While cystolitholapaxy for bladder stones is commonly performed using a transurethral approach,large or complex stone burdens in patients with complex lower urinary tract anatomy may make this inefficient or infeasibl...While cystolitholapaxy for bladder stones is commonly performed using a transurethral approach,large or complex stone burdens in patients with complex lower urinary tract anatomy may make this inefficient or infeasible.Percutaneous cystolitholapaxy is a safe,effective,minimally invasive alternative for diverse indications,including patients with benign prostatic hyperplasia,urethral stricture disease,closed bladder neck,continent catheterized channel,or other urinary diversion.In this article,we review the indications for and advantages of percutaneous cystolitholapaxy and describe our step-by-step technique for this procedure,including representative imaging and favored equipment.We also discuss preoperative and postoperative considerations,management of potential complications,strategies to optimize clinical outcomes and patient safety,and comparisons with transurethral approaches.Finally,we report outcomes from our institutional series of percutaneous cystolitholapaxy cases to highlight the safety and efficacy of the procedure.展开更多
BACKGROUND Genitourinary(GU)schistosomiasis is a chronic infection caused by a parasitic trematode,with Schistosoma haematobium(S.haematobium)being the prevalent species.The disease has a variable prevalence around th...BACKGROUND Genitourinary(GU)schistosomiasis is a chronic infection caused by a parasitic trematode,with Schistosoma haematobium(S.haematobium)being the prevalent species.The disease has a variable prevalence around the world,with a greater burden on,but not limited to Africa,South America,Asia,and the Middle East.CASE SUMMARY We report the case of a 30-year-old man who presented with symptoms of bladder stones.During endoscopic cystolithalopaxy,we did not detect any stones in the bladder.Upon careful scanning of the urinary bladder trigone,sandy patches were detected.We performed endoscopic resection,which revealed a closed diverticulum with bladder stones.The diverticular wall was sent for histopathology and revealed features of chronic granulomatous inflammation with numerous embedded Schistosoma eggs,with some of the eggs having lateral spines.The patient was treated with praziquantel,and his symptoms completely resolved.CONCLUSION GU schistosomiasis is primarily caused by S.haematobium.However,Schistosoma mansoni mediated GU schistosomiasis is unusual,making this a quite interesting case.展开更多
BACKGROUND Rectal prolapse occurs most commonly in children and middle-aged and elderly women and is relatively rare in young men and is occasionally caused by bladder stones.Severe rectal prolapse,bilateral hydroneph...BACKGROUND Rectal prolapse occurs most commonly in children and middle-aged and elderly women and is relatively rare in young men and is occasionally caused by bladder stones.Severe rectal prolapse,bilateral hydronephrosis,and renal insufficiency caused by bladder stones are rare in a 30-year-old man.CASE SUMMARY We report the case of a 30-year-old male patient with cerebral palsy who presented with a large bladder stone that resulted in severe rectal prolapse,bilateral hydronephrosis,and renal insufficiency.Following a definitive diagnosis,the bladder stone was successfully removed,and his kidney function returned to normal.We assessed the patient’s nutritional status and stone composition and concluded that the main cause was malnutrition.CONCLUSION Rectal prolapse is a rare clinical manifestation of bladder stones,particularly in young adults.Cerebral palsy patients are a vulnerable group in society because of their intellectual disabilities and communicative impairments.Accordingly,besides taking care of their daily diet,abnormal signs in their bodies should receive the doctors’attention in a timely manner.展开更多
