ABSTRACT
Objective@#To evaluate the efficacy and safety of different positions external physical vibration lithecbole (EPVL) therapy for ureteral calculi related renal colic.@*Methods@#This study was a prospective multicenter randomized controlled trial. The inclusion criteria was that patients volunteered to participate in the trial and signed informed consent, patients’age ranged from 18-65 years old, ureteral calculi related with renal colic, stone diameter was less than 7 mm, patients were not treated with analgesia, antispasmodic drugs. The exclusion criteria was that combination of severe urinary tract infection, severe hydronephrosis, urinary malformation, severe hypertension, history of cerebrovascular disease, vital organ dysfunction, obesity (BMI>35 kg/m2), history of ureteral calculi exceeded 2 months, abnormal blood coagulation. Patients were randomized into observation group and control group using random number table method. The observation group and the control group were placed on the physical vibration stone arranging machine with head low foot high position and head high foot low position respectively. The inclination angle was 24°. The secondary vibrator vibrated for 6 minutes, then the patient took the prone position and opened the main, the secondary vibrator. The treatment is completed after 6 minutes of vibration. The analgesic effect, stone removal, follow-up effects and adverse reactions in the two groups was compared. We defined the pain relief rate as(VAS score before treatment-VAS score after treatment)/VAS score before treatment×100%.@*Results@#A total of 100 patients were included in the study, 50 in the observation group and 50 in the control group. There were no statistical difference in the age of the two groups [(41.8±11.7)years and (46.6±13.9 years)], gender distribution [37(male)/13(female) and 42(male)/ 8(female)], location of stones (in the observation group, 19 cases in upper ureter, 7 cases in the middle ureter and 24 cases in the lower ureter; in the control group, 12 cases in the upper ureter, 3 cases in the middle ureter, and 35 in the lower ureter), left and right distribution of stones [21(right)/ 29 (left) and 22 (right)/ 28(left)], long diameter of stones [(5.2±0.9)mm and(5.1±1.1)mm], VAS scores before treatment (7.5±1.4 and 7.6±1.5), and readmission rate [22%(11/50)With 18%(9/50)], 1 week stone removal rate [70%(35/50) and 64%(32/50)]. The incidence of adverse reactions was 8%(4/50) in the observation group including 3 cases of nausea, 1 case of vomiting. The incidence of adverse reactions was 4% in the control group (2/50), which 2 cases showed nausea. The number of patients who chose EPVL, ESWL or surgery for the subsequent treatment in observation group was 35 cases, 9 cases, and 6 cases respectively. The number of patients who chose EPVL, ESWL or surgery for the subsequent treatment in the control group was 35 cases, 10 cases and 5 cases respectively. There was no significant difference between the two groups (P>0.05). The VAS score after treatment of the observation group was lower than that of the control group (2.4±1.3 and 3.7±1.5, P<0.01). The total effective rate of the observation group was higher than that of the control group [94%(47/50) and 76%(38/50), P<0.01]. 46 patients underwent urinary ultrasonography to check the degree of hydronephrosis. The reduction rate of hydronephrosis was higher in the observation group than in the control group [54.5%(18/33) and 30.8%(4/13)], but there was no significant difference between the two groups (P=0.146). In the upper ureteral calculi, the VAS score of the observation group was lower than that of the control group (2.4±0.3 and 3.9±0.4, P<0.01). There was no significant difference in the total effective rate between the two groups. In the lower ureteral calculi, the observation group had low VAS score after treatment. In the control group (2.4±0.2 and 3.5±0.2, P<0.01), there was no significant difference in the total effective rate between the two groups; the middle segment stones were less included (10 in total) and were not discussed.@*Conclusions@#The external physical vibration lithecbole adopts " head high and low position" has better effect than "head low foot high position" in treatment of ureteral calculi with renal colic, and security is acceptable.
