同期行输尿管结石钬激光碎石和经尿道前列腺电切的安全性和疗效观察

目的探讨同期行经尿道输尿管镜碎石和经尿道前列腺电切的安全性和疗效观察。方法对20例输尿管下段结石合并良性前列腺增生的患者,先行经尿道输尿管镜碎石后同期行经尿道前列腺电切术。结果 20例患者均顺利完成手术,无膀胱穿孔和电切综合症,术后并观察随访6～20个月,均排尿通畅。1例患者排尿困难经间断尿道扩张后症状缓解。结论同期行经尿道输尿管镜碎石和经尿道前列腺电切疗效确切,安全可靠,可适用于前列腺增生合并输尿管下段结石患者。     

输尿管镜经尿道电切术治疗输尿管口囊肿

目的 探索输尿管口囊肿的内镜治疗新方法，评价输尿管镜经尿道治疗的效果。方法 2003年11月～2006年11月，我院收治此类病例32例，全部行输尿管镜经尿道电切术，与我院前期的20例开放手术对比分析。结果 输尿管镜经尿道电切术的平均手术时间35min，平均住院时间5～6天，手术时间及住院时间小于开放手术，差异有显著性。输尿管镜经尿道电切术后平均随诊18个月，术后输尿管反流，输尿管末端窄及感染的发生率与开放性手术相比，差异无显著性。结论 输尿管镜经尿道电切术治疗输尿管口囊肿方法简单、损伤小、手术效果确切。     

经尿道腔镜下囊肿内切开术治疗单纯输尿管囊肿

目的探讨经尿道腔镜下囊肿内切开术治疗单纯输尿管囊肿的疗效。方法回顾总结12例行经尿道输尿管囊肿内切开术治疗的单纯输尿管囊肿患者临床资料，所有患者均经IVP、超声、膀胱镜检查确诊，手术方法包括行囊肿切开术4例及部分囊肿壁切除术8例。结果所有手术均取得成功，无一例转为开放手术，术后随访5～21个月，临床症状消失，肾积水减轻，无膀胱输尿管反流发生。结论经尿道电切术治疗单纯输尿管囊肿，具有创伤小，患者痛苦小，术后恢复快，并发症少等优点，可作为单纯输尿管囊肿治疗的首选方法。     

输尿管镜技术临床应用637例报告

目的总结输尿管镜技术的临床应用,探讨该技术的应用价值。方法回顾性分析637例（次）肾和输尿管结石、尿道狭窄、输尿管狭窄、尿道断裂、尿道结石等患者采用输尿管镜相关技术进行治疗的效果。结果输尿管镜下碎石术治疗输尿管结石523例,碎石成功率93.1%,其中在门诊局麻条件下完成78例,碎石成功率85.9%;行改良输尿管镜下筋膜扩张器治疗尿道狭窄23例,均顺利扩张,3例狭窄因狭窄段较长,后期改冷刀内切开联合电切术治愈;行微造瘘经皮肾镜碎石治疗肾结石、输尿管上段结石36例次,术后残石率19.4%;行输尿管镜下尿道会师术治疗后尿道断裂2例,输尿管镜下碎石治疗尿道结石16例,输尿管镜检查35例及输尿管镜扩张治疗输尿管狭窄2例均取得成功。结论输尿管镜相关技术适合治疗泌尿外科多种疾病,治疗效果良好,可广泛推广应用。     

经尿道输尿管囊肿电切术22例报告

目的:探讨经尿道电切术治疗成人输尿管囊肿的经验.方法:对22例成人输尿管囊肿行经尿道电切术.结果:本组患者均一次手术切开囊肿,随访6～25个月,所有患者术后症状改善,复查IVU及B超,未见囊肿复发及尿液反流.结论:B超结合IVU、膀胱镜检查可以明确诊断,经尿道输尿管囊肿电切术是一种安全、有效的治疗方法.     

