[ 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yuana1111 : 勃起不全
病患者男 - 34歲 自我九月發生胞皮血管性水腫和發燒，和陰莖根部會痛，事發前一晚有進行兩次手淫，到九月.......Shumkp : 前列腺問題
病患者男 - 20歲 想知可以透過什麼方式知自己有前列腺發炎，同去診所醫生運用什麼方式去查，我尿口少刺痛.......Cheung Ho Ching : 下體不明位置莫名痕癢
病患者男 - 18歲 你好。大概半年前，我曾經試過排尿出血，唯獨有一天特別嚴重，沒有前科，後來問題也沒有.......Lww : 前列腺超聲波一問
病患者男 - 28歲 你好醫生 本人早前確診前列腺炎，醫生給予了抗生素及消炎藥。但長期不能根治。 .......Ivan : 陰莖撞到
病患者男 - 20歲 醫生你好 本人在一星期前於行房中不小心撞到 但沒有變形、紅腫、血尿等任何異樣 .......袒鄏疸 : 包皮掉皮
病患者男 - 20歲 最近1至3個月時間裡，包皮逐漸出現掉皮症狀，皮膚也有點龜裂，每次想要嘗試反開包皮都.......chung : 平訓6-8小時下腹會疼痛
病患者男 - 33歲 每次平訓超過6個鐘就開始下腹疼痛,肚馳對下一兩吋左右,我搞唔清係腸痛定膀胱痛,已經.......Kong Yiu Chau : 右邊腹部下及睪丸對上時有陣痛感覺，前列腺問題嗎？
最近兩年右邊腹部下及睪丸對上時有陣痛感覺，懷疑是否前列腺問題嗎？情況是多尿感，正常淡黄色，排尿後間中會痛，摸過.......劉 : 包皮奇怪現象
病患者男 - 24歲 有次與女朋友發生性行為，但沒有做到尾，未射精就停了 但第二日起身發現龜頭.......Shumkp : 泌尿科
病患者男 - 20歲 醫生，想問一般去睇沁尿科係咪會叫驗尿先，同冇得攞薬？如果私家診所尿常規一般價錢係5....... 發出提問使用細則
致葉維晉醫生 提問
即時提問 ?
