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Comparing the Efficacy and Safety of Percutaneous Nephrolithotomy vs Extracorporeal Shock Wave Lithotripsy for Lower Calyceal Stones 1-2 cm 经皮肾镜取石术与体外冲击波碎石术治疗下肾盏1 ~ 2 cm结石的疗效和安全性比较
Pub Date : 2018-01-01 DOI: 10.4172/2168-9857.1000209
Montadhar H Nimaa, Shahad A. Ibraheem
Purpose: To distinguish the ESWL and PCNL treatment procedures of 1-2 cm of lower calyceal renal calculi in order to assess the ability and safety of the procedures.Materials and Methods: Patients that undergone treatments within the time frame of June 2015 to March 2018 was selected for the study. 220 patients were identified, where; they were diagnosed with stone size ranging from 1-2 cm in lower calyceal. Selected patients were grouped into to Extracorporeal Shock Wave Lithotripsy (ESWL) and Percutaneous Nephrolithotomy (PCNL) groups. The demographic information comprising age, gender, size of the stone, operation time and stone-free rate (SFR) was collected and analyzed. After the operation, identified patients were tested with stone detection procedure (KUB and US) and CT scan at day 10th and 12th week respectively.Result: It was observed that both groups were eligible for preoperative parameters comparison. The mean (SD) of operating time was significantly longer for Group B [6.71 (38) mins] compared to Group A, yet statistically significant as the p-value was <0.001. On the other hand, the SFR value obtained for both groups were different, 27% and 82% for Group A and Group B respectively.Conclusion: In summary, it was proven that both ESWL and PCNL treatment procedures are comparable for treating lower calyceal stones ranging from 1-2 cm. Despite having the longer hospital stay and intraoperative complications, PCNL was observed to have longer operating time compared to ESWL. Besides that, PCNL also possesses a higher tendency of post-operative infection as the SFR value obtained was higher than ESWL.
目的:区分ESWL和PCNL治疗1 ~ 2cm下盏肾结石的术式,评价两种术式的能力和安全性。材料与方法:选取2015年6月至2018年3月期间接受治疗的患者作为研究对象。确定了220例患者,其中;他们被诊断为下盏结石大小为1-2厘米。选择的患者分为体外冲击波碎石(ESWL)组和经皮肾镜取石(PCNL)组。收集并分析患者的年龄、性别、结石大小、手术时间、结石清除率(SFR)等人口统计学信息。术后患者分别于第10天和第12周行肾结石检查(KUB和US)和CT扫描。结果:两组术前参数比较均符合要求。B组平均手术时间(SD)明显长于A组(6.71 (38)min), p值<0.001,差异有统计学意义。另一方面,两组的SFR值不同,A组为27%,B组为82%。结论:综上所述,ESWL和PCNL治疗1-2 cm的下盏结石具有可比性。尽管PCNL有较长的住院时间和术中并发症,但与ESWL相比,PCNL的手术时间更长。此外,PCNL术后感染的倾向也较高,因为获得的SFR值高于ESWL。
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引用次数: 1
Urinary and Fecal Control and Incontinence: Pathogenesis and Management 尿便控制和尿失禁:发病机制和管理
Pub Date : 2018-01-01 DOI: 10.4172/2168-9857.1000203
A. E. Hemaly, L. Mousa, K. IbrahimM., Il, M. Morad, Mervat M. Ibrhaim, Fatma S. Al Sokkary, M. Ragab
Introduction: Urinary and Fecal Control depends on two factors, the first is an inherent, and the second is an acquired. The inherent factor is the presence of an intact sound IUS and IAS. The acquired factor is, through toilet training, having and maintaining high sympathetic tone at the IUS and the IAS. This keeps the sphincters contracted and the urethra and the anal canal empty and closed all the time. Laceration of the collagen chassis of the IUS leads to its weakness and subsequent stress urinary incontinence (SUI) and/or over active bladder (OAB). Similarly, lacerations of the collagen chassis of the IAS lead to its weakness and subsequent fecal incontinence (FI). The lacerations in one/or both sphincters are mainly caused by childbirth trauma (CBT). The pelvic collagen is hormone dependent and drop in the estrogen level causes further weakness of the sphincters. In men senile prostatic enlargement compress the upper part of the urethra leading to irregular dilatation of the bladder neck allowing some urine to enter the urethra on increases of abdominal pressure causing frequent desire to void. The start of voiding may take some time (hesitancy) because of the effort to open the urethra which is compressed by the enlarged prostate. Reconstructive surgery: In women the commonest cause of incontinence is traumatic lacerations of the collagen chassis of the IUS and/or the IAS from CBT. Reconstructive surgery is to restore the normal anatomy and it will restore the function. A new operation “urethra-ano-vaginoplasty” is introduced where mending the torn collagen chassis of the IUS and overlapping the anterior vaginal wall flaps over the mended IUS; and mending the torn chassis of the IAS, overlapping the posterior vaginal wall flaps over the mended sphincter, approximate the two levator ani muscles and repair of the perineum is done.
