Contraceptive complication: Emergence of a bladder stone - A case report.

INTRODUCTION AND IMPORTANCE: Bladder stones, although rare in a healthy bladder, can emerge due to various factors, including obstructions in urinary flow, recurrent infections, and foreign bodies. Intrauterine contraceptive devices (IUCDs) are known for their potential to migrate from the uterine cavity, leading to unusual complications such as bladder stone formation. CASE PRESENTATION: A 52-year-old woman, previously treated for a complicated urinary tract infection, presented with intermittent lower abdominal pain, dysuria, and hematuria. She had a history of an IUCD insertion 15 years earlier, which was later documented as missing. Diagnostic imaging revealed a large bladder stone, encasing the previously inserted IUCD. An open vesicolithotomy was performed, during which a stone measuring 6 × 5 cm was removed, revealing the IUCD within. The patient had an uncomplicated recovery with no further urinary tract infections at a 6-month follow-up. CLINICAL DISCUSSION: The migration of an IUCD can lead to various complications, depending on its final location. The formation of bladder stones around a migrated IUCD is a rare but significant complication, necessitating a thorough diagnostic approach. Radiography and ultrasonography proved sufficient for diagnosing the intravesical migration in this case. CONCLUSION: This case underscores the importance of considering a migrated IUCD in the differential diagnosis of patients presenting with urinary symptoms, especially those with a history of a missing IUCD. Timely diagnosis and management are crucial in preventing further complications.

Bicentric retrospective study comparing the postoperative outcomes of patients treated surgically for bladder stones with or without concomitant surgery for BPH.

PURPOSE: To compare the postoperative outcomes of male patients who underwent bladder stone (BS) removal, with or without concomitant benign prostatic hyperplasia (BPH) surgery. PATIENTS AND METHODS: All men aged > 50 years who underwent BS removal at two French university hospitals between 2009 and 2018 were retrospectively reviewed. Four binary outcome criteria were identified during the follow-up: early postoperative complications, stone recurrence, subsequent surgery for BS or BPH, and late surgical complications. A composite score ranging from 0 to 4 was calculated by combining the four criteria. RESULTS: A median follow-up period of 42 months was observed in 179 patients. Of these, 107 patients were in the "concomitant surgical treatment" (CST) group and 72 in the bladder "stone removal alone" (SRA) group. The CST group presented higher baseline post-void residual volume (105 vs. 30 ml, p = 0.005). Patients who underwent CST had a significantly lower rate of BS recurrence (12% vs. 39%; p = 0,001) and underwent fewer subsequent surgeries (14% vs. 44%; p < 0.001). There was no significant difference in the early (51% vs. 35%, p = 0,168) and late (26% vs. 17%, p = 0,229) complications rates between the two groups. A better composite score was observed in the CST than in the SRA, but the difference was not significant (3.07 vs. 2.72, p = 0.078). CONCLUSION: As CST increases morbidity and decreases the risk of reoperation, each situation should be considered, taking into account patient choice and comorbidities.

Which Laser System Is Optimal for Cystolithotripsy of Large Bladder Calculi?

Introduction and Objective: A variety of laser sources are available to treat bladder stones. The aim of this study was to compare time and cost efficiency of the thulium fiber laser (TFL) to four holmium lasers (HLs) with different powers or technologies, including MOSES™ during simulated cystolithotripsy. Materials and Methods: In a benchtop simulation of laser cystolithotripsy, 25 identical 4-cm BegoStones (calcium oxalate monohydrate consistency) were placed on a grid within a 3D-printed bladder model. Lasers were operated at maximal energy, using a 550 µm fiber. Lasers compared were as follows: 60 W TFL, 120 W HL with MOSES, and conventional 120, 100, and 30 W HLs. Five trials were performed for each laser with endpoints of laser time, total time, number of fiber strippings, and total energy. Cost-effectiveness was modeled using laser purchase price, fiber, and operating room (OR) time cost. ANOVA with Tukey's B post hoc was performed to compare outcomes. Spearman's test was used to assess correlation between laser power and procedure time. Results: The laser and total operating times were significantly different between the five systems (p < 0.001). The 120 W HL with MOSES was the fastest with 60.9 minutes of laser and 68.3 minutes of procedure times, while the 30 W HL was the slowest with 281.2 minutes of laser and 297.5 minutes of procedure times. The 60 W TFL was faster than the 30 W HL, but slower than the higher power HLs. Higher laser power was associated with shorter procedure time (Rs = -0.98; p = 0.002). When estimating cost per procedure, the MOSES HL was the cheapest, but had the highest purchase cost. The TFL was not cost-effective for large bladder stones compared with the 100 W HL. Conclusions: When treating large bladder stones, total laser power was highly correlated with laser and procedure times and the TFL was limited by its total power. The most cost-effective laser for use will depend on the case volume.

