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2.
BMC Vet Res ; 15(1): 273, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31370897

RESUMO

BACKGROUND: Struvite urolithiasis with bacterial urinary tract infection (UTI) is commonly reported in dogs; few data exist to describe successful dissolution protocols in dogs with naturally occurring disease. We hypothesized that a dry therapeutic urinary diet combined with targeted antimicrobial therapy can effectively dissolve presumptive struvite cystolithiasis in dogs with naturally occurring urease-producing bacterial UTI. RESULTS: Ten dogs with presumed infection-induced struvite cystolithiasis based on lower urinary tract signs (LUTS), radiodense cystoliths, and urease-producing bacterial UTI were enrolled. At enrollment, antimicrobials and dry therapeutic urinary diet were dispensed. In addition to lack of radiographic resolution of urolithiasis, dogs with persistent clinical signs were considered non-responders. There was no significant difference in pH between responders and non-responders; USG was significantly higher in the responder group. Recheck visits continued until radiographic dissolution or failure was documented. Five of the 10 dogs achieved radiographic dissolution of cystolithiasis within a median of 31 days (range 19-103). In the other 5 dogs, surgical urolith removal was necessary due to persistent LUTS (3 dogs within 2 weeks) or lack of continued dissolution noted radiographically (1 dog with numerous cystoliths failed at day 91; 1 dog failed by day 57 with questionable owner compliance). CONCLUSIONS: Dissolution of urinary tract infection induced struvite cystoliths can be accomplished in some dogs fed this dry therapeutic urinary diet in conjunction with antimicrobial therapy. Case selection could increase the likelihood of successful dissolution; however, if calcium phosphate is present, this could also prevent stone dissolution. If clinical signs persist despite diet and antimicrobials, stone removal is advised.


Assuntos
Anti-Infecciosos/uso terapêutico , Doenças do Cão/dietoterapia , Doenças do Cão/tratamento farmacológico , Estruvita/química , Cálculos da Bexiga Urinária/veterinária , Urolitíase/veterinária , Animais , Doenças do Cão/cirurgia , Cães , Resultado do Tratamento , Cálculos da Bexiga Urinária/dietoterapia , Cálculos da Bexiga Urinária/tratamento farmacológico , Cálculos da Bexiga Urinária/cirurgia , Infecções Urinárias/complicações , Infecções Urinárias/veterinária , Urolitíase/dietoterapia , Urolitíase/tratamento farmacológico , Urolitíase/cirurgia
3.
Urology ; 132: 213, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31238047

RESUMO

OBJECTIVE: To describe a novel surgical option for cystolithiasis management in female patients with no urethral access and prior abdominal surgeries. We present a 51-year-old female with a history of traumatic spinal cord injury with pelvic fractures and resultant neurogenic bladder. She underwent transabdominal bladder neck closure and bladder augmentation with continent diversion 2 years prior. CT abdomen/pelvis demonstrated a 3 cm stone and significant amount of bowel anterior to the bladder. METHODS: Pouchoscopy was performed via ureteroscope through the catheterizable stoma to assess stone location and mobility. A 14F-Foley was inserted for intraoperative decompression. An inverted-U incision was made on the anterior vaginal wall overlying the bladder base. Sharp and blunt dissection was performed in an avascular plane to dissect the vagina off of the bladder. Electrocautery was utilized to open perivesical tissue and the detrusor layer transversely. Further sharp dissection of perivesical tissue was achieved using Metzenbaum scissors. The bladder was filled via stoma Foley to improve visualization of bladder mucosa. Cystotomy was made and the 3 cm stone was removed, intact, using a Babcock. The bladder was closed in 2 layers with absorbable suture in running fashion. The bladder was refilled and the closure was watertight. The outer detrusor layer was closed with running locking 2-0 Polysorb, and a separate layer of perivesical tissue was closed over our 2-layer bladder closure using simple interrupted stitches. The vaginal flap was closed with running-locking 2-0 Polysorb. RESULTS: Operative time was 55 minutes. Estimated blood loss was 25 cc. The patient was discharged on postoperative-day 0 with a 14F-Foley in the catheterizable channel. The Foley was removed at the 3-week postoperative visit and patient resumed self-catheterization. No postoperative imaging was required. No complications were reported within 1 year. CONCLUSION: We demonstrate the feasibility of transvaginal cystolithotomy in females with bowel overlying bladder and no urethral access.