BACKGROUND Prostatic urethral lift(PUL)therapy is an alternative to minimally invasive and other surgeries in younger patients who want to preserve their sexual and ejaculatory functions,and in elderly male patients w...BACKGROUND Prostatic urethral lift(PUL)therapy is an alternative to minimally invasive and other surgeries in younger patients who want to preserve their sexual and ejaculatory functions,and in elderly male patients with benign prostatic hyperplasia who cannot be anesthetized because of the risk of anesthesia.The procedure can be performed as an outpatient and without anesthesia,and complications are few and temporary.In long-term follow-up,encrustations that require retreatment are rarely seen.CASE SUMMARY In our case,a 62-year-old prostate patient who had a PUL operation 8 years ago and had a stone on the PUL material near the bladder neck was treated.The patient’s stone was removed by endoscopic cystolithotripsy using pneumatic fragmentation.Bipolar transurethral resection of the prostate was applied to the patient in the same session.After the patient’s 7-year follow-up,the patient’s complaints relapsed,and cystoscopy was performed again.In cystoscopy,stone formation adjacent to the wall was observed at the junction of the bladder neck to the left lateral wall.The stone was fragmented with a pneumatic lithotripter.CONCLUSION Placing clips too close to bladder neck in the PUL procedure may result in clip migration.展开更多
Introduction: Gallstone disease, also known as gallbladder stones or GBS, is almost always asymptomatic but can result in a number of problems, including ascending cholangitis and obstructive jaundice. The frequency o...Introduction: Gallstone disease, also known as gallbladder stones or GBS, is almost always asymptomatic but can result in a number of problems, including ascending cholangitis and obstructive jaundice. The frequency of gallbladder stones among patients who were sent for abdominal ultrasound at Mogadishu Somali Turkey Training and Research Hospital, Mogadishu, Somalia, during the period between January 2018 and June 2022 was assessed in this study. Methods: This is a record-based study that was carried out at the radiology department of Mogadishu Somali Turkey Training and Research Hospital on patients who were chosen for abdominal ultrasounds during the months of January 2018 and January 2022. The study focused on cases that occurred within those periods. Reports of abdominal ultrasounds served as the source of the collected data. Results: Records from 2352 patients are included in this study. They were divided into 451 (19.1%) males and 1901 (80.8%) females. Patients with GBS were present in 76.4 percent of cases. 73.2 percent of patients had big stones larger than 5 mm, while 53.4 percent of patients had several stones. GBS 1474 (77.5%) was substantially more common in females than in males (71.6%: 323/451) (P 0.008). The presence of small stones (less than 5 mm) was also shown to be significantly different between males and females (P = 0.015). Furthermore, compared with men, females had a considerably higher frequency of big GBS (5 mm) (P 0.015). Conclusion: In this study, it was discovered that females were significantly more likely than males to have GBS. Small stones were found much more frequently in the males. When compared to men, females had a considerably higher frequency of large GBS.展开更多
Purpose: This study aimed to evaluate the efficacy and safety of endoscopic lithotripsy with the lithoclast (EMS, Switzerland) and laser Holmium YAG in the management of bladder calculi. Materials and methods: This wa...Purpose: This study aimed to evaluate the efficacy and safety of endoscopic lithotripsy with the lithoclast (EMS, Switzerland) and laser Holmium YAG in the management of bladder calculi. Materials and methods: This was a retrospective study carried out from January 2013 to December 2019 on 32 patients with bladder calculi. All the patients underwent either Lithoclast or Laser lithotripsy using a 22F Storz cystoscope at the Centre medico-chirugicale d’urologie in Douala, Cameroon. Data on patients’ ages, clinical symptoms, stone sizes, type of lithotripsy, surgery duration, and results of lithotripsy were collected and analyzed using Epi info 7. Results: We recruited 32 participants (24 men and 8 women) with a median age of 41.28 [22 - 68] years into this study. In 9 (28.12%) participants, macroscopic hematuria was the main presenting complaint, followed by lower urinary tract symptoms in 8 (25%) patients. A cystoscopy was performed in 17 (53.12%) patients to confirm the diagnosis of a bladder stone, and ultrasonography of the upper urinary tract was performed in 29 (90.6%) cases to certify the absence of another stone. Lithoclast EMS was used to manage the stones in 23 (71.87%) patients while laser lithotripsy was used in 9 (28.13%). A dormia basket was used to remove stone fragments in 10 (31.25%) patients. The mean surgery duration was 33.59 ± 14.2 minutes, and the bladder stones were successfully managed in all the participants of this study. Minor complications such as pain during micturition were found in 28 (87.37%) patients, with complete resolution occurring two weeks after surgery. Conclusion: Endoscopy with lithotripsy is a safe and effective method of management of bladder stones. This technique is also associated with short surgical procedures and postoperative hospitalization periods. We believe that it is an excellent treatment modality in the management of bladder stones.展开更多