导读:尿便控制取决于两个因素,第一是先天的,第二是后天的。其内在因素是存在一个完整的健全的IUS和IAS。后天因素是,通过如厕训练,在IUS和IAS中拥有并保持高交感音调。这使括约肌收缩,尿道和肛管始终保持通畅和关闭。IUS胶原蛋白基底的撕裂导致其虚弱和随后的压力性尿失禁(SUI)和/或膀胱过度活动(OAB)。同样,IAS的胶原基底的撕裂导致其虚弱和随后的大便失禁(FI)。单侧或双侧括约肌撕裂伤主要由分娩创伤(CBT)引起。骨盆胶原蛋白依赖于激素,雌激素水平的下降会导致括约肌进一步虚弱。在男性中,老年性前列腺肿大压迫尿道上部,导致膀胱颈部不规则扩张,使一些尿液进入尿道,腹部压力增加,导致频繁的排尿欲望。开始排尿可能需要一些时间(犹豫),因为要努力打开尿道,尿道被前列腺肿大所压缩。重建手术:在女性中,尿失禁最常见的原因是CBT引起的IUS和/或IAS胶原基底的创伤性撕裂。重建手术就是恢复正常的解剖结构和功能。介绍了一种新的手术“尿道-阴道-阴道成形术”,其中修复IUS的胶原蛋白底盘并将阴道前壁皮瓣重叠在修复的IUS上;修复IAS撕裂的基底,在修复的括约肌上重叠阴道后壁皮瓣,近似于两条提肛肌,会阴修复完成了。
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引用次数: 2
Renal Replacement Lipomatosis with Psoas Abscess Mimicking asXanthogranulomatous Pyelonephritis 肾替代性脂肪变性伴腰肌脓肿,类似黄色肉芽肿性肾盂肾炎
Pub Date : 2018-01-01 DOI: 10.4172/2168-9857.1000204
S. Nathani, Kapsioor Singh, P. Mehta
Renal replacement lipomatosis also known as fibrolipomatosis is a rare chronic pathological condition of the kidney characterized by atrophy and damage to renal parenchyma with excessive proliferation of fat beginning from renal sinus and gradually replacing entire kidney by a fatty pseudotumor. We are presenting a case report of renal replacement lipomatosis in an elderly male with the long-term history of renal stones and coexistent psoas abscess on imaging mimicking as xanthogranulomatous pyelonephritis. Role of (computed tomography) CT imaging is described as preferred modality of investigation to describe unique features of this disease, to differentiate it from xanthogranulomatous pyelonephritis and as a roadmap to surgery.