经尿道电切术治疗输尿管囊肿18例报告

目的总结经尿道电切术治疗成人输尿管囊肿的手术经验。方法经尿道电切术治疗后发生输尿管囊肿18例,其中男11例、女7例,年龄21~59岁,囊肿位于左侧10例、右侧8例、双侧3例。其中9例伴有同侧肾脏不同程度积水,2例伴有囊肿内结石。主要症状为反复尿路感染7例,无痛性肉眼血尿8例;腰部及下腹部胀痛5例,常规体格检查发现2例。18例患者均常规行B超检查,明确诊断为输尿管囊肿13例,2例为膀胱结石。16例行静脉造影检查,13例诊断为输尿管囊肿。所有患者均经膀胱镜检查确诊为输尿管囊肿,输尿管囊肿直径约为1.8~5.2cm。结果本组患者均经一次手术切开囊肿,18例术后均获随访6~22个月,平均12个月,患者症状完全消失或明显减轻。复查I VU及B超提示囊肿消失。肾脏积水明显改善。术后行膀胱造影16例,有3例有轻度反流,均为囊肿较大,切开长度较长者,2例合并结石患者也在此列,未发现其他并发症,效果良好。结论经尿道电切术治疗成人输尿管囊肿较开放手术视野清晰操作简单、创伤小、并发症少等优点,是一种比较理想的手术方法。     

前列腺增生症合并膀胱结石的腔内治疗分析

目的 探讨腔内泌尿外科技术治疗前列腺增生症(BPH)合并膀胱结石的应用价值.方法 对74例BPH合并膀胱结石患者分别采用大力碎石钳、输尿管镜气压弹道、标准肾镜超声碎石等方法结合经尿道前列腺电切进行治疗.结果 1例大力钳碎石因膀胱穿孔改行开放手术,2例耻骨上小切口切开取石,另外71例均完全进行腔内治疗,术后5～7 d拔除...     

经尿道等离子电切术治疗输尿管囊肿的临床效果观察

目的探讨输尿管囊肿的内镜治疗方法。方法回顾性分析本院2013年6月至2018年1月收治的12例膀胱内型输尿管囊肿患者的临床资料,采用经尿道等离子电切术治疗输尿管囊肿,术中保留上方囊壁作为抗反流的活瓣,预防反流。结果12例患者均手术成功,症状缓解,手术平均时间33 min,平均住院日为5 d,术后随访6个月至1年,11例患者术后症状消失,肾积水及输尿管扩张减轻或消失,1例患者出现输尿管膀胱反流,二期行腹腔镜下输尿管膀胱乳头再植术后治愈。结论经尿道等离子电切术是一种治疗输尿管囊肿安全有效的微创治疗方法,利用等离子电切镜经尿道途径是值得尝试的手术方案。     

不同术式治疗输尿管结石效果分析

目的比较经尿道输尿管镜钬激光与气压弹道等碎石术治疗输尿管结石的效果及安全性。方法选取2017-03—2019-02间收治的90例输尿管结石患者,分别予以经尿道输尿管镜钬激光碎石术(观察组)和输尿管镜下气压弹道碎石术(对照组),每组45例。回顾性分析患者的临床资料。结果观察组的手术及住院时间均短于对照组,治疗有效率高于对照组,差异均有统计学意义(P<0.05)。2组术前肌酐、血尿素氮水平差异无统计学意义(P>0.05)。术后2组肌酐、血尿素氮水平较术前均有明显改善,且观察组改善程度优于对照组,差异均有统计学意义(P<0.05)。结论经尿道输尿管镜下钬激光碎石术治疗输尿管结石微创、有效率高,患者术后恢复快。     

