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1.
Gac. méd. espirit ; 23(2): 107-114, 2021. graf
Artículo en Español | LILACS | ID: biblio-1339939

RESUMEN

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.


Asunto(s)
Perforación Uterina , Cálculos de la Vejiga Urinaria , Cistitis/epidemiología , Migración de Dispositivo Intrauterino , Dispositivos Intrauterinos
2.
Rev. cienc. med. Pinar Rio ; 25(2): e4828, 2021. graf
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1289122

RESUMEN

RESUMEN Introducción: la litiasis vesical gigante es poco frecuente. Se diagnostica cuando el cálculo sobrepasa los 100 g de peso. Objetivo: comentar a la comunidad médica un nuevo caso de litiasis vesical gigante diagnosticado en un hombre de edad avanzada. Presentación del caso: paciente masculino de 72 años de edad, con antecedentes de infecciones urinarias a repetición, quien consultó por presentar dolor en bajo vientre y síntomas urinarios irritativos. Con el empleo de estudios de imagen se detectó un cálculo vesical de gran tamaño. Se utilizó anestesia regional espinal, se realizó adenomectomía y cistolitotomía convencional. Se extrajo un cálculo gigante con un peso de 460 g. Conclusiones: la litiasis vesical gigante es un padecimiento poco frecuente. Actualmente no representa un problema de salud en el territorio. La cistolitotomía convencional es la técnica de elección para la extracción de cálculos gigantes.


ABSTRACT Introduction: Giant bladder lithiasis is rare. It is diagnosed when the calculus exceeds 100g in weight. Objective: to comment to the medical community a new case of giant bladder lithiasis diagnosed in an elderly man. Case report: a 72-year-old male patient with a history of repeated urinary tract infections consulted for lower abdominal pain and irritative urinary symptoms. With the use of imaging studies a large bladder stone was discovered. Spinal regional anesthesia was applied, adenomectomy and conventional cystolithotomy were performed, and a giant stone weighing 460g was removed. Conclusions: giant bladder lithiasis is a rare entity. At present it does not represent a health problem in the territory. Conventional cystolithotomy is the technique of choice to remove giant stones.

3.
Philippine Journal of Internal Medicine ; : 65-68, 2020.
Artículo en Inglés | WPRIM | ID: wpr-886660

RESUMEN

@#BACKGROUND: This is a rare case of two large urinary bladder stones causing severe infection of the urinary tract affecting the bone marrow due to chronic immune stimulation in a patient with recurrent anemia. Urinary bladder calculi are hard masses of minerals. They develop when the minerals in concentrated urine crystallize. This often happens when the bladder cannot be emptied. Signs and symptoms can vary from severe abdominal pain to blood in the urine. Sometimes, bladder stones don't cause any symptoms. If left untreated, bladder stones may lead to infections and other complications such as hepatic abscess via a hematogenous route. CASE: This is a case of a seventy-eight-year-old man with a history of multiple blood transfusions secondary to anemia of unknown cause. He came into our institution for a second opinion. We worked up the patient, which showed hepatic abscess and two large urinary bladder calculi. Further investigation of the anemia later led to a diagnosis of primary myelofibrosis. DIAGNOSTICS: Ultrasound showed a complex mass on the left hepatic lobe measuring 7.5 cm x 6.0 cm x 2.1 cm consistent with a hepatic abscess. The culture of the abscess was positive for E. coli. Computed Tomography (CT) scan of the lower abdomen showed heterogeneous mass measuring 8.6 cm x 8.7 cm x 9.2 cm within the urinary bladder (see Figure 2). Urinalysis was consistent with a urinary tract infection. Urine culture showed E. coli. Video-assisted cystoscopy showed two urinary bladder calculi, measuring 1.5 cm x 3.2 cm x 4.2 cm weighing 30 grams each (see Figure 3). The calculi were composed of 100% Calcium Oxalate. He underwent a series of diagnostic examinations for anemia including gastroscopy to rule out a bleeding ulcer. Complete blood count showed hemoglobin of 77 g/L and a hematocrit of 0.23. Finally, bone marrow core biopsy was done which is consistent with primary myelofibrosis. CONCLUSION: Urinary bladder stones can be asymptomatic and may present only with vague abdominal pain. It should be one of the considerations in asymptomatic patients with long-standing prostatitis or benign prostatic hyperplasia. Detailed history, thorough physical examinations, and cautious diagnostic tests are mandatory to confirm the diagnosis. A hepatic abscess may arise from infections in the urinary tract such as prostatitis through hematogenous extension. Therefore, it is important to address the origin of the infection to prevent such complications. This is a rare case of an elderly man who presented with chronic anemia and later found out to have large urinary bladder stones that caused severe infection leading to immune stimulation of the bone marrow, hence the diagnosis of primary myelofibrosis by bone marrow biopsy. Such a rare case must be thought of holistically and analytically.


