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Objective To investigate the clinical characteristics of testicular torsion,and to provide the strategies for its early diagnosis and timely therapy.Methods The clinical data in the patients with testicular torsion diagnosed by surgical exploration from March 2011 to December 2016 were reviewed.The clinical characteristics were compared between the testis-preserving group and testis-resection group.The latest advances in the diagnosis and treatment of testicular torsion were summarized.Results A total of 64 cases of testicular torsion were included in this study.There were 27 cases in the testicle-preserving group with the age range of(8-40) years old,the average age was(19.00±5.28) years old,the onset time range was(1-24) h,the average time was (8.78 ± 6.73) h;the intraoperative sper matic cord twist range was (180-540) ° and average (290.00 ±103.92) °;6 cases were misdiagnosis with the misdiagnosis rate of 22.22 ％.There were 37cases in the testicle-resection group with the age range of(10-34),the average age was(19.00 ± 7.45) years old;the onset time range was (12-168) h,the average time was(66.92 ± 47.01) h,the intraoperative spermatic cord twist range was(180-720)° and average(457.00± 168.88)°;22 cases were misdiagnosed with the misdiagnosis rate of 59.46 ％.The onset time,spermatic cord twist degree and misdiagnosis rate had statistically significant difference between the two groups(P＜0.05).Conclusion Testicular torsion is an important urinary emergency condition which can not be ignored.Timely and effective treatment is the key to save the testicles.
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With the deepening of the reform of public hospitals at the county level,as well as the development of medical technology personnel training and medical technology development in county hospitals,county hospitals should be able to make use of the latest technology to undertake the common diseases and frequently occurring diseases of county residents.So at present,the teaching hospitals affiliated to medical universities should carry out the short-term training of the latest special techniques in the training of the regular doctors.Department of Urology of the first Affiliated Hospital of Chongqing Medical University,in the 3 month training cycle,with improving the self-learning ability of the refresher doctors as the core,carried out the hand by hand teaching of small classes and introducing model teaching,which achieved good results.
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Objective To evaluate the value of cough test in the tension-free vaginal tape (TVT)procedure.Methods A cohort of 85 women with stress urinary incontinence underwent the TVT procedure with cough test (n =41) or without cough test (n =44).Patients in cough test group were performed according to the Ulmsten’s method strictly,with the stress of tape adjusted in light of cough test; whereas in other 44 operations,the tape was placed on the urethral tract without stress,and no cough test was performed.The urine catheter was removed after 48 hours postoperatively and follow-up evaluation was carried out at 12 month postoperatively.Results TVT procedure was carried out successfully in all patients by a single experienced surgeon.Four cases of urinary retention and 5 cases of voiding difficulty were observed in the cough test group.However,urinary retention or voiding difficulty was not detected in the nun-cough test group.Based on the twelve-month follow-up results,the cure rate was 92.6％ (38/41) in the cough test group and 93.1％ (41/44) in the non-cough test group.Flow-pressure study indicated that 11 cases in cough test group were in the obstruction zone,while only 3 cases in the obstruction zone were detected in the non-cough test group.Conclusions TVT is a safe as well as effective minimally invasive surgical procedure to treat female stress urinary incontinence.However,Adjusting stress of tape in accordance with cough test during the TVT may potentially increase the incidence of urinary dysfunction postoperatively.Therefore,no convincing evidence was gained to support the efficacy of cough test during TVT in terms of preventing postoperative voiding dysfunction.
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Objective:To evaluate the therapeutic effect and adaptability of minimally invasive percutaneous nephrolithotomy(MPCNL) guided by ultrasound.Method:30 patients with renal calculi,who were treated with MPCNL guided by ultrasound from October 2005 to April 2006,were retrospectively analyzed.Results:The success rate of which the introducer needle tip was correctly positioned at the target point inside kidney was 96.8%(30/31),and the catheter has been placed satisfactorily was 93.5%(29/31).The successive rate or single puncture is very high,up to 95%,free from block in all cases after operations.Conclusions:A high success rate and less trauma were the merits of MPCNL,the technique is claimed to be safe and reliable.and it is worthwhile to be widely used.
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Objective:To evaluate the curative effect of ureteroscope and pneumatic lithotripsy on the treatment of ureteral stones and the prevention and cure of the complications.Methods:297cases of 318 sides of ureteral stones were treated by the use of the ureteroscope and pneumatic lithotripsy.Results:95.0%(282/297) of the stones were fragmented on one session,94.0%(279/297) of the stones being expelled within 7 days after the procedure.Complications occurred in 3%(9/297)of these.Conclusion:Treatment of the ureteral stones by the use of ureteroscope and pneumatic lithotripsy is safe,effective and less invasive.It should be the first choice of treatment for middle and lower ureteral stone.