Benign prostatic hyperplasia,which can be abbreviated as prostatic hyperplasia,is a urinary system disease that has a high incidence in middle-aged and elderly male populations in China.The incidence of benign prostat...Benign prostatic hyperplasia,which can be abbreviated as prostatic hyperplasia,is a urinary system disease that has a high incidence in middle-aged and elderly male populations in China.The incidence of benign prostatic hyperplasia is increasing year by year.Patients with benign prostatic hyperplasia are prone to have bladder outlet obstruction,which in turn leads to an increase in residual urine volume in the bladder and impurities in the urine,such as upper urinary calculi that enter the bladder,urine crystals,various exfoliated cells,etc.If these substances stay in the bladder for a long time,stones in the bladder will be generated.Benign prostatic hyperplasia with bladder stones can severely obstruct the urinary tract,causing clinical symptoms such as urinary tract infections,urinary urgency,frequent urination,and dysuria.These symptoms seriously affects the physical and mental health of patients,leading to low levels of normal work and quality of life.With the development of medical technology,surgical treatment is commonly used in clinical practice.Among them,transurethral prostatectomy is widely used in clinical treatment,and has achieved good results.展开更多
Objective: To assess the safety and efficacy of bladder irrigation for reducing the morbidity of bladder stones in patients with neurological lower urinary tract dysfunction (NLUTD). Methods: From June 2012 to July 20...Objective: To assess the safety and efficacy of bladder irrigation for reducing the morbidity of bladder stones in patients with neurological lower urinary tract dysfunction (NLUTD). Methods: From June 2012 to July 2013, patients with NLUTD were prospectively randomized and assigned to either a bladder irrigation group or a no bladder irrigation group. Bladder irrigations were performed twice a week by urologists. Patients were followed up at 6 months respectively. Primary outcomes were Incontinence-Specific Quality-of-Life Instrument (I-QoL), the rate incidences of bladder stone. All adverse events were also noted. Results: A total of 80 eligible patients participated and 78 (97.5%) patients (bladder irrigation, n = 39;no bladder irrigation, n = 39) completed 24 weeks of follow-up. Out of the 78 patients, 19 (24.3%) developed bladder stones. All occurred in no bladder irrigation group. In 8 of the 19 patients (42.1%), stones were only detected by cystoscopy. The bladder stones were mostly thin with an eggshell appearance (78.95% for diameter of stone < 5 mm, 84.21% for volume of bladder stone < 0.2 cm3). Bladder stones were removed by vigorous bladder irrigation guided by ultrasound (73.68%) or endoscopic lithotripsy (26.32%). The I-QOL was significantly better in the bladder irrigation group than in no bladder irrigation group at weeks 6, 12, 18, and 24 of follow-up. Conclusion: Bladder irrigation may be more effective and safer than no bladder irrigation for reducing the morbidity of bladder stone in spinal cord injury patients.展开更多
BACKGROUND An intrauterine device(IUD)is a commonly used contraceptive among women in China.It is widely used because it is safe,effective,simple,economic,and reversible.Among the possible complications,an ectopic IUD...BACKGROUND An intrauterine device(IUD)is a commonly used contraceptive among women in China.It is widely used because it is safe,effective,simple,economic,and reversible.Among the possible complications,an ectopic IUD in the bladder is rare.It occurs insidiously,has a long course,is associated with a high risk for injury,and is difficult to treat.CASE SUMMARY A 44-year-old woman was admitted for repeated episodes of urinary frequency,urgency,and dysuria over three months.Laboratory tests revealed significantly elevated urine leukocytes and bacteria.Urine culture suggested colonization with Enterococcus faecalis.Abdominal computed tomography images suggested an abnormally positioned IUD that was protruding