Asunto(s)
Masculino , Prostatitis , Hiperplasia Prostática , Cálculos de la Vejiga Urinaria , Absceso Hepático , Anemia
4.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 1347-1350, 2019.
Artículo en Chino | WPRIM | ID: wpr-801499

RESUMEN

Objective@#To evaluate the clinical value of suprapubic Trocar puncture lithotripsy in the treatment of benign prostatic hyperplasia and bladder stones.@*Methods@#From February 2016 to August 2018, 60 patients with benign prostatic hyperplasia and bladder stones in the Second Hospital of Pujiang County were randomly selected.The patients were divided into transurethral prostatic bipolarplasma electrotomy group(control group, 30 cases) and transurethral prostatic bipolar excision procedure combined with suprapubic Trocar puncture cystinolithotomy group(study group, 30 cases) according to the operation methods.The operation time, stone extraction time, removal of bladder fistula time, catheter extraction time, success of one stone extraction, postoperative complications of the two groups were statistically analyzed.@*Results@#The operation time, stone removal time, bladder fistula removal time and catheter removal time of the study group were significantly shorter than those of the control group(t=6.965, 4.541, 3.365, 3.306, all P<0.05). The success rate of the first stone extraction in the study group was 100.0%(30/30), which was significantly higher than 86.7%(26/30) in the control group (χ2=12.83, P<0.05). The incidence rate of postoperative complications in the study group was 10.0%(3/30), which was significantly lower than 23.3%(7/30) in the control group(χ2=13.34, P<0.05).@*Conclusion@#Suprapubic Trocar puncture lithotripsy has high value in the treatment of benign prostatic hyperplasia and bladder stones.

5.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 1347-1350, 2019.
Artículo en Chino | WPRIM | ID: wpr-753600

RESUMEN

Objective To evaluate the clinical value of suprapubic Trocar puncture lithotripsy in the treatment of benign prostatic hyperplasia and bladder stones.Methods From February 2016 to August 2018,60 patients with benign prostatic hyperplasia and bladder stones in the Second Hospital of Pujiang County were randomly selected.The patients were divided into transurethral prostatic bipolarplasma electrotomy group (control group,30 cases) and transurethral prostatic bipolar excision procedure combined with suprapubic Trocar puncture cystinolithotomy group (study group,30 cases) according to the operation methods.The operation time,stone extraction time,removal of bladder fistula time,catheter extraction time,success of one stone extraction,postoperative complications of the two groups were statistically analyzed.Results The operation time,stone removal time,bladder fistula removal time and catheter removal time of the study group were significantly shorter than those of the control group(t =6.965,4.541,3.365,3.306,all P <0.05).The success rate of the first stone extraction in the study group was 100.0% (30/30),which was significantly higher than 86.7% (26/30) in the control group (x2 =12.83,P <0.05).The incidence rate of postoperative complications in the study group was 10.0% (3/30),which was significantly lower than 23.3% (7/30) in the control group(x2 =13.34,P < 0.05).Conclusion Suprapubic Trocar puncture lithotripsy has high value in the treatment of benign prostatic hyperplasia and bladder stones.

6.
Malaysian Family Physician ; : 29-31, 2019.
Artículo en Inglés | WPRIM | ID: wpr-825396

RESUMEN

@#An Intrauterine contraceptive devices (IUCD) is commonly inserted by the primary health care physician. It can migrate into pelvic or abdominal organs. When a pregnancy occurs following an insertion of an IUCD, there should be a high suspicion of uterine perforation or possible migration. A radiograph can be done in the primary health care clinic to search for a missing IUCD. Early referral to the urology service is warranted when a patient presents with recurrent urinary tract infections. Removal of an intravesical IUCD can be managed with cystoscopy, laparoscopy or open surgery. Herein, we report a case of IUCD migration into the bladder. This case will highlight the importance of proper technique, careful insertion and the role of ultrasound.