经尿道电切镜鞘气压弹道碎石术治疗膀胱结石

目的探讨经尿道电切镜鞘气压弹道碎石术治疗膀胱结石的疗效。方法2003年3月~2007年5月,采用经尿道电切镜鞘气压弹道碎石术治疗膀胱结石32例。结果32例均一次手术成功,无中转开放手术。22例合并前列腺增生症碎石后行经尿道前列腺电切术(transurethral prostatectomy,TURP),4例膀胱颈挛缩行膀胱颈电切术,4例尿道狭窄入镜前行尿道扩张,2例单纯行膀胱结石碎石。手术时间25~90min,(45±25)min,均无结石残留,无膀胱穿孔。术后尿道狭窄1例。结论经尿道电切镜鞘输尿管肾镜气压弹道碎石术治疗膀胱结石具有方法可靠、创伤小、手术并发症少等优点,特别适合于合并前列腺增生者。     

The safety and efficacy of endoscopic incision of orthotopic ureterocele in adult

Endoscopic incision is a good management option for orthotopic ureterocele. But most of the literature has shown its efficacy only in children. We have done this retrospective study to evaluate the safety and efficacy of endoscopic incision of orthotopic ureterocele in adults. From March 2004 to January 2008, at our center, 26 adults underwent transurethral, transverse incision of an ureterocele. The perioperative data of these patients were retrospectively analyzed. The literature was reviewed to identify all the reported options for management of this relatively rare condition in adults. Unilateral ureterocele was present in 24 patients and two patients had bilateral ureterocele. One patient had associated upper tract stones. Three patients had associated stones in ureterocele. Transurethral, transverse incision of ureterocele was given in all patients. The mean postoperative hospital stay was 50.5 h. Twenty-three patients were available for follow-up at three, six and 12 months. All patients were symptom free. At three months ultrasound and intravenous urography revealed no residual ureterocele but four patients showed residual hydronephrosis, but with a decrease in the grade indicating decompression. Micturating cystourethrography revealed vesico-ureteral reflux (VUR) in two patients and the reflux persisted in one patient even at 6 months. We conclude that in adults, management with endoscopic incision of orthotopic ureterocele is safe and effective. VUR may occur in a few cases.     

输尿管囊肿伴发结石的腔内微创治疗

目的：评价腔内微创治疗输尿管囊肿伴结石的疗效。方法：回顾性分析2004年3月～2008年12月收治的12例输尿管囊肿伴发结石病例资料。囊肿位于左侧8例,右侧4例,均为单侧发病。9例伴输尿管囊内结石,3例并输尿管结石。输尿管囊肿采用经尿道输尿管囊肿切除术,术时保留上方囊壁作为抗反流的活瓣。结石采用输尿管镜钬激光碎石术。结果：12例患者均一次手术成功。术后随访3个月～1年,临床症状均消失,8例B超提示肾积水消失,4例明显减轻。4例行排尿性膀胱尿道造影未见明显反流现象。结论：使用腔内镜微创治疗输尿管囊肿伴发结石是一种简单有效的治疗方法。     

输尿管囊肿的影像学诊断与早期处理(附7例报告)

目的：探讨输尿管囊肿的诊断与治疗方案。方法：回顾性分析7例输尿管囊肿患者的临床资料，3例采用三角区重建术治疗，2例行经尿道囊肿低位横切开术，1例外院行经尿道囊肿切开术后反流患者行输尿管再植术，1例行重复上半肾及输尿管切除术。结果：7例患者均获治愈，随访6个月～11年，无并发症发生。结论：输尿管囊肿主要依靠影像学诊断；手术处理宜早期进行，输尿管口囊肿切除、三角区重建术是一种好的术式；输尿管反流和泌尿系感染是各种治疗不应忽视的问题。     

Endoscopic management of adult orthotopic ureterocele and associated calculi with holmium laser: experience with 16 patients over 4 years and review of literature

