The effectiveness and side effects of ureteroscopic HoLL of ureteral stones should be evaluated. In 63 patients (17 female, 46 males) a total of 75 stones of 3-20 mm diameter were treated with ureteroscopic HoLL. 18.7 percent of stones were located in the proximal third, 24.0 percent in the middle third and 57.3 percent in the distal third of the ureter. HoLL was performed with small diameter semirigid and flexible ureteroscopes, 220 or 365 nm flexible laser fibers and a holmium:YAG laser at a power of 5-15 W (0.5-1.0 J, 10- 15 Hz). 47 of 63 patients (74.6 percent) were immediately free of stones, and 8 others (12.6 percent) lost their residual fragments spontaneously within two weeks. Another 2 patients received additional chmolitholysis for uric acid stone fragments, i.e. 90.5 percent of patients were stone free by one sitting of ureterscopic HoLL. Of the remaining 6 patients (9.5 percent) who still had residual calculi 4 weeks after HoLL, 2 asymptomatic patients refused any additional treatment, 2 patients preferred treatment with ESWL, and 2 patients had a successful second HoLL, thereby raising the success rate of ureteroscopic HoLL to 93.7 percent. 2 patients showed contrast medium extravasation on retrograde ureterograms, due to guide wire perforation. No ureteral stricture occurred. In conclusion, transurethral ureteroscopic HoLL proved to be a safe and successful minimal invasive treatment of ureteral calculi.
The prognosis of superficial bladder cancer is strongly related to a high recurrence rate and the presence of concomitant plane tumor lesions such as severe dysplasia or carcinoma in situ. They are frequently overlooked on white light cystoscopy. Furthermore, the traditional transurethral tumor resection of superficial bladder tumor is frequently incomplete. This prospective study aimed to evaluate whether or not 5-ALA induced PPIX fluorescence cystoscopy could increase the detection of superficial bladder tumors and/or plane carcinoma in situ invisible on white light cystoscopy. 100 patients with superficial TCC of the urinary bladder underwent cystoscopy under white light and under blue fluorescence light. 2 hours (1-4 hours) prior to cystoscopy 50 ml 3 percent 5-ALA-solution were intravesically instilled into the empty bladder. All lesions visible on white light cystoscopy were compared with fluorescence findings and, vice versa, all fluorescence findings were compared with white light cystoscopy findings. All lesions visible under white light, and all lesions only visible under 5-ALA induced fluorescence were resected/biopsied and histologically examined.
In this prospective study, the efficiency of HoLEP inpatients with prostates larger than 80 grams was to be evaluated. 64 urodynamically obstructed patients with prostate glands of 103 (80-230) grams of weight underwent HoLEP (80 W, 2.0 J, 40 Hz, 550 nm bare laser fibers). The resected weight was 70 (50-200) grams, the resection time was 120.5 (83-170) min., the average resection weight was 0.7 gm/min. The postoperative catheter time was 1.3 (1-3) days. The postoperative hospital stay was 2.5 (1-7) days. HoLEP induced a significant, pronounced and immediate improvement of lower urinary tract symptoms and micturition. The symptom score decreased from 22.3 preoperatively to 5.7 one week and 2.8 one year postoperatively. The peak urinary flow rate of 4.3 ml/sec preoperatively increased to 22 ml/sec one week and 32 ml/sec one year postoperatively. The residual urine dropped from 267 ml preoperatively to 11.5 ml one week and 5.0 ml one year postoperatively. There was one incident of postoperative arterial bleeding, one patient developed urethral stricture and two patients needed a second HoLEP. HoLEP appeared to be a highly effective treatment for prostates larger than 80 grams, with excellent functional results, minor blood loss, low complication rate and very short catheter time and hospital stay.
Conference Committee Involvement (5)
Urology: Diagnostics, Therapeutics, Robotics, and Minimally Invasive
20 January 2007 | San Jose, California, United States
Urology: Diagnostics and Therapeutics
21 January 2006 | San Jose, California, United States
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