Predictors of clinical and surgical characteristics of giant stones of the urinary bladder: a retrospective study.

BACKGROUND: Giant stones of the urinary bladder (GSBs) are rare and usually presented as case reports. We aimed to assess the clinical and surgical characteristics of GSBs and identify their predictors. METHODS: A retrospective study of 74 patients with GSBs who presented between July, 2005 and June, 2020 was performed. Patients' demographics, clinical presentations, and surgical peculiarities were studied. RESULTS: Older age and male gender were risk factors for the occurrence of GSBs. The irritative lower urinary tract symptoms (iLUTS) were the main presenting symptoms (97.3%). Most patients were treated with cystolithotomy (90.1%). Univariate analyses showed that solitary (p < 0.001) and rough surface (P = 0.009) stones were significant factors for occurrence of iLUTS as the presenting symptoms. Also, the severity of symptoms (p = 0.021), rough surface (p = 0.010) and size (p < 0.001) of stones, and farmer occupation (p = 0.009) were significantly associated with adherence of the stone to the bladder mucosa at surgery. In multivariate analysis, the rough surface (p = 0.014) and solitary (p = 0.006) stones, and concomitant ureteral stones (p = 0.020) were independently associated with iLUTS as the main presentation. However, the stone size and severity of iLUTS were the independently associated factors for adherence of GSBs to the bladder mucosa. CONCLUSIONS: Solitary GSB, rough surface and the association with ureteral stones are independent risk factors for the occurrence of long-standing iLUTS. The stone size and severity of iLUTS were the independent predictors of adherence of GSBs to the bladder mucosa. Cystolithotomy is the main treatment, but it may be more difficult when there is bladder mucosa adherence.

Coincidental finding of a giant bladder calculus and squamous cell carcinoma of bladder: A case report.

Chronic irritation of bladder by urinary bladder calculus is a known risk factor for bladder cancer. The use of Wrigley's obstetrical forceps in general surgical practice is a rare event. Herein, we report a case of a giant urinary bladder calculus which was removed by Wrigley's obstetrical forceps during open cystolithotomy. The bladder biopsy showed squamous cell carcinoma of the bladder. With this report, we aim to create an awareness among surgeons about the role of the Wrigley's obstetrical forceps during open cystolithotomy, and the role of taking urinary bladder biopsy from chronically inflamed/unhealthy sites.

Migración de un dispositivo intrauterino a vejiga con litiasis vesical secundaria y cistitis recurrente como forma clínica de presentación. Reporte de caso / Migration of an intrauterine device to the bladder with secondary bladder lithiasis and recurrent cystitis as a clinical presentation. Case report

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.

A sandwich technique for the removal of stone embedded intrauterine devices in the urinary bladder.

A urinary bladder stone in young adults is uncommon. Dislocation of an IUD to adjection organs is a rare condition. We present a case of a 28-year female with a chief complaint of right side pelvis discomfort, off and on with the urinary system. In this case, we performed cystoscopy assisted laser lithotripsy, hysteroscopy to localize and remove IUD, transurethral resectoscope for removing IUD residual, and resection sinus tract. This article's objective states that the multidisciplinary approach to removing dislocated IUD is safe and effective and raises awareness of forgotten contraceptive devices and their potential complications.

Complete Erosion of Abdominal Cerclage Into the Bladder.

