Application of Percutaneous Holmium Laser Lithotripsy in the Treatment of Bladder Calculi with Lower Urinary Tract Obstruction or Pelvic Joint Disease

2021 ◽  
pp. 1-6
Author(s):  
Xingguo Yang ◽  
Pinxin Huang ◽  
Jun Cao ◽  
Zhixiu Cao ◽  
Yong Nie
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Laser Lithotripsy ◽  
Joint Disease ◽  
Holmium Laser ◽  
Lithotomy Position ◽  
Bladder Calculi ◽  
Holmium Laser Lithotripsy ◽  
Lower Urinary Tract Obstruction ◽  
Lower Urinary

<b><i>Objective:</i></b> The aim was to summarize the experience of percutaneous holmium laser lithotripsy in the treatment of bladder calculi with lower urinary tract obstruction or pelvic joint disease in our hospital, explore its efficacy and safety, and improve the minimally invasive surgical technique for bladder calculi. <b><i>Methods:</i></b> The clinical data of 61 patients with bladder calculi combined with lower urinary tract obstructive diseases, including urethral stricture, benign prostatic hyperplasia, and bladder neck contracture or pelvic joint diseases in our hospital from 2017 to 2019 were retrospectively analyzed. All patients with bladder stones measuring 1.5–9 cm were placed in supine or lithotomy position. B-scan was conducted to locate the puncture above the pubic symphysis, establishing a 16–30 Fr bladder channel, and Lumenis holmium laser lithotripsy was subsequently performed through a Li Xun Nephroscope. The crushed stones were flushed out through the percutaneous bladder channel or taken out with foreign body forceps. After surgery, the cystostomy tube was indwelled for 3 days. <b><i>Results:</i></b> All the 61 cases were operated successfully with an average lithotripsy time of 25 min, and there was no conversion to open surgery. Postoperative reexamination showed neither residual calculi nor complications such as severe infection, massive hemorrhage, and intestinal injury. <b><i>Conclusion:</i></b> Percutaneous holmium laser lithotripsy is an improved minimally invasive surgical technique for the treatment of bladder calculi with the advantages of clear surgical field, high stone removal efficiency, less trauma, low-pressure bladder perfusion, and low incidence of accessory injury and infection. For patients with lower urinary tract obstructive disease resulting in obstruction of transurethral surgery and patients with pelvic joint disease resulting in difficult lithotomy position placement, this procedure is more advantageous than transurethral surgery. It is also suitable for bladder calculus with a long diameter &#x3e;5 cm or multiple calculi.

Myokardiale Funktion bei Feten mit Lower Urinary Tract Obstruction

2018 ◽  
Author(s):  
O Graupner ◽  
C Enzensberger ◽  
M Götte ◽  
A Wolter ◽  
V Müller ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Lower Urinary Tract Obstruction ◽  
Lower Urinary

Evaluation of the Fetal Therapy Evidence in Lower Urinary Tract Obstruction: Would an ERAS Guideline Improve Outcomes?

2021 ◽  
pp. 1-13
Author(s):  
R. Douglas Wilson ◽  
Gregg Nelson
Keyword(s):  
Quality Improvement ◽  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Fetal Surgery ◽  
Fetal Therapy ◽  
Lower Urinary Tract Obstruction ◽  
Evidenced Based ◽  
Process Elements ◽  
Lower Urinary

<b><i>Background:</i></b> Pregnancies that are prenatally identified to have fetal anomalies are complex and require expert multidisciplinary care. As many conditions can impact the fetus prenatally and require intervention, an enhanced recovery after surgery (ERAS) for lower urinary tract obstruction (LUTO) is being evaluated to determine the level of evidenced-based data available. <b><i>Problem:</i></b> The percutaneous ultrasound-guided fetal surgery procedure for bladder neck obstruction is the focus for elements of preoperative counseling, intraoperative procedure/risk complications, and postoperative management. <b><i>Methods:</i></b> A quality improvement review Squire 2.0 (2000–2020) was undertaken for the percutaneous LUTO fetal surgery shunting (lower urinary tract obstruction), process and procedure which require 2 process pathways, one to evaluate the fetal candidate and a second to treat. This structured review is focused on identifying the process elements to allow the determination of the number of evidenced-based elements that would allow for audit and measurement of the clinical element variance for comparative feedback to the individual surgical provider or surgery center. <b><i>Interventions:</i></b> Titles and abstracts were screened to identify potentially relevant articles with priority given to meta-analyses, systematic reviews, randomized controlled studies, nonrandomized controlled studies, reviews, and case series. <b><i>Results:</i></b> A series of potential clinical elements for the diagnostic fetal evaluation and for the 3 protocol areas of surgical care for the procedures (pre-, intra-, and postoperative care) are identified using an ERAS-like process. <b><i>Conclusions:</i></b> The identified clinical elements have the potential for ERAS-LUTO fetal therapy guideline. Multidisciplinary collaboration (surgeon, anesthesia, nursing, imaging, and laboratory) is required for ERAS quality improvement in the pre-, intra-, and postoperative processes. Process elements in each of the operative areas can be audited, evaluated, compared, and modified/improved.