肾脏替代性脂肪瘤病也称为纤维脂肪瘤病,是一种罕见的肾脏慢性病理状况,其特征是肾实质萎缩和损害,并伴有从肾窦开始的脂肪过度增生,逐渐被脂肪性假瘤取代整个肾脏。我们报告一位老年男性肾脏替代脂肪瘤病患者,长期有肾结石病史并并发腰肌脓肿,影像学表现为黄色肉芽肿性肾盂肾炎。CT成像的作用被描述为首选的调查方式,以描述该疾病的独特特征,将其与黄色肉芽肿性肾盂肾炎区分开来,并作为手术的路线图。
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引用次数: 2
Large Spontaneous Steinstrasse: An Unusual Occurrence 大型自发性施坦斯特拉斯:一种不寻常的现象
Pub Date : 2018-01-01 DOI: 10.4172/2168-9857.1000202
K. Parmar, A. Chandna, Santosh Kumar, Anuj Sharma, A. Khanna
Steinstrasse, a German word for “Stone Street” is described as column of stone fragments in the ureter following extracorporeal shock wave lithotripsy (SWL). It is a well-recognized, transient, and usually asymptomatic complication of SWL that occurs in 4%–7% of cases. Majority of steinstrasse clears spontaneously, about 6% require intervention. Spontaneous steinstrasse without prior history of SWL is a rare occurrence and only few case reports have been reported. We herein present a rare case of massive spontaneous steinstrasse in a young male and discuss its aetiology and management.
Steinstrasse是德语单词,意为“石头街”,被描述为体外冲击波碎石术(SWL)后输尿管内的石头碎片柱。这是一种公认的、短暂的、通常无症状的SWL并发症,发生在4% ~ 7%的病例中。大多数脓疱自行清除,约6%需要干预。无SWL既往史的自发性肺积水是罕见的,仅有少数病例报道。我们在此报告一例罕见的年轻男性大量自发性脓肿病例,并讨论其病因和治疗方法。
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引用次数: 1
Evaluation of the Role of Micropercutaneous Nephrolithotomy (Microperc) and Retrograde Intrarenal Surgery (RIRS) in the Management of Small Lower Caliceal Kidney Stones 微经皮肾镜取石术(Microperc)和逆行肾内手术(RIRS)在肾盏下小肾结石治疗中的作用评价
Pub Date : 2018-01-01 DOI: 10.4172/2168-9857.1000206
Mohamed Yehiaa, M. Thangavelu
Introduction: Management of lower caliceal stones is challenging. Recent advances in technology have led to the implementation of micro percutaneous nephrolithotomy (microperc) as well as retrograde intrarenal surgery (RIRS) in the management of lower caliceal kidney stones. Objective: Review of studies evaluating the role of RIRS and microperc techniques for the treatment of lower caliceal kidney stones. Evidence acquisition: A systematic literature review was performed in September 2017 using the PubMed, Scopus, and Web of Science databases to identify relevant studies. Conclusion: Microperc and RIRS, both are valid options for the treatment of small lower caliceal stones in adult patients. The stone clearance rates in both microperc and RIRS are comparably high and the complication rates are comparably low. Microperc is associated with more post-operative pain and more fall in the haemoglobin level while RIRS is associated with more intraoperative DJ insertion.
导言:下盏结石的治疗具有挑战性。最近的技术进步已经导致实施微经皮肾镜取石术(microperc)以及逆行肾内手术(RIRS)在肾盏下肾结石的管理。目的:综述RIRS和微量钙技术在肾盏下肾结石治疗中的作用。证据获取:2017年9月,使用PubMed、Scopus和Web of Science数据库进行了系统的文献综述,以确定相关研究。结论:微钙石和RIRS是治疗成人肾盏下小结石的有效选择。微量和RIRS的结石清除率都相对较高,并发症发生率相对较低。Microperc与更多的术后疼痛和血红蛋白水平下降相关,而RIRS与更多的术中DJ插入相关。
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引用次数: 0
Four Factor Prothrombin Complex Concentrate for Anticoagulation Reversal in an LVAS Patient Undergoing Robotic Prostatectomy: A Case Report 四因子凝血酶原复合物浓缩物在LVAS患者行机器人前列腺切除术中的抗凝逆转:一例报告
Pub Date : 2018-01-01 DOI: 10.4172/2168-9857.1000208
J. Rimsans, B. Fortin, K. Sylvester, Peter E Collins, Mollie Semmer, K. Frankel, J. Howard, A. Kibel, L. Coakley, M. Givertz, J. Connors
Recipients of left ventricular assist system (LVAS) require long-term anticoagulation with warfarin to prevent thromboembolic complications. We discuss a successful case of the use of four factor prothrombin complex concentrate (4F-PCC) for temporary warfarin reversal in a patient with a HeartMate 3 LVAS requiring robotic assisted laparoscopic prostatectomy.