7.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 1325-1328, 2018.
Artículo en Chino | WPRIM | ID: wpr-701921

RESUMEN

Objective To observe the effect of suprapubic lithocystotomy combined with transurethral resection of the prostate ( TURP) in the treatment of benign prostatic hyperplasia ( BPH) complicated with bladder stones ,and to summarize the surgical technique .Methods Eighty-two BPH patients with bladder stones were selected ,and they were randomly divided into two groups according to the digital table ,with 41cases in each group.The control group received TURP combined with pneumatic lithotripsy .The study group was treated with TURP combined with lithocystotomy .The treatment effect was compared between the two groups .Results The blood loss ,duration of stone surgery and total operative time in the study group were (64.1 ±1.3)mL,(12.6 ±2.5)min,(63.1 ±1.6)min, respectively,which were significantly lower than those in the control group [(92.1 ±1.8) mL,(23.6 ±2.1) min, (83.1 ±1.7)min,t=17.294,11.391,15.125,all P<0.05].The maximal urinary flow rate (Qmax) of the study group was (18.4 ±4.3)mL/s,which was significantly higher than (9.5 ±5.1)mL/s of the control group(t =15.294,P<0.05).The international prostate symptoms score (IPSS),residual urine volume (RUV),quality of life (QOL) score in the study group were (8.8 ±1.7)points,(15.8 ±5.3)mL,(1.4 ±0.6)points,which were signifi-cantly lower than those in the control group [(17.3 ±2.8)points,(42.5 ±6.1)mL,(3.6 ±1.8)points] (t=15.391,22.125,12.935,all P<0.05).The incidence rate of postoperative complications in the study group (7.1%) was significantly lower than 40.5%in the control group (χ2 =6.935,P<0.05).Conclusion TURP combined with lithocystotomy in the treatment of BPH complicated with bladder stones is helpful to improve the therapeutic effect and reduce the risk of complications .

8.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 212-216, 2018.
Artículo en Chino | WPRIM | ID: wpr-701699

RESUMEN

Objective To analyse the clinical efficacy and adverse reactions of transurethral plasmakinetic resection of prostate ( PKRP ) combined with pneumatic lithotripsy ( TULT ) in the treatment of benign prostatic hyperplasia(BPH) and bladder stones.Methods 78 cases with BPH and bladder stones were selected as the study subjects ,and they were randomly divided into two groups ,39 cases in each group .They were all treated with transure-thral PKRP,on this basis,patients in the control group were treated with small incision incision ,patients in the obser-vation group were treated with TULT .The clinical effect and complications were analyzed .Results The gravel time of the observation group was (28.56 ±4.73) min,which was significantly shorter than that of the control group .The intraoperative blood loss in the observation group was (103.47 ±10.58)mL,which was significantly less than that of the control group,there were statistically significant differences between the two groups (t =6.44,6.85,all P <0.05).There was no statistically significant difference in the operation time between the two groups (t=1.44,P>0.05 ) .The postoperative catheterization time ,bladder irrigation time and hospitalization time in the observation group were (5.26 ±1.38)d,(1.27 ±0.84)d and (6.34 ±1.25)d,respectively,which were significantly shorter than those in the control group,the differences were statistically significant (t=7.84,7.16,8.01,all P<0.05).The postopera-tive residual urine volume,IPSS score and QOL score in the observation group were (36.19 ±17.22)mL,(10.26 ± 1.58)points and (2.11 ±0.84)points,respectively,which were significantly lower than preoperation ,the Qmax was (13.98 ±2.46)mL/s,which was significantly higher than preoperation ,there were statistically significant differences (t=8.97,7.80,7.62,7.54,all P<0.05).There were no statistically significant differences between the observation group and the control group (t=1.44,2.06,1.86,2.30,all P>0.05).The incidence rate of complications of the observation group was 2.56%,which was significantly lower than 5.13%of the control group(χ2 =2.36,P>0.05). Conclusion The clinical efficacy and adverse reactions of transurethral PKRP combined with TULT in the treatment of BPH and bladder stones has significant effect , the utility model has the advantages of simple operation , small trauma,quick recovery and less complications ,it can be used as the first choice for the treatment of elderly patients with BPH and bladder stones .

