[ 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afnet0628 : 突發陽痿
病患者男 - 28歲 近兩天突然陽痿 有少許晨勃 但之後都係唔得 可以說是完全無反應 過去一個月.......cindy : 腎石會影響左上腹及左上背痛嗎?
請問醫生腎石會影響左上腹及左上背痛嗎 （本來只有左下腹及腰痛痛， 而家牽連到左上復及 左上背都痛埋）， 腎石係.......KC : 前列腺炎復發還是性病？
病患者男 - 27歲 本人幾年前患有前列腺炎 曾做過檢查只驗出有前列腺肥大 吃藥後疼痛消失了便沒再理.......Mr Chan : （求助）有關自慰後，細佬會有刺痛既問題。
本人男，27歲，有時候，（10次有2次係咁）自慰完之後，隔一陣下體細佬都會開始刺痛，好似係尿道位置，會有尿急，.......Rex leung : 前列腺增生栓塞手術
病患者男 - 65歲 想請問現時有那位私營醫生,可以進行前列腺增生栓塞手術?費用大約多少錢? Th.......hero9112001 : 前列腺炎和慢性附睪炎問題
病患者男 1:本人精液驗到少量E coli（大腸桿菌），請問此細菌進入女性陰道會否造成女性盆腔炎，卵巢炎.......Sam : 小便痛
病患者男 - 42歲 葉醫生你好, 本人大概在5天前開始, 小便的時候, 感覺到尿道赤痛(近陰頭住.......poon : 泌尿問題
病患者男 - 44歲 醫生你好 由於幫小弟診症的醫生不在香港所以麻煩各位比點意見 事情是咁的,我.......Wai : 尿液檢查如果report Leu 500./ Pro 10
病患者女 - 歲 尿液檢查如果report Leu 500./ Pro 10 尿液檢查時 發現Leu 5.......Zac : 睪丸痛
病患者男 - 25歲 你好，本人於這數天有睪丸痛問題。 只要站立一段時間(大約半小時)就開始痛 坐下....... 發出提問使用細則
致葉維晉醫生 提問
即時提問 ?