Assuntos
Cálculos da Bexiga Urinária/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Urológicos/métodos , Vagina
4.
J Coll Physicians Surg Pak ; 29(6): S62-S64, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31142426

RESUMO

We report and discuss a rare case of inguino-scrotal urinary bladder herniation (IBH) complicated with a big urinary bladder stone and contralateral indirect inguinal bowel hernia. A 68-year male patient presented to the outpatient urology department with a 4-year history of right inguino-scrotal pain and swelling, which was gradually increasing in size, and of intermittent swelling in the left groin. Physical examination revealed right irreducible inguino-scrotal hernia and reducible left inguinal hernia extending to the groin. Computerised Tomography (CT) revealed that the right side of urinary bladder was herniating through the inguinal canal into the right hemiscrotum along with a 22 mm urinary bladder stone. The patient underwent bilateral Lichtenstein tension-free mesh hernioplasty through inguinal incisions and transurethral laser cystolithotripsy in the same session. To the best of the authors' knowledge, this is the first reported case of bilateral inguinal hernia with concomitant bladder stone in the literature.


Assuntos
Hérnia Inguinal/cirurgia , Herniorrafia/métodos , Escroto/patologia , Tomografia Computadorizada por Raios X/métodos , Cálculos da Bexiga Urinária/cirurgia , Doenças da Bexiga Urinária/cirurgia , Bexiga Urinária/diagnóstico por imagem , Idoso , Hérnia Inguinal/diagnóstico por imagem , Humanos , Canal Inguinal/diagnóstico por imagem , Masculino , Escroto/cirurgia , Telas Cirúrgicas/efeitos adversos , Resultado do Tratamento , Cálculos da Bexiga Urinária/diagnóstico por imagem , Doenças da Bexiga Urinária/complicações , Doenças da Bexiga Urinária/diagnóstico
5.
Urol Clin North Am ; 46(2): 193-205, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30961853

RESUMO

Next-generation holmium laser systems provide the user with a range of parameters that can help optimize fragmentation efficiency. Ureteroscopic strategies broadly consist of fragmentation with active retrieval, or dusting, which uses low pulse energy settings to break stones into fine fragments for spontaneous passage. Techniques for dusting include dancing, chipping, and popcorning. The Moses technology is a multipulse mode that may help reduce retropulsion and increase fragmentation. The thulium fiber laser is an emerging laser technology that provides an extensive parameter range for dusting. Future studies are needed to define the role of these technologies and techniques for laser lithotripsy.


Assuntos
Cálculos Renais/cirurgia , Lasers de Estado Sólido/uso terapêutico , Litotripsia a Laser/métodos , Cálculos da Bexiga Urinária/cirurgia , Previsões , Humanos , Litotripsia a Laser/instrumentação , Litotripsia a Laser/tendências , Ureteroscopia
6.
Pediatr Surg Int ; 35(6): 737-741, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30972489

RESUMO

Surgeons removed bladder stones by perineal lithotomy in ancient times. The first surgeon who dared to invade a body cavity knew human anatomy and was skilled in the use of surgical instruments. The operation probably originated in India since the Sushruta Samhita, a surgical text, antedates Hippocrates by several hundred years. Sushruta's knowledge of bladder of stones, surgical complications and instrumentation identifies him as originator of vesicolithotomy. Why did Hippocrates advise his students to leave operations for bladder stones to practitioners who were skilled in the art? Who were these practitioners and how did knowledge of vesicolithotomy reach Greece from India? Our research suggests that the operation came to Greece from India over ancient trade routes and with surgeons who accompanied Alexander the Great's army. The Sushruta Samhita was translated in Arabic and may have reached Europe during the dark ages by way of Arabian surgeons such as Albucasis. Chelseldon, an eighteenth century English surgeon, brought Sushruta's vesicolithotomy to a peak of perfection.


Assuntos
Posicionamento do Paciente/história , Cálculos da Bexiga Urinária/história , Arábia , Criança , Grécia , História do Século XV , História do Século XVI , História Antiga , História Medieval , Humanos , Índia , Instrumentos Cirúrgicos/história , Cálculos da Bexiga Urinária/cirurgia , Ocidente
7.
Cir Cir ; 86(1): 99-106, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30951035

RESUMO

Here, two papers are presented, which constitute the first reports of surgical procedures in Mexican children performed at the 19th century. The two publications refer to surgical operations for the extraction of bladder stones. At that time, there was no anesthesia, so part of the description alludes to the suffering of the patients and the operative difficulties. The first case, is referred to as a lithotomy in a 17-year-old girl, performed by surgeon José Victoriano Guerrero in Guadalajara in 1822. The publication is not an academic report, but a pamphlet written as a gift to Emperor Augustin I to celebrate his ascension to the throne. The second work, is a lateral lithotomy in a 5-year-old boy, published by Dr. Luis Jecker in the first issue of the Periódico de la Academia de Medicina de Mégico in 1836.


