Ureteroscopic management for ureteral stones after failed ESWL / 中国微创外科杂志

Objective To study therapeutic effects of ureteroscopic treatment for ureteral stones after failed extracorporeal shock wave lithotripsy (ESWL). Methods A total of 23 patients with ureteral stones received ureteroscopic treatment after the ESWL had failed. By using pneumatic lithotripter and self-made needle-shaped electrotome, stones were fragmented and removed, and polyps were resected. Results Two patients with stones fragmented but surrounded by granuloma tissue received a polyp resection and stone extraction.Pneumatic ballistic lithotripsy and stone removal was conducted in 16 patients with stones partly fragmented.In 4 patients with stones adherent to the ureteral wall and polyps,the polyps were removed by using self-made needle-shaped electrotome and the stones were fragmented and extracted.And in 1 patient with stones embedded beneath the ureteral mucous membrane, which was difficult to be expelled,the mucous membrane covering the stones was opened by using the needle-shaped electrotome and the stones were fragmeathed and extracted.The procedure duration was 30~55 min(mean,42 min).Re-examination 6 months postoperatively found no residual stones. Conclusions After the ESWL had failed, patients with ureteral stones can be treated ureteroscopically by using pneumatic lithotripsy and self-made needle-shaped electrotome.

Management of ureteral stricture with a self-made needle-shaped ureteroscopic electrotome / 中国微创外科杂志

Objective To study the clinical application of a self-made needle-shaped ureteroscopic electrotome in the treatment of ureteral stricture. Methods Sixty-seven patients with ureteral stricture (24 cases of stricture after ureterlithotomy, 39 cases of ureteral polyp and 4 cases of congenital stricture) were operated on by using self-made needle-shaped electrotome under ureteroscope. Results The operating time was 10~30 min and the intraoperative blood loss was 5~20 ml. Follow-up for 3 months showed effective results in 53 cases (79 1%), improved in 10 cases (14 9%) and unresponsive in 4 (6 0%). No severe complications emerged. Conclusions Application of self-made needle-shaped ureteroscopic electrotome in the management of ureteral stricture gives simple performance.

Adrenal incidentalomas:clinical analysis of 52 cases / 中华泌尿外科杂志

Objective To improve the diagnosis and differential diagnosis of adrenal incidentalomas for the optimal management of adrenal masses. Methods The clinical data of 52 cases (35 men and 17 women;mean age,42 years;age range,23-65 years) of adrenal incidentalomas was reviewed.Among them, 33 cases had tumors ≥ 3.0 cm in diameter.None of 52 cases had clinical symptoms and signs of hypertension and endocrine dysfunction.All of the tumors were incidentally found by ultrasonography or CT on regular physical examination.A series of blood chemical examinations (including electrolytes,adrenal cortical and medullary metabolic biochemistry),abdominal ultrasound and CT were performed in all 52 cases;and MRI,PET and  131 I-MIBG imaging were performed in 6,2 and 1 cases,respectively.Surgery and postoperative pathological study were performed in all. Results Postoperative pathology showed adrenocortical adenoma in 27 cases,adrenal metastatic carcinoma in 7,adrenal pheochromocytoma in 5,adrenal cyst in 4,primary aldosteronoma in 3,adrenal neurinoma in 2,adrenocortical carcinoma in 1,retroperitoneal neuroblastoma in 1,retroperitoneal primary lymphoma in 1 and adrenal ganglionic fibroma in 1.Diagnoses based on the results of imaging examinations and laboratory tests were correct in 14 cases (27%).Of the 10 patients with malignancies,5 with primary diseases died 6-10 months after chemotherapy and 5 were lost to follow-up.The remaining 42 patients were followed up for 6 months to 9 years with no evidence of recurrence. Conclusions Multidisciplinary approaches are required to identify and differentiate adrenal incidentalomas, and early surgical treatment is suggested.

A study on the natural history of hematuria associated with benign prostatic hyperplasia and the effect of finasteride / 中华泌尿外科杂志

Objective To study the effect of finasteride on hematuria associated with benign prostate hyperplasia. Methods We evaluated 61 patients with intermittent hematuria who were randomized to a finasteride treated group or control group.Routine urinoscopy was carried out once a week in all the 61 patients. Results In the untreated control group hematuria recurred in 20/31 within a year but in only 7/28 in the finasteride group,which was a statistically significant difference (P