F4.8 visual miniature nephroscope for the diagnosis and treatment of hematospermia / 中华男科学杂志

<p><b>Objective</b>To explore the practicability and safety of the F4.8 visual miniature nephroscope in the diagnosis and treatment of hematospermia.</p><p><b>METHODS</b>This study included 12 cases of refractory hematospermia accompanied by perineal or lower abdominal pain and discomfort. All the patients failed to respond to two months of systemic anti-inflammatory medication and local physiotherapy. Seminal vesicle tumor and tuberculosis were excluded preoperatively by rectal seminal vesicle ultrasonography, MRI or CT. Under epidural anesthesia, microscopic examination was performed with the F4.8 miniature nephroscope through the urethra and ejaculatory duct orifice into the seminal vesicle cavity, the blood clots washed out with normal saline, the seminal vesicle stones extracted by holmium laser lithotripsy and with the reticular basket, the seminal vesicle polyps removed by holmium laser ablation and vaporization, and the seminal vesicle cavity rinsed with diluted iodophor after operation.</p><p><b>RESULTS</b>Of the 10 patients subjected to bilateral seminal vesiculoscopy, 3 with unilateral and 2 with bilateral seminal vesicle stones were treated by holmium laser lithotripsy, saline flushing and reticular-basket removal, 2 with seminal vesicle polyps by holmium laser ablation and vaporization, and the other 3 with blood clots in the seminal vesicle cavity by saline flushing for complete clearance. The 2 patients subjected to unilateral seminal vesiculoscopy both received flushing of the seminal vesicle cavity for clearance of the blood clots. The operations lasted 10－55 (25 ± 6) minutes. There were no such intra- or post-operative complications as rectal injury, peripheral organ injury, and external urethral sphincter injury. The urethral catheter was removed at 24 hours, anti-infection medication withdrawn at 72 hours, and regular sex achieved at 2 weeks postoperatively. The patients were followed up for 6－20 (7 ± 2.3) months, during which hematospermia and related symptoms disappeared in 10 cases at 3 months and recurrence was observed in the other 2 at 4 months after surgery but improved after antibiotic medication.</p><p><b>CONCLUSIONS</b>The F4.8 visual miniature nephroscope can be applied to the examination of the seminal vesicle cavity and treatment of seminal vesicle stones and polyps, with the advantages of minimal invasiveness, safety and reliability.</p>

Clinical observation of FURS combined with ultrasound guided all seeing needle treatment of low pole renal calculi / 中国内镜杂志

Objective?To observe the clinical effect of FURS combined with ultrasound guided all seeing needle treatment of low pole renal calculi.?Methods?From January 2016 to January 2017, 63 patients with low pole renal calculi were enrolled in this study. 16 patients with multiple stones and 47 cases with single stones were treated by FURS combined with ultrasound guided all seeing needle. We retrospectively analyzed all the patients clinical data, including the operation time, bleeding volume, stone clearance rate, the incidence of postoperative complications, then assess the safety and effectiveness of the surgical approach.?Results?The operation time was 30 ~ 60 min, the average time was 45 min, postoperative complications in 3 cases, 2 cases of pain; no blood transfusion; 2 cases of percutaneous nephrolithotomy. Postoperative hospital stay wad 2 ~ 3 d, an average of 2 d, postoperative residual stone in 3 cases, 2 weeks after the treatment of external lithotripsy, 1 case of stone clearance rate of 100.0%.?Conclusion?Retrograde FURS combined with ultrasound guided visual puncture for renal calculi is safe, effective and feasible.

Laparoscopy and short poly FURS for treatment of ureteropelvic junction obstruction combined with renal stones / 中国内镜杂志

Objective To evaluate the clinical efficacy of laparoscopy and short poly FURS in treatment of UPJO combined with renal stones. Methods From May 2014 to November 2016, 20 patients with ureteropelvic junction stricture in our hospital were treated with Laparoscopy and short poly FURS lithotripsy, the clinical data of the patients before and after operation were retrospectively analyzed. Results The patients in this group were successfully operated in stage I, and the hemoglobin descent rate did not change significantly before and after operation. No need of blood transfusion, the first day after the review of urinary tract plain film observed DJ tube position, postoperative back to hospital in March pulled out of DJ tube, postoperative follow-up 6 months to 1 year, the patient recovered well, no long-term complications. Conclusion Laparoscopy and short poly FURS lithotripsy, has satisfactory effects and no significant complications which should be promoted.

