[ 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Ben : 細菌性腺列腺炎
病患者男 - 32歲 之前check report 指精液有scanty growth streptoc.......alex : 睪丸痛
病患者男 - 26歲 你好醫生 三四日前發覺睪丸有脹的感覺和感覺陰囊有下墜的感覺，而且有時帶有輕微的疼痛.......Yan : 前列腺癌復發疑問
病患者男 - 68歲 我爸爸2010年做左切除前列腺手術,當時Gleason Score 3 + 3, .......Jason fong : 前列線炎
病患者男 - 41歲 我有以下病徵呢幾排出現左，當射精時及射精後發現肚濟对下陰莖有少少痛.而且有尿频.背.......xiang : 感觉小便的尿道容易被受阻导致尿不出
病患者男 - 33歲 有天我坐到一个凹凸不平的椅子压到我的会阴导致我龟头发麻过后发现小便受租,排尿困难,.......yip0411404 : 陰莖彎曲矯正手術費用,住院
病患者男 - 28歲 陰莖彎曲矯正手術費用,是否要住院.......Thomas : 性病
病患者男 - 27歲 2019年10月22 最後一次不安全性行為，11月27號（36日）去驗性病無事，期.......Fan : 去勢
病患者女 - 20歲 葉醫生你好，本人是名跨性別人士 但未有身心和時間還有金錢上的準備完成完全的性別重.......West : 泌尿外科
病患者男 - 28歲 小便疼痛 ，坐下時直腸位置不適痕癢，未知是否前列腺炎或尿道炎.......Hands : 非淋病尿道炎
病患者男 醫生好， 本人在大約4-5年前曾患非淋病尿道炎。經專科醫生醫應診服葯。醫生判斷已痊癒(再....... 發出提問使用細則
致葉維晉醫生 提問
即時提問 ?
