Objective To observe therapeutic effects of intravesical instillation of mitomycin C (MMC) immediately after TUR added with low dose BCG maintenance therapy to prevent recurrence of superficial bladder cancer. Methods 83 patients with superficial bladder cancer were randomly divided into two groups, 50 cases were managed with intravesical instillation of mitomycin C immediately after TUR added with low dose BCG maintenance therapy (group A), 33 cases were treated with traditional method of MMC therapy (group B) to prevent recurrence of superficial bladder cancer. Results After 12-66 months (mean 32 months) following up, 3 patients had tumor recurrence in the group A and 7 patients in the group B, the rate of tumor recurrence of the group A was 6.0% (3/50) and that of the group B was 21.2%(7/33), and there was a significantly difference between two groups (P<0.05). Side effects of the group B were obviously more than that of the group A. Conclusion Intravesical instillation of MMC immediately after TUR added with low dose BCG maintenance therapy is effective to prevent patients with superficial bladder cancer from recurrence.

Objective To evaluate the impact of lower renal calyceal anatomic structure on flexible fibreoptic ureteroscopy with holmium laserin treatment of calyceal calculi.Methods From January 2007 to December 2011,a total of 60 patients with a lower calyceal renal stone were enrolled in this study.The mean age was 51 years (range 23 to 78 years).The mean height was 169.8 cm,and mean body mass was 71.2 kg.Intravenous urogram (IVU) was performed on all patients and the lower pole anatomy (including infundibulopelvic angle,length of the inferior caliceal infundibulum and infundibular width) were measured in these patients.The correlation between lower pole anatomy and the success of flexible fibreoptic ureteroscopy with holmium laser for calyceal calculi was analyzed.Results Of the 60 patients,42 patients were successful in stone clearance.The patients in the stone-free group age of (50.1 ± 14.6) years,height (169.8 ±5.1) cm,body mass (71.4 ±5.1) kg,the maximum stone size in diameter (10.9 ±2.1) mm,stone burden (85.4 ± 9.5) mm2,lower infundibular length (36.3 ± 3.7) mm and lower infundibular width (4.9 ±1.4) mm; the other 18 patients age (50.7 ± 11.7) years,height (169.9 ±6.4) cm,body mass (71.6±4.7) kg,the maximum stone size in diameter (11.3 ±2.4) mm,stone burden (82.5 ±8.6)mm2,lower infundibular length (37.2 ± 2.3) mm and lower infundibular width (4.8 ± 1.9) mm.There was no difference between the stone-free group and the residual group in all above parameters (P ＞ 0.05).However,the infundibulopelvic angle in the stone-free group was significantly greater than that in the residual group (63.4 ± 23.2 vs 45.32 ± 17.6,P ＜ 0.05).x2 test showed the stone clearance rate in patients with angle ≥45 was better than that in those with angle ＜45 (84.6％ vs 42.7％,P ＜0.05).If grouped by infundibulopelvic angle,patients with infundibulopelvic angle greater than 90°had stone clearance rate 92.3％ (12/13),those with angle ranged from 30° to 90° had 73.2％ (30/41),and those with infundibulopelvic angle smaller than 30° had 0％ (0/6).Logistic regression analysis showed that the angle was a significant independent predictor of stone clearance (OR =1.12,P ＜ 0.05).Conclusions The infundibulopelvic angle has adverse influences on the performances of flexible ureteroscopy.The samller the angle is,the poorer the performances of flexible ureteroscopy is.

Objective To treat hematospermia by ureteroscopy and investigate its application value for the treatment of hematospermia.Methods Nineteen patients with persistent hematospermia, TRUS,seminal vesicle MRI or CT were examined to exclude seminal vesicle tumor, tuberculosis, prostatic occupancy and preoperative prostatic fluid and drug sensitivity.Transurethral 4.5 - 6 F ureteroscopy entered through the microscopic seminal vesicle, wash of the old blood, reserved perfusion with Quinolones, and the lithoclasty on the seminal stones by holmium laser, resection of small polypi.Results The ureteroscopy was successful in 18 (95%) cases for bilateral seminal vesicle, wash and drug reserved perfusion, and one case was also successful seminal vesicle microscopy on the affected side; five cases with the seminal stones by olmium laser, three cases with small polypi by resection.The averse duration of the procedure was 35 10 -75) min.There were no compliocations during or after the operation.In 18 cases at 6 - 12 months follow-up the hematospermia and symptoms of hematospermia disappeared fully after 90 d.There was recurrence in one case which improved with anti-inflammaotry treatment.Conclusions Ureteroscopic treatment for persistent hematospermia by 4.5 - 6 F ureteroscopy through the seminal vesicle is effective and safe method and results in a micro-wound.

Objective To evaluate the efficacy and safety of external ureteral catheterization of tubeless mini-percutaneous nephrolithotomy(mini-PCNL)in the treatment of single urinary calculus.Methods Clinical data of 21 patients with single renal or upper ureteral calculi treated with tubeless mini-PCNL from June 2021 to December 2022 were retrospectively analyzed.Among them,there were16 cases of kidney stones and5 cases of upper ureteral stones.The length of stones was1.5-3.5 cm(mean,2.07±0.56 cm).The ureteral catheter was indwelled by cystoscope and retained for catheterization,and the ureteral catheter and catheterization were fixed.If there were no residual stones after mini-PCNL,the Peel-away sheath was removed and the incision was sutured.Results All the operations were successfully completed,and the catheterization and ureteral catheter were removed 3-5 days after operation.There were slight gross hematuria in all the cases,fever in 3 cases,perirenal hematoma in 4 cases,and no urinary extravasation postoperatively.One month after discharge,B-ultrasonography or CT scanning showed no lithiasis,urinary cyst or hematoma formation around the kidney.Conclusion In selected cases(single and non-staghorn stones,without intraoperative stone residue or ureteral stenosis),external ureteral catheterization of tubeless mini-PCNL is safe and effective.