BACKGROUND: Abdominal cerclage is indicated for some women with cervical insufficiency. Long-term complications from cerclage are rare. CASE: Here we report the case of a patient who presented with recurrent urinary tract infection and hematuria 5 years after laparoscopic abdominal cerclage. Cystoscopy revealed bladder stones surrounding a foreign body. Another cystoscopy 3 months later showed complete erosion of the cerclage into the bladder. CONCLUSION: This case reminds us that differential diagnosis of urinary symptoms in women who have undergone cervical cerclage should include suture erosion into the bladder. Cerclage removal can be offered to women who have completed childbearing to prevent this rare complication.

Litiasis vesical gigante / Giant bladder lithiasis

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.

Bladder-embedded ectopic intrauterine device with calculus.

The present study aimed to analyze the data of embedded intrauterine device (IUD) in the bladder wall with the additional presence of calculus. This case series study included 11 female patients with partially or completely embedded IUD in the bladder wall. Their median age was 34 (range, 32-39) years. The median duration of IUD placement was 36 (range, 24-60) months. The median duration of symptoms was 9 (range, 3-12) months. Six patients underwent laparoscopy: the operation duration was 129 (range, 114-162) min, blood loss was 15 (range, 10-25) mL, the hospital stay was 4 (range, 4-4.5) days, the visual analog scale (VAS) for pain at 6 h after surgery was 3 (range, 2-6), and the time to removal of the urethral catheter was 7 (range, 7-8) days. Five patients underwent open surgery: the operation duration was 126 (range, 96-192) min, blood loss was 30 (range, 20-50) mL, the hospital stay was 7 (range, 7-15) days, the VAS was 6 (range, 4-9) at 6 h after surgery, and the time to removal of the urethral catheter was 9 (range, 8-17) days. The IUD and bladder stones were successfully removed in all 11 (100%) patients.

Bladder teratoma with pilimiction in a male adolescent.

Teratomas are tumors consisting of two or three germ layers, seen commonly during childhood. Mature teratomas are benign and demonstrate well differentiated tissues such as sebaceous glands, hair, and teeth. Bladder is a very rare extragonadal site for teratoma, moreover so in adults. Presentation may vary from with irritative lower urinary tract symptoms or urinary retention to pilimiction (passage of hair in the urine). We hereby present a case of mature teratoma of the urinary bladder, with a classical symptom of pilimiction, in a 22-year-old male patient, which to our knowledge is the first male case reported in the literature.

Tale of Two: A ‘case report’ of two giant urinary bladder stones and recurrent anemia in a 78-year-old Filipino male

@#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.

A Rare Delayed Bladder Migration of a Hem-o-lok Clip 5 Years after Robotic-Assisted Radical Prostatectomy.

Bladder migration of a Hem-o-lok® clip, due to robotic-assisted radical prostatectomy (RARP), is uncommon, and would form a foreign body in the bladder and present as lower urinary tract symptoms after the early postoperative period. We hereby report a rare, delayed appearance of a secondary bladder stone due to the migration of a Hem-o-lok® clip that occurred 5 years after RARP.

Clinical value of suprapubic Trocar puncture lithotripsy in the treatment of benign prostatic hyperplasia and bladder stones / 中国基层医药

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.

Clinical value of suprapubic Trocar puncture lithotripsy in the treatment of benign prostatic hyperplasia and bladder stones / 中国基层医药

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.

Long-term Outcomes of Augmentation Cystoplasty in a Pediatric Population With Refractory Bladder Dysfunction: A 12-Year Follow-up Experience at Single Center.

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. CONCLUSION: 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.

Efficacy and safety of modified transurethral plasmakinetic enucleation of prostate combined with cystolithectomy in elderly patients with high risk of large volume benign prostatic hyperplasia complicated with large urinary bladder calculi / 中国医师进修杂志

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.

Long-term Outcomes of Augmentation Cystoplasty in a Pediatric Population With Refractory Bladder Dysfunction: A 12-Year Follow-up Experience at Single Center / 대한배뇨장애요실금학회지

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.

Effect of suprapubic lithocystotomy combined with transurethral resection of the prostate in the treatment of prostatic hyperplasia complicated with bladder stones / 中国基层医药

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 .