9.
Chinese Journal of Postgraduates of Medicine ; (36): 393-396, 2018.
Artículo en Chino | WPRIM | ID: wpr-700229

RESUMEN

Objective To evaluate the efficacy and safety of modified transurethral plasmakinetic enucleation of prostate (M-TPEP) combined with cystolithectomy in elderly patients with high risk of large volume benign prostatic hyperplasia (BPH) complicated with large urinary bladder calculi. Methods Seventy-one patients with high risk of large volume BPH complicated with large urinary bladder calculi were selected, and the patients were treated with M-TPEP combined with cystolithectomy. The operation time, intraoperative blood loss, hospitalization time, complications, and the maximum urinary flow rate (Qmax), post-void residual volume (PVR), serum potassium, international prostate symptom score (IPSS), quality of life (QOL) score preoperative and postoperative 3 months were recorded. Results Seventy-one patients successfully completed the operation, and no death occurred. The operation time was (75.48 ± 6.51) min, intraoperative blood loss was (82.63 ± 10.08) ml, and postoperative hospitalization time was 5-7 d. Incidence of intraoperative capsule perforation was 2.82% (2/71), incidence of postoperative temporary urinary incontinence was 7.04% (5/71), incidence of urethral and bladder irritation after operation was 8.45% (6/71), and incidence of postoperative wound infection was 2.82% (2/71). The PVR, IPSS and QOL score 3 months after operation were significantly lower than those before operation: (6.89 ± 0.74) ml vs. (205.13 ± 40.08) ml, (2.71 ± 0.45) scores vs. (28.62 ± 3.57) scores and (1.36 ± 0.24) scores vs. (4.93 ± 0.38) scores, the Qmaxwas significantly higher than that before operation: (22.46 ± 2.97) ml/s vs. (5.24 ± 0.43) ml/s, and there were statistical differences (P<0.01);there was no statistical difference in serum potassium between before operation and 3 months after operation (P>0.05). Conclusions M-TPEP combined with cystolithectomy has short operation time, quick recovery after operation and low complication rate. It is a proper operative method for the elderly patients with high risk of large volume BPH and large urinary bladder calculi.

10.
International Neurourology Journal ; : 287-294, 2018.
Artículo en Inglés | WPRIM | ID: wpr-718566

RESUMEN

PURPOSE: Augmentation cystoplasty (AC) is a surgical procedure used in adults and children with refractory bladder dysfunction, including a small bladder capacity and inadequate bladder compliance, and in whom conservative and medical treatment has failed. This study was aimed to determine the long-term outcomes of AC in children. METHODS: A retrospective analysis was conducted of 42 patients (31 males; mean age, 14.2±6.2 years) who underwent AC for neurogenic and nonneurogenic bladder dysfunction, with a median 12.0±1.5 years of follow-up. All patients underwent AC using the ileum with or without continent reconstruction. Pre-AC, concurrent, and post-AC procedures and complications were analyzed. Patients who underwent ureterocystoplasty, were lost to follow-up, or had less than 10 years of follow-up were excluded. The primary outcomes were the complication and continence rates, the post-AC linear rate of height and weight gain, and renal function. The Student t-test was used to evaluate between-group differences and the paired t-test was used to evaluate longitudinal changes in measured variables. RESULTS: Renal function was stable or improved in 32 of 42 patients (76.2%), with a post-AC continence rate of 88.1%. Thirty patients (71.4%) required 72 procedures post-AC. There was no statistically significant difference in the mean percentile of height (P=0. 212) or weight (P=0.142) of patients in the pre- and post-AC periods. No cases of bladder perforation or malignancy were detected. CONCLUSIONS: We consider AC to be a safe and effective procedure that does not negatively affect future physical growth, while achieving a good rate of stable renal function. Patients need long-term follow-up to address long-term complications.


Asunto(s)
Adulto , Niño , Humanos , Masculino , Adaptabilidad , Estudios de Seguimiento , Íleon , Perdida de Seguimiento , Estudios Retrospectivos , Cálculos de la Vejiga Urinaria , Vejiga Urinaria , Aumento de Peso
11.
Acta méd. peru ; 34(3): 221-224, jul.-set. 2017. ilus
Artículo en Español | LILACS | ID: biblio-989150

RESUMEN

Se reporta el caso de un paciente con litiasis vesical gigante e hiperparatiroidismo primario. El hiperparatiroidismo primario se caracteriza por la producción autónoma de parathormonona, presentando hipercalcemia o calcio sérico normal-alto, con valores séricos de hormona paratiroidea elevados. El hiperparatiroidismo primario siempre debe ser tenido en cuenta en pacientes con historia de cálculos renales, nefrocalcinosis, dolor óseo, fracturas patológicas y resorción subperióstica. Se presenta caso de paciente masculino de 16 años de edad con antecedente de lito transuretral que acude a la emergencia por hematuria macroscópica y dolor abdominal suprapúbico. Se le realizó radiografía simple de pelvis, la que confirmó la presencia de litiasis vesical de grandes proporciones. Se reportó nivel de hormona paratiroidea de 335 pg/ml. Los pacientes con historia de cálculos de vías urinarias deben ser estudiados por patologías paratiroideas


We report the case of a patient with giant bladder lithiasis and primary hyperparathyroidism. This latter condition characterizes itself by the autonomous production of parathyroid hormone (PTH), leading to hypercalcemia or normal or elevated serum calcium levels, and there are also high values of PTH. Primary hyperparathyroidism must always be taken into account in patients with history of renal calculi, nephrocalcinosis, bone pain, pathological fractures, and subperiosteal reaction. The case is a 16-year old male patient with history of a previous transurethral procedure, who presented in the emergency room with macroscopic hematuria and suprapubic abdominal pain. A simple pelvis X-ray film was taken, which confirmed the presence of a large bladder calculus. The parathyroid hormone value was 335 pg/mL. Patients with history of renal calculi must be studied for determining the presence of parathyroid pathological conditions