into the bladder.Cystoscopy revealed a metallic foreign body with multiple stones on its surface in the left posterior bladder wall.The foreign body measured approximately 1 cm.Hysteroscopy revealed the arm of a V-type metal IUD embedded in the middle and upper sections of the anterior wall of the cervical canal.The majority of the IUD was located in the uterine cavity.Cystoscopy was performed,and a holmium laser was utilized to break the stones attached to the portion of the IUD in the bladder.The IUD was then removed through hysteroscopy.CONCLUSION Ectopic IUDs in the bladder can be diagnosed with thorough imaging and safely removed through cystoscopy or hysteroscopy.展开更多
目的探讨前列腺增生症(BPH)合并膀胱结石的安全有效的治疗方法。方法2003年12月～2006年12月该院45例BPH并膀胱结石患者,分别采用大力碎石钳+经尿道前列腺电切术(transurethral resection of prostate,TURP)、输尿管镜下气压弹道碎石+T...目的探讨前列腺增生症(BPH)合并膀胱结石的安全有效的治疗方法。方法2003年12月～2006年12月该院45例BPH并膀胱结石患者,分别采用大力碎石钳+经尿道前列腺电切术(transurethral resection of prostate,TURP)、输尿管镜下气压弹道碎石+TURP、耻骨上小切口取石+TURP治疗。结果45例均1次手术成功,手术时间50～120min,平均80min,无电切综合征和膀胱穿孔,术后留置导尿管5～7d,排尿通畅。随访1～3年,IPSS由术前(26.7±5.6)下降至(6.3±0.5),最大尿流率>15mL/s。结论针对不同前列腺增生症合并膀胱结石患者,采用合适的微创手术方法,可取得满意的效果。展开更多
文摘While cystolitholapaxy for bladder stones is commonly performed using a transurethral approach,large or complex stone burdens in patients with complex lower urinary tract anatomy may make this inefficient or infeasible.Percutaneous cystolitholapaxy is a safe,effective,minimally invasive alternative for diverse indications,including patients with benign prostatic hyperplasia,urethral stricture disease,closed bladder neck,continent catheterized channel,or other urinary diversion.In this article,we review the indications for and advantages of percutaneous cystolitholapaxy and describe our step-by-step technique for this procedure,including representative imaging and favored equipment.We also discuss preoperative and postoperative considerations,management of potential complications,strategies to optimize clinical outcomes and patient safety,and comparisons with transurethral approaches.Finally,we report outcomes from our institutional series of percutaneous cystolitholapaxy cases to highlight the safety and efficacy of the procedure.
文摘BACKGROUND Genitourinary(GU)schistosomiasis is a chronic infection caused by a parasitic trematode,with Schistosoma haematobium(S.haematobium)being the prevalent species.The disease has a variable prevalence around the world,with a greater burden on,but not limited to Africa,South America,Asia,and the Middle East.CASE SUMMARY We report the case of a 30-year-old man who presented with symptoms of bladder stones.During endoscopic cystolithalopaxy,we did not detect any stones in the bladder.Upon careful scanning of the urinary bladder trigone,sandy patches were detected.We performed endoscopic resection,which revealed a closed diverticulum with bladder stones.The diverticular wall was sent for histopathology and revealed features of chronic granulomatous inflammation with numerous embedded Schistosoma eggs,with some of the eggs having lateral spines.The patient was treated with praziquantel,and his symptoms completely resolved.CONCLUSION GU schistosomiasis is primarily caused by S.haematobium.However,Schistosoma mansoni mediated GU schistosomiasis is unusual,making this a quite interesting case.
基金Supported by Bureau of Science and Technology in Xiaoshan District,Hangzhou,China,NO.2020210。
文摘BACKGROUND Rectal prolapse occurs most commonly in children and middle-aged and elderly women and is relatively rare in young men and is occasionally caused by bladder stones.Severe rectal prolapse,bilateral hydronephrosis,and renal insufficiency caused by bladder stones are rare in a 30-year-old man.CASE SUMMARY We report the case of a 30-year-old male patient with cerebral palsy who presented with a large bladder stone that resulted in severe rectal prolapse,bilateral hydronephrosis,and renal insufficiency.Following a definitive diagnosis,the bladder stone was successfully removed,and his kidney function returned to normal.We assessed the patient’s nutritional status and stone composition and concluded that the main cause was malnutrition.CONCLUSION Rectal prolapse is a rare clinical manifestation of bladder stones,particularly in young adults.Cerebral palsy patients are a vulnerable group in society because of their intellectual disabilities and communicative impairments.Accordingly,besides taking care of their daily diet,abnormal signs in their bodies should receive the doctors’attention in a timely manner.
