[F4.8 visual miniature nephroscope for the diagnosis and treatment of hematospermia].

OBJECTIVE: To explore the practicability and safety of the F4.8 visual miniature nephroscope in the diagnosis and treatment of hematospermia. METHODS: This study included 12 cases of refractory hematospermia accompanied by perineal or lower abdominal pain and discomfort. All the patients failed to respond to two months of systemic anti-inflammatory medication and local physiotherapy. Seminal vesicle tumor and tuberculosis were excluded preoperatively by rectal seminal vesicle ultrasonography, MRI or CT. Under epidural anesthesia, microscopic examination was performed with the F4.8 miniature nephroscope through the urethra and ejaculatory duct orifice into the seminal vesicle cavity, the blood clots washed out with normal saline, the seminal vesicle stones extracted by holmium laser lithotripsy and with the reticular basket, the seminal vesicle polyps removed by holmium laser ablation and vaporization, and the seminal vesicle cavity rinsed with diluted iodophor after operation. RESULTS: Of the 10 patients subjected to bilateral seminal vesiculoscopy, 3 with unilateral and 2 with bilateral seminal vesicle stones were treated by holmium laser lithotripsy, saline flushing and reticular-basket removal, 2 with seminal vesicle polyps by holmium laser ablation and vaporization, and the other 3 with blood clots in the seminal vesicle cavity by saline flushing for complete clearance. The 2 patients subjected to unilateral seminal vesiculoscopy both received flushing of the seminal vesicle cavity for clearance of the blood clots. The operations lasted 10－55 (25 ± 6) minutes. There were no such intra- or post-operative complications as rectal injury, peripheral organ injury, and external urethral sphincter injury. The urethral catheter was removed at 24 hours, anti-infection medication withdrawn at 72 hours, and regular sex achieved at 2 weeks postoperatively. The patients were followed up for 6－20 (7 ± 2.3) months, during which hematospermia and related symptoms disappeared in 10 cases at 3 months and recurrence was observed in the other 2 at 4 months after surgery but improved after antibiotic medication. CONCLUSIONS: The F4.8 visual miniature nephroscope can be applied to the examination of the seminal vesicle cavity and treatment of seminal vesicle stones and polyps, with the advantages of minimal invasiveness, safety and reliability.

Combined standard percutaneous nephrolithotomy and 4.8Fr micro- percutaneous nephrolithotomy and for multiple renal calculi (46 cases) / 中国内镜杂志

Objective To explore the application of visible standard channel combined with F4.8 visible puncture percutaneous nephrolithotomy in the treatment of multiple renal calculi. Methods The clinical data of 46 patients with multiple renal calculi from October 2015 to September 2016 were retrospectively analyzed. There were 28 male and 18 female, with a mean age of 42.6 years (aged from 25 to 65 years). Stone diameter 3.0~5.2 cm, average (4.3 ± 0.8) cm. Application of F4.8 visual puncture assisted angioplasty to establish the standard channel, nephrolithotomy combined with ultrasonic lithotripsy treatment in the field of visible stones, then apply the F4.8 visual micro puncture percutaneous nephrolithotomy combined with holmium laser treatment of other parts of the stone, summarizes the channel establishment total time, operation time, blood red protein decreased and stone clearance rate and complication index. Results All cases were successfully established single standard channel under the guidance of F4.8 visual puncture, 24 cases were combined with single ultramicro channel, 16 cases were combined with double ultramicro channels, and the other 6 cases were combined with the three ultra micro channels. Postoperative indwelling single renal fistula, micro channel indwelling fistula, postoperative indwelling F5 double J tube. F4.8 visual puncture established standard channel establishment time (6.8 ± 1.8) min, single F4.8 visible puncture ultra - channel establishment time of (4.5 ± 0.9) min, operation time of (92.0 ± 15.0) min. A stone clearance rate was 91.3% (42/46), a decrease in hemoglobin value of (12.2 ± 2.5) g/L, 8 cases of postoperative fever, given anti-inflammatory treatment improved, 4 cases with residual calyceal stones visible 0.5~0.8 cm, given extracorporeal shock wave lithotripsy combined with postural drainage, stone, 1 months after the treatment of stones were discharged, did not appear Shi Jie, delayed bleeding, adjacent organ injury, ureteral injury cases. Conclusion Visual standard channel combined with F4.8 ultra visible puncture percutaneous nephrolithotomy in treatment of multiple renal calculi has the advantages of reducing the large number of channels, high stone clearance rate, safety, less complications, F4.8 was used to establish the visual puncture channel is more safe and accurate.

Combined standard percutaneous nephrolithotomy and 4.8Fr micro- percutaneous nephrolithotomy and for multiple renal calculi (46 cases) / 中国内镜杂志

Objective To explore the application of visible standard channel combined with F4.8 visible puncture percutaneous nephrolithotomy in the treatment of multiple renal calculi. Methods The clinical data of 46 patients with multiple renal calculi from October 2015 to September 2016 were retrospectively analyzed. There were 28 male and 18 female, with a mean age of 42.6 years (aged from 25 to 65 years). Stone diameter 3.0~5.2 cm, average (4.3 ± 0.8) cm. Application of F4.8 visual puncture assisted angioplasty to establish the standard channel, nephrolithotomy combined with ultrasonic lithotripsy treatment in the field of visible stones, then apply the F4.8 visual micro puncture percutaneous nephrolithotomy combined with holmium laser treatment of other parts of the stone, summarizes the channel establishment total time, operation time, blood red protein decreased and stone clearance rate and complication index. Results All cases were successfully established single standard channel under the guidance of F4.8 visual puncture, 24 cases were combined with single ultramicro channel, 16 cases were combined with double ultramicro channels, and the other 6 cases were combined with the three ultra micro channels. Postoperative indwelling single renal fistula, micro channel indwelling fistula, postoperative indwelling F5 double J tube. F4.8 visual puncture established standard channel establishment time (6.8 ± 1.8) min, single F4.8 visible puncture ultra - channel establishment time of (4.5 ± 0.9) min, operation time of (92.0 ± 15.0) min. A stone clearance rate was 91.3% (42/46), a decrease in hemoglobin value of (12.2 ± 2.5) g/L, 8 cases of postoperative fever, given anti-inflammatory treatment improved, 4 cases with residual calyceal stones visible 0.5~0.8 cm, given extracorporeal shock wave lithotripsy combined with postural drainage, stone, 1 months after the treatment of stones were discharged, did not appear Shi Jie, delayed bleeding, adjacent organ injury, ureteral injury cases. Conclusion Visual standard channel combined with F4.8 ultra visible puncture percutaneous nephrolithotomy in treatment of multiple renal calculi has the advantages of reducing the large number of channels, high stone clearance rate, safety, less complications, F4.8 was used to establish the visual puncture channel is more safe and accurate.