12.
China Journal of Endoscopy ; (12): 26-30, 2017.
Artículo en Chino | WPRIM | ID: wpr-661154

RESUMEN

Objective To compare the effectiveness of ureteroscopic via urethral Peel-away sheath and transurethral ureteroscopy in treatment of bladder calculi. Methods Clinical data of 76 cases of bladder calculi patients were collected from January 2013 to December 2015. All the patients were randomly divided into two groups: Group A was performed by ureteroscopic lithotripsy via urethral Peel-away sheath (n = 45). Group B was transurethral ureteroscopic lithotripsy (n = 31). Results 76 cases of bladder calculi were successfully treated by one-time lithotripsy. Lithotripsy time: group A was (17.8 ± 5.9) min, group B was (22.7 ± 8.3) min (t = 2.96, P = 0.004); stone clearance time: group A (12.6 ± 4.9) min, group B (24.5 ± 5.3) min (t = 9.90, P = 0.000);Intraoperative urethral mucosa injury : group A (1.0 ± 0.5), group B (2.1 ± 0.4) (t = 9.47, P = 0.000); VAS score:group A (1.9 ± 0.6), group B (2.6 ± 0.6) points (t = 4.72, P = 0.000); indwelling catheter time: group A (1.0 ± 0.2) d, B group (1.4 ± 0.9) d (t = 2.59, P = 0.012); There was no significant difference in hospitalization expense, group A was (7437.4 ± 356.7), group B was (7296.8 ± 333.8) (t = -1.73, P = 0.087). There were no complications such as hemorrhage, perforation and rupture of the 2 groups, without convertion to open surgery either. After the treatment of oral antibiotic, 1 case of postoperative urinary tract infection was cured in group B. In our study, case of postoperative urinary retention was 1 in group A, versus 5 in group B, with statistical difference (χ2 = 6.43, P = 0.011). Follow up: 13 patients were lost to follow-up, the other patients were followed up for 6 ~ 12 months. There was 1 case of elderly male patient with urinary retention due to BPH in each of the 2 groups, the other patients had no recurrence of calculus. By analyzing the statistical results, it was found that the experimental group had obvious advantages over the control group in the lithotripsy time, stone clearance time, urethral mucosa injury, postoperative pain and postoperative indwelling catheter time. Conclusion There is no significant difference in efficacy of the treatment of bladder calculi between ureteroscopic via urethral Peel-away sheath and transurethral ureteroscopy. However, our study shows the Peel-away ureteroscopy has the advantages of shorter lithotripsy time, shorter time of stone clearance and less injury of urethra mucosa menbrane, there was no significant difference in operation cost between two groups. Therefore, Ureteroscopic via urethral Peel-away sheath is an effective method for endoscopic bladder lithotripsy.

13.
China Journal of Endoscopy ; (12): 26-30, 2017.
Artículo en Chino | WPRIM | ID: wpr-658266

RESUMEN

Objective To compare the effectiveness of ureteroscopic via urethral Peel-away sheath and transurethral ureteroscopy in treatment of bladder calculi. Methods Clinical data of 76 cases of bladder calculi patients were collected from January 2013 to December 2015. All the patients were randomly divided into two groups: Group A was performed by ureteroscopic lithotripsy via urethral Peel-away sheath (n = 45). Group B was transurethral ureteroscopic lithotripsy (n = 31). Results 76 cases of bladder calculi were successfully treated by one-time lithotripsy. Lithotripsy time: group A was (17.8 ± 5.9) min, group B was (22.7 ± 8.3) min (t = 2.96, P = 0.004); stone clearance time: group A (12.6 ± 4.9) min, group B (24.5 ± 5.3) min (t = 9.90, P = 0.000);Intraoperative urethral mucosa injury : group A (1.0 ± 0.5), group B (2.1 ± 0.4) (t = 9.47, P = 0.000); VAS score:group A (1.9 ± 0.6), group B (2.6 ± 0.6) points (t = 4.72, P = 0.000); indwelling catheter time: group A (1.0 ± 0.2) d, B group (1.4 ± 0.9) d (t = 2.59, P = 0.012); There was no significant difference in hospitalization expense, group A was (7437.4 ± 356.7), group B was (7296.8 ± 333.8) (t = -1.73, P = 0.087). There were no complications such as hemorrhage, perforation and rupture of the 2 groups, without convertion to open surgery either. After the treatment of oral antibiotic, 1 case of postoperative urinary tract infection was cured in group B. In our study, case of postoperative urinary retention was 1 in group A, versus 5 in group B, with statistical difference (χ2 = 6.43, P = 0.011). Follow up: 13 patients were lost to follow-up, the other patients were followed up for 6 ~ 12 months. There was 1 case of elderly male patient with urinary retention due to BPH in each of the 2 groups, the other patients had no recurrence of calculus. By analyzing the statistical results, it was found that the experimental group had obvious advantages over the control group in the lithotripsy time, stone clearance time, urethral mucosa injury, postoperative pain and postoperative indwelling catheter time. Conclusion There is no significant difference in efficacy of the treatment of bladder calculi between ureteroscopic via urethral Peel-away sheath and transurethral ureteroscopy. However, our study shows the Peel-away ureteroscopy has the advantages of shorter lithotripsy time, shorter time of stone clearance and less injury of urethra mucosa menbrane, there was no significant difference in operation cost between two groups. Therefore, Ureteroscopic via urethral Peel-away sheath is an effective method for endoscopic bladder lithotripsy.

