[ 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Unknown : 慢性前列腺炎
病患者男 - 21歲 經常易肚痾肚痛 特別是射精後 下腹有不適 大約可能直腸位置就會痛然後肚痾肚痛 平日.......Stella : 尿量不多
病患者女 - 35歲 最近去上小便要坐上了馬桶5-10秒才有尿排出，尿量也不多，排尿較慢，而且往往要用一點力.......eric : 泌尿的不適
病患者男 - 60歲 本人昨年頭確診膀胱癌早期和良性增生的問題。 九月頭做完膀胱鏡後，翌日晚感到不適，且.......MYT : 細菌性前列腺炎
病患者男 - 29歲 Levofloxacin 是不是治療細菌性前列腺炎最好的藥？.......Ivan : 解脲脲原體dna
病患者男 - 38歲 你好,本人驗尿後報告發現解脲脲原體DNA結果是positive,參考值為negat.......jack : 解脲脲原體
病患者男 - 30歲 你好, 我驗到有解脲脲原體感染, 請問治療期間(食抗生素)同伴侶互相幫對方手淫會有.......心煩人 : 懷疑前列腺癌
病患者男 - 60歲 政府醫生只驗過尿和血說懷疑前列腺癌。 病癥：尿頻，屙尿不暢順，性功能有問題。 .......Unknown : 盆骨前傾會否影響生殖泌尿系統?
病患者男 - 21歲 本人有明顯的盆骨前傾問題 經常手淫後有不適和痛症出現 主要圍繞下腹至下體部份 想知.......086 ian : 尿頻半年以上
今年28歲男。2020年10月突然出現尿頻情況 每天差不多24小時都會有尿意 但不是膀胱脹的感覺 只是不停.......黃强 : 性功能碍礙証
病患者男 - 57歲 本人每次和太太行房，陰莖不太硬而且很快回軟，很難再堅挺起來，但有時朝早很急尿時，它....... 發出提問使用細則
致葉維晉醫生 提問
即時提問 ?