左心室辅助系统(LVAS)接受者需要长期使用华法林抗凝以预防血栓栓塞并发症。我们讨论了一个成功的案例,使用四因子凝血酶原复合物浓缩物(4F-PCC)暂时逆转华法林患者心脏伴侣3 LVAS需要机器人辅助腹腔镜前列腺切除术。
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引用次数: 0
Predicting the Immune Response Following Intravesical BCG; is it Possible? 膀胱内卡介苗对免疫应答的预测可能吗?
Pub Date : 2018-01-01 DOI: 10.4172/2168-9857.1000213
M. Yehia, M. Thangavelu
Objective: To demonstrate and quantify the immune response changes over time in patients with Non-muscleinvasive Bladder Cancer (NMIBC) treated with bacillus Calmette-Guerin (BCG).Methods: The study enrolled 52 patients. Group A included 32 patients with high risk and intermediate risk NMIBC treated with TURBT and intravesical BCG. Group B included 20 patients underwent cystoscopy for other indications. Monitoring immune changes was done by quantifying the percentage of T lymphocytes in urine samples taken before BCG therapy, immediately after BCG therapy and 3 months later. Patients in Group A were followed for 1 year and the clinical outcome was correlated to the level of the immune response.Results: In the initial urine samples taken before BCG therapy the mean flowcytometeric percentages of the T lymphocytes were comparable in both groups. Six weeks after BCG therapy, Group A revealed a significantly elevated mean flowcytometeric measurement 53.3% which dropped after 3 months to 22.4% but still significantly more than that of Group B (which did not show a significant rise after 6 weeks and after 3 months). Out of the 32 patients in Group A, 25 patients (78%) revealed significantly elevated flowcytometeric measurements after BCG therapy in comparison to the mean percentage of the control group (strong responders), while 7 patients (22%) revealed minimally elevated measurements (weak responders). Three cases from the strong responders group (12%) had tumor recurrence during follow up period compared to 3 cases (43%) from the weak responders.Conclusion: Flowcytometery is a feasible method for monitoring the BCG immune response by measuring the percentage of T lymphocytes in urine.
目的:研究和量化卡介苗(BCG)治疗非肌肉侵袭性膀胱癌(NMIBC)患者免疫应答随时间的变化。方法:纳入52例患者。A组包括32例经TURBT和膀胱内卡介苗治疗的高危和中度NMIBC患者。B组20例患者行膀胱镜检查其他适应症。通过量化卡介苗治疗前、治疗后立即和3个月后尿液样本中T淋巴细胞的百分比来监测免疫变化。A组患者随访1年,临床结果与免疫应答水平相关。结果:在卡介苗治疗前的初始尿液样本中,两组T淋巴细胞的平均流式细胞术百分比具有可比性。卡介苗治疗6周后,A组平均流式细胞术测量值显著升高53.3%,3个月后下降至22.4%,但仍显著高于B组(6周和3个月后无显著升高)。在A组的32例患者中,与对照组(强应答者)的平均百分比相比,25例患者(78%)在卡介苗治疗后显示出显著升高的流式细胞术测量值,而7例患者(22%)显示最小升高的测量值(弱应答者)。强应答组随访期间肿瘤复发3例(12%),弱应答组随访期间肿瘤复发3例(43%)。结论:流式细胞术通过测定尿中T淋巴细胞百分比监测卡介苗免疫反应是一种可行的方法。
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引用次数: 0
Largest Metanephric Adenoma Kidney with Polycythemia Incidentally Detected in a Blood Donor 在一个献血者偶然发现的最大后肾腺瘤伴红细胞增多症
Pub Date : 2018-01-01 DOI: 10.4172/2168-9857.1000212
V. Manoharan, K. Parmar, V. Attri, S. Singh, P. Vasisht, P. Bhatia, Meenu Singh, ita Kakkar
Metanephric adenoma of kidney is a rare entity. It presents in young individuals and its association with polycythemia is well described. Differentiation from Wilm’s tumor and renal cell carcinoma is challenging and hence definitive diagnosis is made by histopathology with immunohistochemistry. Recognition of this entity is important as it has a more favourable clinical outcome compared with Wilms' tumor and renal cell carcinoma. We report a case of largest metanephric adenoma presenting with polycythemia incidentally detected in young female during blood donation and managed by radical nephrectomy.