14.
International Journal of Traditional Chinese Medicine ; (6): 114-117, 2016.
Artículo en Chino | WPRIM | ID: wpr-485870

RESUMEN

Objective To evaluate the improvement of lower urinary tract symptoms in benign prostatic hyperplasia (BPH) patients with bladder calculi by lithotripsy and adjuvant traditional Chinese decoction. Methods A total of 72 BPH patients with bladder calculi were recruited and randomly divided into the non-adjuvant treatment group (37 patients) and the adjuvant treatment group (35 patients). The adjuvant treatment group received adjuvant traditional Chinese decoction from 2 days before lithotripsy for 2 weeks. The maximum urinary flow rate (Qmax) , residual urine volume (RU), International Prostate Symptom Score (IPSS) and Quality of Life (QOL) were assessed before and after the treatment. The time of urine routine returned to normal and the indwelling time of catheter were compared between two groups. Urinary incontinence and recurrent bladder calculi were followed up for 6 months. Results After the treatment, the score of the IPSS (12.9 ± 4.5 vs. 15.7 ± 3.9;t=2.826, P=0.006) and the RU (47.3 ± 9.2 ml vs. 58.4 ± 11.3 ml;t=4.556, P<0.001) in the adjuvant treatment group were significantly lower than those in the non-adjuvant treatment group, and the Qmax (30.4 ± 4.7 ml/s vs. 21.4 ± 3.9 ml/s;t=8.862, P<0.001 ) was significantly higher. The indwelling time of catheter (5.7 ± 2.1 d vs. 8.1 ± 2.2d;t=4.730, P<0.001) and the time of urine routine returned to normal (6.9 ± 2.3 d vs. 10.2 ± 3.1 d;t=5.106, P<0.001) in the adjuvant treatment group were significantly shorter than those in the non-adjuvant treatment group. The 6-month follow-up showed that the incidence of urinary incontinence (2.9% vs. 18.9%;χ2=4.698, P=0.030) and recurrent bladder calculi (5.7% vs. 24.3%;χ2=4.813, P=0.028) in the adjuvant treatment group were significantly shorter than those in the non-adjuvant treatment group, and the total effective rate was significantly higher (62.9%vs. 29.7%; χ2=6.672, P=0.011). Conclusions Lithotripsy and adjuvant traditional Chinese decoction can reduce the IPSS score and RU, increase Qmax, decrease urinary incontinence and recurrent bladder calculi, and improve lower urinary tract symptoms in BPH patients with bladder calculi.

15.
Int. braz. j. urol ; 41(1): 134-138, jan-feb/2015. graf
Artículo en Inglés | LILACS | ID: lil-742866

RESUMEN

Objective To identify whether stabilization of larger bladder stones would improve the efficacy of combination (ultrasonic/pneumatic) lithotripsy in a phantom bladder stone model for percutaneous cystolithopaxy. Materials and Methods Using 1cm phantom Bego stones, a spherical model bladder was used to simulate percutaneous bladder access. A UroNet (US Endoscopy, USA) was placed alongside a Swiss Lithoclast probe through the working channel of a Storz 26Fr rigid nephroscope. Using a 30Fr working sheath, the stone was captured, and fragmented for 60seconds. Resulting fragments and irrigation were filtered through a 1mm strainer, and recorded. Five trials were performed with and without the UN. Durability was then assessed by measuring net defects, and residual grasp strength of each instrument. Descriptive statistics (mean, standard deviations) were used to summarize the data, and Student’s t-tests (alpha<0.05) were used to compare trials. Results The mean time to stone capture was 12s (8-45s). After fragmentation with UN stabilization, there were significant improvements in the amount of residual stone (22% dry weight reduction vs 8.1% without UN, p<0.001), number of fragments (17.5 vs 5.0 frag/stone, p=0.0029), and fragment size (3.6mm vs. 7.05 mm, p=0.035). Mesh defects were noted in all nets, ranging from 2-14 mm, though all but one net retained their original grip strength (36.8N). Conclusions Bladder stone stabilization improved fragmentation when used in conjunction with ultrasonic/pneumatic lithotripsy. However, due to limitations in maneuverability and durability of the UN, other tools need to identified for this indication. .


