[ 會員#24702 ] Dream
膀胱石治療方法
病患者男 - 56歲
Dear Dr Andrew Yip,
Your are a great, kind and caring doctor. Thank you so much for your reply. I have a bladder stone 3.1 cm * 1.7 cm * 2.1 cm. There is a research about treatment options for treating bladder stone.
Vesical calculus is a common problem that is treated traditionally with open cystolithotomy or cystolithalopaxy. Open surgery has the inherent problems of a long scar, prolonged catheterization, extended hospitalization, and risk of infection. Transurethral cystolithalopaxy also requires special instruments that carry a risk of trauma, which could lead to urethral strictures. Thirty-eight patients (15 children and 23 adults) were treated for vesical calculi by percutaneous cystolithotomy (PCCL), a minimally invasive procedure. A fluoroscopic-guided tract was made to the bladder through a small suprapubic puncture (9-10 mm) and a nephroscope was inserted via an Amplatz sheath placed suprapubically. The calculus was fragmented with ultrasound or pneumatic energy before being flushed out. A suprapubic catheter was kept in place for 48 hours postsurgery; no urethral catheter was needed. Urethral instrumentation was kept to a minimum. After 48 hours, the suprapubic catheter was clamped and removed after the patient had two or three normal voids. No significant intraoperative or postoperative complication was encountered. Given that the urethra is spared, percutaneous cystolithotomy is a preferred approach in patients with vesical calculi.
https://www.researchgate.net/publication/12923885_Percutaneous_cystolithotomy_for_vesical_calculi_A_better_approach
Dear Dr Andrew Yip,
Your are a great, kind and caring doctor. Thank you so much for your reply. I have a bladder stone 3.1 cm * 1.7 cm * 2.1 cm. There is a research about treatment options for treating bladder stone.
Vesical calculus is a common problem that is treated traditionally with open cystolithotomy or cystolithalopaxy. Open surgery has the inherent problems of a long scar, prolonged catheterization, extended hospitalization, and risk of infection. Transurethral cystolithalopaxy also requires special instruments that carry a risk of trauma, which could lead to urethral strictures. Thirty-eight patients (15 children and 23 adults) were treated for vesical calculi by percutaneous cystolithotomy (PCCL), a minimally invasive procedure. A fluoroscopic-guided tract was made to the bladder through a small suprapubic puncture (9-10 mm) and a nephroscope was inserted via an Amplatz sheath placed suprapubically. The calculus was fragmented with ultrasound or pneumatic energy before being flushed out. A suprapubic catheter was kept in place for 48 hours postsurgery; no urethral catheter was needed. Urethral instrumentation was kept to a minimum. After 48 hours, the suprapubic catheter was clamped and removed after the patient had two or three normal voids. No significant intraoperative or postoperative complication was encountered. Given that the urethra is spared, percutaneous cystolithotomy is a preferred approach in patients with vesical calculi.
https://www.researchgate.net/publication/12923885_Percutaneous_cystolithotomy_for_vesical_calculi_A_better_approach
葉維晉醫生回覆: [ 11/28/2020 ]
Taking out bladder stone from the suprapubic route is a known method. This study showed that it is possible and probably a safe method to deal with bladder stone. However, this approach has not been a popular method in dealing with bladder given the fact that it is invasive because it requires a suprapubic puncture. Moreover, the safety of the transurethral route has been proven over many years of worldwide practice. The surgical community would not overnight change its practice because of one published study. I agree that it may turn out to be a good method of dealing with bladder stone but we may need to wait for more published data to prove the same.
Dr Andrew Yip
Dr Andrew Yip
以上資料只供參考，不能作診症用途，
請與家庭醫生查詢並作出適合治療。
如有身體不適請即求診，切勿延誤治療。
若資料有所漏誤，本網及相關資料提供者恕不負責。
請與家庭醫生查詢並作出適合治療。
如有身體不適請即求診，切勿延誤治療。
若資料有所漏誤，本網及相關資料提供者恕不負責。
其他葉維晉醫生醫務信箱回覆陳生 : 血尿
病患者女 - 29歲 打完二價疫苗後全身無力，發燒，第二日發覺有血尿，驗尿後蛋白質3+,紅血球3+,白血.......HIN : 想問一下治療淋病
醫生你好， 想問一問關於淋病 我早在1月26日睇過普通科門診 未驗個醫生都話我應該係淋病 然後打左針 食.......Aaron : 前列腺炎
病患者男 之前做過性病dna檢測 陰性，尿液和精液種菌都冇野 而陰莖有輕微不適沒有龜頭炎，是否之無菌性.......YEUNG WAI TUNG : 副睾丸炎，導致輸精管有硬塊
病患者男 - 33歲 你好醫生！我先前急症室醫生判斷副睾丸炎，食了抗生素療程30天，疼痛終於減輕了，但是.......吳大大 : 驗尿驗精液一問
想問下驗尿dna 結果是否代表精液結果一致（同一次尿道炎）,及若果是次尿道炎食完抗生素康復（驗尿結果冇事）亦代.......Ivan : 龜頭皮膚泛紅
你好， 早前因陰囊皮膚痕做過各樣血液、hpv、hsv等檢查， 最後驗尿發現有腸球菌，同時龜頭皮膚都有泛.......YEUNG WAI TUNG : 副睾丸炎超過一個月還有疼痛
病患者男 - 33歲 我懷疑自己有附睾丸炎，所以去了急症室，驗咗尿但發現不到細菌，不過急症醫生初步判斷說.......Eric : 不知是否前列線炎問題
病患者男 - 59歲 本人近果幾月開始有夜尿問題，一晚最少兩次夜尿，開始發現小便有咁順暢，近幾日同太太行.......簡浩銘 : 包皮生粒粒後流血
病患者男 - 22歲 你好, 早幾日我龜頭下側包皮個度生左一粒野, 可以移動, 琴日唔知係唔係壓到,然後.......Ivan : 睪丸悶痛
早前驗尿發現有腸球菌屬， 本人有少少容易尿急嘅感覺，間中一兩下尿道口痛， 醫生開左一星期Ciproflox....... 發出提問使用細則
致葉維晉醫生 提問
即時提問 ?