Assuntos
Pediatria/história , Procedimentos Cirúrgicos Urológicos/história , Urologia/história , Criança , História do Século XIX , Humanos , México , Cálculos da Bexiga Urinária/história , Cálculos da Bexiga Urinária/cirurgia
8.
BMJ Case Rep ; 12(2)2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-30709885

RESUMO

We present our experience of two cases: one of a 28-year-old male patient who presented with recurrent episodes of urinary tract infection (UTI) with passage of pus flakes in urine and a history of open cystolithotomy about 10 months ago. The second patient was a 26-year-old woman who underwent bladder exploration for a retained Double-J stent about 10 months ago and presented with recurrent UTI. The first case was treated with open surgery and in the second case, the gauze piece was retrieved endoscopically.


Assuntos
Corpos Estranhos/complicações , Litotripsia/efeitos adversos , Complicações Pós-Operatórias/etiologia , Stents/efeitos adversos , Infecções Urinárias/etiologia , Adulto , Lista de Checagem , Feminino , Humanos , Masculino , Ureter/cirurgia , Bexiga Urinária/cirurgia , Cálculos da Bexiga Urinária/cirurgia
10.
Urol Int ; 102(4): 495-498, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30343289

RESUMO

Bladder migration of a Hem-o-lok® clip, due to robotic-assisted radical prostatectomy (RARP), is uncommon, and would form a foreign body in the bladder and present as lower urinary tract symptoms after the early postoperative period. We hereby report a rare, delayed appearance of a secondary bladder stone due to the migration of a Hem-o-lok® clip that occurred 5 years after RARP.


Assuntos
Adenocarcinoma/cirurgia , Corpos Estranhos/cirurgia , Prostatectomia/efeitos adversos , Neoplasias da Próstata/cirurgia , Instrumentos Cirúrgicos/efeitos adversos , Bexiga Urinária/cirurgia , Adenocarcinoma/diagnóstico por imagem , Idoso , Migração de Corpo Estranho/diagnóstico , Humanos , Masculino , Período Pós-Operatório , Neoplasias da Próstata/diagnóstico por imagem , Procedimentos Cirúrgicos Robóticos , Bexiga Urinária/diagnóstico por imagem , Cálculos da Bexiga Urinária/diagnóstico por imagem , Cálculos da Bexiga Urinária/cirurgia
11.
World J Urol ; 37(2): 373-378, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29955919

RESUMO

OBJECTIVES: To determine the feasibility and safety of performing transvesical laparoendoscopic single-site surgery (T-LESS) in patients with medium-size, hard stones or multiple stones with high burden. METHODS: In this case series study, 12 patients (11 males and one female) with a mean age of 66.8 years were operated on from February 2016 to May 2017 due to bladder calculi, using the T-LESS approach with a single-port device (Tri-Port + , Olympus, Germany). Indications for this procedure were hard, medium-size, solitary stones after previous unsuccessful endoscopic lithotripsy or the presence of multiple high-burden stones. In two patients, additional procedures (diverticulectomy or a ureterocele incision) were performed simultaneously. RESULTS: All stones were removed intact. No serious complications were observed. The mean operative time was 46 min and the postoperative hospital stay was 22 h. The mean diameter of the largest stone and the mean stone volume of each case were 24 mm and 11 cm3, respectively. At the mean follow-up time of 15 months, there was significant improvement of the symptoms. CONCLUSIONS: The T-LESS technique is an efficient, safe and minimally invasive procedure for intact bladder stone removal in selected patients. The method avoids the risk of urethral injury. Nevertheless, further investigation is needed to assess the wider applicability of the procedure.


Assuntos
Cistoscopia , Laparoscopia , Cálculos da Bexiga Urinária/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
12.
Urol Int ; 102(1): 1-12, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30176666

RESUMO

The middle of the 19th century marks the beginning of a global process of science and knowledge transfer from -Europe to the rest of the world. During the phase of globali-zation, Austrian physician and ethnographer Jacob E. Polak (1818-1891) played a key role in the transmission of practical and scientific reasoning, leading to the development of medical science and clinical care in Persia. In 1851, Polak was commissioned by the Persian court to work as an academic teacher at the first secular institution of higher learning in Teheran, the Dar al-Fonun. After 4 years of teaching and working as a doctor and surgeon, Polak was appointed personal physician to the Qajar king, Naser-ad-Din Shah (r. 1848-1896). During Polak's 9 year stay in Persia, he performed numerous surgical operations with specific focus on lithotomies on men and women of all ages. He documented each operation and collected samples of bladder calculi for the purpose of chemical analysis. After his return to Austria, he published a detailed report on his practice of lithotomy in Persia. This extensive documentation is, we believe, the only known historical evidence that currently exists of the introduction of modern urology to Persia. This study will present Polak's role as a pioneer of modern medicine and lithotomy, and will examine how he introduced the latest achievements of Viennese medicine in the field of operative urology to Persia.