Asunto(s)
Litotricia/instrumentación , Litotricia/métodos , Cálculos de la Vejiga Urinaria/terapia , Diseño de Equipo , Ilustración Médica , Reproducibilidad de los Resultados , Factores de Tiempo
16.
Int. braz. j. urol ; 39(5): 702-711, Sep-Oct/2013. tab, graf
Artículo en Inglés | LILACS | ID: lil-695156

RESUMEN

Purpose The purpose of this study is to determine if body mass index (BMI) and stone skin distance (SSD) affect stone free rate (SFR) in obese and morbid obese patients who underwent flexible URS for proximal ureteral or renal stones < 20 mm. Materials and Methods A retrospective chart review was performed of consecutive patients that underwent flexible URS. Inclusion criteria were: proximal ureteral stones and renal stones less than 20 mm in the preoperative computed tomography (CT). SFR were then compared according to SSD and BMI. Results A total of 153 patients were eligible for this analysis, 49 (32.02%) with SSD < 10 cm and 104 (67.97%) with SSD ≥ 10 cm. The mean stone size was 10.5 ± 6.4 mm. The overall SFR in our study was 82.4%. The SFR for the SSD < 10 and ≥ 10 were 79.6% and 83.7% respectively (p = 0.698) and for BMI < 30, ≥ 30 and < 40 and ≥ 40 were 82.9%, 81.7% and 90.9% respectively. Regression analysis showed no affect between BMI or SSD regarding SFR. Conclusion Ureteroscopy should be considered as a first-line of treatment for renal/proximal stones in obese and morbid obese patients. URS may be preferable to SWL in obese patients independently of the SSD, BMI or the location of proximal stones. .


Asunto(s)
Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Índice de Masa Corporal , Cálculos Renales/terapia , Litotricia/métodos , Obesidad/complicaciones , Cálculos Ureterales/terapia , Ureteroscopía/métodos , Pared Abdominal , Tempo Operativo , Obesidad/patología , Tamaño de la Partícula , Valores de Referencia , Análisis de Regresión , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
17.
Rev. Col. Bras. Cir ; 40(3): 227-233, maio-jun. 2013. ilus, tab
Artículo en Portugués | LILACS | ID: lil-680938

RESUMEN

Cálculos vesicais são raros e a maioria dos casos ocorre em homens adultos com obstrução infravesical. Atualmente, existem poucos dados sobre o melhor tratamento desta doença. O objetivo desta revisão foi discutir alguns aspectos da patogênese e abordar o tratamento da litíase vesical. Uma ampla pesquisa na base de dados da "National Library of Medicine"/Pubmed foi realizada com os seguintes unitermos e descritores: vesical ou bexiga associados a cálculo, pedra ou litíase, e cistolitotripsia. Cento e setenta e um artigos foram identificados. Os artigos foram avaliados independentemente por dois revisores com experiência em urolitíase. Foram incluídos quando os resultados, complicações e seguimento foram claramente reportados. No final, 32 estudos preencheram os critérios de inclusão. Nota-se que diversas opções para o tratamento da litíase vesical estão disponíveis, porém não há estudos randomizados comparando-as. Diferentes taxas de pacientes livres de cálculo são descritas, sendo: litotripsia extracorpórea com ondas de choque (75-100%), cistolitotripsia transureteroscópica (63-100%), cistolitotripsia percutânea (89-100%) e cirurgia aberta (100%). O acesso percutâneo apresenta menor morbidade com resultados semelhantes ao tratamento transuretral, enquanto a litotrispsia extracorpórea apresenta as menores de taxas de eliminação de cálculos e fica reservada aos pacientes de alto risco cirúrgico.