ABSTRACT
Objective To evaluate the efficacy and safety of different positions external physical vibration lithecbole (EPVL) therapy for ureteral calculi related renal colic.Methods This study was a prospective multicenter randomized controlled trial.The inclusion criteria was that patients volunteered to participate in the trial and signed informed consent,patients' age ranged from 18-65 years old,ureteral calculi related with renal colic,stone diameter was less than 7 mm,patients were not treated with analgesia,antispasmodic drugs.The exclusion criteria was that combination of severe urinary tract infection,severe hydronephrosis,urinary malformation,severe hypertension,history of cerebrovascular disease,vital organ dysfunction,obesity (BMI ＞ 35 kg/m2),history of ureteral calculi exceeded 2 months,abnormal blood coagulation.Patients were randomized into observation group and control group using random number table method.The observation group and the control group were placed on the physical vibration stone arranging machine with head low foot high position and head high foot low position respectively.The inclination angle was 24°.The secondary vibrator vibrated for 6 minutes,then the patient took the prone position and opened the main,the secondary vibrator.The treatment is completed after 6 minutes of vibration.The analgesic effect,stone removal,follow-up effects and adverse reactions in the two groups was compared.We defined the pain relief rate as(VAS score before treatment-VAS score after treatment)/VAS score before treatment × 100％.Results A total of 100 patients were included in the study,50 in the observation group and 50 in the control group.There were no statistical difference in the age of the two groups [(41.8 ± 11.7) years and (46.6 ± 13.9 years)],gender distribution [37(male)/13 (female) and 42(male)/8(female)],location of stones (in the observation group,19 cases in upper ureter,7 cases in the middle ureter and 24 cases in the lower ureter;in the control group,12 cases in the upper ureter,3 cases in the middle ureter,and 35 in the lower ureter),left and right distribution of stones [21 (right) / 29 (left) and 22 (right) / 28 (left)],long diameter of stones [(5.2 ± 0.9) mm and (5.1 ± 1.1) mm],VAS scores before treatment (7.5 ± 1.4 and 7.6 ± 1.5),and readmission rate [22 ％ (11/50) With 18％ (9/50)],1 week stone removal rate [70％ (35/ 50) and 64％ (32/50)].The incidence of adverse reactions was 8％ (4/50) in the observation group including 3 cases of nausea,1 case of vomiting.The incidence of adverse reactions was 4％ in the control group (2/50),which 2 cases showed nausea.The number of patients who chose EPVL,ESWL or surgery for the subsequent treatment in observation group was 35 cases,9 cases,and 6 cases respectively.The number of patients who chose EPVL,ESWL or surgery for the subsequent treatment in the control group was 35 cases,10 cases and 5 cases respectively.There was no significant difference between the two groups (P ＞0.05).The VAS score after treatment of the observation group was lower than that of the control group (2.4 ± 1.3 and 3.7 ± 1.5,P ＜0.01).The total effective rate of the observation group was higher than that of the control group [94％ (47/50) and 76％ (38/50),P ＜ 0.01].46 patients underwent urinary ultrasonography to check the degree of hydronephrosis.The reduction rate of hydronephrosis was higher in the observation group than in the control group [54.5％ (18/33) and 30.8％ (4/13)],but there was no significant difference between the two groups (P =0.146).In the upper ureteral calculi,the VAS score of the observation group was lower than that of the control group (2.4 ± 0.3 and 3.9 ± 0.4,P ＜ 0.01).There was no significant difference in the total effective rate between the two groups.In the lower ureteral calculi,the observation group had low VAS score after treatment.In the control group (2.4 ±0.2 and 3.5 ±0.2,P＜0.01),there was no significant difference in the total effective rate between the two groups;the middle segment stones were less included (l0 in total) and were not discussed.Conclusions The external physical vibration lithecbole adopts " head high and low position" has better effect than "head low foot high position" in treatment of ureteral calculi with renal colic,and security is acceptable.
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Objective To investigate the efficacy and safety of pedicled labium flap urethroplasty augmentation for female distal urethral stricture.Methods A retrospective review was performed involved 14 female distal urethral stricture patients from October 2014 to December 2016,with mean age of 59.5 years (range 47-77).There was one case secondary to trauma,5 cases secondary to iatrogenic injury,5 cases secondary to repeated urinary tract infection,and 3 cases with unknown etiology.The length of urethral stricture among the patients was 0.5 to 1.0 cm.The preoperative quality of life index was (4.6 ± 0.8),and the IPSS score was (20.7 ± 5.2),presenting severe lower urinary tract obstruction symptoms,with voiding symptom score of (13.6 ±3.9),and storage symptom score of(7.1 ± 1.7).The Qmax was (8.4 ±2.6)ml/s,and median residual urine volume was 88.5 ml(15-210 ml).All patients underwent dorsal onlay pedicled labium flap urethroplasty augmentation.Results The Qmax was (20.7 ± 3.5) ml,(19.5.± 3.9) ml and (18.8 ±2.7)ml at 1 month,6 months and 12 months follow-up,which were all superior to preoperative parameters,and the median residual urine volume was 23.0 ml(0-133 ml),21.5 ml (0-98 ml) and 26 ml (0-89 ml),which were significantly reduced.The quality of life index were (1.8 ± 0.8) and (2.1 ±0.9) after 6 months and 12 months of operation,which were better than preoperative scores.The IPSS score was (15.8 ± 2.8) and (15.7 ± 2.7),and the voiding symptom scores was (9.0 ± 2.1) and (8.9 ±2.0) after 6 months and 12 months of operation,which were all obviously reduced,while no significant change detected in storage symptom scores.At 12 months follow-up,there was no incontinence or recurrence.Condusions The application of dorsal onlay pedicled labium flap urethroplasty is a good option for female distal urethral stricture with the advantages of good safety,excellent effectiveness,few complications,less pain,and high satisfaction rate.
