Neodymium:YAG laser treatment of bladder neck contracture following prostatectomy.

A total of 21 patients with postprostatectomy bladder neck contracture underwent treatment with Nd:YAG laser irradiation. A new 800-microns hemispherical optical quarz fiber was used in contact technique to produce linear incisions in the scarred tissue. Within 11.2 months, median of follow-up, there was improvement in the obstructive voiding symptoms in all the patients. Two patients who had still mild contracture in the first follow-up cystoscopy were managed successfully with a second treatment. Endoscopic application of laser energy in the contact mode enables the immediate vaporization and disintegration of the fibrous area and secondary reepithelization of the bladder neck without scarring.     

经尿道前列腺电切术后膀胱颈挛缩的防治

目的探讨腔内治疗经尿道前列腺电切术（TuRP）后膀胱颈挛缩（BNC）的疗效。方法回顾性分析TURP32例BNC患者,经尿道置入电切镜切除膀胱颈后唇组织,再用冷刀切开膀胱颈．然后再换用电切刀彻底切除疤痕组织。结果32例患者术后症状明显改善,最大尿流率16．2±4．0ml／s和平均尿流率6．8±2．0ml／s均高于术前（P〈0．05）。术后平均随访28个月,一次性手术治愈28例,复发4例,经再次或三次手术治愈。结论经尿道腔内手术治疗TURP术后BNC是一种安全,疗效确切的微创手术方法。     

经尿道前列腺电切术后膀胱颈挛缩的防治

目的:探讨经尿道前列腺电切术(TURP)后膀胱颈挛缩(BNC)的防治。方法:回顾性分析68例BNC患者的诊断和治疗临床资料。结果:经尿道行膀胱颈后唇切除,用冷刀切开膀胱颈部,再换用电切刀切除瘢痕组织。术后平均随访36个月,一次手术治愈60例(89%);复发8例(11%),经再次或三次手术治愈。结论:腔内手术治疗TURP术后BNC是一种安全、有效的方法。     

经尿道针状电极膀胱颈内切开治疗膀胱颈挛缩

目的:探讨治疗膀胱颈挛缩的有效手术方法。方法:对17例膀胱颈挛缩患者行经尿道针状电极膀胱颈内切开术。结果:17例患者术后无明显残余尿,最大尿流率为12.3~27.2ml/s,主诉症状好转。结论:经尿道针状电极膀胱颈内切开治疗膀胱颈挛缩,疗效确切,术后不易复发。     

TURN结合膀胱颈部注射疗法治疗TURP术后膀胱颈挛缩

目的 探讨经尿道膀胱颈部电切术(TURN)结合局部药物注射疗法在经尿道前列腺电切术(TURP)后膀胱颈挛缩治疗中的价值.方法 2006年3月至2009年10月共52例患者接受TURN加膀胱颈部注射地塞米松治疗.首次注射于TURN术后即刻进行,而后每4周行膀胱镜下膀胱颈部地塞米松注射治疗,共4次.随访过程中若膀胱颈部挛缩复发,则再次行TURN术结合定期膀胱颈部注射治疗.结果 所有52例电切镜探查均见膀胱颈部抬高,颈口缩小,黏膜苍白,局部组织僵硬;ToURN术后病理提示:纤维瘢痕组织增生,部分患者标本中可见慢性炎症表现伴淋巴细胞浸润.41例患者(78.8%)1次TURN结合定期注射治疗后,排尿恢复正常,尿流率15～22ml/s,8例患者(15.3%)重复手术结合定期注射治疗后,排尿基本满意,尿流率10～15ml/s,3例患者(5.9%)重复手术结合规律注射后,尿流率<10ml/s,目前仍维持定期尿道扩张.结论 TURN结合局部注射药物疗法是治疗TURP术后膀胱颈挛缩的有效疗法,对顽固性膀胱颈挛缩,也有一定的治疗效果.     

Aerotitis: cause, prevention, and treatment

Aerotitis, an acute inflammation of the middle ear caused by the difference in air pressure between the airplane cabin and the middle-ear space, is becoming more common in the United States as our society becomes increasingly mobile. We describe a case in which a 33-year-old woman with a resolving upper respiratory tract infection and mildly blocked eustachian tubes flew on a business trip. During ascent, her ears became blocked. This blockage was partially alleviated by a Valsalva's maneuver. On descent, however, her ears became severely blocked, she experienced intense pain, and her tympanic membranes ruptured. She became nauseated and vomited. Her hearing became significantly diminished and she experienced vertigo. On landing, she was taken to a local emergency room and treated with penicillin and antivertiginous medication. Subsequent otologic evaluation revealed severe permanent sensorineural hearing loss. The vestibular symptoms lasted several months. She now requires hearing aids on a permanent basis. Suggestions are presented for prevention and treatment of aerotitis.     

