OBJECTIVETo explore the clinical application value of transurethral ureteroscopy in the diagnosis and treatment of hemospermia.

METHODSWe summed up and analyzed the experience in the diagnosis and treatment of 43 hemospermia patients by transurethral ureteroscopy and douching therapy.

RESULTSThe disease causes were clearly determined and the therapeutic procedures successfully accomplished in all the cases. The mean surgical time was 20 (18 -45) minutes. No significant complications developed either intraoperatively or postoperatively. The patients were followed up for 1 -24 months, during which hemospermia symptoms completely disappeared in 35 and were relieved in 6 of the cases, but the other 2 remained unimproved. All the patients had normal sexual life and none experienced retroinfection postoperatively.

CONCLUSIONTransurethral ureteroscopy, advantageous for its safety, high rate of detection, good effect of treatment and fewer complications, deserves to be popularized in the clinical diagnosis and treatment of hemospermia.

Adult ; Aged ; Hemospermia ; diagnosis ; surgery ; Humans ; Middle Aged ; Ureteroscopy ; methods

OBJECTIVETo evaluate the feasibility of kidney biopsy by transgastric and transvesical combined approach in the porcine model.

METHODSFive female pigs (20 to 30 kg) were included in this study. All procedures were performed with pigs under general anesthesia. The transvesical access was established by the ureteroscope. Then monitored by ureteroscopy, the transgastric access was established by a needle knife with cautery. The puncture dilation was performed with balloon through the gastroscope. The vesical hole was enlarged with the dilator of ureteroscope sheath. The kidney biopsy was finished by the scissor from the transvesical access and the grasping forcep from the work channel of gastroscope.

RESULTSAmong five cases the procedure were successful in three cases with 380 min, 180 min, 78 min respectively. Establishment of transvesical and transgastric accesses took place without complications. The exposure and biopsy of the kidney were easily achieved during operation. The transgastric and transvesical access were not closed in the end.

CONCLUSIONSThis new method is a technically feasible procedure in a porcine model. But the safety and the clinical future of it needs more study.

Animals ; Biopsy, Needle ; methods ; Female ; Gastroscopy ; Kidney ; pathology ; Swine ; Ureteroscopy

Aged ; Humans ; Lithotripsy ; methods ; Male ; Stents ; adverse effects ; Ureteroscopy

The effectiveness and safety of ureteroscopic holmium: YAG laser lithotripsy for managing ureteral calculi was evaluated. Ureteroscopic holmium. YAG laser lithotripsy was performed in 168 ureteral calculi (upper 27 cases, middle 33 cases and lower 108 cases). The results showed that the stone-free rate was 92.6% in the upper ureteral calculi, 93.9% in the middle ureteral calculi and 94.4% in the lower ureteral calculi, respectively. The complication rate was 4.8% (8 cases). It was suggested that ureteroscopic holmium: YAG laser lithotripsy is a highly effective and safe treatment modality for managing ureteral calculi.
Holmium ; *Lithotripsy, Laser/methods ; Ureteral Calculi/*therapy ; *Ureteroscopy

OBJECTIVETo prospectively evaluate the efficacy of Removing Stasis and Reducing Heat Formula in accelerating calculus clearance and improving lower urinary tract symptoms of patients with proximal ureteral calculi after ureteroscopic Ho:YAG laser lithotripsy.

METHODSA total of 138 patients with proximal ureteral calculi underwent ureteroscopic Ho:YAG laser lithotripsy by a single endocrinologist. Stone size varied from 10 to 15 mm. After operation, the patients were randomly divided into three groups: the control group (group A), tamsulosin group (group B), and Removing Stasis and Reducing Heat Formula group (group C). The treatment lasted for 4 weeks or until stone clearance. The primary and secondary outcomes of the three groups at follow-up were assessed.

RESULTSOf the 131 patients available for follow-up, 44 cases were in the group A, 45 in the group B, and 42 in the group C, respectively. The stone free rate at 2 weeks in the groups B and C were significantly higher than that in the group A (95.56%, 97.62% vs. 79.55%; all P<0.05). The ureteral colic rate and mean time of fragment expulsion were significantly reduced in the groups B (4.44% and 7.86±4.99 days) and C (2.43% and 6.76±4.37 days) compared with the group A (22.73% and 11.54±9.89 days, all P<0.05). On the day of double-J ureteric stent removal, the group C differed significantly from the group A in the total International Prostate Symptom Score, irritative subscore, obstructive subscore, and quality of life score (all P<0.05).

CONCLUSIONRemoving Stasis and Reducing Heat Formula in the medical expulsive therapy might be an effective modality for patients with calculus in the proximal uretera after ureteroscopic Ho:YAG laser lithotripsy.

