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RESUMEN Fundamento: El dispositivo intrauterino ha sido utilizado durante muchos años como método anticonceptivo; una complicación infrecuente posterior a su inserción es la migración fuera del útero. La localización vesical y la formación de vesicolitiasis, son complicaciones asociadas a la migración. Objetivo: Presentar un caso de migración de un dispositivo intrauterino a vejiga con litiasis sobreañadida como inusual etiología de una cistitis recurrente. Presentación del caso: Caso clínico de un dispositivo intrauterino en vejiga en una paciente de 43 años, cuyo diagnóstico se realizó incidentalmente en estudio de cistitis recurrente; se diagnosticó imagenológica y endoscópicamente en consulta de Urología; se decidió tratamiento quirúrgico mediante cistolitotomía a cielo abierto y se extrajo un cálculo de 4x5 cm de diámetro. La paciente evolucionó satisfactoriamente. Conclusiones: Considérese la posibilidad de migración del dispositivo intrauterino a la vejiga con litiasis sobreañadida como causa de cistitis recurrente, en pacientes femeninas que tengan antecedente de uso de este método anticonceptivo, lo que constituye un elemento importante en el diagnóstico y tratamiento de la infección urinaria baja.
ABSTRACT Background: The intrauterine device has been used for years as a contraceptive method; a non-frequent complication after its insertion is migration out of the uterus. The bladder location and the formation of vesicolithiasis are complications associated with migration. Objective: To present a migration case from an intrauterine device to the bladder with overadded lithiasis as an unusual etiology of recurrent cystitis. Case report: Clinical case of an intrauterine device in the bladder in a 43-year-old patient, whose diagnosis was made incidentally in a recurrent cystitis study, it was diagnosed by imaging and endoscopy in the Urology consultation; surgical treatment was decided by means of open cystolithotomy and a stone 4x5 cm in diameter was extracted. The patient evolved satisfactorily. Conclusions: To consider the possibility of migration of the intrauterine device to the bladder with overadded lithiasis as a cause of recurrent cystitis in female patients who have a preceding use of this contraceptive method, thus it constitutes an important element in the diagnosis and treatment of urinary lower infection.
Subject(s)
Uterine Perforation , Urinary Bladder Calculi , Cystitis/epidemiology , Intrauterine Device Migration , Intrauterine DevicesABSTRACT
Background & objectives: Urolithiasis is one of the most common painful urological disorder.Different chemical compositions of extracted stones has been reported from various parts of our country. The present study was conducted to determines the epidemiological profile of urinary tract calculi patientsand chemical compositions of extracted stones in a tertiary care hospital situated at a rural area of Punjab. Methods: Epidemiological profile and chemical composition of extracted stones from 50 operated patients of urinary calculi were checked. Results: Urinary tract stones were observed more in males residing in urban area and the unilateral stones were more common.Pure vegetarians in the 2nd-3rd decade of life areprone to suffer. The most of renal calculi were composed of calcium oxalate/calcium phosphate. Interpretation &Conclusion: Pure vegetarians Males in urban areas in the 2nd-3rd decadeof life are more prone for Unilateral,Non recurrent calcium oxalate /calcium phosphate stones.
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Objective To investigate the clinical safety and effect of transurethral plasmakinetic enucleation and resection of prostate combined with mini-incision in the treatment of senior and high-risk benign prostatic hyperplasia (BPH) with bladder stones. Methods Clinical data of 42 patients of senior and high-risk benign prostatic hyperplasia (BPH) with bladder stones was analyzed. All patients were treated with transurethral plasmakinetic enucleation and resection of prostate combined with mini-incision cystofithotomy. Results All operations were successfully performed without deaths. The operative time was 52~86 min, mean (63.90 ± 16.60) min. The blood loss was 45.0~136.0 ml, mean (73.90 ± 21.10) ml. There were no significant differences in the immediate life characteristics, serum K+, serum brain natriuretic peptide and other internal environmental indexes before and after operation. There were no serious complications in perioperation. 3 months after operation, international prostate symptomscore (IPSS), quality of life score (QOL), the maximum flow rate (Qmax) improved significantly compared with preoperation, significantly reduced the post void residual volume (PVR). Conclusion Transurethral plasmakinetic enucleation and resection of prostate combined with mini-incision can be particularly applied to elderly patients with high risk BPH complicated with bladder stones with efficaciously and more safety.
