[ 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Law Tin Wah : 尿頻
病患者男 - 65歲 日間每小時都要小便，夜間每亦要小便4至5次，影響睡眠質素，除此之外又沒有其其他不舒.......Michael : 抗生素消化不良
病患者男 - 23歲 本人前列腺炎反覆，吃過levofloxacin第一天便感覺症狀消失，但服藥期間一吃.......jay : 手術後靜脈注射/口服抗生素對精子的影響
病患者男 - 28歲 本人腳筋斷裂而要入院做大概1小時手術，術後有打靜脈抗生素。 請問如正準備計畫懷孕.......Lucky : 感染生殖支原體
公共衛生給我開了10日Moxifloxacin 他說我已沒有發炎 尿道乾淨 所以不再給我開藥 但你說要最少食1.......無助的人 : 生殖支原體感染會否影響前列腺
病患者男 - 55歲 生殖支原體感染 之前看醫生以為是普通尿道炎 醫左一個多月也醫不好 後來發現是生殖支.......Jn : 勃起障礙
病患者男 - 34歲 感謝葉醫生之前回覆，上星期睇左醫生，做咗睪丸超聲波抽血驗睾酮，今日睇報告一切正常。.......George YU : 前列腺癌切除手術
病患者男 - 60歲 本人經測試後証實為前列腺癌二期，請問私院做外科切除手術大約費用多少？用達文西機械人.......Winnie : 急～Pet scan照出肺有3粒7mm Nodules
病患者男 - 85歲 爸85，一月驗出膀胱癌二期，一月做了pet scan及二月七日做過MRI也是説二期.......Jn : 勃起障礙
上個星期開始突然出現情緒起伏，沒多久後突然出現出現勃起障礙，性慾下降，陰莖尺寸比平時縮細.......Jn : 勃起障礙
病患者男 - 34歲 今個星期突然出現勃起障礙，性慾下降，陰莖尺寸比平時縮細....... 發出提問使用細則
致葉維晉醫生 提問
即時提問 ?
