Percutaneous cystolithotomy – A case report

Report one case of a male patient aged 73 years old, admitted to hospital due to difficult urination and sudden stopping during urination. Clinical and ultrasound examination revealed normal prostate, many stones in the bladder, with the largest diameter of 35mm and a diverticulum of bladder. Patient was treated by percutaneous cystolithotomy on September, 22nd 2005 at HCM University Medical Center. Check for removing all stones. Duration of procedure was 30 minutes. Ultrasound examination on the 1st post-operative day showed that there wasn’t any stone in the bladder, no fluid in abdominal cavity. Removing bladder drainage at 2nd post-operative day and urethral drainage at 3rd post-operative day, and then patient was discharged. The incision was dry, not leaking out urine

Neurogenic bladder - Diagnosis and treatment

It is very difficult to diagnose and treat the condition of neurogenic bladder or neurogenic voiding dysfunction. Causes of neurogenic bladder are central nervous system disorders. Diagnosis is based on urodynamic investigations. 80% of patients with neurogenic bladder can be treated by internal medicine therapies, but it is necessary to diagnose correctly the type of disorders (brain, spinal cord, peripheral nerves…) and to define exactly activities of muscle of bladder, urethral sphincter. Targets of treatment are preserving renal functions and improving urinary incontinence. Besides, there are some surgical procedures

Current pharmacological treatments of erectile dysfunction

Summarize some erectile dysfunction drugs which are current popular used, includes: drugs affected to central nerve system as Yohimbine, Apomorphine sublingual tablet; melanindirected peptide; drugs that affected to muscular dilatation of penis such as cavernous injected drugs (Papaverin, Alprostadil), penile suppository drugs, oral drugs (selective inhibition phosphordiesterase-5 (PDE-5) as Sildenafil, Vardenafil, Tadalafil) to prevent hydrolyzing of GMP circle, increase GMP circle’s level in cavernous smooth muscle

Current opinions on genitourinary injuries (Part 2: lower genitourinary tract)

Current opinions on diagnosis and management of lower genitourinary injury: in bladder, urethra and outside genital organ. Bladder trauma included bladder tear and bladder break (break in and outside of peritoneum). Retrograde urethrography with contrast media was a standard method in diagnosis of bladder break. Treatment: bladder sutured operation was absolute indicated for break in peritoneum; break outside of peritoneum could be treated by putting a large size urethra tube. In urethra injury: 37-93% cases of posterior urethral break and at least 75% cases of anterior urethral break experienced bleeding symptoms. Diagnosis method: retrograde urethrography with contrast media. Treatment: percutaneous cystostomy and urethral imaging test performed just before intervention. Outside genital organ’s trauma accounted for 1/3-2/3 of urogenital organ trauma. The injury was common in male, rarely in vulva of female. In cases of skin loss of penis or testicle, they were conservative treated. A partial or total urethra break needed to suture one-stage on catheter to make barrel and urine intubation

Current indications for open kidney stone surgery

The surgical management of kidney-stone disease has undergone dramatic changes over the past 20 years. The introduction and development of percutaneous renal surgery, extracorporeal shock-wave lithotripsy, ureteroscopy, and technical advances in the available modalities for intracorporeal lithotripsy have led to a revolution in the surgicalmanagement of kidney-stone disease. The indications for open kidney-stone surgery have been narrowed significantly, and for the most part open surgery has become a second or third line treatment option. In this article, the authors attempt to better define acceptable indications for open kidney-stone surgery, to review commonly accepted advantages of open stone procedures and to establish expected results and outcomes following open surgery for kidney-stone disease

The role of imaging examination in diagnosis and management of renal trauma

The generalization of some comments about the role of imaging examination in diagnosis of renal trauma as non-preparative adominal tomography: has less value in diagnosis of renal trauma but helps to detect metanephric duct stone. Intravenous urography (UIV): these imagings are main to evaluate the rest of renal function, prevention of cases of traumatic renal excision, has less value in diagnosis of renal trauma. Adominal ultrasound: to detect suggestive signs of internal haemorrhage due to solid viscera breaking in abdomen. CT scan has an important role, to help identifying with or without renal trauma, the level of renal lesions, with or without other viscera lesions. Renal angiography: to block selectively vessels to make haemostatic in some cases of haemorrhage due to renal trauma. MRI is recommended for patients with contraindication of absolute using contrast media