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Objective To explore the clinical effect of suprapubic small cut method combined with transurethral resection prostate(TURP) on the treatment of benign prostatic hyperplasia(BPH) complicated with bladder stones.Methods Sixty patients with BPH complicated with bladder stones ≥ 3 cm in the People's Hospital of Futian Affiliated to Guangdong Medical College from January 2013 to September 2014 were selected as the study group,and another 60 patients with BPH complicated with bladder stones＜3 cm during the same period were selected as the control group.The cases in the study group were treated with suprapubic small cut method combined with TURP,and the cases in control group were treated with transurethral method combined with TURP.The intraoperative indicators (including the time used for crushed stone,total operation time,blood loss,conversion to laparotomy,blood transfusion and bladder perforation),residual bladder stones and complications of postoperative were compared.Results The operations of the two groups of patients were successfully,and there was no conversion to laparotomy and either bladder perforation.The stone removal time and total operative time of patients of the study group were shorter than of the control group,the difference was statistically significant((12.20±3.55) min vs.(24.05±7.68) min,(62.31± 10.49) min vs.(82.46± 16.75)min;t =10.849,7.897;P＜0.001).The intraoperative blood loss and the cases of blood transfusion of patients of the study group were less than the control group,but the prevalence of urinary tract infection were higher(6vs.4),but the difference was not statistically significant(P＞0.05).Residual stones were more commonly in the control group than in the study group (study group:0,control group:6 cases),the difference was statistically significant(x2 =6.316,P=0.012).Conclusion BPH complicated with bladder stones can be treated by the suprapubic small cut method combined with TURP or transurethral method combined with TURP,but suprapubic small cut method combined with TURP is safer and more effective,which is worthy of popularization and application in clinic.
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Objective To explore the construction of a new stone clearance model and evaluate its clinic effect in the treatment of complicated bladder stones in patients with benign prostatic hyperplasia.Methods Forty-two cases of complicated bladder stones in patients with benign prostatic hyperplasia were treated by pneumatic lithotripsy using a three-channel stone clearance system composed of a resectoscope sheath,nephroscope sheath and lateral bladder telescope.Comparisons of gravel effect and I-PSS score,QOL score,BOO grade and Qmax differences preoperatively and 3 months post-operatively were made.Results Forty-two cases were stone-free with the first treatment without complications (bladder perforation,obvious water extravasation,serious bleeding or urethral injury),and the average time for lithotripsy was (43.6 ± 11.2) minutes.Subsequent transurethral resection of the prostate surgery was performed successfully.When measured at 3 months post-operatively,I-PSS score(9.5 ± 3.6) points,QOL score(1.3 ± 1.2) points,Qmax(17.7 ± 5.9) mL and BOO classification were significantly different when compared to preoperative scores.Conclusion The three-channel stone clearance system consisting of resectoscope sheath,nephroscope sheath and lateral bladder telescope can continuously and efficiently handle complicated bladder stones in patients with benign prostatic hyperplasia,leading to good clinical results.
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ObjectiveTo investigate the efficacy and advantages through the combination of transurethral resectoscope outer sheath and ueteroscopy for treatment of bladder stones.MethodsThe Wolf F24 transurethral resectoscope was first placed in bladder to observe the lesions in 68 patients with bladder stones.With the moving out of the body and inner sheath,F8 ureteroscopy sheath was sent into the bladder through outer sheath,then,holmium laser lithotripsy was performed.ResultsSixty-eight patients got successful operations without postoperative stones residual,significant postoperative bleeding,urethral tear,bladder injury and infection complications. The gravel rate reached 100％ 20 - 60 minutes ( 36.7 ± 5 ) min.ConclusionThe combination of transurethral resectoscope outer sheath and ueteroscopy is effective and safe for treatment of bladder stones.
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Microscopic prostatic calculi are not uncommon in late adult life. But a giant prostatic calculus is a rare finding. No symptoms are pathognomic of calculus disease of the prostate gland. The diagnosis is usually established by rectal palpation of the prostate gland, urethroscopic examination, and roentgenographic or ultrasonic study. Usually, no treatment is indicated for patients with asymptomatic prostatic calculi. In patients with significant symptoms, a transurethral or suprapubic prostatectomy may be contemplated. We report a case of a giant prostatic calculus with bladder stones in a 60-year-old male who was treated endoscopically.
Subject(s)
Adult , Humans , Male , Middle Aged , Calculi , Diagnosis , Digital Rectal Examination , Prostate , Prostatectomy , Ultrasonics , Urinary Bladder Calculi , Urinary BladderABSTRACT
Seven patients with bladder stones underwent percutaneous ultrasonic lithotripsy, suprapubically The stones ranged from 1.7 to 4.0 cm (mean 2.3 cm) in diameter. Mean treatment time was 49 minutes with a range of 10 to 120 minutes. The stone free rate was 100%. Among 7 patients 3 had unclear causes for bladder stone formation but 4 associated with etiologic disorders; BPH in 1, neurogenic bladder after spinal injury in 1, anterior urethral stricture in 1 and foreign body (paraffin) in bladder in 1. Under the intravenous narcotics and local anesthesia, all 7 patients well tolerated to pain but 6 complained a minimal voiding sense during the procedure. There was no complication such as bladder injury, bleeding or severe hematuria. Therefore, percutaneous suprapubic ultrasonic lithotripsy is considered to be a simple, safe and efficient outpatient procedure for the treatment of bladder stone.