经尿道前列腺电切术后膀胱颈部挛缩的治疗

目的探讨经尿道前列腺电切（TURP）术后膀胱颈部挛缩（BNC）的有效治疗方法。方法对75例TURP术后的BNC，采用经尿道膀胱颈部瘢痕切除加颈部切开（BNI），观察疗效。结果术后平均随访25个月，72例（96％）1次治愈，1例再手术后治愈，2例前尿道狭窄经尿扩后治愈。结论TUR＋BNI是治疗TURP术后BNC的有效方法。     

手术治疗男性膀胱颈挛缩(附42例报告)

目的：探讨手术治疗男性膀胱颈挛缩的疗效。方法：回顾性分析男性膀胱颈挛缩手术方法的选择及其疗效。结果：行膀胱颈Y—V成形术2例，膀胱颈Y—V成形术加后唇楔形切除术2例，经耻骨上前列腺切除术22例，经尿道膀胱颈狭窄环切除(TUR)8例以及TUR加经尿道前列腺电切术(TURP)8例。结论：TUR或TUR加TURP与其他手术治疗方法相比较，具有损伤小、出血少、疗效好、住院日短和康复快等优点。     

Unilateral bladder neck incision: endoscopic treatment of bladder neck obstruction. Results in 100 patients

Endoscopic diathermy unilateral incision of the bladder neck was carried out in 100 consecutive male patients. This procedure was performed for bladder neck obstruction and small benign prostate. The operative details of this technique are given. Follow-up after 2 months revealed excellent symptomatic and urodynamic results. Morbidity was low. Results remain stable after 13 +/- 9 months. One patient needed a transurethral resection of the prostate. Retrograde ejaculation occurred in 5% of the patients. Unilateral bladder neck incision is a simple procedure safe, and easy to learn, with a low risk of retrograde ejaculation. It is the operation of choice for small benign prostate, bladder neck obstruction and young patients.     

Postoperative sore throat: cause, prevention and treatment

Sore throat is a common postoperative complaint, occurring most often following tracheal intubation. Factors such as tracheal-tube size and cuff design have been shown to be important causative factors. Routine tracheal intubation for elective surgical procedures can result in pathological changes, trauma and nerve damage which may also account for postoperative throat symptoms. Sore throat following the use of a laryngeal mask appears to be related to the technique of insertion but the contribution of intracuff pressure remains to be clarified. It would appear, however, that high intracuff pressure is associated with nerve palsies due to neuropraxia and nerve compression. Careful insertion techniques for both the tracheal tube and laryngeal mask are of paramount importance in the prevention of airway trauma and postoperative sore throat.     

颈部瘢痕挛缩的整复治疗

回顾性分析颈部瘢痕挛缩的治疗方法。自１９９６年６月～１９９７年５月收治１５６例颈部瘢痕挛缩，根据传统分类法分为Ⅰ、Ⅱ、Ⅲ、Ⅳ度，分别采用Ｚ成形术、皮片移植、轴型皮瓣等７种手术方法，其中颈胸真皮下血管网薄皮瓣１８例，肩胸皮瓣４例，扩张后皮瓣２例，超长下斜方肌皮瓣２例。２５例皮瓣成活良好，１例颈胸真皮下血管网薄皮瓣远端因加压包扎不当而部分坏死，皮片移植术后６例边缘及颈前活动部位皮肤小片状坏死，余均成活。根据颈部瘢痕的性质、畸形分度、组织缺损范围及深度，周围正常皮肤残存利用及松弛条件等综合考虑，选择修复方法，可获得较满意的临床效果     

经尿道前列腺电切术后膀胱颈挛缩17例诊治分析

目的探讨经尿道前列腺电切术(TURP)后膀胱颈挛缩的手术方法和预防措施。方法对17例膀胱颈挛缩患者临床资料进行回顾性分析。结果经尿道行残留前列腺组织电切术或先用冷刀切开颈部后换用电切刀切除瘢痕组织,术后3个月随访,17例患者症状均改善或消失。结论经尿道腔内治疗TURP术后膀胱颈挛缩是一种安全有效的方法。     

Fibrous histiocytoma of the bladder.

A case report of a fibrous histiocytoma of the bladder that presented as total, gross, painless hematuria with compression of the intramural ureter is described. Important pathologic aspects are presented and histiocytic tumors are discussed briefly. Any histiocytic tumor not related to a disease of lipid metabolism is rare and we have found no previous report of a fibrous histiocytoma of the bladder.     

The treatment of female bladder neck dysfunction.

During the period 1981-88, 38 women who eventually had the diagnosis of bladder neck obstruction established, were treated by bladder neck incision. Their age range was 28-85 years. The preoperative investigations included a full urodynamic examination and urethro-cystoscopy. The gynecologic examination was normal. The most constant finding was an elevated, rigid bladder neck seen by endoscopy. The treatment included a bladder neck incision either at 4 or at 8 o'clock. The results four weeks postoperatively were good, the symptoms had disappeared or the patients were improved in most cases, and the flow curves were normalized. Mean observation time was 55 months. After a longer period of time the symptoms in some cases returned, and then the incision was repeated. After the final control, we found 76% of the patients symptomatically improved.