ABSTRACT
Objective To evaluate the safety and feasibility of total retroperitoneal laparoscopic nephroureterectomy for a tuberculous non-functional kidney. Methods A total of 15 individuals diagnosed with unilateral non-functional kidney secondary to tuberculosis were encountered from January 2013 to January 2016. There were 12 male and 3 female patients with an average age of 47 (range 36~64 years old) in the cohort. All patients had normal renal function on the contralateral side and underwent the standard three-drug antituberculosis treatment for at least four weeks before surgery. Total retroperitoneal laparoscopic nephroureterectomy was performed in all patients, and the enlarged section of the distal ureter was managed using different auto-suture techniques. Results All the operations were successfully performed without conversion. The median operative time was 109 min (range, 75~138 min), the median blood loss was 157 ml (range, 70~230 ml), and the median hospitalization time was 7 days (range, 5~11 days). Renal vein injury, lumbar vein injury and rupture of distal ureter occurred in 1 patient, respectively. Peritoneum injury was observed in 3 patients. No serious perioperative complications occurred. Anti-tuberculosis chemotherapy was prescribed to all patients, with the entire course of treatment lasting five months. No recurrenceof tuberculosis of the bladder or the contralateral kidney was observed during the median follow-up period of 25 months. Conclusion Total retroperitoneal laparoscopic nephroureterectomy is a safe and feasible approach for the treatment of tuberculous non-functional kidneys, and it is minimal and rapid recuperation.
ABSTRACT
Objective To evaluate the clinical value of small doses of solifenacin to treat children of primary nocturnal enuresis. Methods Children (n=78) of primary nocturnal enuresis were randomly divided into treatment group(39 cases) and control group(39 cases). All children received behavioral intervention therapy, while children in the treatment group were given Solifenacin(5 mg/tablet, 1/3 tablet, 1 times a day for 3 months) orally besides behavioral therapy. Children were followed up for 3 months after the end of the treatment, and the curative effect and recurrence rate were compared between two groups. Results Compared with that of children in control group, cure rate of children in treatment group is higher at the end of treatment (89.7%vs 69.2%, P<0.05) as well as by 3 month of follow-up time (82.1%vs 46.2%, P<0.05). The re?currence rate of children in treatment group, by three months follow-up time, was lower than that of children in control group (8.6%vs 33.3%,P<0.05). Conclusion Small dose of Solifenacin in addition to behavioral intervention is safe and effec?tive in treatment of children with enuresis, which enhance cure rate and reduce recurrence.
ABSTRACT
Objective To evaluate the clinical value of the combination of S-shaped urethral dilator and nephro-scope for the treatment of male urethral stricture disease. Methods Guidewires were inserted into bladder through the nephroscope under direct vision. The urethral dilation with S-shaped urethral dilator was carried out by nephroscope in 41 male patients. All catheters were located across the strictures and remained for 4-6 weeks. The regular follow-up was done on all cases to assess the clinical effect on urine flow. Results All surgeries were successful without serious complications. The mean operative time was (40.16 ± 5.78) min. The voiding symptoms were significantly improved after catheter removal compared with those of preoperation in all cases. Patients were followed up after surgery and were regularly urethral dilation at least 6 weeks. The mean follow-up time was (34.75±6.42) weeks.There were incontinence, diminished sexual function and other complications after operation in all cases. Conclusion Nephroscope combined with S-shaped urethral dilator for the treatment of male urethral stricture disease is feasible, minimally invasive and safe, which is worthy of recommendation.