Bladder stones are rare and most cases occur in adult men with bladder outlet obstruction. Currently, there are few data on the best treatment of this disease. The aim of this review is to discuss some aspects of pathogenesis and treatment approaches for bladder lithiasis. A comprehensive search of the database of the "National Library of Medicine" /pubmed was conducted with the following key words and descriptors: "bladder" or "vesical" associated with "calculus", "stone" or "lithiasis", and "cistolithotripsy ". One hundred and seventy-one articles were identified. The articles were independently assessed by two reviewers with expertise in urolithiasis. They were included in the study when the results, complications and follow-up were clearly reported. In the end, 32 studies met the inclusion criteria. Several options for the treatment of bladder lithiasis are available, but no randomized trials comparing them. Different rates of calculus-free patients are described in each of them, as follows: extracorporeal shock wave lithotripsy (75-100%), transurethral cistolithotripsy (63-100%), percutaneous cistolithotripsy (89-100%) and open surgery (100 %). The percutaneous approach has lower morbidity, with similar results to the transurethral treatment, while extracorporeal lithotripsy has the lowest rate of elimination of calculi and is reserved for patients at high surgical risk.


Asunto(s)
Adulto , Niño , Humanos , Cálculos de la Vejiga Urinaria/cirugía , Procedimientos Quirúrgicos Urológicos/métodos
18.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 3072-3074, 2013.
Artículo en Chino | WPRIM | ID: wpr-436704

RESUMEN

Objective To explore the influence of transurethral plasmakinetic resection of the prostate (PKRP) plus titanium laser lithotripsy on prostate-specific antigen(PSA) and sexual function in prostate hyperplasia patients complicated with bladder stones.Methods 62 patients with prostate hyperplasia and bladder stones were randomly divided into the observation group (n =31 cases) and the control group (n =31 cases).The patients in the observation group were operated through PKRP plus titanium laser lithotripsy,while the patients in the control group were operated through transurethral prostatectomy (TURP) plus pneumatic lithotripsy.Serum PSA was detected before and after operation.Sexual function was evaluated six months after operation.Results The IIEF-5 score in two groups were all decreased after operation.Postoperative IIEF-5 score of the observation group had no significant difference compared with that before operation(t =0.3896,P > 0.05).Postoperative IIEF-5 score of the control group had significant difference compared with that before operation (t =4.2820,P < 0.05).The difference between the two groups was significant (t =3.7473,P < 0.05).Serum PSA in two groups were all significantly decreased 1 month after operation(t =2.0423,15.3077,P < 0.01).It in the observation group was lower than that in the control group(t =13.2142,P < 0.05).Conclusion PKRP plus titanium laser lithotripsy can decrease serum PSA and improve sexual function in prostate hyperplasia patients complicated with bladder stones.

19.
Chinese Journal of Urology ; (12): 276-279, 2013.
Artículo en Chino | WPRIM | ID: wpr-434925

RESUMEN

Objective To evaluate the lithotripsy efficiency of a newly calculi anchoring forceps in vitro.Methods Compared the efficiency with or without calculi anchoring forceps in the circumstances imitate percutaneous nephrolithotomy.There are 24 calculus for each group in random selection.The lithotripsy was completed by one people.the time,energy and retained calculus were compared by T-test.Results When the energy expenditure reaches 2 kJ,the operating time was (4.7 ± 0.9) min in group 1 and (4.2 ± 0.9) min in group 2 (P > 0.05).The removal calculus showed no differences between the two groups (P > 0.05).After the energy used over 2 k J,the operating time of the remained calculus were (4.5 ± 1.2) min in group 1 and (9.2 ± 2.6) min in group 2 respectively (P < 0.05),and the energy consumed (1.7 ± 0.5) kJ and (2.6 ± 0.4) kJ respectively (P < 0.05).Total energy consumed in group 1 and group2 was (3.7±0.5) kJ and (4.6±0.5) kJ (P<0.05).And the cumulate time used was (9.2±1.7) min and (13.4 ±2.7) min in group 1 and group 2 respectively (P <0.05).Conclusions The calculi anchoring forceps can improve the efficiency of lithotripsy in vitro.The improvement was significant for the calculus whose diameter was smaller than lcm.

20.
Chinese Journal of General Practitioners ; (6): 224-225, 2013.
Artículo en Chino | WPRIM | ID: wpr-430418

RESUMEN

The clinical data of 30 patients with vesical calculus of 1.5 cm to 4 cm in diameter,who underwent combination of transurethral pneumatic and ultrasonic cystolithotripsy,were retrospectively analyzed.During the procedure the resectoscopic sheath was inserted into bladder through urethra,then the nephroscope was placed through the sheath.When the stone was located,the ultrasonic and pneumatic devices were used for lithotripsy and the fragments were cleared out.The procedures lasted from 10 to 25 min,all operations were successful.Transurethral resection of prostates (TURP) was performed simultaneously in 28 patients.No serious bleeding,bladder injury or transurethral resection syndrome occurred.One patient with simultaneous TURP developed bladder neck contracture one month after surgery and was later cured by endoresection.No residual chip or stone recurrence was detected.This procedure appears to be safe and highly efficient with low rate of urethrostenosis and is suitable for simotaneous prostate surgery.

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