[ 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Ken : 看了很多次醫生都唔知係泌尿科定婦科
以下是我朋友的病症： 女性，下腹持續壓迫，似急尿，每次屙尿只屙到好少，屙完會覺得屙唔清；屙完尿陰部範圍會麻痺.......Chuchu623 : 一發生性行為龜頭表皮損傷
由上幾個月開始,我和女朋友一次發生性行為,龜頭表皮損了,會有點刺痛,之後會脫皮,我就使用凡士林,過3-4天傷口.......kit1995 : 個人沒割包皮，包皮上有瘡輕撫會有些痛，龜頭亦間歇性出水，尿頻，有時龜頭會灼痛，是龜頭炎還是性疾病
個人沒割包皮，包皮上有一顆瘡輕撫會有些痛，原本有濃液但沖涼時好像弄破了，龜頭亦間歇性出水，尿頻，有時龜頭會灼痛.......Martin : 不舉
我想問葉醫生，我有糖尿病不嚴重，唔使食藥，但有舉而不堅情況，同早洩，想問食偉X可否治療，同會否食上癮，影響健康.......Chan Yun Chung : 老人小便頻密及不清
本人爸爸年齡约100歲，多年来都有小便頻密及不清問題，但最近情況漸趨嚴重，除小便不清外還有不自覺地漏尿問題，曾.......Sam : 泌尿科查詢
你好！請問有醫生的診所可提供daptomycin（泌尿科）的注射藥物嗎？如注射三星期請問如何收費？謝謝.......Kckc : 睪丸隱痛
醫生你好 本人右邊睪丸會出現不定時隱痛 小便正常 並無特別腫脹 醫生可知這什麼情況？.......迷茫小孩子 : 早洩
醫生 你好, 我26歲. 由第一次接觸性開始到現在一直都有早洩的問題, 而且情況一直都好嚴重, 每次性愛的時間.......Hk2015 : 尿道不適
近年經常感到尿道痕癢，做了精液檢查，報告指moderate mixed growth of morganell.......tm : 性功能障礙
醫生： 你好，本人26歲，身型較為肥胖，少運動！與太太行房次數一向都好疏，一個月二，三次。再加上近月轉新工後....... 發出提問使用細則
致葉維晉醫生 提問
即時提問 ?
