The diagnostic value of narrow-band imaging for fiat bladder lesions / 中华泌尿外科杂志

Objective To investigate the diagnostic value of narrow-band imaging for flat bladder lesions.Methods Forty-nine patients with flat bladder lesions diagnosed by white light cystoscopy + narrow-band imaging followed by transurethral resection were included.The diagnostic value of narrow-band imaging was evaluated based on postoperative pathological results.Results A total of 59 flat lesions were identified,in which 8 were normal urothelium,3 were chronic inflammation,1 was papillary urothelial neoplasm of low malignant potential,1 were mild dysplasia,1 was moderate dysplasia,1 were severe dysplasia,3 were carcinoma in situ,16 were low-grade papillary urothelial carcinoma,16 were high-grade papillary urothelial carcinoma,and 8 were invasive papillary urothelial carcinoma.For narrow-band imaging,the sensitivity was 86.7 ％ (39/45),specificity was 57.1％ (8/14),diagnostic accuracy was 79.7 ％ (47/ 59),false-positive rate was 42.9％ (6/14),positive predictive value was 86.7％ (39/45),negative predictive value was 57.1％ (8/14),area under ROC curve was 0.719.Among these lesions,the sensitivity and specificity for postoperative recurrent lesions were 100％ (3/3) and 40％ (2/5),respectively,and those for erythematous patch-like lesions were 90％ (9/10) and 100％ (4/4),respectively.Conclusion Narrow-band imaging can improve the detection rate for flat bladder tumor lesions,and reduce the risk for missed diagnosis under white light cystoscopy,especially for otherwise indistinguishable erythematous patch-like lesions.

Retroperitoneal laparoscopic pyelolithotomy combined with holmium laser lithotripsy under flexible cystoscopy in treatment of complicated nephrolithiasis / 局解手术学杂志

Objective To evaluate the efficacy and safety of retroperitoneal laparoscopic pyelolithotomy ( RLP) combined with holmium laser lithotripsy under flexible cystoscopy in the treatment of complicated nephrolithiasis. Methods The retrospective analysis was made on the clinical data of 37 patients who underwent RLP and holmium laser lithotripsy under flexible cystoscopy for complicated nephrolithiasis from January 2013 to January 2014. The clinic parameters involved basic data of patients,operational time,blood loss,post-operative hospital stay,the status of stone-free,perioperative complications,and the follow-up data of patients were observed. Results No patient was converted to open surgery. The mean stone size was (2. 8 ± 0. 9) cm in diameter,operational time was (89 ± 24) min,blood loss was (21. 3 ± 7. 7) mL,post-operative hospital stay was (6. 8 ± 1. 7) d,the stone removal rate in one session was 94. 6%. One case occurred urinary leakage,1 case occurred fever after operation,who were all recovered through conservative treatment. All cases were followed up at the sixth months after operation. Conclusion RLP combined with holmium laser lithotripsy under flexible cystoscopy is effective and safe for the treatment of com-plicated nephrolithiasis.

A novel continuous irrigation sheath improves vision of flexible cystoscope under hematuria: An in vitro evaluation / 第二军医大学学报

Objective: To quantitatively evaluate the efficacy of a novel continuous irrigation sheath in improving the vision of flexible cystoscopy under hematuria using an in vitro bladder model. Methods: An in vitro bladder model was designed for simulating flexible cystoscopy under hematuria. According to the presence of continuous hemorrhage the experiment was divided into the static experiment and the dynamic experiment. The experiment was divided into three groups according to three levels of the irrigation condition during flexible cystoscopy: no irrigation (Group 1), continuous irrigation without an outflow of water (Group 2), and continuous irrigation with an outflow of water (Group 3). The vision field of flexible cystoscopy and vision precision of flexible cystoscopy images were recorded at 30, 60, 90 and 120 s. Results: The vision field and precision of flexible cystoscopy images were greatly different between the 3 groups in both the static and the dynamic experiments. Compared with Group 1, the vision field and precision were significantly improved in Group 2 and 3 in both the static and the dynamic experiments(P<0. 01). The vision precision of Group 3 was significantly better than that in Group 2 in both the static and the dynamic experiments(P<0. 05,P<0. 01), and the vision field of Group 3 was also significantly better than that in Group 2 in the dynamic experiments (P<0. 05). Conclusion: The novel continuous irrigation sheath can effectively improve the vision field and precision of flexible cystoscopy.

Antegrade insertion of guide wire through suprapubic fistula facilitates retrograde dilation for treatment of early stricture following urethroplasty / 第二军医大学学报

Objective To discuss the feasibility and safety of a novel urethral dilation procedure using antegrade insertion of guide wire through suprapubic fistula (retrograde insertion failed) to facilitate retrograde dilation for treating early stricture following urethroplasty. Methods Thirteen patients, who failed to receive retrograde insertion, developed early stricture following urethroplasty. The guide wire was inserted through a pre-made suprapubic fistula to pass the stricture with the help of flexible cystoscope. Then the guide wire was used to guide polytef catheter to perform retrograde dilation. Results The procedures were successfully done in all the 13 patients. The mean operation time was (10. 7 ± 3. 18) min (8-17 min), and there were no serious complications. Conclusion The present dilation procedure is an effective and safe method for management of early stricture recurrence following urethroplasty.

Initial Experience of Flexible Cystourethroscope / 대한비뇨기과학회지

The advent of endourology has hastened the introduction of flexible fiberoptic technology into urologic practice. And the application of flexible cystourethroscope to the lower urinary tract is a natural extension. Cystourethroscopy was performed with flexible fiberoptic cystourethroscope on 37 cases under local anesthesia followed by a rigid-rod lens instrument. Findings with the flexible system were equivalent to the rigid endoscope. With the flexible instrument, the duration of the examination was unchanged, patients were more comfortable in most cases, and preparation and positioning were simple and quicker. The procedure with flexible instrument was especially safe and reliable in outpatient surveillance of the bladder cancer.