[ 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chanck : 右邊睪丸疼痛
25歲 右邊睪丸疼痛已經痛咗20日，初初頭一星期睇家庭醫生，佢話可能係做運動時拉嚫右邊睪丸，因為醫生就咁檢查.......cindy : 確實有冇泌尿結石，可以做D乜嘢檢查
病患者女 - 40歲 最近兩年， 經常腰腹痛及左下腹3個位置痛，多次到急症室, 醫生每次都認為係腎石， .......cindy : 電腦素描
病患者女 - 40歲 普通的電腦素描同泌尿系統電腦素描有咩分別? .......cindy : 輸尿管結石
病患者女 - 40歲 想請問醫生輸尿管結石係咪一定會引致血尿 及腎水腫？ 假如普通電腦素描照唔到結石，但.......Kwong : 頭痛
病患者男 - 44歲 頭痛， 三個星期前開始 ，本人 每次行房事頭痛， 食止痛藥無效， 頭痛時感覺到頭部.......Man : 陰莖扭轉
病患者男 - 32歲 你好葉醫生、 請問陰莖扭轉可以透過手術矯正嗎 手費用大約要多少？.......病人一名 : 性器官問題
病患者男 - 22歲 我有多年的自慰習慣 有時大壓力就天天一次 小時無割包皮 2017年7月中開始J.......Mavis : 頻尿並左下腹疼痛
病患者女 我最近有頻尿現象，最頻時候大約5分鐘上一次廁所，而且量不多，上廁所時明明就尿意，但坐上廁所後不.......WOOW : 精液顏色帶黃
病患者男 - 32歲 近一年發覺精液顏色一直帶黃 (有時淡黃、有時黃如尿液)，有時則是正常的灰白色，沒有.......Rosina : 近龜頭包皮外側長了約3mm的肉粒
病患者男 - 33歲 本人從未割包皮，最近2個月近龜頭包皮外側位置長了約3mm的肉粒，顏色為比包皮紅一點....... 發出提問使用細則
致葉維晉醫生 提問
即時提問 ?