Assuntos
Litotripsia/história , Urologia/história , Áustria , História do Século XIX , Cooperação Internacional , Pérsia , Cirurgiões , Cálculos da Bexiga Urinária/cirurgia
13.
Int Braz J Urol ; 45(2): 410, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30521162

RESUMO

INTRODUCTION AND OBJECTIVE: Perforation of the bladder or urethra and erosion of the mesh after cystocele repair surgery are not uncommon and have potentially serious complications. Traditionally, surgical management of such complications has involved excision of the mesh using either a transurethral approach or open surgery. In this video, we present our experience of laparoscopic transvesical surgery for exposed mesh and stone. MATERIALS AND METHODS: Patient was placed in the lithotomy position under general anesthesia and a 30° operating cystoscope was inserted under direct vision. After filling the bladder with 300 mL normal saline, a 5 - mm VersaStep™ bladeless trocar was placed 2 cm above the pubic symphysis. Two more 5 mm trocars were placed bilaterally at 3 cm intervals from the initial trocar site. The pneumovesicum state was maintained at 8 - 12 mmHg and a 5 mm telescope was introduced. Using a curved dissector and curved Mayo scissors, the exposed mesh was mobilized and removed. Interrupted 4 - 0 Vicryl sutures were used to close the defect. To localize the ureteral orifice, intravenous Indigo Carmine was used. The bladder stones were removed through the urethra using a stone basket, guided using a ureteral stent pusher. RESULTS: Total operation time was 55 min and the Foley catheter was removed at post - operative day 5 after postoperative cystography. CONCLUSIONS: Excellent visualization of mesh exposure and ureteral orifice was possible under aparoscopic transvesical surgery, and reconstruction including the mucosa and muscle layer was able to be achieved. This method is useful and feasible, with minimal invasiveness and an early post - operative recovery.


Assuntos
Cistotomia/métodos , Laparoscopia/métodos , Cálculos da Bexiga Urinária/cirurgia , Idoso , Feminino , Humanos , Masculino , Telas Cirúrgicas
15.
BMJ Case Rep ; 20182018 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-30366891

RESUMO

Spontaneous rupture of the urinary bladder is extremely rare. We report a case of a 70-year-old man with spontaneous bladder rupture secondary to neglected giant vesicle calculi who presented as acute renal failure. The patient was stabilised with per-urethral catheterisation and extravesical drain placement. About 700 mL pus mixed with urine was drained through the per-urethral catheter and approximately 2000 mL of pus was drained through the extravesical drain. Cystolithotomy showed two large calculi which were removed.


Assuntos
Lesão Renal Aguda/etiologia , Doenças da Bexiga Urinária/etiologia , Idoso , Doença Crônica , Humanos , Masculino , Ruptura Espontânea/etiologia , Ruptura Espontânea/cirurgia , Cálculos da Bexiga Urinária/complicações , Cálculos da Bexiga Urinária/cirurgia , Doenças da Bexiga Urinária/cirurgia , Retenção Urinária/etiologia , Retenção Urinária/cirurgia , Infecções Urinárias/complicações
17.
BMJ Case Rep ; 20182018 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-30209144

RESUMO

Over 200 000 surgeries for vaginal prolapse are done annually, and these are rarely urgent. However, when the rare event of bladder stones causes incarcerated procidentia, surgical intervention should not be delayed, due to unrelenting pain and end-organs effects. We present such a case below. A 71-year-old woman presents to our department with massive uterovaginal and rectal procidentia. This massive prolapse was found to be irreducible due to numerous dahllite stones in the bladder, and was causing obstructive uropathy with left-sided hydronephrosis. A multidisciplinary approach was necessary to surgically correct the prolapse and implement complete removal of all the stones. The simultaneous occurrence of uterovaginal prolapse, rectal prolapse and urolithiasis is uncommon. Stone formation is a result of chronically infected urine presenting a nidus for stone formation. This presentation has occurred very rarely over the last 70 years of the world's literature. Surgical cures can be achieved by either the vaginal or abdominal routes but should be treated emergently to alleviate pain, prevent renal impairment from obstructive uropathy and decrease infectious morbidity.


