Percutaneous intrarenal marsupialization of symptomatic peripelvic renal cysts: a single-centre experience in China.

UNLABELLED: OBJECTIVE.The aim of this study was to report the authors' experience with percutaneous intrarenal marsupialization of symptomatic peripelvic renal cysts. MATERIAL AND METHODS: Thirty-one patients (16 male and 15 female, with a mean age of 49 years) with a peripelvic renal cyst associated with chronic flank or lumbar pain or urinary infection were selected for percutaneous intrarenal marsupialization with a 2 µm laser in the authors' centre from January 2005 to December 2010. Cyst size ranged from 4.5 to 10.5 (mean 6.0) cm. The cysts were punctured by a percutaneous technique guided by ultrasonography, a 20.8 F nephroscope was introduced and the whole internal surface of the cyst was inspected. Methylene blue was injected through the ureteral catheter to help identify the collecting system. A 1.5-4 cm incision was made at the avascular area of the cystic wall by the 2 µm laser to achieve intrarenal marsupialization of the cyst into the renal collecting system. One or two 6 F double-J stents were placed with the proximal end in the cyst for 2-3 months. RESULTS: The mean operation time was 50 (25-120) min. No serious complications such as massive bleeding, urine leak or infected haematoma occurred. The patients were followed up for a mean of 12 (range 3-36) months. All patients were relieved of their symptoms. Eighteen cysts disappeared after surgery, while 13 cysts reduced in size by over one-third and communicated with the renal collecting system. No enlargement of cysts was observed. CONCLUSIONS: Percutaneous intrarenal marsupialization with a 2 µm laser is an effective and safe procedure and may offer a minimally invasive alternative for the management of symptomatic peripelvic renal cysts.

[Percutaneous nephroscopic 2 µm laser incision and drainage treatment of peripelvic renal cysts].

OBJECTIVE: To explore the surgical approaches, efficacy and safety of percutaneous nephroscopic 2 µm laser incision and drainage in the treatment of peripelvic renal cysts. METHODS: The peripelvic renal cysts were punctured percutaneously. A 1.5 - 4.0 cm incision was made at thin avascular area between cyst and pelvis by the 2 µm laser to connect the cyst with the renal collecting system with the help of injecting methylene blue solution into renal pelvis through ureteral catheter. The double-J tube was placed for drainage. RESULTS: The operations were successful in all cases. There were 16 males and 15 females with a mean age of 49 years old. The operative durations ranged from 25 to 120 minutes. And no severe complications occurred. The patients were followed up for an average of 12 months (range: 3 - 36). Among them, cysts disappeared in 18 cases and diminished over 1/3 in 13 cases. There was no recurrence of peripelvic renal cyst. CONCLUSION: Percutaneous nephroscopic 2 µm laser incision and drainage for peripelvic renal cyst is safe, effective and mini-invasive.

Transurethral 2-microm laser in the treatment of urethral stricture.

OBJECTIVES: To evaluate the curative efficacy of transurethral 2-mum thulium laser urethrotomy in the treatment of urethral stricture. METHODS: Two hundred and thirty-eight patients suffering from urethral stricture, all male, aged 47.3 (36-58), underwent transurethral 2-mum thulium laser urethrotomy. The maximum flow rate (MFR), the international prostatic symptom score (IPSS) and the quality of life (QoL) were measured before operation, immediately following the removal of the catheter, and 3 and 6 months postoperatively. RESULTS: The surgery was performed for all the patients with no rectum injury, urine leakage or massive blood loss. All the patients got free urination immediately following the catheter removal with the mean MFR improved from (3.2 + or - 0.3) ml/s preoperatively to (16.7 + or - 3.1) ml/s, which kept steady to (18.7 + or - 2.9) and (19.2 + or - 2.8) ml/s, respectively 3 and 6 months after operation. IPSS significantly improved from 28.3 + or - 5.8 preoperatively to 7.1 + or - 1.9, 6.4 + or - 1.5 and 5.3 + or - 1.3, respectively when catheter removal and 3 and 6 months after operation. Also during the corresponding period, mean QoL improved from 5.4 + or - 1.1 to 1.1 + or - 0.3, 0.9 + or - 0.2 and 0.8 + or - 0.2. 195, patients got permanent uninterrupted urination without recurrence in the whole 6 months of follow-up. Forty-three patients got recurrence and seven patients encountered with incontinence 1-3 weeks (mean 13.8 days) after catheter removal, but they all got final cure after periodic urethral dilatation and physical exercise. CONCLUSIONS: Transurethral 2-mum thulium laser is safe and efficient in the treatment of urethral stricture.

[Efficacy of transurethral 2 microm laser urethrotomy in the treatment of urethral stricture and atresia].

OBJECTIVE: To evaluate the curative efficacy of transurethral 2 microm thulium laser urethrotomy in the treatment of urethral stricture and atresia. METHODS: 192 patients suffering from urethral stricture (n = 179) or atresia (n = 13), all male, aged 45.4 (38-56), underwent transurethral 2 microm thulium laser urethrotomy. The maximum flow rate (MFR) was measured before operation, immediately after removing the catheter, and 3 and 6 months postoperatively. RESULTS: All the patients got fluent urination immediately after the catheter removal with the mean MFR of (16.7 +/- 3.1) ml/s, significantly higher than that before the operation [(3.2 +/- 0.3) ml/s, P < 0.01]. 157 patients got permanent fluent urination without recurrence; 35 patients got recurrence 1 to 3 weeks after the catheter removal and got final cure 3 months later after periodic urethra dilatation. Besides, 6 patients encountered incontinence and all finally got convalescence after physical therapy and exercise. The mean MFR of all the patients 3 months and 6 months postoperatively were (18.7 +/- 3.1) ml/s and (19.2 +/- 2.8) ml/s respectively, both significantly higher than that before operation (both P < 0.01). CONCLUSION: Transurethral 2 microm thulium laser urethrotomy is a safe and efficient method in the treatment of urethral stricture and atresia.