專科分類目錄

醫務信箱

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

葉維晉醫生回覆
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

醫務信箱
發出提問:
名稱:
E-mail
標題:
患者年齡:
患者性別:
詳細問題

** 相關提問將轉至睇中醫網獲取更多專業意見