PERCUTANEOUS BLADDER ASPIRATION AND OTHER METHODS OF URINE COLLECTION FOR BACTERIOLOGIC STUDY

PEDIATRICS ◽  
1965 ◽  
Vol 36 (1) ◽  
pp. 128-131
Author(s):  
Charles V. Pryles
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Needle Aspiration ◽  
Percutaneous Aspiration ◽  
Term Neonates ◽  
The Past ◽  
Lower Urinary Tract Obstruction ◽  
Bladder Urine ◽  
Lower Urinary

IN THE PAST FEW YEARS, a great deal of interest has been focused on the problem of distinguishing true bacteriuria from contamination. The normal urethra is known to harbor bacteria which may contaminate specimens obtained either by voiding or by catheterization. The latter method of obtaining samples may well be the means of introducing organisms that might not have been present before or of replacing sensitive with resistant organisms. Moreover the risk of producing such an infection is greater with the incompletely emptying bladder of lower urinary tract obstruction It has been suggested that percutaneous needle aspiration of the bladder urine may not only be safer than catheterization in some circumstances, but would also obviate contamination of samples during voiding or catheterization. Elsewhere in this issue, Nelson and Peters relate their experience with suprapubic percutaneous aspiration of the urinary bladder in premature and full-term neonates. Aspiration of bladder urine for bacteriologic purposes was first reported in 1956 by Guze and Beeson, who compared colony counts in urine samples obtained both by bladder aspiration and catheter in a small group of women free from urinary tract infection. The following year a comparison of bacterial counts of the urine obtained by needle aspiration of the bladder, catheterization, and midstream collection was described by Manzon and her associates. In 1959 we obtained samples of urine by percutaneous needle aspiration of the bladder and compared the quantitative cultures with those obtained immediately thereafter by catheterization; all these samples were from infants and children prior to elective laparotomies.

scholarly journals Genome-Wide Survey for Microdeletions or -Duplications in 155 Patients with Lower Urinary Tract Obstructions (LUTO)

Genes ◽  
2021 ◽  
Vol 12 (9) ◽  
pp. 1449
Author(s):  
Luca M. Schierbaum ◽  
Sophia Schneider ◽  
Stefan Herms ◽  
Sugirthan Sivalingam ◽  
Julia Fabian ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
De Novo ◽  
Urinary Tract Obstruction ◽  
Posterior Urethral Valves ◽  
Rare Cnvs ◽  
Genome Wide ◽  
Lower Urinary Tract Obstruction ◽  
Human Specific ◽  
Lower Urinary

Lower urinary tract obstruction (LUTO) is, in most cases, caused by anatomical blockage of the bladder outlet. The most common form are posterior urethral valves (PUVs), a male-limited phenotype. Here, we surveyed the genome of 155 LUTO patients to identify disease-causing CNVs. Raw intensity data were collected for CNVs detected in LUTO patients and 4.392 healthy controls using CNVPartition, QuantiSNP and PennCNV. Overlapping CNVs between patients and controls were discarded. Additional filtering implicated CNV frequency in the database of genomic variants, gene content and final visual inspection detecting 37 ultra-rare CNVs. After, prioritization qPCR analysis confirmed 3 microduplications, all detected in PUV patients. One microduplication (5q23.2) occurred de novo in the two remaining microduplications found on chromosome 1p36.21 and 10q23.31. Parental DNA was not available for segregation analysis. All three duplications comprised 11 coding genes: four human specific lncRNA and one microRNA. Three coding genes (FBLIM1, SLC16A12, SNCAIP) and the microRNA MIR107 have previously been shown to be expressed in the developing urinary tract of mouse embryos. We propose that duplications, rare or de novo, contribute to PUV formation, a male-limited phenotype.

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