文摘BACKGROUND Prostatic urethral lift(PUL)therapy is an alternative to minimally invasive and other surgeries in younger patients who want to preserve their sexual and ejaculatory functions,and in elderly male patients with benign prostatic hyperplasia who cannot be anesthetized because of the risk of anesthesia.The procedure can be performed as an outpatient and without anesthesia,and complications are few and temporary.In long-term follow-up,encrustations that require retreatment are rarely seen.CASE SUMMARY In our case,a 62-year-old prostate patient who had a PUL operation 8 years ago and had a stone on the PUL material near the bladder neck was treated.The patient’s stone was removed by endoscopic cystolithotripsy using pneumatic fragmentation.Bipolar transurethral resection of the prostate was applied to the patient in the same session.After the patient’s 7-year follow-up,the patient’s complaints relapsed,and cystoscopy was performed again.In cystoscopy,stone formation adjacent to the wall was observed at the junction of the bladder neck to the left lateral wall.The stone was fragmented with a pneumatic lithotripter.CONCLUSION Placing clips too close to bladder neck in the PUL procedure may result in clip migration.
文摘Introduction: Gallstone disease, also known as gallbladder stones or GBS, is almost always asymptomatic but can result in a number of problems, including ascending cholangitis and obstructive jaundice. The frequency of gallbladder stones among patients who were sent for abdominal ultrasound at Mogadishu Somali Turkey Training and Research Hospital, Mogadishu, Somalia, during the period between January 2018 and June 2022 was assessed in this study. Methods: This is a record-based study that was carried out at the radiology department of Mogadishu Somali Turkey Training and Research Hospital on patients who were chosen for abdominal ultrasounds during the months of January 2018 and January 2022. The study focused on cases that occurred within those periods. Reports of abdominal ultrasounds served as the source of the collected data. Results: Records from 2352 patients are included in this study. They were divided into 451 (19.1%) males and 1901 (80.8%) females. Patients with GBS were present in 76.4 percent of cases. 73.2 percent of patients had big stones larger than 5 mm, while 53.4 percent of patients had several stones. GBS 1474 (77.5%) was substantially more common in females than in males (71.6%: 323/451) (P 0.008). The presence of small stones (less than 5 mm) was also shown to be significantly different between males and females (P = 0.015). Furthermore, compared with men, females had a considerably higher frequency of big GBS (5 mm) (P 0.015). Conclusion: In this study, it was discovered that females were significantly more likely than males to have GBS. Small stones were found much more frequently in the males. When compared to men, females had a considerably higher frequency of large GBS.
文摘Purpose: This study aimed to evaluate the efficacy and safety of endoscopic lithotripsy with the lithoclast (EMS, Switzerland) and laser Holmium YAG in the management of bladder calculi. Materials and methods: This was a retrospective study carried out from January 2013 to December 2019 on 32 patients with bladder calculi. All the patients underwent either Lithoclast or Laser lithotripsy using a 22F Storz cystoscope at the Centre medico-chirugicale d’urologie in Douala, Cameroon. Data on patients’ ages, clinical symptoms, stone sizes, type of lithotripsy, surgery duration, and results of lithotripsy were collected and analyzed using Epi info 7. Results: We recruited 32 participants (24 men and 8 women) with a median age of 41.28 [22 - 68] years into this study. In 9 (28.12%) participants, macroscopic hematuria was the main presenting complaint, followed by lower urinary tract symptoms in 8 (25%) patients. A cystoscopy was performed in 17 (53.12%) patients to confirm the diagnosis of a bladder stone, and ultrasonography of the upper urinary tract was performed in 29 (90.6%) cases to certify the absence of another stone. Lithoclast EMS was used to manage the stones in 23 (71.87%) patients while laser lithotripsy was used in 9 (28.13%). A dormia basket was used to remove stone fragments in 10 (31.25%) patients. The mean surgery duration was 33.59 ± 14.2 minutes, and the bladder stones were successfully managed in all the participants of this study. Minor complications such as pain during micturition were found in 28 (87.37%) patients, with complete resolution occurring two weeks after surgery. Conclusion: Endoscopy with lithotripsy is a safe and effective method of management of bladder stones. This technique is also associated with short surgical procedures and postoperative hospitalization periods. We believe that it is an excellent treatment modality in the management of bladder stones.