摘要肾后肾腺瘤是一种罕见的肿瘤。它出现在年轻人和它与红细胞增多症的关系是很好的描述。从肾母细胞瘤和肾细胞癌的鉴别是具有挑战性的,因此通过组织病理学和免疫组织化学做出明确的诊断。认识到这种实体是很重要的,因为与肾母细胞癌和肾细胞癌相比,它具有更有利的临床结果。我们报告一例最大的后肾腺瘤表现为红细胞增多症偶然发现在年轻女性献血和管理的根治性肾切除术。
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引用次数: 0
Penile Location of Buschke-Löwenstein Tumor Buschke-Löwenstein肿瘤的阴茎位置
Pub Date : 2018-01-01 DOI: 10.4172/2168-9857.1000I104
Youness Jabbour, H. Palamino, T. Karmouni, K. Khader, A. Koutani, A. Andaloussi, B. Hassam
{"title":"Penile Location of Buschke-Löwenstein Tumor","authors":"Youness Jabbour, H. Palamino, T. Karmouni, K. Khader, A. Koutani, A. Andaloussi, B. Hassam","doi":"10.4172/2168-9857.1000I104","DOIUrl":"https://doi.org/10.4172/2168-9857.1000I104","url":null,"abstract":"","PeriodicalId":89536,"journal":{"name":"British journal of medical & surgical urology","volume":"44 1","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78792710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Two Cases of Female Urethral Primary Cancer: Review of Clinico Pathological and Therapeutic Aspects 女性尿道原发癌2例临床、病理及治疗回顾
Pub Date : 2018-01-01 DOI: 10.4172/2168-9857.1000211
Kouka Scn, Y. Diallo, M. Jalloh, L. Bentefouet, R. Ly, Ndiaye, M. Daher, Diop Ak, C. Sylla
The authors report two cases of female primary urethral carcinoma in two patients 70 years-old and 27 years-old. The patients were referred for difficulty passing urine, initial hematuria and episodic genital bleeding. Physical examination revealed a swelling of the meatus associated with induration of the anterior vagina wall. Pathology of the biopsy showed an urethral adenocarcinoma for case 1 and urothelial carcinoma for case 2. Anterior pelvectomy with ileal conduit was performed. Postoperative period was uneventful. They received adjuvant chemotherapy. The epidemiology, diagnosis, prognosis and disease management aspects are discussed through a review of the literature.
本文报告两例女性原发性尿道癌,年龄分别为70岁和27岁。这些患者因排尿困难、首发血尿和阵发性生殖器出血而被转诊。体格检查发现阴道道肿胀伴阴道前壁硬化。病理活检显示1例为尿道腺癌,2例为尿路上皮癌。采用回肠导管行骨盆前切除术。术后无意外。他们接受了辅助化疗。通过文献回顾,讨论了流行病学、诊断、预后和疾病管理方面的问题。
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引用次数: 1
期刊
British journal of medical & surgical urology
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