Adult ; Female ; Humans ; Lithotripsy, Laser ; methods ; Male ; Middle Aged ; Prospective Studies ; Ureteral Calculi ; therapy ; Ureteroscopy ; methods

The effectiveness and safety of ureteroscopic holmium: YAG laser lithotripsy for managing ureteral calculi was evaluated. Ureteroscopic holmium. YAG laser lithotripsy was performed in 168 ureteral calculi (upper 27 cases, middle 33 cases and lower 108 cases). The results showed that the stone-free rate was 92.6% in the upper ureteral calculi, 93.9% in the middle ureteral calculi and 94.4% in the lower ureteral calculi, respectively. The complication rate was 4.8% (8 cases). It was suggested that ureteroscopic holmium: YAG laser lithotripsy is a highly effective and safe treatment modality for managing ureteral calculi.
Adult ; Aged ; Female ; Holmium ; Humans ; Lithotripsy, Laser ; methods ; Male ; Middle Aged ; Ureteral Calculi ; therapy ; Ureteroscopy

OBJECTIVETo evaluate the therapeutic effects of pneumatic lithotripsy on children urethral calculi.

METHODSTwenty-two cases of the male children with urethral calculi were treated with pneumatic lithotripsy under ureteroscopy.

RESULTSAll the patients were treated successfully in a single procedure. The time of lithotripsy was (5.5 +/- 2.2) minutes, and no serious complication such as obvious hematuria, infection and urethral stricture occurred.

CONCLUSIONSIt is suggested that pneumatic lithotripsy under ureteroscopy is an effective and simple way for the treatment of urethral calculi in children.

Adolescent ; Child ; Child, Preschool ; Humans ; Lithotripsy ; methods ; Male ; Ureteral Calculi ; therapy ; Ureteroscopy

Retrograde intrarenal surgery (RIRS) is being performed for the surgical management of upper urinary tract pathology. With the development of surgical instruments with improved deflection mechanisms, visuality, and durability, the role of RIRS has expanded to the treatment of urinary calculi located in the upper urinary tract, which compensates for the shortcomings of shock wave lithotripsy and percutaneous nephrolithotomy. RIRS can be considered a conservative treatment of upper urinary tract urothelial cancer (UTUC) or for postoperative surveillance after radical treatment of UTUC under an intensive surveillance program. RIRS has a steep learning curve and various surgical techniques can be used. The choice of instruments during RIRS should be based on increased surgical efficiency, decreased complications, and improved cost-benefit ratio.
Carcinoma, Transitional Cell/surgery ; Humans ; Lithotripsy, Laser/methods ; Perioperative Care/methods ; Ureteroscopy/*methods/trends ; Urolithiasis/surgery ; Urologic Neoplasms/surgery

OBJECTIVETo determine the efficacy and incidence of complications of extracorporeal shock-wave lithotripsy (ESWL) compared with pneumatic ureteroscopic lithotripsy (URSL) in the treatment of lower uretheral calculi.

METHODSFrom August 1997 to June 1999, 210 patients with lower ureteric calculi were treated with ESWL and the other 180 with URSL. The stones were fragmented with pneumatic lithotripter. The outcome was assessed by evacuation, retreatment and complication rates.

RESULTSESWL for lower ureteric calculi resulted in a stone evacuation rate of 78.1%, compared with 93.3% for URSL (P < 0.05). ESWL had a retreatment rate of 11.9% and a perforation rate of 0, while URSL caused perforation of ureters in 3.3% of patients and a refreatment of 2.2%.

CONCLUSIONFor the management of lower ureteric calculi, ESWL provides a non-invasive, simple and safe option, and URSL has a higher stone evacuation rate but causes ureter perforation more frequently than ESWL does. Both ESWL and URSL have their respective advantages. It is recommended, however, that URSL be extensively developed for better treatment efficacy, given that the operator has an adequate technical background.

Adolescent ; Adult ; Aged ; Female ; Humans ; Lithotripsy ; adverse effects ; methods ; Male ; Middle Aged ; Ureteroscopy ; Urethral Diseases ; therapy ; Urinary Calculi ; therapy

OBJECTIVE: To compare the efficacy and safety of endoscopic laser lithotripsy (LL) and endoscopic pneumatic lithotripsy (PL) for ureteral stones. METHODS: We retrospectively analyzed the clinical data of 415 patients with ureteral calculi treated with endoscopic laser lithotripsy (n = 214 ) and pnumatic lithotripsy (n = 201 ). RESULTS: The overall successful fragmentation rate of all ureteral stones in a single session of the LL group was higher than that of the PL group (95% vs. 69%, P < 0.01). The average stonefree time of the LL group was shorter than that of the PL group (18 days vs. 31 days, P < 0.01). No complications such as perforation during the operation were observed in the LL group whereas 3 perforations occurred in the PL group. CONCLUSION LL has its advantage over PL in its better clinical effect for the stone fragmentation and low complication rate and is an effective and safe treatment for ureteral stones.
Adolescent ; Adult ; Aged ; Female ; Holmium ; Humans ; Lithotripsy, Laser ; adverse effects ; methods ; Male ; Middle Aged ; Retrospective Studies ; Ureteral Calculi ; therapy ; Ureteroscopy