[ 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 : 自慰後常有痛症及不適感
病患者男 - 21歲 經常自慰後容易下腹痛 有時候會痛到腰 有脹尿感 尿頻 有啲痌唔清尿感覺 入邊亦會有.......Ck117 : Esr偏高及小便穩血
病患者女 - 29歲 在9/2020身體檢查得出 esr 35 和小便常規 blood 1+ 最近再.......Kei : 龜頭流白色黏物
病患者男 - 26歲 你好醫生，呢兩日小便尿道有痛，而且平時有白色黏物流在內褲上，請問是什麼問題，我應該.......WILLIAM : 前列腺炎
病患者男 - 28歲 本人一 二年前開始出現尿頻的情況，晚上和大便後更為嚴重，平時會有左下腹痛，睪丸間中.......jasmine : 腎石自然排出過後左下腹及腰部隱隱作痛
病患者女 - 28歲 自從0.53cm腎石排出過後，肚臍左下方約5cm位置及腰部持續四個月仍隱隱作痛，大.......Ken Cheng : 包皮變薄
病患者男 - 48歲 烏龜頭後的包皮 變得薄了 一磨擦很容易破損.......TrisL : 會陰位置腫脹
病患者男 - 24歲 醫生你好 最近勃起時會感覺會陰位置腫脹，但沒有痛楚，只是腫脹感覺。 而且射精時.......Dick : 有關小便有時吉痛/袁痛
病患者男 - 30歲 你好 我小便有時吉痛/袁痛 也有半年以上， 有時按壓後端陰莖/按壓會陰位，.......Honnn : 龜頭皮膚問題
病患者男 - 25歲 你好葉醫生，請問龜頭表面皮膚會否因受刺激而有異樣？.......Hk_009 : 陰莖刺痛
病患者男 - 30歲 一星期前 陰莖無源刺痛一下 已經一星期情況也是一樣 問題情況 ： 包皮覆蓋龜頭....... 發出提問使用細則
致葉維晉醫生 提問
即時提問 ?