PURPOSE: To retrospectively evaluate the safety and effectiveness of holmium laser endoscopic incision and laser lithotripsy in adults with orthotopic ureterocele and associated calculi. PATIENTS AND METHODS: From May 2003 to August 2007 at our center, 16 adults underwent transurethral incision of an ureterocele and intracorporeal holmium laser lithotripsy for associated calculi. The perioperative data of these patients were retrospectively analyzed. The literature was reviewed to identify all the reported options for management of this relatively rare condition. RESULTS: Ureterocele was associated with a single system in 13 patients. Two patients had bilateral ureteroceles. Four patients had associated upper tract stones. The procedure was uneventful in all patients. The average postoperative hospital stay was 19.3 hours. All patients were stone free after the procedure. Eleven patients were available for follow-up at 3 and 6 months. None of these patients had any evidence of residual ureterocele and/or hydronephrosis when evaluated with intravenous urography at 3 months. Micturating cystourethrography (MCU) at 3 months revealed low-grade vesicoureteral reflux (VUR) in four patients; no reflux was found with MCU at 6 months. CONCLUSIONS: Laser endoscopic management of adult orthotopic ureterocele and associated calculi effectively decompressed ureterocele and removed stones in all patients without any significant postoperative morbidity. Low-grade VUR that may occur postoperatively resolved at 6 months. A literature review suggests that the ability of the holmium laser to manage both ureterocele and calculi simultaneously should make holmium laser management a procedure of choice at centers that possess the equipment.     

微创手术方法治疗输尿管囊肿（附28例报告）

目的：探讨输尿管囊肿的病因和诊治方法。方法：对28例输尿管囊肿的临床资料进行回顾性分析。其中22例经尿道输尿管囊肿电切治疗,6例经尿道钬激光治疗。结果：手术全部成功,随访3个月～8年,症状消失22例,好转6例,肾积水均明显好转。结论：B超是诊断输尿管囊肿的首选方法,尿路平片和静脉尿路造影、磁共振尿路水成像及膀胱镜检查可确定诊断,了解是否合并尿路结石。经尿道电切或钬激光治疗是简便、安全、有效的治疗方法,对伴发结石者钬激光更具优越性。     

Comparison of electrocautery versus holmium laser energy source for transurethral ureterocele incision: an outcome analysis from a tertiary care institute

Lasers in Medical Science - Transurethral endoscopic incision is an established treatment option for management of obstructing ureterocele. It can be performed using monopolar electrocautery or...     

Prolapse of simple ureterocele following transurethral incision

The patient was a 35-year-old woman with complaints of residual sensation and pollakisuria. Excretory urography and magnetic resonance imaging revealed right ureterocele with hydronephrosis. Transurethral incision of the ureterocele was carried out. Two months postoperatively, the ureterocele prolapsed through the external urethral meatus, and transurethral resection of ureterocele was performed. Forty-one cases of prolapsed ureterocele reported in the Japanese literature are reviewed.     

成人输尿管囊肿12例报告

为提高对成人输尿管囊肿的诊断和治疗水平，报道１４年来收治的１２例患者临床资料。１２例中，男５例，女７例，年龄２０￣４７岁，平均３４岁。行输尿管囊肿切除术７例（其中２例行输尿管囊肿开口成形术），行经尿道输尿管囊肿电切术５例。随访１￣１２年，患者症状消失，复查ＩＶＵ，肾、输尿管积水消失，排尿期膀胱造影无反流。认为成人输尿管囊肿多数在３ｃｍ左右，术前行排尿期膀胱造影如无输尿管反流，不伴有膀胱或囊肿内其它     

经尿道电切治疗输尿管口囊肿18例报告

目的探讨经尿道电切治疗输尿管囊肿的临床效果。方法回顾性分析18例输尿管囊肿的临床资料。结果 18例均一次手术治愈。随防6个月～3年,效果良好。所有患者均未见囊肿复发,无管口狭窄及返流。结论经尿道输尿管囊肿的腔内手术疗效显著,减少了手术创伤及术后并发症,缩短了手术及住院时间,是目前治疗输尿管囊肿的首选方法。