文摘Benign prostatic hyperplasia,which can be abbreviated as prostatic hyperplasia,is a urinary system disease that has a high incidence in middle-aged and elderly male populations in China.The incidence of benign prostatic hyperplasia is increasing year by year.Patients with benign prostatic hyperplasia are prone to have bladder outlet obstruction,which in turn leads to an increase in residual urine volume in the bladder and impurities in the urine,such as upper urinary calculi that enter the bladder,urine crystals,various exfoliated cells,etc.If these substances stay in the bladder for a long time,stones in the bladder will be generated.Benign prostatic hyperplasia with bladder stones can severely obstruct the urinary tract,causing clinical symptoms such as urinary tract infections,urinary urgency,frequent urination,and dysuria.These symptoms seriously affects the physical and mental health of patients,leading to low levels of normal work and quality of life.With the development of medical technology,surgical treatment is commonly used in clinical practice.Among them,transurethral prostatectomy is widely used in clinical treatment,and has achieved good results.
文摘Objective: To assess the safety and efficacy of bladder irrigation for reducing the morbidity of bladder stones in patients with neurological lower urinary tract dysfunction (NLUTD). Methods: From June 2012 to July 2013, patients with NLUTD were prospectively randomized and assigned to either a bladder irrigation group or a no bladder irrigation group. Bladder irrigations were performed twice a week by urologists. Patients were followed up at 6 months respectively. Primary outcomes were Incontinence-Specific Quality-of-Life Instrument (I-QoL), the rate incidences of bladder stone. All adverse events were also noted. Results: A total of 80 eligible patients participated and 78 (97.5%) patients (bladder irrigation, n = 39;no bladder irrigation, n = 39) completed 24 weeks of follow-up. Out of the 78 patients, 19 (24.3%) developed bladder stones. All occurred in no bladder irrigation group. In 8 of the 19 patients (42.1%), stones were only detected by cystoscopy. The bladder stones were mostly thin with an eggshell appearance (78.95% for diameter of stone < 5 mm, 84.21% for volume of bladder stone < 0.2 cm3). Bladder stones were removed by vigorous bladder irrigation guided by ultrasound (73.68%) or endoscopic lithotripsy (26.32%). The I-QOL was significantly better in the bladder irrigation group than in no bladder irrigation group at weeks 6, 12, 18, and 24 of follow-up. Conclusion: Bladder irrigation may be more effective and safer than no bladder irrigation for reducing the morbidity of bladder stone in spinal cord injury patients.
文摘BACKGROUND An intrauterine device(IUD)is a commonly used contraceptive among women in China.It is widely used because it is safe,effective,simple,economic,and reversible.Among the possible complications,an ectopic IUD in the bladder is rare.It occurs insidiously,has a long course,is associated with a high risk for injury,and is difficult to treat.CASE SUMMARY A 44-year-old woman was admitted for repeated episodes of urinary frequency,urgency,and dysuria over three months.Laboratory tests revealed significantly elevated urine leukocytes and bacteria.Urine culture suggested colonization with Enterococcus faecalis.Abdominal computed tomography images suggested an abnormally positioned IUD that was protruding into the bladder.Cystoscopy revealed a metallic foreign body with multiple stones on its surface in the left posterior bladder wall.The foreign body measured approximately 1 cm.Hysteroscopy revealed the arm of a V-type metal IUD embedded in the middle and upper sections of the anterior wall of the cervical canal.The majority of the IUD was located in the uterine cavity.Cystoscopy was performed,and a holmium laser was utilized to break the stones attached to the portion of the IUD in the bladder.The IUD was then removed through hysteroscopy.CONCLUSION Ectopic IUDs in the bladder can be diagnosed with thorough imaging and safely removed through cystoscopy or hysteroscopy.
文摘目的探讨前列腺增生症(BPH)合并膀胱结石的安全有效的治疗方法。方法2003年12月～2006年12月该院45例BPH并膀胱结石患者,分别采用大力碎石钳+经尿道前列腺电切术(transurethral resection of prostate,TURP)、输尿管镜下气压弹道碎石+TURP、耻骨上小切口取石+TURP治疗。结果45例均1次手术成功,手术时间50～120min,平均80min,无电切综合征和膀胱穿孔,术后留置导尿管5～7d,排尿通畅。随访1～3年,IPSS由术前(26.7±5.6)下降至(6.3±0.5),最大尿流率>15mL/s。结论针对不同前列腺增生症合并膀胱结石患者,采用合适的微创手术方法,可取得满意的效果。
