilatation,but improved furtherly six months later.The follow-up was six to twelve months.23 cases were cured.2 osses were improved.The recovery rate was 92%.The effective rate was 100%.Conclusion It was safe and effective to treat urethral stricture with balloon dilation catheter led by guide wires.