ABSTRACT
Objective To investigate the efficacy and safety of pedicled labium flap urethroplasty augmentation for female distal urethral stricture.Methods A retrospective review was performed involved 14 female distal urethral stricture patients from October 2014 to December 2016,with mean age of 59.5 years (range 47-77).There was one case secondary to trauma,5 cases secondary to iatrogenic injury,5 cases secondary to repeated urinary tract infection,and 3 cases with unknown etiology.The length of urethral stricture among the patients was 0.5 to 1.0 cm.The preoperative quality of life index was (4.6 ± 0.8),and the IPSS score was (20.7 ± 5.2),presenting severe lower urinary tract obstruction symptoms,with voiding symptom score of (13.6 ±3.9),and storage symptom score of(7.1 ± 1.7).The Qmax was (8.4 ±2.6)ml/s,and median residual urine volume was 88.5 ml(15-210 ml).All patients underwent dorsal onlay pedicled labium flap urethroplasty augmentation.Results The Qmax was (20.7 ± 3.5) ml,(19.5.± 3.9) ml and (18.8 ±2.7)ml at 1 month,6 months and 12 months follow-up,which were all superior to preoperative parameters,and the median residual urine volume was 23.0 ml(0-133 ml),21.5 ml (0-98 ml) and 26 ml (0-89 ml),which were significantly reduced.The quality of life index were (1.8 ± 0.8) and (2.1 ±0.9) after 6 months and 12 months of operation,which were better than preoperative scores.The IPSS score was (15.8 ± 2.8) and (15.7 ± 2.7),and the voiding symptom scores was (9.0 ± 2.1) and (8.9 ±2.0) after 6 months and 12 months of operation,which were all obviously reduced,while no significant change detected in storage symptom scores.At 12 months follow-up,there was no incontinence or recurrence.Condusions The application of dorsal onlay pedicled labium flap urethroplasty is a good option for female distal urethral stricture with the advantages of good safety,excellent effectiveness,few complications,less pain,and high satisfaction rate.
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Objective To elavluate the efficacy of pelvic floor muscle training (PFMT) on symptoms and quality of life in the treatment of female overactive bladder (OAB).Methods Ninety-one female patients with OAB completed the prospective study and were divided into 2 groups.The study group had PFMT combined with comprehensive health education and tolterodine (n =46),and the control group had comprehensive health education combined with tolterodine (n =45).OAB symptom score (OABSS),King's health questionnaire (KHQ) and modified Oxford scale (MOS) were evaluated at baseline,2 weeks,1 month and 3 months.The patients were followed up for 6 months.Results The MOS and OABSS score in study group before the treatment were 2.87±0.65 and 7.61 ±2.28,respectively,and in control group they were 2.80±0.55 and 7.44±2.41,respectively.There was no significant difference between the 2 grotps (P＞ 0.05).There was no significant difference in KHQ domains before the treatment between the 2 groups (P＞ 0.05).The MOS scores were 3.15±0.63 and 3.57±0.58 after treatment of 1 and 3 months in study group,which were significantly improved compared with the values of 2.89±0.57 and 3.09±0.67 in control group (P＜0.05).The OABSS score was 1.13± 1.93 in study group after treatment of 6 months,which was significantly improved compared with the values of 2.47±2.18 in control group (P＜0.05).The Incontinence impact,Role Limitations,Physical Limitations,Social Limitations and Symptom Severity in study group improved significantly compared with the values in control group after treatment of 3 months (P＜0.05).Domains of KHQ scores were totally significantly improved after treatment of 6 months in study group than in control group(P＜0.05).Conclusion Long term PFMT may play an important role in the treatment of OAB,and can also improve the quality of life of the patients.