Ultramini nephrostomy tract combined with flexible ureterorenoscopy for the treatment of multiple renal calculi in paediatric patients

PURPOSE: To assess the safety and efficacy of an ultramini nephrostomy tract, which we were using for the first time, combined with flexible ureterorenoscopy (URS) in the treatment of pediatric patients with multiple renal calculi. MATERIALS AND METHODS: Twenty pediatric patients (age, < or =6 years) underwent ultramini percutaneous nephrolithotomy (PCNL) combined with flexible URS. The group had multiple renal calculi, which were bilateral in 3 cases and were located in a total of 23 sites. The calculi were located in 2 calyces in 10 cases, scattered in more than 2 calyces in 7 cases, and limited to 1 calyx in 3 cases. The average patient age was 37.35 months (range, 14-68 months). The average stone diameter was 2.0 cm (range, 1-3.0 cm). In all patients, an ultramini nephrostomy tract was established under ultrasound guidance (dilated to F10) with simultaneous sheath placement. The flexible URS was placed into the collecting system during holmium laser lithotripsy. RESULTS: When ultramini PCNL was combined with flexible ureterorenoscopic holmium laser lithotripsy, the complete stone-free rate was 87% (20/23). The average level of hemoglobin decreased to 1.0 g/dL after the operation. No blood transfusions were needed. Levels of blood urea nitrogen, creatinine, and C-reactive protein were not significantly different before and after the operation. The average duration of hospitalization was approximately 4.85 days, and all cases were followed up for 6 to 12 months. No complications were found. CONCLUSIONS: Ultramini PCNL combined with flexible ureterorenoscopic holmium laser lithotripsy is a safe and effective treatment for children with multiple renal calculi.

Transurethral resection of the prostate for urinary retention after seed implantation for prostate cancer: report of 2 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the effect of transurethral resection of the prostate (TURP) in the treatment of urinary retention following seed implantation for prostate cancer.</p><p><b>METHODS</b>We treated 2 cases of urinary retention following seed implantation for prostate cancer by TURP, and analyzed their clinical data.</p><p><b>RESULTS</b>The operations were successful in both of the cases, with mean operation time of 60 min. Postoperative nocturnal urination of the patients averaged 2 times per night as compared with 5 - 6 times per night preoperatively, and their scores on IPSS and quality of life were significantly improved after surgery.</p><p><b>CONCLUSION</b>TURP affords satisfactory results in the treatment of urinary retention following seed implantation for prostate cancer patients.</p>

TRUS-guided transperineal biopsy with 9 + X method for the diagnosis of prostate carcinoma: retrospective analysis of 420 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the clinical value and safety of TRUS-guided transperineal biopsy with the 9 + X method in the diagnosis of prostate carcinoma.</p><p><b>METHODS</b>A total of 420 men underwent TRUS-guided transperineal biopsy with the 9 + X method for suspected prostate carcinoma. Their clinical data were retrospectively analyzed.</p><p><b>RESULTS</b>Prostate carcinoma was detected in 160 (38.1%) of the 420 cases, accounting for 7.4%, 17.8% and 65.4% in those with PSA < 4.0 microg/L, 4 -10 microg/L and > 10 microg/L respectively, 25.0% in those with abnormal findings on digital rectal examination (DRE), and 22.2% in those with abnormal echoes on TRUS or abdominal ultrasound examination. Complications after prostatic biopsy included gross hematuria in 79 cases (18.8%), acute urinary retention in 13 (3.1%) and fever in 9 (2.1%), but no other serious complications were observed.</p><p><b>CONCLUSION</b>TRUS-guided transperineal biopsy with the 9 + X method, with high accuracy and fewer complications, is an ideal approach to the diagnosis of prostate carcinoma.</p>

Diagnosis and treatment of primary epididymal tumor: a report of 35 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the diagnosis and treatment of primary epididymal tumor.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 35 cases of pathologically confirmed primary epididymal tumor. Of the total number of patients, 10 underwent tumor excision, 23 received epididymectomy, 1 was treated by simple orchidoepididymectomy, and by radical orchidoepididymectomy with second-stage retroperitoneal lymph node dissection.</p><p><b>RESULTS</b>Postoperative pathology confirmed 33 cases of benign tumor (including 21 adenomatoid tumor, 7 leiomyoma, 4 fibroma, and 1 papillary cystadenoma), and 2 cases of malignancy (1 malignant fibrous histiocytoma and 1 adenocarcinoma). The follow-up lasted 10 months to 6 years, which revealed no recurrence, metastasis and death.</p><p><b>CONCLUSION</b>Primary epididymal tumor is difficult to be definitely diagnosed preoperatively. Surgical exploration is the first choice for those highly suspected of the disease. Tumor excision or epididymectomy can be considered for benign cases, while radical orchidoepididymectomy with retroperitoneal lymph node dissection is recommended in case of malignancy.</p>