Assuntos
Prolapso de Órgão Pélvico/etiologia , Cálculos da Bexiga Urinária/complicações , Idoso , Diagnóstico Diferencial , Feminino , Procedimentos Cirúrgicos em Ginecologia/métodos , Humanos , Prolapso de Órgão Pélvico/cirurgia , Reto/cirurgia , Bexiga Urinária/cirurgia , Cálculos da Bexiga Urinária/cirurgia , Procedimentos Cirúrgicos Urológicos/métodos , Vagina/cirurgia
18.
Pan Afr Med J ; 29: 28, 2018.
Artigo em Francês | MEDLINE | ID: mdl-29875910

RESUMO

A 67 years old patient has consulted for hypogastric pain, associated with a pollakiuria running for more than 12 months. The medical story reported genital prolapse, some episodes of haematuria and dysuria. Pelvic ultrasound showed a voluminous image of lithiasic appearance with irregular borders. A cystotomy was performed under perimedullary anesthesia allowing the extraction of a giant bladder stone measuring 7.2 cm as major axis and 5.5 cm for small axis.


Assuntos
Cistotomia/métodos , Ultrassonografia/métodos , Cálculos da Bexiga Urinária/diagnóstico , Idoso , Disuria/etiologia , Feminino , Hematúria/etiologia , Humanos , Dor/etiologia , Cálculos da Bexiga Urinária/patologia , Cálculos da Bexiga Urinária/cirurgia
19.
Pan Afr Med J ; 29: 4, 2018.
Artigo em Francês | MEDLINE | ID: mdl-29632626

RESUMO

Giant urinary bladder stone is defined as a stone with a weight higher than 100 g. It is rare in women, accounting for approximately 2%. Its occurrence in the urinary bladder does not exceed 5% of the whole of the urinary tract. In women, the occurrence of urinary bladder stone is often secondary to a predisposing factor including intravesical foreign body, neurogenic bladder, repeated urinary infections, a history of surgery treating stress urinary incontinence. Therefore, there are some patients with a bladder stones without any obvious cause, such as primary idiopathic stone. We here report the case of a 31-year old patient with giant urinary bladder stone affecting the superior part of the urinary tract causing acute renal failure. The patient initially underwent bilateral nephrostomies to drain the superior part of the urinary tract; then giant urinary bladder stone was removed by open cystolithotomy. Etiological assessment didn't show any obvious cause.


Assuntos
Lesão Renal Aguda/etiologia , Cálculos da Bexiga Urinária/complicações , Lesão Renal Aguda/cirurgia , Adulto , Feminino , Humanos , Nefrotomia/métodos , Cálculos da Bexiga Urinária/diagnóstico , Cálculos da Bexiga Urinária/cirurgia
20.
Urology ; 114: 233-235, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29410329

RESUMO

OBJECTIVE: To evaluate the safety and efficacy of sheath (JQL sheath) in the treatment of bladder calculi. MATERIALS AND METHODS: We used the novel sheath that we have invented. The water sealing cap can only be passed through the ureteroscope without water leakage, and the diameters of the side hole and the sheath are sufficiently large. The clinical data of the 2 groups of patients include 45 cases of the novel sheath group and 41 cases in the control group. RESULT: The overall success rate of the 2 groups was 94.79%. The success rate of the new stone sheath group was 97.78% and that of the control group was 90.24%. The operation times were 25.8 ± 12.5 and 46.6 ± 26.3 minutes for the new stone sheath and control groups, respectively. The stones were divided into 3 groups according to their sizes: less than 1.5, 1.5-2.5, and greater than 2.5 cm. The durations of the novel sheath groups were 12.5 ± 6.5, 24.5 ± 9.5, and 37.5 ± 11.5 minutes, whereas those of the control groups were 17.6 ± 6.5, 39.5 ± 18.5, and 49.5 ± 20.5 minutes. Five patients with unsuccessful endovascular treatment were treated with open surgery. Among the 5 cases, 1 case belongs to the novel sheath group and 4 cases to the control group. CONCLUSION: The novel sheath, whose production is simple and low cost, improves the efficiency of transurethral treatment of bladder calculi and shortens the operation time; furthermore, it involves skills that can be easily mastered and presents clinical application value.


Assuntos
Ureteroscopia/instrumentação , Ureteroscopia/métodos , Cálculos da Bexiga Urinária/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Litotripsia , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Adulto Jovem
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