[ 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kwan : 前列腺醫療方法
病患者男 - 72歲 請問前列腺癌最有效醫療法有幾種,食藥可以嗎?食蕃茄可有幫助.如何食法?.......kwan : 前列腺癌
病患者男 - 72歲 抽血驗到psa8.1 醫生現提意檢查在肛門插入超音波及要打12針.但有風險.或現由.......panda0012 : 前列腺炎
病患者男 你好 那我想問驗精 驗出了streptococcus agalactiae是性病會傳染嗎？雖.......ho : 驗血
病患者男 - 40歲 請問醫生，如果我想驗晒所有性病的項目同前列腺癌，一般要幾錢，唔該.......kwan : 前列腺
病患者男 - 72歲 請問psa指數8.1.是可否係患前列腺癌?.......Him : 小便後尿道有灼熱感
病患者男 - 26歲 醫生你好, 我每次小便後有灼熱感, 沒有痛, 此感覺令我很想再去小便. 但休息20.......Peter : 尿道口紅，尿急尿頻
病患者男 - 19歲 尿道口紅和左面恥骨附近有"酸"的感覺已經有好幾年，平常大多沒有痛楚，只是尿道口有時.......Joe : 去廁所間唔中會有不順
病患者男 - 25歲 如果驗出streptococcus faecalis同staphylococcus.......黃小姐 : 尿道炎後
病患者女 - 44歲 尿道炎及腰痛看了醫生,食藥後病情持續。 去做了腎功能測試化驗檢查,報告正常,有三.......Tom : 嚴重尿急，尿頻問題
每次如廁後過了十幾分鐘即有尿意，在戶外甚至有時候突如其來的強烈尿意，曾有過一次痛苦的忍尿經歷，不知是否因此影響....... 發出提問使用細則
致葉維晉醫生 提問
即時提問 ?
